The Effect of Acupuncture for ATP Activity in Brain Diseases: Protocol of a Systematic Review and Meta-Analysis of Animal Experiments

Background: Brain is an energy-consuming organ, which is highly depended on adenosine triphosphate (ATP) supplying energy to maintain the functions of memory, thinking, cognition etc. Some animal experiment findings have indicated that ATP depletion was correlated with multiple brain diseases [brain injury, Parkinson disease (PD), stroke, brain tumor, Alzheimer’s disease (AD), vascular dementia (VD), etc.]. Acupuncture has been identified that it has a therapeutic effect for brain diseases. However, the mechanism of acupuncture for brain diseases remains to be determined. Lack of high-quality evidence of underlying mechanism could result in a limitation of acupuncture in clinical practice. Therefore, we aim to conduct a systematic review (SR) and meta-analysis of animal experiments to identify the effect of acupuncture for ATP activity in brain diseases and hope to provide a robust evidence for acupuncture in brain disease. Methods: Six databases [PubMed, Embase, web of Science, the China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan Fang database] will be systematically searched from the inception dates to July, 2020. Two researchers will independently screen titles and abstracts for eligibility. Eligible articles will be restricted to animal studies correlated with acupuncture treatment for brain diseases. The primary outcomes are ATP activity, ATP content, Na+-k+-ATPase activity, and Ca2+ activity. Secondary outcomes are as following: the context of glucose (Glu) and mitochondrial respiratory enzyme activity including complex I, complex II, complex III, complex V and cytochrome c (Cyt c) enzyme activity etc. Data extraction and evaluation of risk of bias will be operated by two researchers independently. The SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool will be utilized to examine the risk of bias. Review Manager 5.3 and Stata.12 software will be used for data synthesis.Discussion: Numerous animal experiments have been conducted and investigated the underlying mechanism of acupuncture in brain diseases. We will retrieve the current animal experiments associated with the mechanism of acupuncture and perform a SR to provide a robust evidence for acupuncture improving ATP activity in brain diseases.Systematic review registration: The registration number is CRD 42020184971.