Acupuncture Therapy for Huntington's Disease: An Evidence Review and Mechanistic Insights

Objective Huntington's disease (HD) is a neurodegenerative disorder caused by expanded cytosine–adenine–guanine (CAG) repeats in the huntingtin protein (HTT) gene. Currently, there are no effective therapies targeting its core pathology. This review evaluates acupuncture as a complementary therapy for HD, exploring its clinical evidence and mechanisms. Methods Database searches (PubMed, Embase, CNKI, etc.) were conducted until June 2025 to identify clinical and animal studies. Two independent reviewers analyzed the data. The protocol was registered in PROSPERO (Registration ID: CRD420251066624) on June 3, 2025. Results Acupuncture significantly improved motor symptoms and neurological function in HD patients, with a response rate of 92.19%. High-frequency acupoint combinations [Baihui (GV20), Hegu (LI4), Taichong (LR3)] are aligned with traditional Chinese medicine theory. Acupuncture provides neuroprotection through the inhibition of apoptosis, enhancement of autophagy, and suppression of neuroinflammation via the TLR4/NF-κB/NLRP3 pathway. However, evidence is limited to case reports, with only one descriptive study providing Level II evidence. Conclusions Acupuncture shows promise in treating HD but requires well-designed randomized controlled trials to validate its efficacy and elucidate mechanisms.