| Objective: The subjects of this study were Menstrual migraine without aura MMOA patients with menstrual migraine without aura.Brain resting blood oxygen level dependent functional magnetic resonance imaging(fMRI)technique was used to observe the effects of acupuncture at acupoints and non-meridians on brain function in patients with MMOA,and to extract the changes of brain function in patients with MMOA as compared with those in healthy subjects.To observe the effect of acupuncture on brain function and local brain function network in patients with MMOA,to explain the central regulatory mechanism of acupuncture on MMOA from pain perception network,and to provide objective basis for neuroimaging of acupuncture prevention and treatment of MMOA.Methods: This study included 55 patients with MMOA and 27 healthy women.The patients were randomly divided into acupoint group and non-meridian group.The two sides of Fengchi,rate Valley,Neiguan,Taichong and Sanyinjiao were used in the Meridian acupoint group and 5 non-acupoint points in the nonmeridian non-acupoint group.The first week before menstruation began treatment,the second day,a total of 3 times;menstrual onset 1 week,a total of 2 times;the rest of the time,2 times a week.A total of 3 menstru al cycles of continuous treatment,a total of 27 times.Before and after treatment,the therapeutic effect was evaluated at 4 weeks and 8 weeks and 12 weeks after treatment.Resting functional magnetic resonance imaging was performed before and after 12 weeks of treatment to observe the effects of acupuncture on brain function and local brain function network in patients with MMOA.To explore the central nervous mechanism of acupuncture in the treatment of MMOA from pain perception network.Results: 1.There was no significant difference in the baseline of demography and disease related indexes between MMOA patients and healthy subjects(P > 0.05).There was no significant difference in the baseline of demographic and disease related indexes between acupoint group and non-acupoint group(P > 0.05).2.After three months of acupuncture treatment,the frequency of headache attack and the intensity of headache were significantly improved in MMOA group,and VAS-HIT-6 in non-meridian acupoint group was significantly improved after three months of acupuncture treatment compared with that in non-meridian acupoint group before and after treatment.3 months after acupuncture treatment,VASHIT-6 of MMOA patients in non-meridian acupoint group was significantly improved than that in non-meridian acupoint group.There was a significant difference in headache intensity and VAS between the two groups at the 4th week of treatment,but there was no significant difference between the two groups(P > 0.05).3.The local consistency of left middle cingulate gyrus,right caudate nucleus,left inferior frontal gyrus,left inferior occipital gyrus,left cerebral island and left superior temporal gyrus in MMOA patients were significantly higher than those in healthy controls.The local consistency of right cuneate lobe,left middle occipital gyrus,right superior frontal gyrus and right postcentral gyrus decreased significantly.4.After three months of treatment,the local consistency of bilateral anterior cingulate gyrus,bilateral middle cingulate gyrus,bilateral fusiform gyrus,left inferior frontal gyrus,left superior frontal gyrus and bilateral middle temporal gyrus in the meridian acupoint group were significantly increased,while the left cuneiform lobe,left inferior parietal lobule,left lingual gyrus,left cuneiform lobe,left inferior parietal lobe,left lingual gyrus,Right middle frontal gyrus,left occipital middle gyrus,bilateral thalamus local consistency decreased significantly.The local consistency of left middl e cingulate gyrus,left posterior cingulate gyrus,left middle frontal gyrus,right cerebral island,left parahippocampal gyrus,right posterior central gyrus,left precuneal lobe and right anterior cuneate lobe were significantly increased in non-meridian non-acupoint group,and right anterior cingulate gyrus.The local consistency of right inferior temporal gyrus,bilateral middle occipital gyrus,left middle temporal gyrus,right superior frontal gyrus,left superior temporal gyrus and right superior frontal gyrus were significantly decreased.5.The results of functional connectivity analysis of the secondary sensory cortex S2 on the posterior central gyrus were as follows: after three months of treatment,the functional connectivity of left cerebral is lets increased in the meridian group with S2 and left anterior cingulate gyrus.In non-meridian nonpoint group,the connection degree between S2 and bilateral thalamus and right cerebral island decreased,but increased with right occipital lobe.Conclusion: 1.By observing the clinical curative effect of acupuncture on MMOA patients,it was found that the pain intensity and headache times of MMOA patients after acupuncture at acupoints and non-acupoints were significantly improved compared with those before treatment.The results showed that acupuncture was effective for MMOA.Acupuncture at acupoints was more effective than non-meridian acupuncture in improving headache times.2.Compared with the healthy subjects,the local consistency of MMOA pa tients was mainly composed of S2 temporal lobe,posterior cingulate gyrus,and the executive network mainly composed of parietal lobe and frontal lobe.These abnormal brain functions may be central pathological factors of headache in patients with menstrual migraine.3.The S2 of postcentral gyrus was the most significant brain area in the meridian group and non-meridian group before and after treatment.4.It was found that the functional connection between S2 and anterior cingulate gyrus might be related to the disease course of MMOA by selecting S2 as the region of interest.The degree of functional connection of S2-anterior cingulate gyrus may be closely related to the improvement of headache intensity at acupoints in patients with MMOA.Non-meridian non-point may regulate MMOA patients through S 2-thalamus. |
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