For many migraine sufferers, tablets are not always enough, or end up causing other problems. So some turn toacupuncturesometimes with good results, sometimes without obvious effect. A Chinese team has just provided more solid evidence: in a rigorous clinical study, acupuncture reduced the pain of patients suffering from migraine without aura, and brain examinations made it possible to identify those who benefited the most.
Acupuncture: a trial on migraine without aura
This form called
migraine without aurathe most common, manifests itself as painful attacks without warning visual or sensory signs. Intense throbbing pain can really impair patients’ quality of life. Conventional treatments, whether taken for prevention or at the time of the crisis, are not always effective or well tolerated in the long term. In this trial, the researchers not only asked whether acupuncture worked better than a fake treatment: they also scanned the brain to look for a “profile” of a good responder.
The study, conducted at the Beijing Hospital of Traditional Chinese Medicine between 2021 and 2023, included 120 adults aged 18 to 65 (mean age 36.8 years, 79% female) suffering from migraine without aura. They were randomly divided into two groups: real treatment, with needles placed on 8 standard points for 30 minutes, and fake acupuncture, with superficial needles on “non-active” points. Each participant received 12 sessions over four weeks and kept a diary of their seizures.
After one month, both groups had fewer migraine days, with an advantage for real acupuncture: on median, 1 fewer migraine day per month compared to the control group. The pain decreased further (−1 point on the scale of 0 to 10). Disability (HIT-6 score) decreased by 8.3 points compared to 5.4, as did the consumption of medication to manage crises. Result: the quality of life measured by the MSQ improved significantly and these patients were able to resume their daily activities more easily, their headaches bothering them more. Adverse effects, rare and mild, were comparable in the two groups.
Functional MRI identifies the brains of good responders
Before the first session, each participant took a
Functional MRI. The researchers identified two connectivity patterns that better predicted the response.
- Lower connectivity between the default mode network and deeper regions including the cerebellum (coordination center) was linked to greater pain reduction;
- Stronger connectivity between the coordination centers and the motor network heralded a reduction in disability.
“These results highlighted core functional connectivity markers associated with improved outcomes and provided objective neuroimaging biomarkers for personalized treatment“, write the authors.
Towards more personalized treatments for migraine
This work indicates that theacupuncture can provide additional relief in migraine without aura and works well on the brain. They also suggest that targeted imaging could, in the future, help choose the patients most likely to benefit from it.
These results confirm that acupuncture can represent a credible complementary option compared to traditional treatments, which are sometimes poorly tolerated. And open the way to more targeted care, based on objective criteria.