The Modifying of Functional Connectivity Induced by Peripheral Nerve Field Stimulation using Electroacupuncture for Migraine: A Prospective Clinical Study

Objective We examined the functional connectivity (FC) in patients with migraine compared with healthy subjects before and after C2 peripheral nerve field stimulation with electroacupuncture (EA-C2-PNfS) to evaluate the effect of EA-C2-PNfS and elucidate the mechanism of migraine. Methods Twenty-six patients with migraine and 24 healthy controls were recruited. All patients underwent resting state functional magnetic resonance imaging before and after 3 months of EA-C2-PNfS. We evaluated a numerical rating scale, the Headache Impact Test, and the Self-Rating Depression Scale, which assesses depression. Healthy controls underwent magnetic resonance imaging twice at a 3-month interval without acupuncture. An analysis of FC in the region of interest in the pain matrix was performed. Results Twenty patients with migraine and 23 healthy controls (mean +/- standard deviation: 44.9 +/- 12.9 years of age) were included. Three patients had migraine with aura (55.0 +/- 18.0 years of age), 11 patients had migraine without aura (MWoA) (45.6 +/- 14.6 years of age), and six patients had chronic migraine (40.8 +/- 13.9 years of age). The clinical assessments significantly improved after EA-C2-PNfS in the MWoA group only. In FC analysis, the MWoA group showed a significant decrease after EA-C2-PNfS in FC between the right hypothalamus and left insula. Right hypothalamus-related FC was lower before acupuncture in the chronic migraine group than in the MWoA group. Conclusion After EA-C2-PNfS for MWoA, significant changes in FC were observed at the hypothalamus and insula. Our results indicate that EA-C2-PNfS could improve migraine headache by modifying pain-related FC.

Automated summary

This study aimed to investigate the effect of C2 peripheral nerve field stimulation with electroacupuncture (EA-C2-PNfS) on functional connectivity (FC) in patients with migraine and to elucidate the underlying mechanism. The results showed that FC in patients with migraine without aura (MWoA) significantly changed after EA-C2-PNfS, indicating that EA-C2-PNfS can improve migraine headache by modifying the connectivity between pain-related brain regions.