Acupuncture modulates the abnormal brainstem activity in migraine without aura patients.
Acupuncture modulates the abnormal brainstem activity in migraine without aura patients.
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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
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kong J
中科院分区：
文献类型：
--
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
偏头痛是一种常见的神经系统疾病，发病率很高，但治疗方案并不令人满意。偏头痛的具体病理生理机制仍不清楚，这限制了针对这种普遍疾病的有效治疗方法的开发。本研究的目的是 1) 使用低频波动幅度 (ALFF) 计算方法比较无先兆偏头痛 (MwoA) 患者和健康对照 (HC) 之间的自发大脑活动差异，2) 探索有效的治疗方法（精穴针灸）如何调节 MwoA 患者的 ALFF。招募了 100 名 MwoA 患者和 46 名匹配的 HC。患者被随机分为为期 4 周的真针灸组、假针灸组和等候组。患者在治疗前后进行静息态 BOLD-fMRI 扫描，而 HC 仅在基线时进行静息态 BOLD-fMRI 扫描。采用头痛强度、头痛频率、焦虑自评、抑郁自评进行临床疗效评价。与 HC 相比，MwoA 患者的岛叶后部和壳核/尾状核 ALFF 增加，延髓头端腹内侧 (RVM)/三叉颈复合体 (TCC) ALFF 减少。纵向精针治疗后，偏头痛患者的 RVM/TCC ALFF 降低正常化。真针和假针对偏头痛患者RVM/TCC ALFF有不同的调节作用。我们的结果表明，三叉血管伤害性通路稳态的受损与偏头痛的神经病理生理学有关。有效的治疗方法，例如针灸，可以帮助恢复这种不平衡。脑干活动稳态受损与偏头痛的神经病理生理学有关。有效的治疗方法，例如针灸，可以帮助偏头痛中异常的脑干活动正常化。真针和假针对偏头痛异常脑干活动有不同的调节作用。
Migraine is a common neurological disease with a high prevalence and unsatisfactory treatment options. The specific pathophysiological mechanisms of migraine remain unclear, which restricts the development of effective treatments for this prevalent disorder. The aims of this study were to 1) compare the spontaneous brain activity differences between Migraine without Aura (MwoA) patients and healthy controls (HCs), using amplitude of low-frequency fluctuations (ALFF) calculation method, and 2) explore how an effective treatment (verum acupuncture) could modulate the ALFF of MwoA patients. One hundred MwoA patients and forty-six matched HCs were recruited. Patients were randomized to four weeks' verum acupuncture, sham acupuncture, and waiting list groups. Patients had resting state BOLD-fMRI scan before and after treatment, while HCs only had resting state BOLD-fMRI scan at baseline. Headache intensity, headache frequency, self-rating anxiety and self-rating depression were used for clinical efficacy evaluation. Compared with HCs, MwoA patients showed increased ALFF in posterior insula and putamen/caudate, and reduced ALFF in rostral ventromedial medulla (RVM)/trigeminocervical complex (TCC). After longitudinal verum acupuncture treatment, the decreased ALFF of the RVM/TCC was normalized in migraine patients. Verum acupuncture and sham acupuncture have different modulation effects on ALFF of RVM/TCC in migraine patients. Our results suggest that impairment of the homeostasis of the trigeminovascular nociceptive pathway is involved in the neural pathophysiology of migraines. Effective treatments, such as verum acupuncture, could help to restore this imbalance. Impairment of the homeostasis of the brainstem activity is involved in the neural pathophysiology of migraines. Effective treatments, such as verum acupuncture, could help to normalise the abnormal brainstem activity in migraines. Verum and sham acupuncture have different modulation effects on the abnormal brainstem activity in migraines.