Clinical Efficacy and Plasma Metabolomics Analysis of Acupuncture for Migraine Treatment

Migraine, a prevalent neurological disorder characterized by recurrent, debilitating headaches, poses significant challenges due to limited understanding of its pathophysiology and variable treatment outcomes. Acupuncture has emerged as a promising intervention, yet its clinical efficacy and underlying metabolic mechanisms remain underexplored. This study aimed to evaluate the therapeutic effects of true acupuncture (TA) compared to sham acupuncture (SA) in migraine patients and to elucidate associated metabolic changes using non-targeted plasma metabolomics.

Fifty-two migraine patients were randomized into TA and SA groups, receiving 12 sessions of acupuncture over four weeks, with clinical assessments and plasma sample collection at baseline and week 4.

The TA group exhibited a significant reduction in migraine attack frequency (p<0.05) compared to baseline, while the SA group showed no significant change (p>0.05). Additionally, the TA group demonstrated greater improvements in attack frequency, duration, visual analog scale (VAS) scores, and migraine-specific quality of life (MSQ) emotional and dysfunction subscales compared to the SA group (p<0.05). Metabolomic analysis identified distinct metabolic profiles. TA was associated with five key metabolites, including the lipid regulators 1-oleoyl-sn-glycero-3-phosphoethanolamine (LysoPE) and Pe (16:0/19,20-epdpe), which correlated with reduced attack duration and improved quality of life scores. In contrast, metabolic changes in the SA group were less pronounced. Pathway analysis revealed that TA predominantly modulated amino acid and pyrimidine metabolism.

These findings indicate that TA is more effective than SA in alleviating migraine symptoms, likely through specific regulation of metabolic pathways. The identified metabolites offer potential biomarkers for evaluating treatment response, though further validation is required.