Regulatory Effects of Acupuncture on Emotional Disorders in Patients With Menstrual Migraine Without Aura: A Resting-State fMRI Study

Abstract

Background: Menstrual migraine without aura (MMoA) refers to a specific type of migraine that is associated with the female ovarian cycle. It is particularly serious and has brought huge life pressure and mental burden to female patients. Acupuncture has been commonly used to prevent migraines and relieve concomitant emotional disorders; however, the physiological mechanism underlying this intervention remains unclear. This study aimed to use resting-state functional magnetic resonance imaging (rsfMRI) to investigate whether acupuncture can modulate brain function and if the potential influence on brain activity correlates with improving emotional symptoms in MMoA patients.Methods: Overall, 44 patients were randomly divided into a true acupuncture (TA) group and the sham acupuncture (SA) group. Patients underwent rsfMRI before and after 3-month treatment, the amplitude of low-frequency fuctuations (ALFF) and regional homogeneity (ReHo) in rsfMRI were calculated. Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), frequency of migraine attacks, visual analog scale, and intensity of the migraine were used for evaluate the clinical effect. The clinical changes of variables were also used to further assess the correlation with brain activity in MMoA patients.Results: After acupuncture treatment, the emotional symptoms of both groups of patients improved, and the clinical symptoms of migraine were alleviated. The major finding of our study was that patients with MMoA showed lower ALFF value in the left anterior cingulate and the value was positively correlated with the decreases in the SAS and SDS scores. In the SA group, common brain regions responded both in ALFF and regional homogeneity values mainly in the insula, and no significant correlations were observed between brain regions and clinical variables.Conclusions: These results indicated that both two acupuncture treatments were helpful in treating migraine and could improve emotion symptoms. TA had a relatively better effect in reducing the frequency of migraine attack than SA. The two therapies have different modulation effects as TA regulates emotional disorders by modulating the frontal-limbic regions, and SA may modulate pain perception through the placebo effect on insula and by indirectly regulating emotional disorders. These findings provided evidence that acupuncture is a complementary and alternative therapy to relieve clinical symptoms in female patients with migraines and could help enhance clinical diagnosis and treatment.Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [ChiCTR-IOR-15006648. Registered 23 June 2015].

Abnormal Dynamics of Functional Connectivity Density Associated With Chronic Neck Pain

“…One study found that chronic pain caused a decrease in the gray matter volume of the occipital cortex. Our previous studies of migraine (Zhang et al, 2021) found that the ReHo value of the left middle occipital gyrus or right middle occipital gyrus decreased after acupuncture treatment and that it may be related to the relief of photophobia and the reduction of pain-associated symptoms in migraine patients. These results suggest the occipital lobe's importance to the field of pain and help explain the occipital lobe's higher dFCD variability in CNP.…”

Changes in brain connectivity linked to multisensory processing of pain modulation in migraine with acupuncture treatment

“…Moreover, the STG belongs to the ventral stream of the visual pathway, effectuated as a link between auditory and visual processing, perception, and memory ( Kravitz et al, 2013 ). A recent study found diminished ReHo value in right STG after acupuncture treatment, indicating emotional disorders in menstrual migraine without aura patients and the association with the acupuncture effects as well ( Zhang et al, 2021 ). However, contrary results of an elevated ReHo value in STG and lowered in MTG were reported after acupuncture in a previous study ( Zhao et al, 2014 ).…”

Evaluation of the Glymphatic System With Diffusion Tensor Imaging-Along the Perivascular Space in Cancer Pain

“…Both the SDS and SAS comprise 20 items, each of which is scored on a scale of 1–4, ranging from the absence of the symptom (score of 1) to maximal symptoms (score of 4), and a higher score indicates greater severity of depression or anxiety. Standard scores of 53 (equal to the original raw score of 41) for the SAS and 50 (equal to the original raw score of 40) for the SDS were used as the cut-off scores for Chinese clinical significance, where the higher the score, the more severe the depressive or anxious mood ( Zhang et al, 2021 ).…”