Application of acupuncture and moxibustion for tic disorders: An overview of systematic reviews and meta-analysis

BACKGROUND

Tic disorder (TD) is a neuropsychiatric disorder that often begins in childhood or adolescence. Acupuncture and moxibustion are alternative therapies that have been demonstrated to be effective in the treatment of TD. Over the past few decades, several systematic reviews (SRs) and meta-analyses have reported the effectiveness of acupuncture and moxibustion in treating patients with TD. However, the quality of these SRs varies.

METHODS

Ten electronic databases were searched. Two researchers performed independently in study selection, data extraction, and evaluation. Methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews-2. Evidence levels were assessed using the Grading of Recommendations Assessment, Development, and Evaluation approaches.

RESULTS

In total, 12 studies were included, comprising 106 randomized controlled trials and 7973 patients. In A Measurement Tool to Assess Systematic Reviews-2, most of the SRs were of low or critically low levels since they had more than 1 critical deficiency. In the Grading of Recommendations Assessment, Development, and Evaluation system, 10 outcomes were valued as very low level, 30 as low, 24 as moderate level, and 0 as high level. Most SRs meet the potential benefits of acupuncture and moxibustion for TD. Interestingly, no serious events were shown in these studies.

CONCLUSION

This overview, through analysis of 12 studies, shows that acupuncture and moxibustion were more effective than the conventional Western medicine treatment for TD. Nevertheless, given the subpar methodological quality of the reviews, we cannot draw a more definitive conclusion. Hence, we need more research to improve methodological and reporting quality to yield more robust evidence.