Acupuncture for Migraine Without Aura and Connection-Based Efficacy Prediction: A Randomized Clinical Trial.

Researchers in China studied whether acupuncture could help people suffering from migraine without aura, a type of migraine that occurs without warning signs like visual disturbances. The study included 120 participants who were randomly assigned to receive either real acupuncture at specific points or sham acupuncture at non-therapeutic locations over four weeks (12 sessions total). The scientists also used brain imaging to see if they could predict who would benefit most from treatment. The results showed that real acupuncture was significantly more effective than sham acupuncture. Participants receiving real acupuncture experienced fewer migraine days per month, fewer total headache days, and needed less pain medication. They also reported reduced pain intensity, less disability from their headaches, and better quality of life in daily activities and emotional well-being. Importantly, the brain imaging revealed specific connectivity patterns that could predict treatment success. People with certain brain network characteristics—particularly involving connections between the default mode network and subcortical regions—were more likely to experience pain relief from acupuncture. Similarly, different connectivity patterns involving motor regions predicted who would see the greatest reduction in headache-related disability. This research suggests that acupuncture is an effective treatment for migraine without aura and that brain imaging might one day help practitioners identify which patients are most likely to benefit from this approach, enabling more personalized treatment planning. If you're considering acupuncture for migraines, seek a licensed acupuncturist with experience treating headache disorders.

This single-blind randomized controlled trial (n=120) evaluated acupuncture efficacy for migraine without aura using connectome-based predictive modeling (CPM) of baseline fMRI data. Participants received 12 sessions over 4 weeks of either real acupuncture (8 points with deqi) or sham acupuncture. Real acupuncture demonstrated statistically significant superiority across all outcomes: monthly migraine days (median difference -1.0, P=0.02), monthly headache days (-1.0, P=0.01), acute medication use (-1.0, P=0.02), VAS pain scores (-1.0, P=0.02), HIT-6 disability scores (mean difference -2.9, P=0.02), and MSQ quality-of-life domains (P<0.001 to P=0.02). CPM analysis identified predictive neural signatures: default mode network-subcortical hypoconnectivity predicted VAS reduction (r=0.23, P=0.04) and subcortical-motor hyperconnectivity predicted HIT-6 improvement (r=0.29, P=0.02). These baseline connectivity patterns offer a potential framework for personalized treatment selection in clinical practice.