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The Long-term Effect of Acupuncture for Migraine Prophylaxis: A Randomized Clinical Trial.

Published on Apr 1, 2017in JAMA Internal Medicine20.768
· DOI :10.1001/jamainternmed.2016.9378
Lingdi Zhao19
Estimated H-index: 19
(CDUTCM: Chengdu University of Traditional Chinese Medicine),
Jiao Chen5
Estimated H-index: 5
(CDUTCM: Chengdu University of Traditional Chinese Medicine)
+ 9 AuthorsFanrong Liang26
Estimated H-index: 26
(CDUTCM: Chengdu University of Traditional Chinese Medicine)
Sources
Abstract
Importance The long-term prophylactic effects of acupuncture for migraine are uncertain. Objective To investigate the long-term effects of true acupuncture compared with sham acupuncture and being placed in a waiting-list control group for migraine prophylaxis. Design, Setting, and Participants This was a 24-week randomized clinical trial (4 weeks of treatment followed by 20 weeks of follow-up). Participants were randomly assigned to true acupuncture, sham acupuncture, or a waiting-list control group. The trial was conducted from October 2012 to September 2014 in outpatient settings at 3 clinical sites in China. A total of 249 participants 18 to 65 years old with migraine without aura based on the criteria of the International Headache Society, with migraine occurring 2 to 8 times per month. Interventions Participants in the true acupuncture and sham acupuncture groups received treatment 5 days per week for 4 weeks for a total of 20 sessions. Participants in the waiting-list group did not receive acupuncture but were informed that 20 sessions of acupuncture would be provided free of charge at the end of the trial. Main Outcomes and Measures Participants used diaries to record migraine attacks. The primary outcome was the change in the frequency of migraine attacks from baseline to week 16. Secondary outcome measures included the migraine days, average headache severity, and medication intake every 4 weeks within 24 weeks. Results A total of 249 participants 18 to 65 years old were enrolled, and 245 were included in the intention-to-treat analyses. One hundred eighty-nine (77.1%) were women. Baseline characteristics were comparable across the 3 groups. The mean (SD) change in frequency of migraine attacks differed significantly among the 3 groups at 16 weeks after randomization ( P P  = .002) and in the true acupuncture vs waiting-list group (difference of 1.8 attacks; 95% CI, 1.1-2.5; P P  = .07). Conclusions and Relevance Among patients with migraine without aura, true acupuncture may be associated with long-term reduction in migraine recurrence compared with sham acupuncture or assigned to a waiting list. Trial Registration clinicaltrials.gov Identifier:NCT01687660
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  • References (31)
  • Citations (52)
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References31
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#1Petra I. BaeumlerH-Index: 3
Last. Dominik IrnichH-Index: 26
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Our aim was to distinguish between spinal and supraspinal mechanisms in the intact nervous system by comparing homosegmental and heterosegmental effects of electroacupuncture (EA) and manual acupuncture (MA) on sensory perception in healthy volunteers by means of quantitative sensory testing. Seventy-two healthy volunteers were randomly assigned to receive either MA or EA at SP 6, SP 9, GB 39, and ST 36 at the left leg or relaxed for 30 minutes (control group [CG]). Blinded examiners assessed 13...
9 CitationsSource
#2Peter J. GoadsbyH-Index: 111
Last. Andrew CharlesH-Index: 41
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Objective: To determine whether acute migraine treatment outcome is different in migraine with aura compared with migraine without aura. Methods: We examined pooled outcome data for sumatriptan treatment of migraine with and without aura from the sumatriptan/naratriptan aggregate patient database. We also examined similar outcome data for inhaled dihydroergotamine (DHE) from a single, large randomized controlled study. Results: The pooled pain-free rates 2 hours postdose for sumatriptan 100 mg w...
13 CitationsSource
#1Yanyi WangH-Index: 3
#2Charlie Changli XueH-Index: 34
Last. Zhen Zheng (RMIT: RMIT University)H-Index: 11
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Objectives. This study aimed to evaluate the efficacy and safety of manual acupuncture as a prophylaxis for frequent migraine. Methods. Fifty frequent migraineurs were randomly allocated to receive 16 sessions of either real acupuncture (RA = 26) or sham acupuncture (SA = 24) during 20 weeks. The primary outcomes were days with migraine over four weeks, duration, and intensity of migraine and the number of responders with more than 50% reduction of migraine days. The secondary outcomes were the ...
14 CitationsSource
#1Rebecca Burch (Brigham and Women's Hospital)H-Index: 8
#2Stephen Loder (CHA: Cambridge Health Alliance)H-Index: 4
Last. Todd A. Smitherman (University of Mississippi)H-Index: 22
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Background and Objectives The US National Center for Health Statistics, which is part of the Centers for Disease Control, conducts ongoing public health surveillance activities. The US Armed Forces also maintains a comprehensive database of medical information. We aimed to identify the most current prevalence estimates of migraine and severe headache in the United States adult civilian and active duty service populations from these national government surveys, to assess stability of prevalence e...
175 CitationsSource
#1Mohsen Foroughipour (MUMS: Mashhad University of Medical Sciences)H-Index: 8
#2Amir Reza Golchian (MUMS: Mashhad University of Medical Sciences)H-Index: 2
Last. Hoda Azizi (MUMS: Mashhad University of Medical Sciences)H-Index: 7
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Background Migraine is one of the most common types of headache, with significant socioeconomic effects. Prophylactic drugs are used to prevent migraine headaches but are unpromising. Objective To assess the effects of adding acupuncture to conventional migraine prophylaxis. Methods One hundred patients with migraine (41 male, 59 female), in whom prophylactic drugs had not produced a fall of at least 50% in the number of attacks, entered the study. The patients were randomised into two groups, s...
11 CitationsSource
#1Jiao Chen (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 5
#2Lingdi Zhao (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 19
Last. Fanrong Liang (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 26
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Background The instant-treatment effect of acupuncture for patients with migraines has been corroborated in numerous studies. However, most diseases are chronic and tend to recur, so the long-term effect of acupuncture can verify the existence of sustained efficacy or the placebo effect. Evaluating the efficacy of acupuncture in the prophylaxis of migraine without aura (MWoA) in China is also important because such studies are lacking.
5 CitationsSource
#1Mattias Linde (NTNU: Norwegian University of Science and Technology)H-Index: 24
#2Wim M MullenersH-Index: 12
Last. Dc McCrory (Duke University)H-Index: 51
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Background Some antiepileptic drugs but not others are useful in clinical practice for the prophylaxis of migraine. This might be explained by the variety of actions of these drugs in the central nervous system. The present review is part of an update of a Cochrane review first published in 2004, and previously updated (conclusions not changed) in 2007. Objectives To describe and assess the evidence from controlled trials on the efficacy and tolerability of valproate (valproic acid or sodium val...
50 CitationsSource
According to the recent American Academy of Neurology (AAN) guideline update, a drug can be recommended as possibly effective for migraine prevention if it had demonstrated efficacy in one Class II study.1 Eight drugs are recommended as possibly effective,1 and there are several drugs for which I would question the evidence. Due to space limitations, I have chosen just one example.
14 CitationsSource
#1Andrew J. Vickers A J (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 92
#2Angel M. Cronin (Harvard University)H-Index: 16
Last. Klaus Linde (TUM: Technische Universität München)H-Index: 55
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Methods: We conducted a systematic review to identify randomized controlled trials (RCTs) of acupuncture for chronic pain in which allocation concealment was determined unambiguously to be adequate. Individual patient data meta-analyses were conducted using data from 29 of 31 eligible RCTs, with a total of 17922 patients analyzed. Results: In the primary analysis, including all eligible RCTs, acupuncture was superior to both sham and noacupuncture control for each pain condition (P.001 for all c...
552 CitationsSource
#1Lin-Peng Wang (Capital Medical University)H-Index: 12
#2Xiao-Zhe Zhang (Capital Medical University)H-Index: 2
Last. Shan-Shan Li (Capital Medical University)H-Index: 2
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Objective. We aim to investigate the efficacy of acupuncture for acute migraine attacks comparing with sham acupuncture. Design. The study was designed as a multicenter, single-blinded, randomized controlled clinical trial. Setting and Patients. From March 2007 to February 2009, 150 patients were randomly allocated to verum or sham acupuncture group in a ratio of 1:1. Interventions. Every patient received a verum or sham acupuncture treatment when having a migraine attack and, medications were a...
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#1Chung-Chih Liao (China Medical University (Taiwan))
Last. Jung-Miao Li (PRC: China Medical University (PRC))H-Index: 1
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Background: Migraine, a common neurological disorder, increases the risk of psychiatric disorders. Currently, the efficacy of conventional therapies is considered unsatisfactory. Acupuncture has been gaining popularity in treatment of neuropsychiatric disease. This study aimed to investigate the effect of acupuncture on medical expenditure and the risk of depression and anxiety in migraine patients. Methods: Patients with migraine were either selected for acupuncture treatment or no treatment ba...
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#1Shabei Xu (HUST: Huazhong University of Science and Technology)H-Index: 5
#2Ling-Ling Yu (HUST: Huazhong University of Science and Technology)H-Index: 1
Last. Huitao JingH-Index: 1
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Abstract Objective To assess the efficacy of manual acupuncture as prophylactic treatment for acupuncture naive patients with episodic migraine without aura. Design Multicentre, randomised, controlled clinical trial with blinded participants, outcome assessment, and statistician. Setting Seven hospitals in China, 5 June 2016 to 15 November 2018. Participants 150 acupuncture naive patients with episodic migraine without aura. Interventions 20 sessions of manual acupuncture at true acupuncture poi...
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#1Yuxi LiH-Index: 1
#2Xi-li XiaoH-Index: 1
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Background. Migraine is a common neurological disease, which burdens individuals and society all over the world. Acupuncture, an important method in Traditional Chinese Medicine, is widely used in clinical practice as a treatment for migraine. Several systematic reviews (SRs) have investigated the effectiveness and safety of acupuncture for migraine. Objective. To summarize and critically assess the quality of relevant SRs and present an objective and comprehensive evidence on the effectiveness ...
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#2Yuebao Guo (Guangzhou University of Chinese Medicine)
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Objective. This study aimed at assessing the clinical effectiveness of acupuncture for lateral epicondylitis (LE). Methods. The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. Randomized controlled trials (RCTs) meeting the inclusion criteria were included. RevMan 5.3 software was used to...
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#1Leixiao Zhang (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 1
Last. Siyi Yu (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 4
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The purpose of this study was to observe and compare the clinical efficacy of active acupuncture and placebo acupuncture in the treatment of insomnia and mood disorders. 96 patients with insomnia in Chengdu were randomly divided into two groups (1:1). The active acupuncture group (AA group n = 48) received the tube of Park sham device with deep needle insertion. The placebo acupuncture group (PA group n = 48) received the tube of Park sham device with a retractable needle shaft and a blunt tip. ...
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Last. Bing ZhuH-Index: 14
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Abstract Peripheral neurostimulation within the trigeminal nerve territory has been used for pain alleviation during migraine attacks, but the mechanistic basis of this non-invasive intervention is still poorly understood. In this study, we investigated the therapeutic role of peripheral stimulation of the trigeminal nerve, which provides homosegmental innervation to intracranial structures, by assessing analgesic effects in a nitroglycerin-induced rat model of migraine. As a result of neurogeni...
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#1Ruirui SunH-Index: 2
#2Zhaoxuan HeH-Index: 2
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Deqi is taken as an indispensable requirement to achieve acupuncture efficacy. This study aimed to explore the central influence of deqi on the efficacy of acupuncture for functional dyspepsia (FD). 70 FD patients were randomized to receive 20 sessions' acupuncture treatment with (n = 35) and without deqi (n = 35). In each group, 25 FD patients randomly selected underwent functional magnetic resonance imaging (fMRI) scans before and after treatment. After group re-division according to deqi resp...
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Abstract In recent years, the brain mechanism research speeds up for the effect of acupuncture intervention on chronic pain. Currently, in the relevant articles, the brain mechanism research in chronic pain focuses on muscular and skeletal system diseases, in which, the rigorous controlled designs has been adopted in the most of researches and the effect verification has been predominated as the research objective. The corresponding results indicate that the brain mechanism of acupuncture effect...
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#1Yiheng TuH-Index: 7
#2Fang ZengH-Index: 14
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Objective To identify and validate an fMRI-based neural marker for migraine without aura (MwoA) and to examine its association with treatment response. Methods We conducted cross-sectional studies with resting-state fMRI data from 230 participants and machine learning analyses. In studies 1 through 3, we identified, cross-validated, independently validated, and cross-sectionally validated an fMRI-based neural marker for MwoA. In study 4, we assessed the relationship between the neural marker and...
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#2L. Liu (Capital Medical University)H-Index: 4
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Abstract Introduction Acupuncture has become a relevant complementary and alternative treatment for acute migraine; however, the neurophysiological mechanism (C-fibers) underlying this effect remains unclear. C-fibers play a crucial role for diffuse noxious inhibitory controls (DNIC) at wide dynamic range (WDR) neurons in the trigeminocervical complex (TCC) in migraine attacks, and we supposed that this may be the mechanism of acupuncture analgesia. This study aimed to examine the neurophysiolog...
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