Acupuncture for Parkinson's Disease: A Narrative Review of Clinical Efficacy and Mechanistic Insights.

Parkinson's disease (PD) has been recognized for more than two centuries. Historically viewed as a clinicopathological entity, PD may have diverse genetic or environmental factors that initiate the disease through various, albeit partially overlapping, pathways. The disease manifests both motor and non-motor symptoms, which may occur individually or concurrently, with a tendency to gradually worsen and intensify as the disease progressed. Together, PD poses rapidly escalating healthcare challenges with profound global repercussions. Encouragingly, PD is treatable, particularly when the interventions are tailored through a personalized approach. In recent years, acupuncture, a cornerstone of traditional Chinese medicine, has garnered widespread acceptance as a therapeutic intervention for PD, demonstrating clinically meaningful effects across multiple domains-including motor symptoms (eg, tremor and bradykinesia), non-motor manifestations (eg, sleep disturbances and depression), and cognitive impairment-based on accumulating evidence from both mechanistic and clinical studies. Elucidating the therapeutic mechanisms and clinical efficacy of acupuncture in PD could substantially enhance treatment alternatives. While accumulating evidence supports its benefits, several critical research gaps persist including comparative effectiveness among acupuncture modalities (eg, manual versus electroacupuncture) in modifying disease progression; sustained neuroprotective effects versus transient symptomatic improvement; and development of standardized protocols tailored to distinct motor and non-motor symptom profiles. Methodical investigation of these aspects may yield more targeted, evidence-based interventions for PD management. This narrative review synthesizes evidence from PubMed, Web of Science, CNKI, VIP, Wanfang, and CBM, to examine the application of acupuncture in PD, subsequently summarized the available evidence supporting its utilization and outlined the mechanisms by which acupuncture may exert its therapeutic effects. These mechanisms include preventing the accumulation of α-synuclein in dopaminergic neurons, mitigating apoptosis and oxidative stress, modulating dopamine-related neuroinflammation, and regulating the circuits surrounding dopaminergic neurons in the ganglia. Our study provides the comprehensive integration of clinical and preclinical evidence, which offers a mechanistic explanation for acupuncture's therapeutic benefits while identifying optimal treatment protocols for clinical application. In summary, acupuncture shows significant potential as an effective treatment for PD.