Stockholm, Sweden — Both acupuncture and bee venom acupuncture showed promising results in improving symptoms in patients with Parkinson's disease in a new small study.

The study was presented at the recent International Parkinson and Movement Disorder Society (MDS) 18th International Congress of Parkinson's Disease and Movement Disorders.

Senor author of the study, Seong-Uk Park, MD, Stroke and Neurological Disorders Center, Kyung Hee University Hospital, Gangdong, Seoul, Korea, explained to Medscape Medical News that studies suggest acupuncture might be beneficial in Parkinson's disease by increasing the efflux and turnover of dopamine. It has also been suggested to enhance the benefits of L-dopa and alleviate the adverse effects.

Commenting on the results, Louis Tan, MD, National Neuroscience Institute in Singapore, who was not involved in the study, said, "The results showed significant improvement of movement outcomes with acupuncture and bee venom acupuncture. These results are important as it has been found that up to 70% of patients in some countries use complementary therapies for the management of Parkinson's disease."

Dilute Bee Venom

Bee venom acupuncture involves a subcutaneous injection of diluted bee venom at a point of acupuncture. This is aimed at enhancing and prolonging the effects of stimulation of acupuncture points. 

"So the mechanisms of bee venom acupuncture might be similar to those of acupuncture. Or there could be another effect due to the bee venom itself," Dr. Park said. He added that bee venom is thought to have antineuroinflammatory effects, and the possibility of its use in the treatment of neurodegenerative disorders has been suggested.

In the study 43 patients with Parkinson's disease were randomly assigned into 3 groups: acupuncture, bee venom acupuncture, or control. Acupuncture involved insertion of needles into 10 acupuncture points at a depth of 1.0 to 1.5 cm. Needles were rotated at 2 Hz for 10 seconds and the position was maintained for 20 minutes. The treatment was repeated twice a week for 8 weeks.

During the trial, 14 patients were excluded, leaving 35 patients (13 in the acupuncture group, 13 in the bee venom acupuncture group, and 9 in the control group) for analysis. Baseline characteristics did not significantly differ between groups.

Participants in the bee venom acupuncture group showed significant improvement on the Unified Parkinson's Disease Rating Scale (UPDRS) (total score, as well as parts II and III individually), the Berg Balance Scale (BBS), and the 30-meter walking time.

In the acupuncture group, the UPDRS (part III and total scores) and the Beck Depression Inventory (BDI) improved significantly. The control group showed no significant changes in any outcome after 8 weeks.

Changes in Clinical Outcomes in Each Group After 8 Weeks

Measure Bee Venom Acupuncture Group Acupuncture Group Control Group
UPDRS –8.0 –7.0 6.0
BBS 1 0 1
30-m walking time (sec) –1.56 0.75 –0.09
BDI –1 –5 –1

 

No serious adverse events from the bee venom or acupuncture treatments occurred. One patient in the bee venom group reported itchiness.

Dr. Park acknowledged that because of the small number of patients in this study, no definite conclusion can be drawn, but he believes the results are still promising. He added that a second trial is now underway, and is expected to be completed later this year.

Dr. Tan said the study "extends the field, but is very preliminary." He explained to Medscape Medical News that acupuncture studies always suffer from the problem of adequate control.

"Acupuncture is quite commonly used for Parkinson's disease but hard evidence of benefit is lacking," Dr. Tan noted. "It is difficult to know how to control [an] acupuncture study in a blinded way. You can insert pins in nonacupuncture points or penetrate the skin but not deep enough to cause an acupuncture effect. These are challenges the field faces."

He suggested that the bee venom could be acting like botulinum toxin, causing a transient paralysis of the muscles.

International Parkinson and Movement Disorder Society (MDS) 18th International Congress of Parkinson's Disease and Movement Disorders. LBA 11.

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