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Evidence of Potential Mechanisms of Acupuncture from Functional MRI Data for Migraine Prophylaxis

  • Chronic Daily Headache (SJ Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To summarize the clinical neuroimaging evidence pertaining to the potential mechanisms of acupuncture for migraine prophylaxis.

Recent Findings

From a descriptive perspective, converging evidence from recent neuroimaging studies, mainly from functional MRI (fMRI) studies, has demonstrated that when compared with sham acupuncture, verum acupuncture could normalize the decrease of the functional connectivity of the rostral ventromedial medulla-trigeminocervical complex (RVM/TCC) network, frontal-parietal network, cingulo-opercular networks, and default mode network and could normalize sensorimotor network connectivity with sensory-, affective-, and cognitive-related brain areas. These areas overlap with those of the pain matrix. Verum acupuncture works in a more targeted and unique manner compared with sham acupuncture in patients with migraine.

Summary

These findings from neuroimaging studies may provide new perspectives on the validation of acupoints specificity and confirm the central modulating effects of acupuncture as a migraine prevention treatment. However, the exact mechanism by which acupuncture works for migraine prophylaxis remains unclear and warrants investigation. Future studies with larger sample sizes are still needed to confirm the current results and to further evaluate the complex and specific effects of acupuncture by analyzing different stimulus conditions, such as verum vs. sham acupuncture, deqi vs. no deqi, different acupuncture points or meridians, and different manipulation methods. Moreover, instead of focusing on the changes in a single area of the brain, researchers should focus more on the relationships among the functional connectivity network of brain areas such as the RVM/TCC, thalamus, anterior cingulate cortex (ACC), superior temporal gyrus (STG), and supplementary motor area (SMA) to explore the underlying mechanism of the effects of acupuncture.

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Funding

This study was supported by a grant from Kuang Tien General Hospital, Taichung, Taiwan, and Taipei Veterans General Hospital, Taipei, Taiwan. This research was supported by Ministry of Science and Technology, Taiwan (MOST109-2321-B-010-006), and Brain Research Center, National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan.

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Author notes

  1. Ching-Mao Chang and Chun-Pai Yang contributed equally to this work.

Authors and Affiliations

  1. Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Ching-Mao Chang

  2. Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Ching-Mao Chang & Shuu-Jiun Wang

  3. Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Ching-Mao Chang & Po-Hsuan Shih

  4. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Ching-Mao Chang

  5. Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan

    Chun-Pai Yang

  6. Department of Nutrition, Hungkuang University, Taichung, Taiwan

    Chun-Pai Yang

  7. Department of healthcare administration, Asia University, Taichung, Taiwan

    Cheng-Chia Yang

  8. Department of Chinese Medicine, Cheng Hsin General Hospital, Taipei, Taiwan

    Po-Hsuan Shih

  9. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, 11217

    Shuu-Jiun Wang

  10. Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Shuu-Jiun Wang

  11. College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Shuu-Jiun Wang

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Contributions

CMC, CPY, and SJW were responsible for the study concept, design, and review and interpretation of the data. CMC, CPY, CCY, and PHS were responsible for drafting the manuscript. SJW made modifications to the study design and revised the manuscript. CMC, CPY, and PHS contributed to the collection and analysis. CMC, CPY, and SJW contributed to the interpretation of the data and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shuu-Jiun Wang.

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Chang, CM., Yang, CP., Yang, CC. et al. Evidence of Potential Mechanisms of Acupuncture from Functional MRI Data for Migraine Prophylaxis. Curr Pain Headache Rep 25, 49 (2021). https://doi.org/10.1007/s11916-021-00961-4

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