| ObjectiveThis study was conducted on patients with menstrual migraine.Based on the observation of the clinical efficacy of acupuncture in the treatment of pain and mood disorders in patients with menstrual migraine,fMRI was used to explore the differences in local brain function between patients and healthy subjects.ALFF and ReHo methods were used to investigate the neuroimaging mechanism of the onset of menstrual migraine and the central mechanism of acupuncture in the regulation of mood disorders in patients with menstrual migraine.In addition,the correlation analysis was carried out in combination with the clinical effect indexes of the patients,so as to provide scientific basis for the clinical application of acupuncture in the treatment of menstrual migraine.MethodA total of 46 patients with menstrual migraine and 27 healthy subjects were included in this study.Patients were randomly divided into acupoint group and non-acupoint group,total 27±6 sessions of acupuncture treatments were completed in 3 months.Healthy subjects receive resting-state fMRI scan and clinical evaluation before treatment,and patients receive resting-state fMRI scan and clinical evaluation before and after treatment respectively to complete the following analysis:1.By comparing ALFF and ReHo in resting state between patients with menstrual migraine and healthy subjects,the characteristics of local brain functional activity in patients with menstrual migraine and healthy subjects were discussed.2.By comparing the emotional state(SAS,SDS score),headache frequency and headache degree(VAS score,headache intensity)of menstrual migraine patients before and after treatment in two groups,the clinical effect of acupuncture on menstrual migraine patients was discussed.3.By comparing the similarities and differences between ALFF and ReHo in acupoint group and non-acupoint group after acupuncture treatment,the changes in brain functional activities and the improvement of emotional state indexes were analyzed,so as to further explore the central nervous mechanism of acupuncture in regulating mood disorders in patients with menstrual migraine.Results1.Baseline data of patients with menstrual migraine and healthy subjects were balanced and comparable(P>0.05).The data of patients in acupuncture group and non-acupoint group were balanced and comparable(P>0.05).2.There were significant differences in SAS and SDS scores between the patients and healthy subjects(P<0.05),indicating that the patients had significant symptoms of anxiety and depression compared with healthy subjects.3.After acupuncture treatment,SAS,SDS score,headache frequency,VAS score and headache intensity in the acupoints group were significantly improved compared with those before treatment(P<0.05);Non-acupoint group's SAS,SDS score,VAS score and headache intensity of patients were significantly improved after acupuncture treatment compared with those before treatment(P<0.05).The clinical effects of headache attacks in acupoint group is better than non-acupoint group(P<0.05).There were significant differences in the headache intensity after four weeks treatment between the two groups(P<0.05).As for other indexs,there is no significant difference between the two groups(P> 0.05).4.Results of the study on local brain functional activity in patients with menstrual migraine and healthy subjects.(1)Compared with healthy subjects,the ALFF values of bilateral caudate and right precuneus were significantly increased and the ALFF values of right middle temporal gyrus were significantly decreased in patients with menstrual migraine,and the changes in the ALFF values of the middle temporal gyrus were positively correlated with the VAS values of headache onset in patients(P<0.05).(2)Compared with healthy subjects,the bilateral lingual gyrus,left middle occipital gyrus ReHo values significantly increased in patients with menstrual migraine,and left thalamus ReHo value significantly decreased,and there was no significant correlation between ReHo value changes in brain regions and patients' condition baseline data(P>0.05).5.Effects of acupuncture on local brain function in patients with menstrual migraine.(1)After acupuncture treatment in the acupoint group,the ALFF value of the left anterior cingulate gyrus and the right inferior frontal gyrus decreased significantly,and the ALFF value of the right middle frontal gyrus increased significantly,the change of the ALFF value of the anterior cingulate gyrus was significantly positively correlated with the improvement of SAS and SDS scores(P<0.05).After treatment,the ReHo value of the left cuneus,right superior frontal gyrus and right middle frontal gyrus was significantly increased,and the ReHo value of the right superior temporal gyrus was significantly decreased.There was no significant correlation between the changes of ReHo value in the acupoint group and the clinical indexes(P>0.05).(2)After treatment in non-acupoint group,ALFF values of the right lingual gyrus and left insula were significantly increased,but no brain regions with significantly decreased ALFF values were found.The ReHo value of the left insula was significantly increased,and no brain region with significantly decreased ReHo value was found.There was no significant correlation between the changes of brain local function and clinical indexes in the non-acupoint group(P>0.05).Conclusion1.Acupuncture both on acupoint and non-acupoint can significantly improve the emotional state,headache degree and other clinical indicators of patients with menstrual migraine.Acupuncturing on acupoint can significantly improve the headache frequency than acupuncture on non-acupoint.2.Correlational analysis of ALFF changes in brain regions in patients with menstrual migraine with baseline data shows that precuneus local functional changes associated with the emotional state.Changes in local function in the middle temporal gyrus were associated with headache severity.By comparing the analysis of local brain function activities of MM patients and healthy subjects,basal ganglia-occipital lobe-thalamus may be the core brain areas of pain processing in MM patients.These abnormal brain areas may be key factors for headache and mood disorders in patients with menstrual migraine.3.After acupuncture treatment,local brain function changes in the acupoint group were mainly concentrated in the prefrontal lobe-limbic area.Acupuncture on acupoints may regulate the brain function changes in the prefrontal lobe-limbic system of patients with MM,so as to regulate the negative emotions of patients.4.After acupuncture treatment,ALFF value and ReHo value of the left insula were both increased,indicating that acupuncture activated the neuron activity in the insula of MM patients.Non-acupoint treatment may exert the placebo effect through the insula to improve the pain experience of patients and indirectly regulate the negative emotions of MM patients. |
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