title: Scalp acupuncture for Parkinson's disease: a systematic review of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson's disease (PD) patients.
  
  
  METHODS
  Two independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines.
  
  
  RESULTS
  In total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, -3.94; 95% confidence interval (CI), -6.05 to -1.84, P=0.01; I(2) =0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I(2) =84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low.
  
  
  CONCLUSIONS
  The result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.
authors.affiliation: School of Korean Medicine, Pusan National University, Yangsan, South Korea.
authors.forename: Hun-Soo
authors.initials: HS
authors.lastname: Lee
authors.forename: Hye-Lim
authors.initials: HL
authors.lastname: Park
authors.forename: Seung-Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Byung-Cheul
authors.initials: BC
authors.lastname: Shin
authors.forename: Jun-Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
mesh_terms: D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000009:adverse effects; D006801:Humans; D010300:Parkinson Disease / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012535:Scalp / Q000473:pathology*; D016896:Treatment Outcome
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