Acupuncture modulates the abnormal brainstem activity in migraine without aura patients

Area of Science:

• Neurology
• Neuroimaging
• Pain Research

Background:

• Migraine is a prevalent neurological disorder with unclear pathophysiology and limited treatment options.
• Understanding the neural mechanisms of migraine is crucial for developing effective therapies.
• Spontaneous brain activity alterations may underlie migraine pathophysiology.

Purpose of the Study:

• To compare spontaneous brain activity, using Amplitude of Low-Frequency Fluctuations (ALFF), between Migraine without Aura (MwoA) patients and healthy controls (HCs).
• To investigate the modulatory effects of verum acupuncture on ALFF in MwoA patients.
• To evaluate the clinical efficacy of verum acupuncture in treating migraine symptoms.

Main Methods:

• Resting-state BOLD-fMRI scans were acquired from 100 MwoA patients and 46 HCs.
• MwoA patients were randomized into verum acupuncture, sham acupuncture, and waiting list groups for four weeks.
• ALFF analysis was performed, alongside clinical assessments of headache, anxiety, and depression.

Main Results:

• MwoA patients showed increased ALFF in the posterior insula and putamen/caudate, and decreased ALFF in the rostral ventromedial medulla (RVM)/trigeminocervical complex (TCC) compared to HCs.
• Verum acupuncture treatment normalized the reduced ALFF in the RVM/TCC of MwoA patients.
• Both verum and sham acupuncture demonstrated distinct modulation effects on RVM/TCC ALFF.

Conclusions:

• Impaired trigeminovascular pathway homeostasis contributes to migraine pathophysiology.
• Verum acupuncture may restore neural balance in migraine patients.
• ALFF analysis provides insights into migraine mechanisms and treatment effects.