Changes in brain connectivity linked to multisensory processing of pain modulation in migraine with acupuncture treatment

Liu, Lu; Lyu, Tianli; Fu, Ming-Yang; Wang, Linpeng; Chen, Ying; Hong, Jia-Hui; Chen, Qiu-Yi; Zhu, Yupu; Tan, Zhenghuai; Liu, Dapeng; Chen, Zi-Wei; Kong, Yazhuo; Li, Bin

doi:10.1016/j.nicl.2022.103168

Cited by 15 publications

(11 citation statements)

References 72 publications

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“…Recent studies [ 60 – 65 ] investigated neural changes associated with acupuncture comparing the effect of verum acupuncture to sham acupuncture, which included inactive acupoints. RS fMRI studies [ 60 – 62 ] described more extensive changes in the function of pain modulatory brain areas in patients receiving verum acupuncture compared to those treated with sham treatment. The study conducted by Li and colleagues [ 65 ] showed that only treatment with verum acupuncture could normalize the lower activity of the rostral ventromedial medulla revealed in migraine patients compared to controls before acupuncture initiation.…”

Section: Resultsmentioning

confidence: 99%

Imaging the brain and vascular reactions to headache treatments: a systematic review

et al. 2023

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Background Neuroimaging studies have made an important contribution to our understanding of headache pathophysiology. This systematic review aims to provide a comprehensive overview and critical appraisal of mechanisms of actions of headache treatments and potential biomarkers of treatment response disclosed by imaging studies. Main body We performed a systematic literature search on PubMed and Embase databases for imaging studies investigating central and vascular effects of pharmacological and non-pharmacological treatments used to abort and prevent headache attacks. Sixty-three studies were included in the final qualitative analysis. Of these, 54 investigated migraine patients, 4 cluster headache patients and 5 patients with medication overuse headache. Most studies used functional magnetic resonance imaging (MRI) (n = 33) or molecular imaging (n = 14). Eleven studies employed structural MRI and a few used arterial spin labeling (n = 3), magnetic resonance spectroscopy (n = 3) or magnetic resonance angiography (n = 2). Different imaging modalities were combined in eight studies. Despite of the variety of imaging approaches and results, some findings were consistent. This systematic review suggests that triptans may cross the blood–brain barrier to some extent, though perhaps not sufficiently to alter the intracranial cerebral blood flow. Acupuncture in migraine, neuromodulation in migraine and cluster headache patients, and medication withdrawal in patients with medication overuse headache could promote headache improvement by reverting headache-affected pain processing brain areas. Yet, there is currently no clear evidence for where each treatment acts, and no firm imaging predictors of efficacy. This is mainly due to a scarcity of studies and heterogeneous treatment schemes, study designs, subjects, and imaging techniques. In addition, most studies used small sample sizes and inadequate statistical approaches, which precludes generalizable conclusions. Conclusion Several aspects of headache treatments remain to be elucidated using imaging approaches, such as how pharmacological preventive therapies work, whether treatment-related brain changes may influence therapy effectiveness, and imaging biomarkers of clinical response. In the future, well-designed studies with homogeneous study populations, adequate sample sizes and statistical approaches are needed.

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Section: Resultsmentioning

confidence: 99%

Imaging the brain and vascular reactions to headache treatments: a systematic review

et al. 2023

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“…Therefore, based on expert consensus and literature research, we choose PSA with sham acupoints as the placebo control intervention in this study, consistent with some presented clinical trials of migraine. 46–48 …”

Section: Discussionmentioning

confidence: 99%

Central Mechanism of Acupuncture Treatment in Patients with Migraine: Study Protocol for Randomized Controlled Neuroimaging Trial

Jia¹,

Yan²,

Zheng³

et al. 2023

JPR

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Purpose Acupuncture has been recognized as an effective and safe alternative therapy for migraine, but its central mechanism has not yet been adequately explained. Meanwhile, research into the clinical efficacy and central mechanism of true acupuncture (TA) and sham acupuncture (SA) is lacking. It is necessary to investigate whether TA has better efficacy than SA, and how they achieve different effects. This study aims to evaluate the efficacy of TA and SA, observe the brain response caused by TA and SA, and further investigate the central nervous mechanism of TA and SA treatment for patients with migraine. Patients and Methods This is a randomized controlled neuroimaging trial combining acupuncture treatment with functional magnetic resonance imaging, with patients and outcome assessors blinded. A total of 60 patients with migraine will be randomly allocated to receive 12 sessions of either TA or SA treatments (three sessions per week for 4 weeks), and 30 healthy participants will be recruited as the healthy control (HC) group. Outcome assessment and neuroimaging will be conducted before and after the entire intervention. A headache diary and questionnaires of life quality and psychological properties will be used to evaluate clinical efficacy. Multimodal magnetic resonance imagining data analysis will be used to investigate the central mechanism of TA or SA in treating migraine. Pearson’s correlation analysis will be used to reveal the relationship between the brain response and clinical improvements. Conclusion The results of this study will reveal the brain response to TA and SA in patients with migraine and contribute to further expanding the knowledge of their central mechanism. Study Registration This trial has been approved by the ethics committee of Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine (DZMEC-KY-2020-38) and registered in the Chinese Clinical Trial Registry (registration number ChiCTR2000033995).

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“…[38] The results suggest that acupuncture may modulate the seed-voxel resting-state-functional connectivity of 2 pain-regulating regions in the right amygdala and right middle cingulate cortex simultaneously, and the middle temporal gyrus and the right superior temporal gyrus may be the key nodes related to the multi-sensory processing of pain regulation in acupuncture treatment of migraine. [38] Liu Shanshan found that acupuncture relieved migraine symptoms, while also improving cerebellar dysfuntion, and that acupuncture activated areas of the brain associated with pain and mood regulation. [39] Interestingly, the cumulative therapeutic effect of acupuncture was found to be more robust and significant than its direct effect.…”

Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of acupuncture for headache from 1974 to 2022: A scoping literature review based on international database

Yue¹,

Cui

et al. 2023

Medicine

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This study aimed to investigate the research hotspots and global trends of acupuncture in the treatment of headaches from 1974 to 2022. The Web of Science core collection database and literature related to acupuncture for headache treatment were retrieved. The CiteSpace (version 5.1.R8) and VOSviewer (version 1.6.19) software perform collaborative network analysis on the information of countries, academic institutions, authors, and co-occurrence network analysis on keywords, co-cited journals, and references. A total of 841 studies were included. Overall, the number of publications has increased over the past 5 decades. We identified and analyzed the countries, institutions, authors, and journals that were most active in the domain of acupuncture treatment for headaches. The most productive countries were the United States and China. Chengdu University of Traditional Chinese Medicine was the most productive institution and Linde Klaus was the most productive author. Cephalalgia was the most productive and co-cited journal, whereas Lancet had the highest impact factor. The research hotspots mainly focus on headache, migraine, tension headache, electroacupuncture, and acupuncture. Research trends have mainly focused on acupuncture therapy and its curative effects, migraine without aura, paroxysmal migraine, and the mechanism of acupuncture treatment. The main research hotspots and frontier trends were the therapeutic effect and mechanism of acupuncture for headaches. The mechanism of acupuncture in the treatment of headache mainly focused on the neural mechanism by multimodal MRI.

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Changes in brain connectivity linked to multisensory processing of pain modulation in migraine with acupuncture treatment

Cited by 15 publications

References 72 publications

Imaging the brain and vascular reactions to headache treatments: a systematic review

Imaging the brain and vascular reactions to headache treatments: a systematic review

Central Mechanism of Acupuncture Treatment in Patients with Migraine: Study Protocol for Randomized Controlled Neuroimaging Trial

Bibliometric analysis of acupuncture for headache from 1974 to 2022: A scoping literature review based on international database

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