Acupuncture at Zuqiaoyin (GB44) Modulates Regional Brain Activity in Migraine Without Aura: A Resting-State Functional Magnetic Resonance Imaging Study.

BACKGROUND: Migraine is considered a common neurological disorder. Acupuncture at Zuqiaoyin (GB44) is effective in the treatment of migraine without aura, but its central mechanism is still unclear. OBJECTIVES: The purpose is to compare the therapeutic effect and brain functional activity difference between acupuncture at GB44 and nonacupoints and explore the central affect mechanism of acupuncture in the treatment of migraine without aura. METHODS: Our study is a randomized controlled trial. A total of 20 patients with migraine without aura were included in the study. Twelve patients received acupuncture at GB44 as the acupuncture group and eight patients received acupuncture at nonacupoints as the sham acupuncture group. Both groups received a 10-time acupuncture intervention for 1 month. Visual analogue scale (VAS) score evaluated the clinical outcomes of acupuncture. Resting-state functional magnetic resonance imaging (fMRI) and fractional amplitude of low frequency fluctuation (fALFF) analysis were adopted to compare differences of brain functional activity between the two groups. RESULTS: We found that improvements in headache severity and migraine-related quality of life in both groups after a 4-week acupuncture intervention but better clinical improvement were observed in the acupuncture group. A decreased fALFF in the right superior frontal gyrus, right insula, and right precuneus and an increased fALFF in the left postcentral gyrus and left precuneus were observed in the acupuncture group, while a decreased fALFF was observed in the left superior frontal gyrus and left precuneus in the sham acupuncture group. The acupuncture group showed a higher fALFF in the right precentral gyrus and right precuneus than the sham acupuncture group. CONCLUSION: Acupuncture at GB44 can significantly relieve the clinical symptoms and improve the quality of life of patients with migraine without aura. More importantly, acupuncture at GB44 can cause changes of brain activity in migraine-affected key regions, which may be one of the central mechanisms of acupuncture in the treatment of migraine without aura. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2000033995.