Efficacy of various acupuncture modalities on alleviating symptoms in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.

Background: Parkinson's disease (PD) is a progressive neurological condition, that often respond poorly to conventional treatments. Acupuncture has gained attention as a supportive therapy, but the clinical effects of its various modalities remain insufficiently defined. This study examined the therapeutic efficacy of different acupuncture approaches in managing symptoms of PD.

Methods: The meta-analysis and systematic review was carried out in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42024627483). Randomized controlled trials (RCTs) assessing acupuncture modalities combined with standard PD therapy was encompassed. The Cochrane RoB 2 tool was utilized to figure out the risk of bias, and subgroup/meta-regression analyses explored heterogeneity. Evidence certainty was rated using the GRADE framework.

Results: In 50 RCTs (n = 3,248), acupuncture significantly outperformed Western medicine across all UPDRS domains, with the strongest effect on treatment-related motor complications (SMD: -2.16; 95% CI: -3.10 to -1.22). It also improved quality of life, pain, sleep, depression, and anxiety. Optimal results were linked to ≥ 10 acupoints, moderate session duration, and thrice-weekly treatment. Among all modalities, electroacupuncture showed the highest overall efficacy. Thinner needles worked better for non-motor symptoms; thicker ones favored motor outcomes. No serious adverse events occurred; mild effects were rare and transient.

Conclusions: This comprehensive analysis highlights acupuncture-especially electroacupuncture-as a clinically valuable adjunct to standard PD therapy. Its benefits across motor, non-motor, and psychological domains, when delivered with optimized parameters, suggest a strong case for its integration into personalized PD management strategies.