针治疗偏头痛没有光环和基于连接的有效性预测:一个随机临床试验
Xinyu Zhang1, Qiuyi Chen1, Yuhan Liu1
1Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China.
JAMA network open
|January 27, 2026
概括
真正针显著改善了患有偏头痛没有光环 (MWOA) 的偏头痛患者的偏头痛症状和生活质量. 基于Connectome的预测建模确定了与缓解疼痛和减少残疾相关的大脑连接模式,提供了个性化的治疗见解.
科学领域:
- 神经科学是一个神经科学.
- 综合医学是一个整体医学.
- 临床神经学 临床神经学
背景情况:
- 没有光环的偏头痛 (MWOA) 是一种普遍的神经疾病,影响生活质量.
- 针是一种传统疗法,但其疗效和MWOA的潜在神经机制需要进一步研究.
- 基于Connectome的预测建模 (CPM) 提供了一种数据驱动的方法,将大脑连接与临床结果联系起来.
研究的目的:
- 评估真实与假治疗MWOA的临床有效性.
- 使用CPM和fMRI识别与针反应相关的大脑连接模式.
- 探索个性化MWOA治疗的潜在生物标志物.
主要方法:
- 一个单盲随机临床试验,涉及120名MWOA患者,比较真实针 (带deqi感觉) 与假针 (没有deqi).
- 功能磁共振成像 (fMRI) 用于基线脑部扫描.
- 将CPM分析应用于基线fMRI数据,以预测治疗结果,包括每月偏头痛天数 (MMDs) 和疼痛评分 (VAS) 的变化.
主要成果:
- 与假相比,真正的针显著减少了MMD,每月头痛日 (MHD),急性药物使用,VAS疼痛得分,HIT-6残疾得分,并改善了MSQ生活质量得分.
- CPM发现了不同的神经特征:默认模式网络和皮质下大脑 (DMN-SC) 低连接性预测了VAS得分的降低 (缓解疼痛).
- 皮下-小脑到运动皮层 (SC-motor) 的超连接性预测了改善的HIT-6分数 (减少残疾).
结论:
- 针在临床上有效改善MWOA患者的疼痛和功能.
- CPM成功地确定了预测治疗反应的特定大脑连接模式 (DMN-SC 低连接性和SC-motor 超连接性).
- 这些发现支持基于神经成像生物标志物的MWOA个性化治疗框架.
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