Revealing the Neural Mechanism Underlying the Effects of Acupuncture on Migraine: A Systematic Review.
Revealing the Neural Mechanism Underlying the Effects of Acupuncture on Migraine: A Systematic Review.
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揭示针刺治疗偏头痛的神经机制：一项系统评价。
DOI：
10.3389/fnins.2021.674852
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发表时间：
2021
影响因子：
4.3
通讯作者：
Zhao L
中科院分区：
文献类型：
--
作者：
Liu L;Tian T;Li X;Wang Y;Xu T;Ni X;Li X;He Z;Gao S;Sun M;Liang F;Zhao L
背景：偏头痛是一种以中、重度头痛发作和各种神经系统症状为特征的慢性神经系统疾病。偏头痛通常通过药物或非药物治疗来缓解疼痛或防止偏头痛发作。药物疗法在缓解头痛方面的效果有限，而且往往伴随着不良反应，而针灸作为一种非药物疗法，在治疗和预防急性偏头痛发作方面的好处已经得到了充分的证明。然而，针刺缓解偏头痛的潜在机制尚不清楚。神经影像技术的最新进展为探索针灸治疗偏头痛的潜在神经机制提供了新的机会。为了为未来的研究铺平道路，本文综述了近10年来针灸治疗偏头痛的神经影像研究。方法：应用计算机检索PubMed2009-01/2020-06期间针灸、神经影像与偏头痛的相关文献，检索PubMed、Embase、Cochrane Central Register of Control Trials、中国国家知识基础设施等有关针灸治疗偏头痛的神经影像研究。所有已发表的随机和非随机对照神经影像研究均纳入其中。我们综述了针刺治疗急性偏头痛的神经机制，以及针刺预防偏头痛持续作用的神经机制。结果：共检索到文献619篇。剔除综述、荟萃分析、动物研究等后，15篇文献符合纳入标准，纳入本综述。使用的方法是正电子发射计算机断层扫描(PET-CT；n=2)、磁共振波谱(n=1)和功能磁共振成像(fMRI；n=12)。所使用的分析方法包括区域同质性(REHO)方法(n=3)、低频幅度(Alff)方法(n=2)、独立成分分析(ICA；n=3)、基于种子的分析(SBA；n=1)、ICA和SBA(n=1)、用于计算脑区之间功能连接性(FC)的Pearson相关(n=1)和机器学习方法(n=1)。针刺即刻效应研究5篇，研究对象为急性偏头痛(n=2)和偏头痛发作间期(n=3)。有10项研究集中于针灸的持久效应，所有研究都选择了发作间期的偏头痛患者。本综述包括5项任务型研究和10项静息态研究。没有一项研究进行了脑功能变化与即时临床疗效之间的相关性分析。对于脑功能改变与持续临床疗效相关分析的研究，针刺对偏头痛的预防作用可能是通过调节视觉网络、默认模式网络(DMN)、感觉运动网络、额顶神经网络(FPN)、边缘系统和/或下行痛觉调制系统(DPMS)来实现的。结论：针刺镇痛即刻效应的神经机制尚不清楚，针刺持续治疗偏头痛的神经机制可能与痛相关脑网络的调节有关。研究针灸治疗偏头痛的神经影像研究的实验设计也存在一些不足，有必要对实验设计进行规范和优化。为了更好地了解针灸治疗偏头痛的神经机制，需要进行多中心神经成像研究。神经成像结果的交叉验证需要集成多种数据分析方法的多模式神经成像研究。此外，在神经成像研究中应用机器学习方法可以帮助预测针灸疗效，并筛选适合针灸治疗的偏头痛患者。
Background: Migraine is a chronic neurological disorder characterized by attacks of moderate or severe headache and various neurological symptoms. Migraine is typically treated by pharmacological or non-pharmacological therapies to relieve pain or prevent migraine attacks. Pharmacological therapies show limited efficacy in relieving headache and are often accompanied by adverse effects, while the benefits of acupuncture, a non-pharmacological therapy, have been well-documented in both the treatment and prevention of acute migraine attacks. However, the underlying mechanism of the effect of acupuncture on relieving migraine remains unclear. Recent advances in neuroimaging technology have offered new opportunities to explore the underlying neural mechanism of acupuncture in treating migraine. To pave the way for future research, this review provides an overview neuroimaging studies on the use of acupuncture for migraine in the last 10 years. Methods: Using search terms about acupuncture, neuroimaging and migraine, we searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure from January 2009 to June 2020 for neuroimaging studies that examined the effect of acupuncture in migraine. All published randomized and non-randomized controlled neuroimaging studies were included. We summarized the proposed neural mechanism underlying acupuncture analgesia in acute migraine, and the proposed neural mechanism underlying the sustained effect of acupuncture in migraine prophylaxis. Results: A total of 619 articles were retrieved. After removing reviews, meta-analyses, animal studies and etc., 15 articles were eligible and included in this review. The methods used were positron emission computed tomography (PET-CT; n = 2 studies), magnetic resonance spectroscopy (n = 1), and functional magnetic resonance imaging (fMRI; n = 12). The analyses used included the regional homogeneity (ReHo) method (n = 3), amplitude of low frequency (ALFF) method (n = 2), independent component analysis (ICA; n = 3), seed-based analysis (SBA; n = 1), both ICA and SBA (n = 1), Pearson's correlation to calculate functional connectivity (FC) between brain regions (n = 1), and a machine learning method (n = 1). Five studies focused on the instant effect of acupuncture, and the research objects were those with acute migraine (n = 2) and migraine in the interictal phase (n = 3). Ten studies focused on the lasting effect of acupuncture, and all the studies selected migraine patients in the interictal phase. This review included five task-based studies and 10 resting-state studies. None of the studies conducted a correlation analysis between functional brain changes and instant clinical efficacy. For studies that performed a correlation analysis between functional brain changes and sustained clinical efficacy, the prophylactic effect of acupuncture on migraine might be through regulation of the visual network, default mode network (DMN), sensory motor network, frontoparietal network (FPN), limbic system, and/or descending pain modulatory system (DPMS). Conclusion: The neural mechanism underlying the immediate effect of acupuncture analgesia remains unclear, and the neural mechanism of sustained acupuncture treatment for migraine might be related to the regulation of pain-related brain networks. The experimental design of neuroimaging studies that examined the effect of acupuncture in migraine also have some shortcomings, and it is necessary to standardize and optimize the experimental design. Multi-center neuroimaging studies are needed to provide a better insight into the neural mechanism underlying the effect of acupuncture on migraine. Multi-modality neuroimaging studies that integrate multiple data analysis methods are required for cross-validation of the neuroimaging results. In addition, applying machine learning methods in neuroimaging studies can help to predict acupuncture efficacy and screen for migraineurs for whom acupuncture treatment would be suitable.
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影响因子：
4.6
作者：
Li Z;Liu M;Lan L;Zeng F;Makris N;Liang Y;Guo T;Wu F;Gao Y;Dong M;Yang J;Li Y;Gong Q;Liang F;Kong J
通讯作者：
Kong J
影响因子：
2.7
作者：
Goffaux, Philippe;Girard-Tremblay, Lydia;Whittingstall, Kevin
通讯作者：
Whittingstall, Kevin
针灸调节无先兆偏头痛患者的异常脑干活动
DOI：
10.1016/j.nicl.2017.05.013
发表时间：
2017
期刊：
NeuroImage. Clinical
影响因子：
--
作者：
Li Z;Zeng F;Yin T;Lan L;Makris N;Jorgenson K;Guo T;Wu F;Gao Y;Dong M;Liu M;Yang J;Li Y;Gong Q;Liang F;Kong J
通讯作者：
Kong J
初治晚年抑郁症患者的异常局部自发神经活动：一项静息态功能磁共振成像研究
DOI：
10.1016/j.pnpbp.2012.07.004
发表时间：
2012-12-03
影响因子：
5.6
作者：
Liu, Feng;Hu, Maorong;Chen, Huafu
通讯作者：
Chen, Huafu
DOI：
10.1186/s10194-015-0518-4
发表时间：
2015
期刊：
The journal of headache and pain
影响因子：
--
作者：
Li K;Zhang Y;Ning Y;Zhang H;Liu H;Fu C;Ren Y;Zou Y
通讯作者：
Zou Y