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Acupuncture Modulation Effect on Pain Processing Patterns in Patients With Migraine Without Aura.
Frontiers in Neuroscience ( IF 3.2 ) Pub Date : 2021-08-26 , DOI: 10.3389/fnins.2021.729218
Zilei Tian 1, 2 , Yaoguang Guo 3 , Tao Yin 1, 2 , Qingqing Xiao 1 , Guodong Ha 1 , Jiyao Chen 1 , Shuo Wang 1 , Lei Lan 1, 2 , Fang Zeng 1, 2, 4
Affiliation  

INTRODUCTION In this retrospective study, resting-state functional connectivity (FC) in patients with migraine was analyzed to identify potential pathological pain processing patterns and compared them to those in healthy controls (HCs). The FC patterns in patients between pre- and post-acupuncture sessions were also analyzed to determine how acupuncture affects neurological activity and pain perception during the migraine interictal period. METHODS In total, 52 patients with migraine without aura (MwoA) and 60 HCs were recruited. Patients with migraine were given acupuncture treatment sessions for 4 weeks. As a primary observation, functional magnetic resonance images were obtained at the beginning and end of the sessions. HCs received no treatment and underwent one functional magnetic resonance imaging (fMRI) scan after enrollment. After the fMRI data were preprocessed, a region of interest (ROI)-to-ROI analysis was performed with predefined ROIs related to pain processing regions. RESULTS The first analysis showed significantly different FCs between patients with MwoA and HCs [false discovery rate corrected p-value (p-FDR) < 0.05]. The FCs were found to be mainly between the cingulate gyrus (CG) and the insular gyrus, the CG and the inferior parietal lobule (IPL), the CG and the superior frontal gyrus, and the middle frontal gyrus and the IPL. The second analysis indicated that acupuncture treatment partly restored the different FCs found in the first analysis (p-FDR < 0.05). Furthermore, subgroup analysis found different brain activity patterns in headache-intensity restored condition and headache-frequency restored condition. Lastly, the correlation analysis suggested a potential correlation between FCs and clinical symptoms (p < 0.05). CONCLUSION This study suggests that pain processing is abnormal in migraine, with significantly abnormal FCs in the frontal, parietal, and limbic regions. This finding could be a typical pathological feature of migraine. Acupuncture has been identified to relieve headache symptoms in two ways: it restores the pain processing function and regulates pain perception.

中文翻译:

针灸调节对无先兆偏头痛患者疼痛处理模式的影响。

引言 在这项回顾性研究中,分析了偏头痛患者的静息状态功能连接 (FC) 以确定潜在的病理性疼痛处理模式,并将其与健康对照组 (HC) 进行比较。还分析了针灸前后患者的 FC 模式,以确定针灸如何影响偏头痛发作间期的神经活动和疼痛感知。方法 总共招募了 52 名无先兆偏头痛 (MwoA) 患者和 60 名 HC。偏头痛患者接受了为期 4 周的针灸治疗。作为主要观察,在会议开始和结束时获得功能性磁共振图像。HC 未接受任何治疗,并在入组后接受了一次功能性磁共振成像 (fMRI) 扫描。在对 fMRI 数据进行预处理后,使用与疼痛处理区域相关的预定义 ROI 执行感兴趣区域 (ROI) 到 ROI 分析。结果 第一项分析显示 MwoA 和 HC 患者之间的 FC 存在显着差异 [错误发现率校正 p 值 (p-FDR) < 0.05]。FC主要位于扣带回(CG)与岛叶之间、CG与顶下小叶(IPL)、CG与额上回、额中回与IPL之间。第二次分析表明,针灸治疗部分恢复了第一次分析中发现的不同 FC(p-FDR < 0.05)。此外,亚组分析发现头痛强度恢复条件和头痛频率恢复条件下的大脑活动模式不同。最后,相关性分析表明,FCs 与临床症状之间存在潜在相关性(p < 0.05)。结论 本研究表明,偏头痛患者的疼痛处理异常,额叶、顶叶和边缘区域的 FCs 明显异常。这一发现可能是偏头痛的典型病理特征。针灸已被确定以两种方式缓解头痛症状:恢复疼痛处理功能和调节疼痛感知。
更新日期:2021-08-26
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