The Effect of Acupressure on Beta-Endorphin, Hypocretin, Cognition, and Patient-Reported Outcome Measures in Multiple Sclerosis Patients

BACKGROUND: Multiple sclerosis (MS) is associated with neurochemical alterations, cognitive impairment, and patient‐reported symptoms that substantially affect quality of life. Although self‐acupressure has shown promise for symptom management, its effects on neuropeptides and cognition remain unclear. This study aimed to evaluate the effects of self‐acupressure on beta‐endorphin, hypocretin, cognition, and patient‐reported outcome measures in individuals with MS. METHODS: A single‐center, randomized, single‐blind controlled trial was conducted in Türkiye. Ninety‐two participants with MS were randomly assigned to an intervention group receiving an 8‐week self‐acupressure program or a control group receiving standard care. Eighty‐two participants completed the study. Primary outcomes were changes in serum beta‐endorphin and hypocretin levels. Secondary outcomes included cognitive performance, pain, fatigue, depressive symptoms, and health‐related quality of life. RESULTS: Compared with the control group, the intervention group demonstrated a significantly greater increase in beta‐endorphin levels (mean change: 56.7 vs. 12.5; P<0.001), whereas no significant between‐group difference was observed for hypocretin levels (P=0.685). Cognitive performance did not differ significantly between groups. However, the intervention group showed significantly greater improvements in pain (P<0.001), fatigue (P<0.001), depressive symptoms (P=0.002), and health‐related quality of life (P=0.016). CONCLUSION: Self‐acupressure improved several patient‐reported outcomes and increased beta‐endorphin levels in people with MS but had no significant effect on hypocretin levels or cognitive performance. These findings support self‐acupressure as a feasible complementary nursing intervention for symptom management in MS and suggest that beta‐endorphin may represent a potential biological mechanism underlying its therapeutic effects.