Regulatory Effects of Acupuncture on Emotional Disorders in Patients With Menstrual Migraine Without Aura: A Resting-State fMRI Study.
Regulatory Effects of Acupuncture on Emotional Disorders in Patients With Menstrual Migraine Without Aura: A Resting-State fMRI Study.
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DOI：
10.3389/fnins.2021.726505
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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：
Zhang Y;Wang Z;Du J;Liu J;Xu T;Wang X;Sun M;Wen Y;Li D;Liao H;Zhao Y;Zhao L
背景：月经性无先兆偏头痛(MMoA)是指与女性卵巢周期相关的一种特殊类型的偏头痛。尤其严重，给女性患者带来了巨大的生活压力和精神负担。针灸通常用于预防偏头痛和缓解伴随的情绪障碍；然而，这种干预背后的生理机制仍不清楚。本研究旨在利用静息功能磁共振成像(RsfMRI)来研究针刺是否可以调节大脑功能，以及对大脑活动的潜在影响是否与改善MMoA患者的情绪症状有关。方法：44例患者随机分为真针刺组(TA组)和假针刺组(SA组)。分别于治疗前和治疗3个月后进行rsfMRI检查，计算rsfMRI的低频功能波幅(Alff)和区域均匀度(ReHo)。采用Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、偏头痛发作次数、视觉模拟评分、偏头痛强度评定临床疗效。并结合临床变量的变化，进一步评估MMoA患者脑活动与临床指标的相关性。结果：针刺治疗后，两组患者的情绪症状均有改善，偏头痛的临床症状均有所缓解。本研究的主要发现是MMoA患者左侧前扣带回的ALFF值降低，且ALFF值与焦虑自评量表(SAS)和抑郁自评量表(SDS)评分的降低呈正相关。在SA组中，共同脑区对ALF值和区域均匀值的反应主要集中在脑岛，而脑区与临床变量之间没有显著的相关性。结论：两种针刺疗法对偏头痛均有治疗作用，并能改善情绪症状。在减少偏头痛发作次数方面，TA的效果相对好于SA。这两种疗法都有不同的调节作用，因为TA通过调节额叶-边缘区域来调节情绪障碍，SA可能通过岛上的安慰剂效应和间接调节情绪障碍来调节疼痛感知。这些发现提供了证据，表明针灸是缓解女性偏头痛患者临床症状的补充和替代疗法，有助于提高临床诊断和治疗水平。临床试验注册：[http://www.chictr.org.cn/index.aspx]，标识符[CHICCTR-IOR-15006648。已于2015年6月23日注册]。
Background: Menstrual migraine without aura (MMoA) refers to a specific type of migraine that is associated with the female ovarian cycle. It is particularly serious and has brought huge life pressure and mental burden to female patients. Acupuncture has been commonly used to prevent migraines and relieve concomitant emotional disorders; however, the physiological mechanism underlying this intervention remains unclear. This study aimed to use resting-state functional magnetic resonance imaging (rsfMRI) to investigate whether acupuncture can modulate brain function and if the potential influence on brain activity correlates with improving emotional symptoms in MMoA patients. Methods: Overall, 44 patients were randomly divided into a true acupuncture (TA) group and the sham acupuncture (SA) group. Patients underwent rsfMRI before and after 3-month treatment, the amplitude of low-frequency fuctuations (ALFF) and regional homogeneity (ReHo) in rsfMRI were calculated. Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), frequency of migraine attacks, visual analog scale, and intensity of the migraine were used for evaluate the clinical effect. The clinical changes of variables were also used to further assess the correlation with brain activity in MMoA patients. Results: After acupuncture treatment, the emotional symptoms of both groups of patients improved, and the clinical symptoms of migraine were alleviated. The major finding of our study was that patients with MMoA showed lower ALFF value in the left anterior cingulate and the value was positively correlated with the decreases in the SAS and SDS scores. In the SA group, common brain regions responded both in ALFF and regional homogeneity values mainly in the insula, and no significant correlations were observed between brain regions and clinical variables. Conclusions: These results indicated that both two acupuncture treatments were helpful in treating migraine and could improve emotion symptoms. TA had a relatively better effect in reducing the frequency of migraine attack than SA. The two therapies have different modulation effects as TA regulates emotional disorders by modulating the frontal-limbic regions, and SA may modulate pain perception through the placebo effect on insula and by indirectly regulating emotional disorders. These findings provided evidence that acupuncture is a complementary and alternative therapy to relieve clinical symptoms in female patients with migraines and could help enhance clinical diagnosis and treatment. Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [ChiCTR-IOR-15006648. Registered 23 June 2015].
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