Acupuncture may reduce pain and improve function in patients with migraine without aura

1. In this randomized clinical trial, acupuncture effectively reduces pain and disability in migraine without aura, and baseline whole-brain functional connectivity can predict which patients are most likely to benefit.

Evidence Rating Level: 1 (Excellent) 

Migraine without aura (MWOA) is common and can significantly reduce quality of life, yet many patients do not have an adequate response to standard medications. Acupuncture is a safe, evidence-based alternative that modulates pain-processing brain networks, but it is unclear which patients will benefit most. Connectome-based predictive modelling (CPM), a whole-brain, data-driven neuroimaging approach, may identify brain connectivity patterns that predict acupuncture response. The goal of this study was to assess the clinical efficacy of acupuncture for MWOA and to use CPM to uncover neural signatures associated with treatment outcomes, supporting personalized therapy. The primary outcome is change from baseline in monthly migraine days (MMDs) over 4 weeks, while the secondary outcomes included monthly headache days (MHDs), acute medication use, pain intensity (VAS), disability (HIT-6), and quality of life (MSQ). This randomized clinical trial (RCT) enrolled eligible adults and assigned them 1:1 to receive either 12 sessions of real acupuncture targeting specific acupoints or sham acupuncture over 4 weeks. The 120 participants were split evenly between real and sham acupuncture and assessed, with improvements from baseline MMDs seen in the real group (median difference, −1.0; 95% CI, −2.0 to 0; P = .02). Significant differences were also seen in MHDs, acute medication use days, VAS score, HIT-6 and MSQ scores. Additionally, CPM showed differing neural signatures, with positive connectivity showing HIT-6 improvements (r = 0.29, P = .02), and negative connectivity showing VAS score reduction (r = 0.23, P = .04). Overall, acupuncture is effective for pain relief and functional improvement in MWOA.

Click here to read the study in JAMA Network Open

Image: PD

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