基于多模态磁共振成像的无先兆偏头痛针刺治疗疗效预测：一项研究方案
Efficacy prediction of acupuncture treatment for migraine without aura based on multimodal MRI: A study protocol.
作者信息
Cheng Shirui, Zhang Xinyue, Zheng Huabin, Jiang Nannan, Zhou Jun, Li Xinling, Fang Yu, Huang Xiaopeng, Liang Jingtao, Yin Tao, Liang Fanrong, Zeng Fang, Li Zhengjie
机构信息
Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Front Neurol. 2022 Oct 10;13:953921. doi: 10.3389/fneur.2022.953921. eCollection 2022.
INTRODUCTION
Acupuncture is an effective and safe therapy for patients with migraine without aura (MwoA), but only 41-59% of patients show improvement with this treatment. Screening positive responders to acupuncture treatment for MwoA can ensure that healthcare resources can be appropriately targeted to specific patients who would most benefit. The objective of this study is to determine whether the structure and functional activity in certain brain regions can predict analgesia response in patients with MwoA who receive acupuncture treatment.
METHODS AND ANALYSIS
A total of 72 patients with MwoA and 72 healthy controls (HCs) will be enrolled in this study. Resting-state structural and functional magnetic resonance imaging (MRI) data will be collected from each participant at baseline. Patients with MwoA will undergo 12 sessions of acupuncture treatment for 8 weeks, twice per week in the first 4 weeks and once per week for the last 4 weeks. The follow-up will be 12 weeks. The number of days with migraine, frequency of migraine attacks, and average visual analog scale scores will be recorded in detail at weeks 0, 4, 8, 12, and 16 and at the end of follow-up (week 20). The positive response rate will be calculated as the proportion of patients with ≥50% reduction in the number of migraine days during follow-up compared with baseline. Machine learning methods will be applied to classify patients with MwoA and HCs and predict patients with response or non-response to acupuncture treatment based on multimodal MRI parameters, such as gray matter volume, regional homogeneity, amplitude of low-frequency fluctuation, fractional anisotropy, and mean diffusivity.
DISCUSSION
This study aims to establish brain structural and functional characteristics that can identify patients with MwoA who will derive analgesia benefits from acupuncture treatment.
TRIAL REGISTRATION NUMBER
http://www.chictr.org.cn/showproj.aspx?proj=65443, identifier: ChiCTR2100042915.
引言
针刺疗法对无先兆偏头痛（MwoA）患者是一种有效且安全的治疗方法，但只有41%-59%的患者经此治疗后症状有所改善。筛选对MwoA针刺治疗有阳性反应的患者，可确保医疗资源能合理地针对最能从中获益的特定患者。本研究的目的是确定某些脑区的结构和功能活动是否能预测接受针刺治疗的MwoA患者的镇痛反应。
方法与分析
本研究将招募72例MwoA患者和72名健康对照者（HCs）。在基线时，将收集每位参与者的静息态结构和功能磁共振成像（MRI）数据。MwoA患者将接受为期8周的12次针刺治疗，前4周每周2次，后4周每周1次。随访期为12周。将在第0、4、8、12和16周以及随访结束时（第20周）详细记录偏头痛天数、偏头痛发作频率和平均视觉模拟量表评分。阳性反应率将计算为随访期间偏头痛天数较基线减少≥50%的患者比例。将应用机器学习方法对MwoA患者和HCs进行分类，并基于多模态MRI参数（如灰质体积、局部一致性、低频波动幅度、分数各向异性和平均扩散率）预测对针刺治疗有反应或无反应的患者。
讨论
本研究旨在确定脑结构和功能特征，以识别能从针刺治疗中获得镇痛益处的MwoA患者。
试验注册号
http://www.chictr.org.cn/showproj.aspx?proj=65443，标识符：ChiCTR2100042915。
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