A Study Of Effects And FMRI: Acupuncture For Treating Migraine With Acupoints And Non-acupoints

Objective:This study aimed at evaluating the clinical effect of acupuncture on acupoints and non-points for patients with migraine, and observing the influence of brain functional connectivity of migraineurs with the application of magnetic resonace imaging (fMRI) technology during resting-state, in order to explore the central mechanism on treating migraine with acupuncture.Methods:24 migraine patients were randomly assigned into group A:acupoints group (12 patients) and group B:non-acupoints group(12 patients).Group A was treated with following acupoints:Fengchi(GB 20), Jiaosun(SJ 20), Waiguan (SJ 5), Qiuxu(GB 40).Those of group B was as follows:the midpoints of the adjacent two meridians beside the corresponding acupoints. Acupuncture treatments were given every two days for total 16 times, each session lasted for 30 minutes.The following outcome measurements were assessed at 0,4 and 8 weeks:frequency of migraine attack, the visual analog scale (VAS) score, overall scores and migraine-specific quality of life questionnaire(MSQ), etc.Migraine patients received fMRI scan 3 days before acupuncture treatment and 3 days after the end of treatment.The healthy subjects received fMRI scan without any acupuncture intervention, with their scan data taken as the baseline control to the two migraine patients groups.Results:1.4 weeks after the baseline. compared with baseline, group A was decreased while group B was increased in frequency of migraine attack, and there was no significant difference between them (P>0.05), both groups was no significant difference compared with baseline (P>0.05).2.4 weeks after the baseline, VAS scores were lessen, MSQ scores were higher of two groups, but there was no significant difference between them. And MSQ scores of group A are significant different compared with baseline (P<0.05)3.4 weeks after the baseline, compared with baseline, group A was decreased while B group was increased in overal scores, and there was no significant difference (P>0.05), group A has significant difference compared with pre-treatment (P> 0.05).4.8 weeks after the baseline, frequency of migraine attack, VAS scores and overal scores were lessen, MSQ scores were higher, but there were no significant difference between them (P>0.05).Both groups was significant difference compared with pre-treatment (P<0.05).5. After treatment, many brain regions in group A have functional connecivtiy with the right insula, including bilateral anterior cingulate, posterior cingulate, left parahippocampal gyrus, right caudate nucleus, bilateral claustrum, putamen, thalamus:the left substantia nigra, and bilateral subthalamic nucleus, bilateral pontine; bilateral inferior frontal, middle frontal gyrus, medial frontal gyrus, superior frontal gyrus, medial frontal gyrus:bilateral superior temporal gyrus; bilateral inferior parietal lobule; the left side of hill slopes, cerebellar tonsil, bilateral pyramidal(P<0.05).The brain regions including Bilateral anterior cingulate-left posterior cingulate, right parahippocampal gyrus, bilateral caudate nucleus, claustrum and right putamen; bilateral inferior frontal, middle frontal gyrus, medial frontal gyrus, superior frontal gyrus, medial frontal gyrus:bilateral superior temporal gyrus; the left fusiform gyrus, lingual gyrus; bilateral inferior parietal lobule, postcentral gyrus; bilateral summit, slopes, cerebellar tonsil:right side of the pons have functional connectivity with right insula in group B (P<0.05).6. After treatment, there was intensity functional connectivity greater than in primary brain regions in group A.While increased functional connectivity were only found in left anterior cingulate and left pons in group B.Conclusions:1. Acupuncture at both acupoints and non-acupoints could reduce headache attacks, alleviate pain for patients with migraine, but there were no mark differences in the outcome of headache attacks, VAS and MSQ scores. The result showed that acupuncture is effective for migraine prophylaxis, improving migraineurs' quality of life.However no clinic significance difference was founded between two groups, which need to be explored further.2. There were difference and similarities common in the brain functional connectivitis related with the right insula with acupoints and non-acupoints for migraine patients. That acupuncture acupoints caused more links with the regions invloled in pain suggested it was better than non-points in the central mechanism, and did have specific effects.3. The special cerebral pathway of network maybe include right insula-limic system-cerebellar, though which to modulate acupoints analgesia effects.