The Effects Of Needling Different Groups Of Acupoints On The Brain Regional Homogeneity In Migraine Patients:a Resting-state FMRI Study

Objective:To observe the clinical effects and brain regional homogeneity in migraine patients by the treatment of needling different groups of acupoints as to study the cerebral mechanism of acupuncture different groups of acupoints for migraine.By different groups of acupuncture point in the treatment of migraine patients observed after treatment efficacy and impact on brain function Regional homogeneity (ReHo).Methods:1.50patients with migraine were randomly divided into treatment group (group A) and control group (group B)(n=25). Bilateral Fengchi(GB20), Waiguan(SJ5), Yanglingquan(GB34),Qiuxu(GB40) were selected to treat for A-group while bilateral Erheliao (SJ22), Daling (PC7), Guangming (GB37), Taibai (SP3) were chosen fo B-group. The therapy was adopted once every other day for needling with retaining the needles for30minutes,8times succession treatment as one course, and4coures for32days. Observation period of16weeks, including baseline period (-4to0weeks), period of eight weeks of treatment (0to8weeks) and follow-up4weeks (8-12weeks). The migraine degree of the patients were evaluated before the treatment and4th,8th,12th week of treatment.The frequency.duration, visual analogue scale and scoring method scores were recorded before and after the course of treatment as well as in follow-up visit.2.2times of fMRI scanning were adopted including once in3days before the course of treatment and once in3days after the course of treatment.Results:1. Comparing the conditions before the course of treatment and in8thweek,12th of the treatment,the average duration in8th of the treatment in A-group and the frequency of migraine in B-group were not different from the results before the course of treatment(P>0.05),while there were significant difference among other indexes(P>0.05).In the12th week of the treatment, the average duration of A-group was significantly different from the B-group(P>0.05) while other index-es were no obviously differences between the two groups.2. After the course of treatment, A-group shoewd the increased regional homegeneity in the bilateral anterior cing-ulate cortex (ACC), insula, the right side of the lentiform nucleus of limbic system; the bilateral ventral posterior medial nucleus, ventral posterior lateral nucleus, thalamus papillae, right ventrolateral nucleus, the left medial dorsal nucleus and pulvinar thalami of thalamus; the bilateral anterior central gyrus (ACG) and the right inferior frontal gyrus (IFG); the bilateral inferior temporal gyrus (ITG), superior temporal gyrus (STG) and transverse temporal gyrus (TTG); the bilateral cuneus, lingual gyrus and the right middle occipital gyrus; the bilateral posterior central gyrus (PCG); culmen of cerebellum; the bilateral pons and medulla; the right mesencephalic substantia nigra and nucleus ruber. The decreased regional homogeneity of the group in the bilateral middle cingulate gyrus, posterior cingulate gyrus and the left hippocampal gyrus of limbic system; the bilateral middle frontal gyrus, medial frontal gyrus and superior frontal gyrus (SFG); the bilateral middle temporal gyrus (MTG) and the left inferior temporal gyrus (ITG); the left inferior occipital gyrus; the bilateral angular gyrus, precuneus, supramarginal gyrus, the right inferior parietal lobule and the left superior parietal lobule; the bilateral tonsil, the right culmen, the left lingual, declive and nodules of cerebellum.The B-group showed the increased regional homogeneity in the right posterior cingulate cortex, caudate nucleus, insula and the left anterior cingulate cortex of limbic system; the bilateral SFG, MFG and the right IFG; the bilateral STG, MTG and the right supramarginal gyrus, the right middle occipital gyrus; the left declive and uvula of cerebellum. The decreased regional homogeneity were in the bilateral insula, parahippocampal gyrus, the left cingulate gyrus of limbic system; the bilateral MFG, the right SFG、MFG、IFG; the left STG、MTG; the right lingual gyrus and the left fusiform gyrus; the bilateral inferior parietal lobule and the right posterior central gyrus; the right declive, the left culmen and tonsil of cerebellum.Conclusions:1. Needling the two groups of acupoints could reduce the frequency, duration, visual analogue scale and scoring method scores of migraine. On the average duration, there was significant difference between A-group and B-group. The study preliminarily indicated that acupuncture had effect on migraine. It requires a further study to demonstrate whether curative effect of acupuncture different groups of acupoints has a significant difference.2. The brain regional homogeneity in migraine patients by the treatment of needling different groups of acupoints indicated that the increase of congruent regional homogeneity of ACC and prefrontal lobe was possibly related with expectation effect of patients for acupuncture to improve headache symptoms. And the specific increase of congruent regional homogeneity of brainstem and thalamus in treatment group could have relationship with the regulation of the medial and lateral pain system.