Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: A randomized controlled trial on active acupoints and inactive acupoints

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Background: Acupuncture has been commonly used for preventing migraine attacks and relieving pain during a migraine, although there is limited knowledge on the physiological mechanism behind this method. The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical variables and brain responses. Methods and Results: A randomized controlled trial and resting-state functional magnetic resonance imaging (fMRI) were conducted. A total of eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks, and twenty patients in each group were randomly selected for the fMRI scan at the end of baseline and at the end of treatment. The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints. Most of the regions were involved in the pain matrix, lateral pain system, medial pain system, default mode network, and cognitive components of pain processing. Correlation analysis showed that the decrease in the visual analogue scale (VAS) was significantly related to the increased average Regional homogeneity (ReHo) values in the anterior cingulate cortex in the two groups. Moreover, the decrease in the VAS was associated with increased average ReHo values in the insula which could be detected in the active acupoint group. Conclusions: Long-term active acupoint therapy and inactive acupoint therapy have different brain activities. We postulate that acupuncture at the active acupoint might have the potential effect of regulating some disease-affected key regions and the pain circuitry for migraine, and promote establishing psychophysical pain homeostasis. Trial Registration: Chinese Clinical Trial Registry ChiCTR-TRC-13003635 Citation: Zhao L, Liu J, Zhang F, Dong X, Peng Y, et al. (2014) Effects of Long-Term Acupuncture Treatment on Resting-State Brain Activity in Migraine Patients: A Randomized Controlled Trial on Active Acupoints and Inactive Acupoints. PLoS ONE 9(6): e99538. doi:10.1371/journal.pone.0099538 Editor: Mario D. Cordero, University of Sevilla, Spain Received September 28, 2013; Accepted May 14, 2014; Published June 10, 2014 Copyright: 2014 Zhao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This study was supported by the National Basic Research Program of China (973 Program, No. 2012CB518501), National Natural Science Foundation of China (Nos. 30901900, 30930112, 81101108), the Project of Administration of Traditional Chinese Medicine of Sichuan Province (No. 2012-E-038), and the Project of Innovative Research Team Research Fund of Sichuan Provincial Education Department (No. 12TD002). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: acuresearch@126.com (FL); liujixin@life.xidian.edu.cn (JL)