Zhao Jing, Guo Liu-Xue, Li Hong-Ru, Gou Xin-Yun, Liu Xiao-Bo, Zhang Yue, Zhong Dong-Ling, Li Yu-Xi, Zheng Zhong, Li Juan, Feng Yue, Jin Rong-Jiang
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Front Neurosci. 2023 Jan 27;16:1097450. doi: 10.3389/fnins.2022.1097450. eCollection 2022.
BACKGROUND: Previous functional magnetic resonance imaging studies indicated that acupuncture could activate the brain regions in patients with migraine. However, these studies showed inconsistent results. This activation likelihood estimation (ALE) meta-analysis aimed to investigate the consistent activated change of brain regions between pre- and post-acupuncture treatment in migraineurs. METHODS: We conducted a literature search in PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, the Wanfang Database, and the Chinese Biomedical Literature Database from their inception to 18 August, 2022, to obtain articles assessing the functional magnetic resonance imaging changes of acupuncture for migraine. Two investigators independently performed literature selection, data extraction, and quality assessment. The methodological quality was assessed with a modified version of the checklist. The reporting quality of interventions among included studies was evaluated by the Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). Our meta-analysis was conducted according to the GingerALE software. The Jackknife sensitivity analysis was used to assess the robustness of the results. RESULTS: 14 articles were finally included according to the eligible criteria. Regarding the immediate effect of acupuncture on migraine, the ALE meta-analysis demonstrated that the deactivation regions were mainly located in the superior frontal gyrus, and middle frontal gyrus (uncorrected < 0.001). The ALE meta-analysis of the cumulative effect showed that the activation regions were the thalamus, superior frontal gyrus, posterior lobe of the cerebellum, insula, middle frontal gyrus, precentral gyrus, anterior cingulate, and the deactivation brain regions were located in the transverse temporal gyrus, postcentral gyrus, superior temporal gyrus, anterior cingulate, parahippocampal gyrus, inferior parietal lobule, and inferior occipital gyrus (uncorrected < 0.001). CONCLUSION: Acupuncture could activate multiple brain areas related with the regulation of pain conduction, processing, emotion, cognition, and other brain regions in patients with migraine. In the future, the combination of multiple imaging technologies could be a new approach to deeply investigate the central mechanism of acupuncture for migraine.
背景:以往的功能磁共振成像研究表明,针灸可激活偏头痛患者的脑区。然而,这些研究结果并不一致。本激活可能性估计(ALE)荟萃分析旨在探讨偏头痛患者针灸治疗前后脑区一致的激活变化。 方法:我们在PubMed、Embase、Web of Science、Cochrane图书馆、中国知网、中国科技期刊数据库、万方数据库和中国生物医学文献数据库中进行文献检索,检索时间从各数据库建库至2022年8月18日,以获取评估针灸治疗偏头痛的功能磁共振成像变化的文章。两名研究者独立进行文献筛选、数据提取和质量评估。采用修改后的清单评估方法学质量。纳入研究中干预措施的报告质量采用《针灸临床试验干预报告修订标准》(STRICTA)进行评估。我们的荟萃分析是根据GingerALE软件进行的。采用刀切法敏感性分析评估结果的稳健性。 结果:根据纳入标准,最终纳入14篇文章。关于针灸对偏头痛的即时效应,ALE荟萃分析表明,失活区域主要位于额上回和额中回(未校正P<0.001)。累积效应的ALE荟萃分析表明,激活区域为丘脑、额上回、小脑后叶、岛叶、额中回、中央前回、前扣带回,失活脑区位于颞横回、中央后回、颞上回、前扣带回、海马旁回、顶下小叶和枕下回(未校正P<0.001)。 结论:针灸可激活偏头痛患者多个与疼痛传导、处理、情绪、认知等调节相关的脑区以及其他脑区。未来,多种成像技术的结合可能是深入研究针灸治疗偏头痛中枢机制的新方法。
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