Abstract / Summary
Objective: To investigate the temporal dynamics of cerebral blood flow (CBF) responses to Japanese-style acupuncture in patients with episodic migraine using arterial spin labeling (ASL) magnetic resonance imaging (MRI) and to compare these responses with those of healthy controls.
Methods: Patients with episodic migraine were recruited according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), and healthy volunteers without migraine served as controls. Japanese-style acupuncture was administered for 10 min at four clinically relevant cranio-cervical acupoints (ST8, ST6, GB21, and GB12) using nonmagnetic silver needles (0.2 mm in diameter). All acupuncture procedures were performed by the same licensed acupuncturist. CBF was assessed during the interictal period using repeated ASL MRI at baseline, during acupuncture stimulation (early and late phases), immediately after needle removal, and 15 and 30 min after stimulation.
Results: Eleven patients with episodic migraine (3 men and 8 women; mean age, 39.1 ± 4.6 years) and 11 healthy volunteers (4 men and 7 women; mean age, 32.3 ± 9.2 years) were included in the final analysis. Both groups demonstrated increased cerebral perfusion within the operculum, insula, cingulate cortex, and thalamus during acupuncture stimulation. In healthy controls, these perfusion changes gradually returned toward baseline following stimulation. In contrast, patients with episodic migraine exhibited more prolonged cerebral perfusion responses that persisted after needle removal and extended into frontal cortical regions. Compared with healthy controls, migraine patients demonstrated greater temporal persistence of cerebral perfusion modulation.
Conclusions: Temporally organized cerebral perfusion changes were observed during and after Japanese-style acupuncture in both healthy controls and patients with episodic migraine. Compared with healthy controls, patients with episodic migraine exhibited cerebral perfusion changes that remained evident during the poststimulation period. These exploratory findings suggest differences in the temporal dynamics of cerebral perfusion between the two groups. Further controlled studies are required to determine the specificity and physiological significance of these responses.
Trial registration: UMIN Clinical Trials Registry (UMIN-CTR): UMIN000005644.