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Acupuncture therapy in treating migraine: results of a magnetic resonance spectroscopy imaging study - PubMed

  • ️Mon Jan 01 2018

Acupuncture therapy in treating migraine: results of a magnetic resonance spectroscopy imaging study

Tao Gu et al. J Pain Res. 2018.

Abstract

Background: Acupuncture has been proven to be effective as an alternative therapy in treating migraine, but the pathophysiological mechanisms of the treatment remain unclear. This study investigated possible neurochemical responses to acupuncture treatment.

Patients and methods: Proton magnetic resonance spectroscopy imaging was used to investigate biochemical levels pre- and post-acupuncture treatment. Participants (N=45) included subjects diagnosed with: 1) migraine without aura; 2) cervicogenic headache; and 3) healthy controls. Participants in the two patient groups received verum acupuncture using acupoints that target migraine without aura but not cervicogenic headache, while the healthy controls received a sham treatment. All participants had magnetic resonance spectroscopy scans before and after the acupuncture therapy. Levels of brain metabolites were examined in relation to clinical headache assessment scores.

Results: A significant increase in N-acetylaspartate/creatine was observed in bilateral thalamus in migraine without aura after the acupuncture treatment, which was significantly correlated with the headache intensity score.

Conclusion: The data demonstrate brain biochemical changes underlying the effect of acupuncture treatment of migraine.

Keywords: acupuncture; brain; magnetic resonance spectroscopy imaging; metabolites; migraine; pain transmission pathways.

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Conflict of interest statement

Disclosure TG received a Fellowship Award from Beijing Hospital to conduct postdoctoral research in Canada. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1

Locations of the targeted VOI superimposed on T2-weighted imaging (left panels) and the corresponding sample MRS spectra (right panels). Note: From top to bottom: left thalamus (TH-left); right thalamus (TH-right); anterior cingulate gyrus (ACC); posterior part of paracentral gyrus (PPG). Red grids show B0 shimming; green-lined rectangles show the VOIs; yellow squares show the voxels from which the spectra were retrieved and averaged for analysis. Abbreviations: VOIs, voxels of interest; MRS, magnetic resonance spectroscopy; NAA: N-acetylaspartate; Cr: creatine; Cho: choline-containing compounds.

Figure 2
Figure 2

Comparison of the level of metabolite ratios between subject groups at pre-and post-intervention conditions for (A) NAA/Cr and (B) Cho/Cr. Notes: ▲= Significant difference at p<0.050 between pre- and post-intervention conditions. For each test, n=15 for each of the MwoA and CH patient groups, and n=14 for the HC group. Abbreviations: NAA, N-acetylaspartate; Cr, creatine; Cho, choline-containing compounds; MwoA, migraine without aura; CH, cervicogenic headache; HC, healthy control.

Figure 3
Figure 3

The relationship between NAA/Cr and VAS in thalamus at baseline and follow-up conditions. Notes: Symbols represent the observational data and lines represent the linear fitting f(x) = a + bx, where x is the VAS scores and y is the level of metabolites. Solid lines represent the regressions for MowA patients (a1, b1), and dashed lines for the entire sample (a2, b2). Left top panel: a1=2.65, b1=–0.11 (n=15, r=–0.70, p=0.004); a2=2.33, b2=–0.07 (n=44, r=–0.60, p<0.001). Left bottom panel: a1=3.24, b1=–0.18 (n=15, r=–0.71, p=0.003); a2=2.32, b2=0.06 (n=44, r=–0.45, p=0.002). Right top panel: a1=2.55, b1=–0.10 (n=14, r=–0.64, p=0.014); a2=2.16, b2=-0.05 (n=44, r=–0.66, p<0.001). Right bottom panel: a1=2.44, b1=–0.07 (n=14, r=–0.66, p=0.010); a2=2.07, b2=–0.0 (n=44, r=–0.37, p=0.013). Abbreviations: NAA, N-acetylaspartate; Cr, creatine; MwoA, migraine without aura; CH, cervicogenic headache; HC, healthy control; VAS, visual analog scale.

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