Acupuncture modulates the abnormal brainstem activity in migraine without aura patients

Abstract

Migraine is a common neurological disease with a high prevalence and unsatisfactory treatment options. The specific pathophysiological mechanisms of migraine remain unclear, which restricts the development of effective treatments for this prevalent disorder. The aims of this study were to 1) compare the spontaneous brain activity differences between Migraine without Aura (MwoA) patients and healthy controls (HCs), using amplitude of low-frequency fluctuations (ALFF) calculation method, and 2) explore how an effective treatment (verum acupuncture) could modulate the ALFF of MwoA patients. One hundred MwoA patients and forty-six matched HCs were recruited. Patients were randomized to four weeks' verum acupuncture, sham acupuncture, and waiting list groups. Patients had resting state BOLD-fMRI scan before and after treatment, while HCs only had resting state BOLD-fMRI scan at baseline. Headache intensity, headache frequency, self-rating anxiety and self-rating depression were used for clinical efficacy evaluation. Compared with HCs, MwoA patients showed increased ALFF in posterior insula and putamen/caudate, and reduced ALFF in rostral ventromedial medulla (RVM)/trigeminocervical complex (TCC). After longitudinal verum acupuncture treatment, the decreased ALFF of the RVM/TCC was normalized in migraine patients. Verum acupuncture and sham acupuncture have different modulation effects on ALFF of RVM/TCC in migraine patients. Our results suggest that impairment of the homeostasis of the trigeminovascular nociceptive pathway is involved in the neural pathophysiology of migraines. Effective treatments, such as verum acupuncture, could help to restore this imbalance.

Altered local and distant functional connectivity density relate to headache frequency in migraine without aura

“…Stimulation, both pain and pleasure, has been reported to elicit opioid release in the OFG [35]. A recent resting-state MRI study found increased regional brain activity in the OFG in migraineurs after verum acupuncture [36]. Furthermore, persistent orbitofrontal hypofunction was reported to be associated with medication overuse headache [37], and decreased gray matter of this region was predictive of poor response to treatment [38].…”

Acupuncture for emotional disorders in patients with migraine: a systematic review protocol

“…It is confirmed by many studies that acupuncture activates the release of some pain suppressors, such as endorphins, in the central nervous system 24 25. Li et al have concluded that the impairment of the homoeostasis of the trigeminovascular nociceptive pathway was involved in the neural pathophysiology of migraines, and acupuncture could help to restore this imbalance 26. Yue et al have shown that electro-acupuncture exhibited the antidepressant effect and alleviated the hippocampal neuroinflammation 27.…”

Neurological and psychological mechanisms of the specific and nonspecific effects of acupuncture on knee osteoarthritis: study protocol for a randomized, controlled, crossover trial

“…Functional magnetic resonance imaging (fMRI) can reveal the functional changes of the brain, and improve our understanding about the central neurological mechanisms of acupuncture [19]. In recent years, fMRI has been applied to investigate the central regulation mechanisms of the acupuncture's effects [20][21][22]. Acupuncture and sham acupuncture have relatively different brain responses in the medial frontal cortex, periaqueductal gray and rostral ventromedial medulla during analgesia [23,24].…”

“…In recent years, fMRI has been applied to investigate the central regulation mechanisms of the acupuncture's effects [20][21][22]. Acupuncture and sham acupuncture have relatively different brain responses in the medial frontal cortex, periaqueductal gray and rostral ventromedial medulla during analgesia [23,24]. Most clinical trials focus on evaluating abnormal brain activity triggered by the specific effect (acupuncture -sham acupuncture), while ignoring the modulation of nonspecific effect (sham acupuncture) on brain.…”