Migraine watch: Keeping up with the most current research for acupuncture

A PubMed search of findings published in peer-reviewed journals shows that dedicated research is being actively carried out worldwide to establish acupuncture’s role in treatment, from mechanisms of action, to safety studies to comparison with medications. Click on the linked numbers to see the extracts.

In March 2015 the Michigan Head Pain and Neurological Institute report findings that ‘acupuncture seems to be at least as effective as conventional drug preventative therapy for migraine and is safe, long lasting, and cost-effective. It is a complex intervention that may prompt lifestyle changes that could be valuable in patients’ recovery’. (1)

Also in March 2015, in China Zhongguo et al. publish their research, concluding ‘the effect of point selection along affected meridian could be achieved possibly by regulating the MME gene expression.’ (2)

Again in April 2015, an Australian randomised controlled trial carried out by a research team comprised of the Health Innovations Research Institute, the Department of Medicine, Royal Melbourne Hospital and the School of Mathematical and Geospatial Science, RMIT University reports ‘manual acupuncture was an effective and safe treatment for short-term relief of frequent migraine in adults. Larger trials are warranted’. (3)

In April 2015, the Department of Neurology and Stroke Center, Dongzhimen Hospital report findings in the Chinese Journal of Integrated Medicine, ‘acupuncture treatment could increase the functional connectivity of brain regions in the intrinsic decreased brain networks in MWoA [migraine without aura] patients. The results provided further insights into the interpretation of neural mechanisms of acupuncture treatment for migraine. (4)

In June 2015, Zhou et al. report in the same publication that ‘The activation of MLCK [myosin light chain kinase] in the middle meningeal artery was increased by acupuncture at Fengchi (GB 20), indicating its effectiveness in preventing and curing on acute migraine attacks.’ (5)

In 2014 Gündüztepe et al. report in Acupuncture and Electrotherapeutics Research ‘acupuncture treatment appeared to be effective by lowering the levels of serum nitric oxide and acupuncture has cumulative effects. Although there are earlier studies showing the effect of NO in migraine, this has been the 1st study in this field, which shows the effect of acupunctureon NO in migraine patients’. (6)

Evidence collected from trials involving acupuncture over the last twenty years have established   acupuncture can help in the treatment of migraine by:

  • Providing pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurochumoral factors and changes the processing of pain in the brain and spinal cord (Zhao 2008, Zijlstra 2003, Pomeranz, 1987)
  • Reducing inflammation – by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007, Zijlstra 2003).
  • Reducing the degree of cortical spreading depression (an electrical wave in the brain associated with migraine) and plasma  levels of calcitonin gene-related peptide and substance P (both implicated in the pathophysiology of migraine) (Shi 2010).
  • Modulating extracranial and intracranial blood flow (Park 2009).
  • Affecting serotonin (5-hydroxytriptamine) levels in the brain (Zhong 2007). (Serotonin may be linked to the initiation of migraines; 5-HT agonists (triptans) are used against acute attacks.)

Published by the British Acupuncture Council

The National Institute for Clinical Excellence already recommend up to 10 sessions of acupuncture over 5-8 weeks for tension type headache, so I sincerely hope it will be only a matter of time before it is recognised as a mainstream treatment for migraine too, considering the great body of evidence now available. Nevertheless, thousands of people in the UK are seeking private treatment with acupuncture.

References:
Da Silva. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-3. doi: 10.1111/head.12525. Epub 2015 Feb 16.
 Zhongguo Zhong Xi Yi Jie He Za Zhi. Effect of acupuncture along affected meridian on the MME gene expression of migraine patients without aura of gan-yang hyperactivity syndrome. 2015 Mar;35(3):294-8.[Article in Chinese] Huang YL, Wan MY, Liang XS, Liang FR.
Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z. Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up. Epub 2015 Apr 28.
Zhang Y, Li KS, Liu HW, Fu CH, Chen S, Tan ZJ, Ren Y. Acupuncture treatment modulates the resting-state functional connectivity of brain regions in migraine patients without aura. Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China. Chin J Integr Med. 2015 Apr 6. 

Zhou P, Wang A, Li B, Liu C, Wang Y. Effect of acupuncture at Fengchi (GB 20) on the activity of myosin light chain kinase in the middle meningeal artery of migraine modeled rats.J Tradit Chin Med. 2015 Jun;35(3):301-5.

Gündüztepe Y, Mit S, Geçioglu E, Gurbuz N, Salkaci O, Severcan C, Cevik C. The impact of acupuncture treatment on nitric oxide (NO) in migraine patients. Acupunct Electrother Res. 2014;39(3-4):275-83.
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