How does acupuncture release migraine?

Migraine is a common neurological disorder affecting millions of people around the world. The condition is characterized by recurrent headaches, often accompanied by other symptoms such as sensitivity to light and sound, nausea, and vomiting. The exact cause of migraine is not well understood, but it is believed to be related to the activation of the trigeminovascular system, which triggers an inflammatory response that results in pain and other symptoms. In recent years, acupuncture has emerged as a promising non-pharmacological treatment for migraine.

Acupuncture has been used for thousands of years to treat a wide range of conditions, including pain, anxiety, and depression.

Several studies have investigated the effectiveness of acupuncture for the treatment of migraine. One review analyzed data from 40 trials involving different types of migraine, including migraine without aura, chronic migraine, pediatric migraine, pure menstrual and menstrually related migraine, and acute migraine attack. The review found that acupuncture was at least as effective as medication in reducing pain intensity, duration, emotional comorbidity, and days of acute medication intake.

One proposed mechanism by which acupuncture may be effective in the treatment of migraine is by reducing neuroinflammation. Neuroinflammation is believed to be a key driver of migraine attacks. Activation of the trigeminovascular system results in the release of neuropeptides into the perivascular space, which triggers an inflammatory cascade reaction. This leads to a headache, and persistent neuroinflammation could provoke neuronal sensitization, ultimately leading to persistent impairment of brain functioning.

Acupuncture may reduce neuroinflammation by reducing the release of trigeminal-activated neuropeptides, inhibiting dural immune cells, and downmodulating inflammatory mediator levels. Additionally, acupuncture may reduce neuronal sensitization by reducing cytokine levels (BDNF, Glutamate), relieving neuronal activation in migraine-related brain areas, and modulating the endocannabinoid and serotonin systems.

In addition to its effects on neuroinflammation and neuronal sensitization, acupuncture has also been found to alter brain regions involved in pain perception, nociceptive emotional processing, and aura occurrence. For example, acupuncture has been found to modulate the activity of the default mode network (DMN) and amygdala, which are involved in nociceptive emotional processing. Acupuncture has also been found to alter activity in the occipital-temporal cortex, which is involved in aura occurrence.

Overall, the evidence suggests that acupuncture is a safe and effective non-pharmacological treatment for migraine. Acupuncture has been found to be at least as effective as medication in reducing pain intensity, duration, and frequency of attacks, as well as days of acute medication intake. Acupuncture may achieve these effects by reducing neuroinflammation, neuronal sensitization, and altering brain regions involved in pain perception, nociceptive emotional processing, and aura occurrence.

In conclusion, acupuncture is a promising non-pharmacological treatment for migraine. The evidence suggests that acupuncture is at least as effective as medication in reducing pain intensity, duration, and frequency of attacks, as well as days of acute medication intake. Acupuncture may achieve these effects by reducing neuroinflammation, neuronal sensitization, and altering brain regions involved in pain.

References
Ying Chen et al Front Neurosci. 2022; 16: 1022455.

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