Acupuncture for Tourette syndrome: A systematic review and meta-analysis

Introduction: Tourette syndrome (TS) is a tic disorder with multiple motor and vocal or phonic tics. The effect of acupuncture for TS has not been well established. Methods: English, Japanese, Korean and Chinese databases, were explored systematically for randomized controlled trials investigating the use of acupuncture for treating TS, up to August 2016, without language restrictions. All studies evaluating the effects of acupuncture were identified. Studies assessing the effect of moxibustion were excluded. All ages were considered. Data were extracted independently using predefined data fields, including study quality indicators. All pooled analyses were based on random-effects models. The authors individually evaluated risk of bias with the Cochrane Collaboration's tools. Results: Nineteen Studies (N = 1483) were systematically reviewed. A significant benefit was observed for studies comparing acupuncture versus medication (pooled the risk ratio showed improvement by 1.17; 95% confidence interval: 1.10-1.25, p < 0.00001). Reporting of adverse events was poor with only one study which reported that there were no adverse events in their acupuncture treatment group. Conclusions: This analysis provided limited evidence from studies for the practice of acupuncture in treating TS. However, the conclusions were limited by a high risk of bias. Future studies are needed to verify the superior features of acupuncture. Further study into the efficacy and safety of acupuncture is warranted. (C) 2016 Published by Elsevier GmbH.