Therapeutic applications and potential mechanisms of acupuncture in migraine: A literature review and perspectives

Abstract

Acupuncture is commonly used as a treatment for migraines. Animal studies have suggested that acupuncture can decrease neuropeptides, immune cells, and proinflammatory and excitatory neurotransmitters, which are associated with the pathogenesis of neuroinflammation. In addition, acupuncture participates in the development of peripheral and central sensitization through modulation of the release of neuronal-sensitization-related mediators (brain-derived neurotrophic factor, glutamate), endocannabinoid system, and serotonin system activation. Clinical studies have demonstrated that acupuncture may be a beneficial migraine treatment, particularly in decreasing pain intensity, duration, emotional comorbidity, and days of acute medication intake. However, specific clinical effectiveness has not been substantiated, and the mechanisms underlying its efficacy remain obscure. With the development of biomedical and neuroimaging techniques, the neural mechanism of acupuncture in migraine has gained increasing attention. Neuroimaging studies have indicated that acupuncture may alter the abnormal functional activity and connectivity of the descending pain modulatory system, default mode network, thalamus, frontal-parietal network, occipital-temporal network, and cerebellum. Acupuncture may reduce neuroinflammation, regulate peripheral and central sensitization, and normalize abnormal brain activity, thereby preventing pain signal transmission. To summarize the effects and neural mechanisms of acupuncture in migraine, we performed a systematic review of literature about migraine and acupuncture. We summarized the characteristics of current clinical studies, including the types of participants, study designs, and clinical outcomes. The published findings from basic neuroimaging studies support the hypothesis that acupuncture alters abnormal neuroplasticity and brain activity. The benefits of acupuncture require further investigation through basic and clinical studies.

The Analgesic Effect and Potential Mechanisms of Acupuncture for Migraine Rats: A Systematic Review and Meta-Analysis

“…This review also indicates that compared to the model group, the levels of CGRP were significantly inhibited in the group treated with acupuncture. The same positive results from previous meta-analyses conducted by Chen 47 which indicated that acupuncture could significantly alleviated the decrease in paw and facial withdrawal thresholds and significantly lessened the increase in the levels of serum CGRP, thus showing results in migraine treatment. All the above results suggested that acupuncture could suppress pain symptoms in a rat model of migraine and exerted effective analgesic effects.…”

Research hotspots and trends on acupuncture treatment for headache: a bibliometric analysis from 2003 to 2023

“…Neuroimaging studies suggest that acupuncture may alter aberrant functional activity and connectivity in the descending pain modulation system, default mode network, thalamus, anterior cingulate cortex, posterior cingulate cortex, and cerebellum. Acupuncture regulates peripheral and central sensitization, normalizes abnormal brain activity, and thus inhibits the transmission of pain signals ( Chen et al, 2022 ). Additionally, tension-type headache has been a focus.…”

“…Acupuncture can alleviate headache symptoms, including migraines, tension-type headaches, and headaches caused by other factors ( Shih et al, 2017 ; Dong et al, 2019 ; Fan et al, 2022 ; Huang et al, 2022 ; Li et al, 2022 ). Furthermore, some researchers have explored the mechanism of action of acupuncture treatment for headaches, suggesting that acupuncture can play an analgesic role by regulating nervous system activity, influencing pain signal transmission, promoting the release of endogenous substances such as endorphins, regulating inflammatory responses, and affecting neural plasticity ( Chen et al, 2022 ). These findings provide theoretical support for research on acupuncture in treating headaches.…”

Auriculotherapy in prevention of migraine attacks: an open randomized trial

“…These vagal afferents modulate different neurotransmitter systems and possibly play a role in pain and inflammation regulation. More recently it has been proposed that various clinical manifestations of migraine could be the result of abnormal brain network connections ( 19 ). Vagal stimulation could improve resting state functional connectivity ( 22 ).…”