{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:56:21Z","timestamp":1781200581346,"version":"3.54.1"},"reference-count":50,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"State Natural Science Fund","award":["8217150722"],"award-info":[{"award-number":["8217150722"]}]},{"name":"the National Administration of Traditional Chinese Medicine","award":["2022ZD04"],"award-info":[{"award-number":["2022ZD04"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,2,26]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Parkinson\u2019s disease (PD) has a significant impact on a substantial number of individuals in China. Notably, 31% of patients with PD also grapple with the additional burden of anxiety. This dual challenge of managing both PD and anxiety underscores the complexity of the condition and the diverse range of symptoms patients may experience. Considering the circumstances, the cost and potential drawbacks associated with traditional antiparkinsonian drugs become increasingly relevant. Acupuncture emerges as a significant non-pharmacological adjunct therapy. Offering a potentially safer and more cost-effective option, acupuncture addresses the pressing need for holistic and complementary treatments that may alleviate both the motor symptoms of PD and the accompanying anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a multicentre, randomised controlled and assessor-blind trial. A total of 210 eligible patients with PD will be randomly assigned (1:1) to Jin\u2019s three-needle (JTN) acupuncture group or waitlist (WL) group. Patients in the JTN group will receive acupuncture therapy three times per week for 4\u2009weeks. Patients in the WL group will maintain their original dosage of antiparkinsonian drugs and receive acupuncture therapy after the observation period. The primary outcome measure will be the Unified Parkinson\u2019s Disease Rating Scale score. The secondary outcome measures will be the scores of the Hoehn-Yahr Rating Scale, Unified Dyskinesia Rating Scale, Non-Motor Symptoms Scale, 39-item Parkinson\u2019s Disease Questionnaire, Parkinson Anxiety Scale, Hamilton Anxiety Scale, Hamilton Depression Scale, Zarit burden interview and the level of cortisol and adrenocorticotropic hormone. The evaluation will be executed at baseline, the end of the treatment and a follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (K[2023]014). All patients have to provide written, informed consent. The study will be disseminated through presentations in peer-reviewed international journals and at national and international conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry; ChiCTR2300074675.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081312","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T14:03:05Z","timestamp":1711634585000},"page":"e081312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of acupuncture (Jin\u2019s three-needle) on motor symptoms and anxiety in patients with Parkinson\u2019s disease: protocol for a multicentre, randomised, assessor-blinded clinical trial"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0838-1904","authenticated-orcid":false,"given":"Xin","family":"Liu","sequence":"first","affiliation":[{"name":"The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqi","family":"Fan","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian I","family":"Leong","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijing","family":"Lu","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjiao","family":"Gong","sequence":"additional","affiliation":[{"name":"Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixing","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"2025121407484341000_14.3.e081312.1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000247740.47667.03"},{"key":"2025121407484341000_14.3.e081312.2","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1002\/mds.28762","article-title":"Prevalence of Parkinson\u2019s disease: a community-based study in China","volume":"36","author":"Qi","year":"2021","journal-title":"Mov Disord"},{"key":"2025121407484341000_14.3.e081312.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40035-019-0162-z","article-title":"Parkinson\u2019s disease in China: a forty-year growing track of bedside work","volume":"8","author":"Li","year":"2019","journal-title":"Transl Neurodegener"},{"key":"2025121407484341000_14.3.e081312.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.22360"},{"key":"2025121407484341000_14.3.e081312.5","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27340"},{"key":"2025121407484341000_14.3.e081312.6","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26643"},{"key":"2025121407484341000_14.3.e081312.7","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/ene.13217","article-title":"Onset and evolution of anxiety in Parkinson\u2019s disease","volume":"24","author":"Zhu","year":"2017","journal-title":"Eur J Neurol"},{"key":"2025121407484341000_14.3.e081312.8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/mdc3.12157","article-title":"Characteristics and treatment of anxiety disorders in Parkinson\u2019s disease","volume":"2","author":"Dissanayaka","year":"2015","journal-title":"Mov Disord Clin Pract"},{"key":"2025121407484341000_14.3.e081312.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1614.2004.01423.x"},{"key":"2025121407484341000_14.3.e081312.10","doi-asserted-by":"crossref","first-page":"112907","DOI":"10.1016\/j.biopha.2022.112907","article-title":"Acupuncture for Parkinson\u2019s disease: from theory to practice","volume":"149","author":"Fan","year":"2022","journal-title":"Biomedicine & Pharmacotherapy"},{"key":"2025121407484341000_14.3.e081312.11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.wjam.2022.11.002","article-title":"Prosepects for the development of Acupuncture analgesia from an international perspective","volume":"33","author":"Liang","year":"2023","journal-title":"World Journal of Acupuncture - Moxibustion"},{"key":"2025121407484341000_14.3.e081312.12","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.parkreldis.2012.02.002","article-title":"Non-motor symptoms of Parkinson\u2019s disease in China: a review of the literature","volume":"18","author":"Chen","year":"2012","journal-title":"Parkinsonism & Related Disorders"},{"key":"2025121407484341000_14.3.e081312.13","first-page":"2388","article-title":"Jin\u2019s three-Neddle treatment of mental illness","volume":"63","author":"Meichen","year":"2022","journal-title":"Journal of Traditional Chinese Medicine"},{"key":"2025121407484341000_14.3.e081312.14","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.32133","article-title":"Effectiveness of Acupuncture for anxiety among patients with Parkinson disease: A randomized clinical trial","volume":"5","author":"Fan","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2025121407484341000_14.3.e081312.15","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"2025121407484341000_14.3.e081312.16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"2025121407484341000_14.3.e081312.17","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"2025121407484341000_14.3.e081312.18","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s00415-016-8370-2","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease in China","volume":"264","author":"Li","year":"2017","journal-title":"J Neurol"},{"key":"2025121407484341000_14.3.e081312.19","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-018-0602-y","article-title":"Sample size calculation in multi-centre clinical trials","volume":"18","author":"Harden","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"2025121407484341000_14.3.e081312.20","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1177\/0962280219846146","article-title":"Design and analysis of stratified clinical trials in the presence of bias","volume":"29","author":"Hilgers","year":"2020","journal-title":"Stat Methods Med Res"},{"key":"2025121407484341000_14.3.e081312.21","doi-asserted-by":"crossref","first-page":"941566","DOI":"10.3389\/fpsyt.2022.941566","article-title":"The efficacy and safety of jin\u2019s three-needle therapy vs. placebo Acupuncture on anxiety symptoms in patients with post-stroke anxiety: A study protocol for a randomized controlled trial","volume":"13","author":"Li","year":"2022","journal-title":"Front Psychiatry"},{"key":"2025121407484341000_14.3.e081312.22","unstructured":"Xiaodong W , Longxiang H , Jingsheng Z . Interpretation of China National standard nomenclature and location of Meridian points (GB\/T 12346\u20132021). Chinese Acupuncture & Moxibustion 2022;42."},{"key":"2025121407484341000_14.3.e081312.23","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2016.00462","article-title":"More than Deqi: spatial patterns of Acupuncture-induced bodily sensations","volume":"10","author":"Jung","year":"2016","journal-title":"Front Neurosci"},{"key":"2025121407484341000_14.3.e081312.24","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1002\/mds.23096","article-title":"Teaching program for the movement disorder society-sponsored revision of the unified Parkinson\u2019s disease rating scale: (MDS-UPDRS)","volume":"25","author":"Goetz","year":"2010","journal-title":"Mov Disord"},{"key":"2025121407484341000_14.3.e081312.25","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1002\/mds.22563","article-title":"Teaching program for the unified dyskinesia rating scale","volume":"24","author":"Goetz","year":"2009","journal-title":"Movement Disorders"},{"key":"2025121407484341000_14.3.e081312.26","unstructured":"S, F., E. R, and M.o.t.U.D. Committee . Recent Developments in Parkinson\u2019s Disease. Macmillan Health Care Information, 1987: 293\u2013304."},{"key":"2025121407484341000_14.3.e081312.27","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.17.5.427"},{"key":"2025121407484341000_14.3.e081312.28","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1001\/jama.2017.7914","article-title":"Management of Parkinson disease in 2017: personalized approaches for patient-specific needs","volume":"318","author":"Okun","year":"2017","journal-title":"JAMA"},{"key":"2025121407484341000_14.3.e081312.29","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22341"},{"key":"2025121407484341000_14.3.e081312.30","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21596"},{"key":"2025121407484341000_14.3.e081312.31","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20844"},{"key":"2025121407484341000_14.3.e081312.32","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.5.353"},{"key":"2025121407484341000_14.3.e081312.33","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25919"},{"key":"2025121407484341000_14.3.e081312.34","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1959.tb00467.x"},{"key":"2025121407484341000_14.3.e081312.35","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"2025121407484341000_14.3.e081312.36","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.2147\/NDT.S403002","article-title":"Parkinson\u2019s disease related depression and anxiety: A 22-year Bibliometric analysis (2000-2022)","volume":"19","author":"Zhang","year":"2023","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2025121407484341000_14.3.e081312.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.04.028"},{"key":"2025121407484341000_14.3.e081312.38","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/20.6.649"},{"key":"2025121407484341000_14.3.e081312.39","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1111\/j.1440-1819.2009.02019.x","article-title":"Zarit Caregiver burden interview: development, Reliability and validity of the Chinese version","volume":"63","author":"Lu","year":"2009","journal-title":"Psychiatry Clin Neurosci"},{"key":"2025121407484341000_14.3.e081312.40","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1002\/mds.29037","article-title":"The Chinese Parkinson\u2019s disease Registry (CPDR): study design and baseline patient characteristics","volume":"37","author":"Zhou","year":"2022","journal-title":"Mov Disord"},{"key":"2025121407484341000_14.3.e081312.41","doi-asserted-by":"crossref","first-page":"120015","DOI":"10.1016\/j.jns.2021.120015","article-title":"Parkinsonism and dementia","volume":"433","author":"Koros","year":"2022","journal-title":"J Neurol Sci"},{"key":"2025121407484341000_14.3.e081312.42","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.j1951","article-title":"Parkinson\u2019s disease: summary of updated NICE guidance","volume":"358","author":"Rogers","year":"2017","journal-title":"BMJ"},{"key":"2025121407484341000_14.3.e081312.43","first-page":"701","article-title":"On connotation of jin\u2019s three-Neddle technique","volume":"34","author":"Qing","year":"2014","journal-title":"Chinese Acupuncture & Moxibustion"},{"key":"2025121407484341000_14.3.e081312.44","doi-asserted-by":"publisher","DOI":"10.1136\/acupmed-2016-011342"},{"key":"2025121407484341000_14.3.e081312.45","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.cger.2019.09.012","article-title":"Depression and anxiety in Parkinson disease","volume":"36","author":"Ray","year":"2020","journal-title":"Clin Geriatr Med"},{"key":"2025121407484341000_14.3.e081312.46","doi-asserted-by":"publisher","DOI":"10.1177\/08919887211018267"},{"key":"2025121407484341000_14.3.e081312.47","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s10654-015-0019-4","article-title":"Incidence and prediction of falls in Parkinson\u2019s disease: a prospective cohort study","volume":"30","author":"Gazibara","year":"2015","journal-title":"Eur J Epidemiol"},{"key":"2025121407484341000_14.3.e081312.48","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1002\/mds.28404","article-title":"Neuroimaging of anxiety in Parkinson\u2019s disease: A systematic review","volume":"36","author":"Carey","year":"2021","journal-title":"Mov Disord"},{"key":"2025121407484341000_14.3.e081312.49","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1080\/15622975.2016.1190867","article-title":"Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. part II: neurochemistry, Neurophysiology and Neurocognition","volume":"18","author":"Bandelow","year":"2017","journal-title":"World J Biol Psychiatry"},{"key":"2025121407484341000_14.3.e081312.50","doi-asserted-by":"crossref","DOI":"10.1210\/endrev\/bnaa002","article-title":"Dynamics of ACTH and Cortisol secretion and implications for disease","volume":"41","author":"Lightman","year":"2020","journal-title":"Endocr Rev"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:48:56Z","timestamp":1765727336000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,28]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bmjopen-2023-081312"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081312","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}