偏头痛针刺治疗的静息态fMRI相关性：基于坐标的荟萃分析。
完整摘要 · 中文译文
背景：尽管针刺对偏头痛已显示出预防获益，但其神经机制仍不明确。本研究系统综合了全脑静息态功能磁共振成像（fMRI）证据，以刻画偏头痛患者接受针刺治疗后自发脑活动的改变。 方法：我们系统检索了八个数据库，纳入采用全脑分析比较偏头痛患者针刺前后状态的静息态fMRI研究。仅报告低频波动振幅（ALFF）或局部一致性（ReHo）的研究符合定量荟萃分析的条件。采用种子点d Mapping结合受试者图像置换法（SDM-PSI）进行基于坐标的荟萃分析。荟萃回归分析探讨了区域性脑改变与临床结局之间的关联。 结果：共纳入13项研究，包含19个数据集和312例患者。在预先设定的未校正SDM-PSI阈值下，针刺治疗与右侧额中回ALFF升高、左侧角回和右侧颞上回ReHo升高以及右侧楔前叶ReHo降低相关。探索性荟萃回归提示，疼痛减轻程度越大与右侧颞上回ReHo升高幅度越小相关，而发作频率减少程度越大与左侧角回ReHo升高幅度越大相关。 结论：针刺可能与调节 执行控制网络、默认模式网络和多感觉处理区域的……这些发现为偏头痛针刺的中枢相关提供了初步的神经影像学证据。然而，鉴于证据基础有限、方法学异质性以及荟萃回归分析的探索性性质，对这些发现应谨慎解读。 PROSPERO注册：本综述已在PROSPERO注册（CRD420251145641）。
完整摘要 · 英文原文
BACKGROUND: Although acupuncture has shown prophylactic benefits for migraine, its neural mechanisms remain elusive. This study systematically synthesized whole-brain resting-state functional magnetic resonance imaging (fMRI) evidence to characterize changes in spontaneous brain activity after acupuncture treatment in patients with migraine. METHODS: We systematically searched eight databases for resting-state fMRI studies that used whole-brain analyses to compare patients with migraine before and after acupuncture. Only studies reporting amplitude of low-frequency fluctuation (ALFF) or regional homogeneity (ReHo) were eligible for quantitative meta-analysis. Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) was used to conduct the coordinate-based meta-analysis. Meta-regression analyses explored associations between regional brain changes and clinical outcomes. RESULTS: Thirteen studies comprising 19 datasets and 312 patients were included. At the prespecified uncorrected SDM-PSI threshold, acupuncture treatment was associated with increased ALFF in the right middle frontal gyrus and increased ReHo in the left angular gyrus and right superior temporal gyrus, together with decreased ReHo in the right precuneus. Exploratory meta-regression suggested that greater pain reduction was associated with smaller ReHo increases in the right superior temporal gyrus, whereas greater reduction in attack frequency was associated with greater ReHo increases in the left angular gyrus. CONCLUSIONS: Acupuncture may be associated with altered spontaneous neural activity in regions of the executive control network, default mode network, and multisensory processing regions. These findings provide preliminary neuroimaging evidence for the central correlates of acupuncture in migraine. However, they should be interpreted cautiously given the limited evidence base, methodological heterogeneity, and exploratory nature of the meta-regression analyses. THE PROSPERO REGISTRATION: The review was registered in PROSPERO (CRD420251145641).