Changes of cerebrovascular response to visual stimulation in migraineurs after repetitive sessions of somatosensory stimulation (acupuncture): a pilot study.

OBJECTIVES

To evaluate the effect of repetitive somatosensory stimulation (acupuncture) on cerebrovascular response in migraineurs by functional transcranial Doppler.

METHODS

Changes of cerebral blood flow velocity in the right posterior and left middle cerebral arteries were measured by functional transcranial Doppler during visual stimulation (flickering light over 57 seconds) in 10 migraineurs before and after 10 acupuncture sessions. The same stimulation paradigm was performed in 10 control subjects. Cerebral blood flow velocity data were analyzed with a previously validated technique based on automated stimulus-related averaging. To evaluate the clinical effect of the treatment, a headache diary monitored the frequency and intensity of the migraine attacks. A positive treatment effect was defined as a reduction of at least 50% in the attack frequency or the mean headache intensity (or both).

RESULTS

Before treatment, migraineurs showed overshooting cerebral blood flow velocity changes at the beginning and at the end of the stimulation and a delayed decline to baseline compared with control subjects. After treatment, this response pattern was significantly diminished (P</=.05) in those who benefited from treatment (n = 6). Those who did not benefit from treatment (n = 4) showed a significantly (P</=.05) more marked alteration of the cerebral blood flow velocity pattern.

CONCLUSIONS

Data indicate that repetitive somatosensory stimulation (acupuncture) might positively influence the abnormal cerebrovascular response in migraineurs. In a subgroup of migraineurs, however, the dysfunction of the cerebrovascular system might deteriorate under the treatment.