Acupuncture therapy in treating migraine: results of a magnetic resonance spectroscopy imaging study

Abstract

BackgroundAcupuncture has been proven to be effective as an alternative therapy in treating migraine, but the pathophysiological mechanisms of the treatment remain unclear. This study investigated possible neurochemical responses to acupuncture treatment.Patients and methodsProton magnetic resonance spectroscopy imaging was used to investigate biochemical levels pre- and post-acupuncture treatment. Participants (N=45) included subjects diagnosed with: 1) migraine without aura; 2) cervicogenic headache; and 3) healthy controls. Participants in the two patient groups received verum acupuncture using acupoints that target migraine without aura but not cervicogenic headache, while the healthy controls received a sham treatment. All participants had magnetic resonance spectroscopy scans before and after the acupuncture therapy. Levels of brain metabolites were examined in relation to clinical headache assessment scores.ResultsA significant increase in N-acetylaspartate/creatine was observed in bilateral thalamus in migraine without aura after the acupuncture treatment, which was significantly correlated with the headache intensity score.ConclusionThe data demonstrate brain biochemical changes underlying the effect of acupuncture treatment of migraine.

Different Brain Activation after Acupuncture at Combined Acupoints and Single Acupoint in Hypertension Patients: An Rs-fMRI Study Based on ReHo Analysis

“…For example, Li et al observed increased functional connectivity of acupuncture in addition to western medicine group from pre- and posttreatment for stroke [12]. The others compared either the differences of functional brain activities changes between acupoints combination and sham acupoints on patients [13] or acupoints combination manipulation on patients and the healthy controls [14, 15]. Reviewing the recent studies, there is a substantial lack of comparison between acupoints combination and single acupoint in brain activities observation.…”

Altered thalamic neurotransmitters metabolism and functional connectivity during the development of chronic constriction injury induced neuropathic pain

“…Studies have shown that dysfunction in inhibitory neurons caused by decreased NAA concentrations in neuropathic pain conditions is mediated by the activation of thalamic glial cells [ 10 , 30 – 35 ]. In addition to neuropathic pain, the thalamic NAA/Cr ratio detected by MRS was significantly lower in patients with non-neuropathic pain, such as migraine, unilateral pain due to lumbar spine diseases, and osteoarthritis [ 36 – 38 ].…”

Acupuncture and Its Role in the Treatment of Migraine Headaches

“…The authors note the small sample size and discuss how more frequent sessions may increase the treatment’s efficacy Liao et al (2020) [ 46 ] Retrospective study on patients with migraines ( n = 21,209) with 1:1 propensity score matching to control for various demographic information (e.g., sex, age, income). The comparison was between 1948 acupuncture users and 1948 non-acupuncture users There was a statistically significant reduction in cumulative incidence of anxiety, depression, and medical expenditure in the acupuncture users cohort versus the non-acupuncture users cohort The data provide support for using acupuncture in migraine patients with common comorbidities of depression and anxiety Gu et al (2018) [ 44 ] Participants ( n = 45) spread across 3 groups: (1) Migraine without aura (2) Cervicogenic headache (3) Healthy controls The two patient groups received verum accupuncture, while the healthy controls received a sham treatment There was a significant increase in N -acetylaspartate/creatine in the bilateral thalamus after acupuncture treatment in patients with migraines without aura, which was associated with a decrease in headache intensity score Acupuncture significantly increases certain brain metabolites involved in the transmission of pain during migraines, which could explain how acupuncture is able to effectively relieve migraine-associated pain Farahmand et al (2018) [ 48 ] Patients with diagnosis of acute migraine attacks ( n = 60) Some patients received acupuncture, while some patients received a placebo The acupuncture group had significantly lower pain scores at intervals up to 1 h post-treatment; however, there was no significant difference between the two groups at 2, 3, or 4 post-treatment There is no significant difference in pain scores between the acupuncture group and the placebo group following intervention Musil et al (2018) [ 50 ] Patients with a diagnosis of migraines Patients either received acupuncture ( n = 42) or a standard pharmacological treatment ( n = 44) Number of migraine days was reduced more in the acupuncture than the medication group (5.5 vs. 2.0 days) after 12 weeks of intervention. Number of migraine days per 4 weeks was reduced more at the end of a 6-month follow-up in the acupuncture group (difference: − 4; 95% CI − 6 to − 2).…”