Mechanism Of Acupuncture Influence On Local Functional Network Of Menstrual Migraine Without Aura

Objects In this study,we conducted a resting-state f MRI study on menstrual migraine without aura patients and healthy subjects by focusing on differences of the brain network.Findings revealed different intrinsic neural activity and functional networks on pathological or physiological state and regulating effect of acupuncture therapy on it's function,then provided insight into the mechanism of acupuncture.Methods Thirty participants with menstrual migraine without aura and twenty-four gender-and age-matched healthy subjects were assigned into our study.All patients with menstrual migraine without aura were randomly assigned into Group A(puncturing on meridian points)and Group B(puncturing on sham acupoints),with 15 people in each group.We chose bilateral acupoints in group A including GB20,GB8,PC6,SP6,LR3.We chose bilateral meridian acupoints in roup A and sham-acupoints 1-5 in group B.We started our first treatment prior to the week of the menstruation,with 3 times a week and 2 times in the rest of the week.Total 27 sessions of acupuncture treatments were completed in 3 months.Basic information,mental state,lab tests and f MRI data of all participants were collected at the baseline and at the end of the therapy.We completed the following analysis:1.We compared the differences of the clinical indicators before and after the acupuncture treatments.2.By comparing Re Ho signal and FC between patients and HCs,we discussed the unique character of the patients.3.By comparing Re Ho signal and FC between group A and group B,we discussed the modulation effect of acupuncture.4.By comparing FC before and after acupuncture,we analyzed clinical and imaging data aiming to detect the correlation between clinical outcome improvements and f MRI signal changes after acupuncture,then further explore the regulating mechanism of acupuncture on resting-state functional networks patients with menstrual migraine without aura.Results 1.Baseline comparison results were basically comparable between patients and healthy subjects,with their baseline comparison were comparable between two groups of patients(P>0.05).Baseline comparison results were basically comparable between Group A(puncturing on meridian points)and Group B(puncturing on sham acupoints),with their baseline comparison were comparable between two groups of patients(P>0.05).2.At the baseline,it was bilateral hippocampus,left anterior cingulum,left middle cingulum,bilateral amygdala where the Re Ho signal became lower when comparing between patients and healthy subjects.Re Ho signal became higher in bilaterial inferior parietal lobe,bilaterial post-central lobe,bilaterial precuneus lobe,bilaterial angular,bilaterial superior occipital lobe,bilaterial postcingulate lobe,left thalamus,right middle frontal gyrus.Compared with HCs,the functional connectivity between hippocampus and dorsolateral prefrontal cortex,bilateral thalamus,bilateral amygdala,left middle temporal lobe and right cerebellum decreased in patients with menstrual migraine without aura.The duration of disease was negatively correlated with the connectivity.3.After three-months intervention,participants from Group A improved in frequency of onset,VAS,headache intensity scale,HIT-6,MSQ functional deficiency,and MSQ functional inability(P?0.05).The duration of headache,MSQ emotional deficiency,Self-Rating Anxiety Scale,Self-Rating Depression Scale did not show obvious improvement.While in Group B,VAS,headache intensity scale,HIT-6,MSQ functional deficiency,MSQ functional inability,SDS improved significantly(P?0.05).The Frequency of onset,duration of headache,MSQ emotional deficiency,SAS did not show obvious improvement.Howerer,there is no differences between groups(P>0.05).4.After puncturing on acupoints from meridians,Re Ho was higher in bilateral superior temporal lobe,bilateral hippocampus,bilateral cerebellum,bilateral thalamus.Re Ho was lower in bilateral superior frontal lobe,right middle occipital lobe,left inferior occipital lobe,right anterior cingulate and right middle cingulate.In the sham points group,Re Ho was higher in left cerebellum and left middle cingulate.Re Ho was lower in left hippocampus,right precentral lobe,left middle temporal lobe and and right occipital lobe.After puncturing on acupoints from meridians,the connectivity between hippocampus and DLPFC,bilateral brainstem increased.The change of number of headache attacks and headache intensity was negatively correlated with the connectivity.After puncturing on sham acupoints,the connectivity between hippocampus and bilateral thalamus,right anterior cingulate decreased,the connectivity between hippocampus and right occipital lobe increased.The change of SAS was negatively correlated with the connectivity.Conclusions 1.Acupuncture improved clinical symptoms and emotional and quality of life in patients with menstrual migraine without aura.However,because of the limitation of number of patients and the short duration of observation,further studies were still in need to get deep investigation.2.Compared with HCs,patients with menstrual migraine without aura showed abnormal Re Ho changes in parietal lobe,prefrontal lobe,occipital lobe,and limbic system.The duration of disease was negatively correlated with the connectivity of hippocampus and DLPFC.3.Hippocampus was the brain area where the Re Ho changes obviously when compared with group A and group B.4.The change of FC between hippocampus and DLPFC was correlated with headache attack numbers and headache intensity.Puncturing at acupoints regulate the functional network between key nodes of hippocampus and DLPFC.The change of FC between hippocampus and anterior cingulate was correlated with the change of SAS.Puncturing at sham-acupoints regulate the functional network between key nodes of hippocampus and anterior cingulate.