Study On The Central Effect Mechanism Of Acupuncture At Zuqiaoyin In The Treatment Of Shaoyang Headache On The Patient's Mood Stat

Background Migraine is a common chronic neurovascular disorder with a high incidence and disability rate,which seriously affects the quality of life of individuals and imposes a certain economic burden on society.In particular,migraineurs suffer from varying degrees of anxiety and depression,which interact with headache symptoms in a vicious cycle.Previous studies have shown that acupuncture treatment for migraine can improve headache symptoms as well as anxiety and depression in patients,and has a good safety profile,which is worthy of clinical promotion.The pathogenesis of migraine is not yet fully understood,and the central effect of acupuncture on anxiety and depression in migraine patients is still being explored.Our research team has found that acupuncture at Jing acupuncture points can not only relieve headache symptoms but also improve anxiety and depression,based on the "Gen-Jie" theory.Objective In this study,patients with migraine without aura(MwoA)were studied,and the ALFF method based on fMRI technique was used to investigate the central effect mechanism of acupuncture based on the "Gen-Jie" theory for the treatment of Shaoyang headache on the state of mind of MwoA patients,so as to provide an objective basis for acupuncture to improve the state of mind of MwoA patients and provide benign feedback in the treatment of migraine.Methods A total of 30 healthy subjects and 26 subjects who met the diagnostic criteria for MwoA and the inclusion and exclusion criteria for this trial were included in this study.The patients were divided into two groups:the test group and the control group.The test group was given acupuncture to the foot orthopedic yin and the control group was given acupuncture to non-menstrual non-acupuncture points.Both groups received 10 acupuncture sessions for 4 weeks.Healthy subjects were assessed on clinical scales,and MwoA patients were required to undergo a cranial fMRI scan and clinical scale evaluation before the start of the intervention and after the end of the intervention.The brain areas with changes in functional activity before and after the acupuncture intervention were observed using the analysis of low-frequency fluctuation amplitude;the Hospital Anxiety and Depression Scale(HADS),the Self-Assessment Anxiety Scale(SAS)and the Self-Assessment Depression Scale(SDS)were used to assess changes in the subjects’ state of mind before and after the acupuncture intervention;the Migraine-Specific Quality of Life Questionnaire(MSQ)was used to assess the patients’ quality of life before and after the acupuncture intervention.Results(1)There was a statistically significant difference in SAS and SDS scores in MwoA patients compared to healthy subjects(P<0.05).(2)There was no statistically significant difference in SAS,SDS,HADS and MSQ scores at baseline between test and control groups(P>0.05),and the two groups were comparable in terms of their state of mind and quality of life at baseline.(3)Compared with pre-treatment,there was a statistically significant difference in SAS scores after treatment in the test group(P<0.05),but there was no statistically significant difference in SDS and HADS scores after treatment(P>0.05);there was no statistically significant difference in SAS,SDS and HADS scores after treatment in the control group(P>0.05).(4)Compared with the pre-treatment period,there were statistically significant differences in the post-treatment MSQ and MSQ dimensions scores of the subjects in the test group(P<0.05);there were statistically significant differences in the post-treatment MSQ and functional limitation dimension(MSQ-R)scores of the control group(P<0.05),but the post-treatment emotional dimension(MSQ-E)and functional impairment dimension(MSQ-P)scores were There was no statistically significant difference(P>0.05).(5)After treatment,there were no statistically significant differences between the two groups in the scores of SAS,SDS,HADS dimensions,MSQ and MSQ dimensions(P>0.05),which were comparable.(6)Before treatment,there was no statistically significant difference between the two groups in terms of the scores on the Acupuncture Treatment Expectancy Evaluation Scale and the expected degree of symptom improvement(P>0.05),and the two groups were comparable.(7)Compared with the pre-treatment period,ALFF values in the right medial superior frontal gyrus,right insula and bilateral precuneus were increased and ALFF values in the left postcentral gyrus were decreased in the test group after treatment;ALFF values in the left medial superior frontal gyrus and left precuneus were increased and no brain areas with decreased ALFF values were found in the control group after treatment.(8)After the acupuncture intervention,ALFF values in the right paracentral lobule and the right precuneus were elevated in the test group compared with the control group,and no areas with significantly lower decreasing ALFF values were found.Conclusions(1)Compared to healthy individuals,migraine patients had significant anxiety and depression.(2)Acupuncture of GB44 was effective in improving the anxiety state and quality of life of Shaoyang headache patients,and did not significantly improve the depression state;acupuncture of non-meridian and non-acupuncture points had a moderating effect on the functional limitation dimension of quality of life of Shaoyang headache patients,but did not improve their anxiety and depression state or the emotional and functional impairment dimensions of quality of life.(3)Both acupuncture of GB44 and the non-meridian non-acupuncture points produced modulating effects on brain areas related to pain emotions and negative emotions.The main brain areas activated by acupuncture in GB44 include the precuneus,superior frontal gyrus and insula,while the main brain areas activated by acupuncture in the non-transverse non-acupuncture points are the precuneus and superior frontal gyrus.Combined with the improvement in anxiety in the test group of MwoA patients and the differences between groups,the modulation of insula activity by acupuncture may be one of the central mechanisms responsible for its effect.(4)Acupuncture of GB44 improves migraine-related dysfunction in MwoA patients,which may be achieved by acupuncture modulating the functional activity of the postcentral gyrus.