Insights & Discussion
Acupuncture has the advantage for acute and preventive treatment of migraine in pain improvement and safety.
This overview included a considerable number of systematic reviews/meta analyses (SR/MAs), illustrating that acupuncture has the advantage in pain improvement of VAS score, headache days/frequency, analgesic use and efficacy of response rate, and effective rate according to the present evidence.
In terms of conclusion, the results of all 15 (100%) SR/MAs were positive. For treatment, 6 SR/MAs reported acupuncture had superiority relative to drugs; 4 SR/MAs reported acupuncture had superiority relative to sham acupuncture, drugs; 3 SR/MAs reported acupuncture had superiority relative to sham acupuncture; 1 SR/MA reported acupuncture had superiority relative to drugs, other TCM treatments. 1 SR/MA reported that acupuncture had superiority in treating migraine, but did not mention the control group in the conclusions.
Based on previous evidence we reviewed, we supposed acupuncture might be a kind of available treatment for migraine in preventive or acute treatment, but in consideration of low methodological quality of present SR/MAs or RCTs of acupuncture for migraine, we need more high-quality evidence to demonstrate the effect of acupuncture for migraine.
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A 6-week course of acupuncture proves as effective as 6-month drug prophylaxis for migraines, with specific Chinese point selection and stimulation appearing less important.
2022 Expert Review of Neurotherapeutics Role of acupuncture in the treatment of migraine Endres HG, Diener HC, Molsberger A
Review Article Headache & Migraine Migraine
The study began by revisiting previous research on acupuncture as a treatment for headache, finding shortcomings in many of these studies. It explored the influence of acupuncture on migraine and how it potentially functions. The methodology involved running several large, randomized trials comparing the use of acupuncture to conventional prophylactic drug treatments, spanning a time frame of six weeks to six months, respectively.
In the discussion of the results, it was found that the 6-week acupuncture treatment was just as effective in treating migraines as the 6-month drug treatment. Specific attributes of the acupuncture treatment, such as the selection and stimulation of Chinese points and the depth of the needles, were found to have lower significance than traditionally believed. The paper therefore suggested the integration of acupuncture into existing migraine therapy protocols.
Acupuncture could be as effective as pharmacological drugs for migraine prevention, with improved patient compliance and fewer adverse events.
2021 Frontiers in Neurology A Randomized Clinical Trial on Acupuncture Versus Best Medical Therapy in Episodic Migraine Prophylaxis: The ACUMIGRAN Study Giannini G, Favoni V, Merli E, Nicodemo M, Torelli P, Matrà A, et al.
Randomised Controlled Trial Migraine
In the study, patients experiencing migraines who hadn't undergone preventive treatment in the prior 3 months were randomly divided into two groups. Group A underwent 12 acupuncture sessions, while Group B received a range of suitable medications for each individual. The frequency of headaches was compared at the beginning and end of treatment, and both groups were assessed after three and six months post-treatment.
Results highlighted that both treatments led to a significant decrease in headache frequency. Of the patients, around 34% saw a 50% reduction of headache days post-treatment. The improvements seen at the end of treatment were maintained in 57.3% of patients three months after and in 38.8% of patients six months after, notably in the acupuncture group. Based on this data, acupuncture can be seen as an effective alternative for migraine prophylaxis.
Migraine patients exhibit lower intracellular magnesium levels, which can be increased by consuming magnesium-rich mineral water, demonstrating its bioavailability.
2000 Clinica Chimica Acta Free and total magnesium in lymphocytes of migraine patients — effect of magnesium-rich mineral water intake Thomas J, Millot JM, Sebille S, Delabroise AM, Thomas E, Manfait M, et al.
Clinical Study Magnesium Migraine Mineral Water
The study started by identifying a common issue with lower-than-recommended dietary intakes of magnesium in Western countries. The focus was on migraine patients, as low brain magnesium and impaired magnesium metabolism had been reported in migraine cases. A non-invasive and sensitive test to detect these deficiencies was sought. Magnesium, being an intracellular cation, was tested in 29 migraine patients and 18 control subjects. The tests were for total magnesium in plasma, erythrocytes, lymphocytes and ionized magnesium in lymphocytes.
The analysis found that there were lower concentrations of total magnesium in erythrocytes and ionized magnesium in lymphocytes of migraine patients compared to controls. These findings indicated a notable overall difference between the migraine patients and the controls, despite there being overlaps in some individual values.
The researchers then subjected the migraine patients to a 2-week intake of a mineral water rich in magnesium. An increase in all intracellular magnesium concentrations was observed, with no effect on plasma magnesium. This increase demonstrated the bioavailability of magnesium from the mineral water. Interestingly, the most sensitive index of magnesium deficiency turned out to be ionized magnesium in lymphocytes, which saw the most significant increase after the intake of the magnesium-rich mineral water.