Multi-Spatial Voxel-Scale Modulation of Acupuncture on Abnormal Brain Activity in Migraine Patients Without Aura: A Randomized Study Neuroimaging Trial

Abstract

Background: The role of acupuncture in treating migraine has been widely recognized, but the systematic, comprehensive and, multi-spatial voxel-scale mechanism of brain function changes is still unclear. Objective: Resting-state functional magnetic resonance imaging (rs-fMRI) was used to investigate the modulatory effect of acupuncture on brain activity in patients with migraine without aura (MwoA) at different spatial voxel scales. Methods: A total of 64 patients with MwoA were randomized into true acupuncture (TA) and sham acupuncture (SA) groups. MwoA patients received TA or SA three times a week for four weeks, a total of 12 sessions. A clinical symptoms assessment and rs-fMRI scans were evaluated before and after four weeks of treatment. Amplitude of low frequency fluctuation (ALFF) and fractional ALFF (fALFF), regional homogeneity (ReHo), and degree centrality (DC) were used to evaluate the spontaneous activity, activity coherence and connectivity importance of brain function at the single voxel, local voxel, and global voxel scales, respectively. Results: The clinical symptoms of both groups were improved compared with baseline. There were significant differences between the TA group and the SA group in migraine frequency, days and pain intensity. The neuroimaging data suggest that TA modulates a broader and more significant brain neural activity than SA. TA modulates the neural activity of the default mode network (DMN), visual network (VN), and sensorimotor network (SMN) at the single voxel scale, local voxel scale and global voxel scale, and these changes are correlated with the improvement of the migraine and quality of life. Conclusions: TA could exert therapeutic effects at different spatial voxel scales by modulating the DMN, VN, and SMN, which may be the neuroimaging mechanism of acupuncture for MwoA.