Among neurological disorders, migraine is a leading cause of disability and significantly contributes to individual and societal burdens owing to pain and environmental sensitivities. Quiz Ref ID The prevalence of migraine is 14.9% in the United States,¹ and 8.4% to 12.7% in Asia.² Approximately 25% to 38% of migraineurs need preventive therapy,^3,4 and pharmacotherapies, such as divalproex sodium, topiramate, metoprolol, and propranolol, are recommended for migraine prevention. However, such treatments are often associated with an increased risk of adverse events (AEs), including weight gain, fatigue, sleep disturbance, and gastrointestinal intolerance.^4,5 Excessive use of analgesics or specific antimigraine treatments could cause medication overuse–induced headache and an increase in headache frequency.^3,6 Because of the limitations associated with these conventional treatments, efforts have been made to identify effective, low-risk interventions.

The mechanisms of action underlying acupuncture, including acupuncture point specificity, are not well understood. In the previous decade, an increasing number of studies have applied fMRI to investigate brain response to acupuncture stimulation. Our aim was to provide a systematic overview of acupuncture fMRI research considering the following aspects: 1) differences between verum and sham acupuncture, 2) differences due to various methods of acupuncture manipulation, 3) differences between patients and healthy volunteers, 4) differences between different acupuncture points. We systematically searched English, Chinese, Korean and Japanese databases for literature published from the earliest available up until September 2009, without any language restrictions. We included all studies using fMRI to investigate the effect of acupuncture on the human brain (at least one group that received needle-based acupuncture). 779 papers were identified, 149 met the inclusion criteria for the descriptive analysis, and 34 were eligible for the meta-analyses. From a descriptive perspective, multiple studies reported that acupuncture modulates activity within specific brain areas, including somatosensory cortices, limbic system, basal ganglia, brain stem, and cerebellum. Meta-analyses for verum acupuncture stimuli confirmed brain activity within many of the regions mentioned above. Differences between verum and sham acupuncture were noted in brain response in middle cingulate, while some heterogeneity was noted for other regions depending on how such meta-analyses were performed, such as sensorimotor cortices, limbic regions, and cerebellum. Brain response to acupuncture stimuli encompasses a broad network of regions consistent with not just somatosensory, but also affective and cognitive processing. While the results were heterogeneous, from a descriptive perspective most studies suggest that acupuncture can modulate the activity within specific brain areas, and the evidence based on meta-analyses confirmed some of these results. More high quality studies with more transparent methodology are needed to improve the consistency amongst different studies.

Cardiovascular disease is the leading cause of death worldwide, causing more than 17.3 million deaths per year and possibly growing to more than 23.6 million deaths annually by 2030.¹ With the growth and aging of the Chinese population, the prevalence of cardiovascular disease morbidity continues to rise.² Chronic stable angina (CSA) is the main symptom of myocardial ischemia and is associated with an increased risk of major cardiovascular events and sudden cardiac death.³ Chronic stable angina affects a mean of 3.4 million people older than 40 years each year.⁴ The most recent survey reported a prevalence of CSA of 9.6% in China,⁵ making it a considerable burden on health care and medical costs considering China’s large population.

Summary: Background: Functional dyspepsia (FD) is a common disease without an established optimal treatment.Aim: To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non‐acupoint; and (iii) the effect difference among different acupoints.Methods: A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non‐specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non‐acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow‐up period of 12 weeks were arranged. The outcomes were the (i) patients’ response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality‐of‐life improvement based on Nepean Dyspepsia Index.Results: All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups.Conclusions: Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non‐acupoint puncture. The benefit of acupuncture relies on acupoint specificity.

Objective To investigate the dynamic functional connectivity of thalamocortical networks in interictal migraine patients and whether clinical features are associated with abnormal connectivity. Methods We investigated dynamic functional network connectivity (dFNC) of the migraine brain in 89 interictal migraine patients and 70 healthy controls. We focused on the temporal properties of thalamocortical connectivity using sliding window cross-correlation, clustering state analysis, and graph-theory methods. Relationships between clinical symptoms and abnormal dFNC were evaluated using a multivariate linear regression model. Results Five dFNC brain states were identified to characterize and compare dynamic functional connectivity patterns. We demonstrated that migraineurs spent more time in a strongly interconnected between-network state, but they spent less time in a sparsely connected state. Interestingly, we found that abnormal posterior thalamus (pulvinar nucleus) dFNC with the visual cortex and the precuneus were significantly correlated with headache frequency of migraine. Further topologic measures revealed that migraineurs had significantly lower efficiency of information transfer in both global and local dFNC. Conclusion Our results demonstrated a transient pathologic state with atypical thalamocortical connectivity in migraineurs and extended current findings regarding abnormal thalamocortical networks and dysrhythmia in migraine.