Gene expression microarray analysis of the spinal trigeminal nucleus in a rat model of migraine with aura

Cortical spreading depression can trigger migraine with aura and activate the trigeminal vascular system. To examine gene expression profiles in the spinal trigeminal nucleus in rats following cortical spreading depression-induced migraine with aura, a rat model was established by injection of 1 M potassium chloride, which induced cortical spreading depression. DNA microarray analysis revealed that, compared with the control group, the cortical spreading depression group showed seven upregulated genes-myosin heavy chain 1/2, myosin light chain 1, myosin light chain （phosphorylatable, fast skeletal muscle）, actin alpha 1, homeobox B8, carbonic anhydrase 3 and an unknown gene. Two genes were downregulated-RGD1563441 and an unknown gene. Real-time quantitative reverse transcription-PCR and bioinformatics analysis indicated that these genes are involved in motility, cell migration, CO2/nitric oxide homeostasis and signal transduction.

Comparison of Pharmacological Treatment Versus Acupuncture Treatment for Migraine Without Aura——Analysis of Socio-medical Parameters

This study was carried out in 120 patients affected by migraine without aura, treated in 4 public health centers and randomly divided into acupuncture group (AG) and conventional drug therapy group (CDTG). The evaluation of clinical results was made 6 and 12 months after the beginning of treatment and was worked out as well according to socio-medical parameters. Acupuncture was applied to the following points: Touwei (ST 8), Xuanlu (GB 5), Fengchi (GB 20), Dazhui (GV 14), Lieque (LU 7), treated with the reducing method. In AG, the figure scoring the entity and frequency of migraine attacks drops from 9,823 before treatment to 1,990 6 months after and 1,590 12 months after; while in CDTG, it drops from 8,405 before treatment to 3,927 6 months after and 3,084 12 months after. In AG, the total absence from work amounted to 1,120 working days/year, with a total cost (private + social costs) of 186,677,000 Italian liras. In CDTG, the absence from work amounted to 1,404 working days/year, with a total cost of 266,614,000 Italian liras. If we consider that in Italy the patients affected by migraine without aura are around 800,000, and that acupuncture therapy is able to save 1,332,000 Italian liras on the total average cost supported for every single patient, the application of acupuncture in the treatment of migraine without aura would allow a saving of the health expenses in Italy of over 1,000 billion liras.

Acupuncture Treatment Modulates the Resting-State Functional Connectivity of Brain Regions in Migraine Patients without Aura

Objective： To investigate the modulatory effect of acupuncture treatment on the resting-state functional connectivity of brain regions in migraine without aura （MWoA） patients. Methods： Twelve MWoA patients were treated with standard acupuncture treatment for 4 weeks. All MWoA patients received resting-state functional magnetic resonance imaging （fMRI） scanning before and after acupuncture treatment. Another 12 normal subjects matched in age and gender were recruited to serve as healthy controls. The changes of resting- state functional connectivity in MWoA patients before and after the acupuncture treatment and those with the healthy controls were compared. Results： Before acupuncture treatment, the MWoA patients had significantly decreased functional connectivity in certain brain regions within the frontal and temporal lobe when compared with the healthy controls. After acupuncture treatment, brain regions showing decreased functional connectivity revealed significant reduction in MWoA patients compared with before acupuncture treatment. Conclusions： Acupuncture treatment could increase the functional connectivity of brain regions in the intrinsic decreased brain networks in MWoA patients. The results provided further insights into the interpretation of neural mechanisms of acupuncture treatment for migraine.

Acupuncture for migraine without aura:a systematic review and metaanalysis

Background： Migraine without aura （MWoA）, the most common type of migraine, has great impacts on quality of life for migraineurs. Acupuncture is used in the treatment and prevention of migraine for its analgesic effects. Objective： The aim of this systematic review and meta-analysis is to systematically assess the therapeutic and preventive effect of acupuncture treatment and its safety for MWoA,Search strategy： Nine electronic databases （PubMed, MEDLINE, Cochrane Library, Lilacs, Embase, China National Knowledge Infrastructure （CNKI）, Chongqing VIP （CQV1P）, Wanfang Data and Chinese Clinical Trial Registry （ChiCTR）） were systematically searched from their beginning through June 2017 using MeSH terms such as ＂acupuncture, acupuncture therapy, electro-acupuncture, ear acupuncture, acupuncture points, acupuncture analgesia,＂ and ＂migraine disorders, cluster headache.＂ Manual searching included other conference abstracts and reference lists. Inclusion criteria： Randomized controlled trials （RCTs） with a clinical diagnosis of MWoA, which were treated with acupuncture versus oral medication or sham acupuncture treatment. Data extraction and analysis： Two evaluators screened and collected literature independently; they extracted information on participants, study design, interventions, follow-up, withdrawal and adverse events and assessed risk of bias and quality of the acupuncture intervention. The primary outcomes were frequency of migraine （FM） and number of migraine days （NM）. Secondary outcomes included the visual analogue scale （VAS） score, effective rate （ER） and adverse events. Pooled estimates were calculated as mean difference （MD） with 95% confidence interval （CI） for continuous data and relative risk （RR） with 95% CI for dichotomous data. Results： Overall, 14 RCTs including 1155 participants were identified. The analysis found that acupunc- ture had a significant advantage over medication in reducing FM （MD）=-1.50; 95% CI： -2.32 to -0.68; P〈 0.001） and VAS score （MD =0.97; 95% CI： 0.63-1.31; P〈 0.00001） and had a higher ER （RR = 1.30; 95Z Cl： 1.16-1.45; P 〈 0.00001）. Acupuncture also had a significant advantage over sham acupuncture in the decrease of FM （MD = -1.05; 95% CI： -1.75 to -0.34; P=0.004） and VAS score （MD = -1.19; 95g CI： -1.75 to -0.63; P〈 0.0001）. Meanwhile, acupuncture was more tolerated than medication because of less side effect reports （RR= 0.29; 95% CI： 0.17-0.51; P〈 0.0001）. However, the quality of evidence in the included studies was mainly low （to very low）, making confidence in the FM and VAS score results low. Conclusion： Our meta-analysis shows that the effectiveness of acupuncture is still uncertain, but it might be relatively safer than medication therapy in the treatment and prophylaxis of MWoA. Further proof is needed.

Effect and Safety of Penetrating Moxibustion in Treatment of Migraine without Aura:A Randomized Controlled Trial

Objective To observe the clinical effect of penetrating moxibustion on migraine without aura(MO)patients.Methods Totally 60 MO patients from the Acupuncture Clinic of the Third Affiliated Hospital of Henan University of Chinese Medicine were collected from November 2015 to February 2017.All patients were assigned to a treatment group and a control group using a random number table,30 cases in each group.The treatment group was treated with penetrating moxibustion,and the control group was treated with mild moxibustion,thrice a week for 4 consecutive weeks.The total effective rate,Visual Analogue Scale(VAS)scores,headache intensity,and Migraine Specific Quality of Life Questionnaire(MSQ)scores of patients after treatment were compared between the two groups.The moxibustion sensation and reaction after moxibustion were observed,and the adverse reactions were evaluated.All patients were followed up at 4 and 16 weeks after treatment.Results The total effective rate of the treatment group was significantly higher than that of the control group(93.33%vs.80.00%,P<0.05).The improvement of VAS scores,headache intensity,and the role restrictive and role preventive scores in MSQ in the treatment group was better than those in the control group(P<0.05).The person-time of moxibustion sensations of itching,numbness and cold as well as flushing and sweating after moxibustion in the treatment group was all significantly higher than that in the control group(P<0.01).There was no significant difference in safety evaluation between the two groups(P>0.05).Conclusions Penetrating moxibustion can significantly relieve pain and improve quality of life of MO patients.After penetrating moxibustion,flushing and sweating of patients were obvious,and the curative effect was superior to the mild moxibustion.