认知与发展心理学研究室知识库

偏头痛是一种复杂的神经功能紊乱疾病。本研究旨在探讨针刺治疗非先兆偏头痛的神经影像学机制。本研究综合运用多种神经影像技术，从不同角度探索针刺治疗对偏头痛的影响及其可能的神经生物学基础。本研究共招募偏头痛患者54例，健康被试30例，使用针刺治疗作为预防性治疗手段干预偏头痛，通过临床观察、行为问卷和磁共振技术对偏头痛患者展开研究。实验一，通过临床观察实验，评估非先兆偏头痛患者在疼痛认知以及感知觉方面的改变，以及针刺治疗对非先兆偏头痛患者的临床疗效。收集患者在针刺治疗前后的临床指标、心理学问卷以及行为学评分等数据。研究结果表明，偏头痛患者的疼痛焦虑、疼痛灾难化和睡眠障碍显著高于健康人，内源性疼痛调控能力显著低于健康人。针刺治疗有效地缓解了患者的偏头痛发作，同时疼痛焦虑和疼痛灾难化也显著缓解。此外，研究发现，患者的日常功能障碍与疼 痛认知的变化存在关联，且治疗后疼痛认知的改善与头痛持续时间的减少呈现出相关性。此外，患者个人忧伤项与日常功能障碍的关系受到了疼痛恐惧的影响。这些发现揭示了针刺治疗对于非先兆偏头痛患者的积极影响，并为进一步的治疗策略提供了科学依据。

实验二，利用磁共振成像技术，探究针刺治疗对非先兆偏头痛患者大脑结构的改变。通过比较治疗前后患者的大脑灰质密度和白质结构的变化，初步揭示针刺治疗对脑结构的潜在影响。结果显示，偏头痛患者的楔前叶灰质显著萎缩，楔前叶可能参与了偏头痛的发病过程。偏头痛患者在接受治疗后，丘脑的灰质密度显著降低，提示针刺治疗改善偏头痛发作的主要靶点可能在丘脑。偏头痛发病使患者冠状束的通路完整性受损，并且针刺治疗改善了白质通路受损。

实验三，运用功能磁共振成像技术，研究针刺治疗对非先兆偏头痛患者大脑功能的改变。通过对血氧水平依赖信号变化的分析，探讨针刺治疗对脑功能、认知功能及情绪状态等方面的影响。结果显示，偏头痛的发作影响了患者楔前叶-前扣带回和楔前叶-丘脑的功能连接。楔前叶-前扣带回功能连接与患者生活质量、疼痛认知和疼痛敏感性显著相关，楔前叶-丘脑的功能连接与患者的发作次数、疼痛焦虑和睡眠状况显著相关。针刺治疗主要改变了楔前叶-中央后回和楔前叶-丘脑的功能连接，同时这些功能连接与患者疼痛认知的改变显著相关。

实验四，基于脑功能连接图谱，探讨辨别偏头痛患者的可能性。通过构建健康对照组与偏头痛患者之间的脑功能连接模式，并分析其差异性，尝试建立 一种基于脑功能连接的偏头痛诊断模型，为临床诊断提供新的思路和方法。结果显示，利用全脑功能连接矩阵可以区分偏头痛患者和健康人以及治疗前后的偏头痛患者，模型针对健康人和患者的分类准确率为 75%，对患者治疗前后的数据分类的准确率为 69%。同时，楔前叶在全脑功能连接中具有显著高权重值。

综上所述，本研究通过一系列临床实验、磁共振实验和神经影像学分析，全面深入地探讨了针刺治疗非先兆偏头痛的神经生物学机制，为临床应用提供了科学依据，并为未来研究提供了新的方向和思路。

Migraine is a complex neurologic disorder. This study aims to investigate the neural mechanisms of acupuncture treatment in migraine without aura patients. The thesis encompasses four experiments, integrating various neuroimaging techniques to unveil the impact of acupuncture on migraine and its potential neurobiological underpinnings from multiple perspectives. A total of 54 migraine patients and 30 healthy subjects were recruited in this study to intervene in migraine using acupuncture as a prophylactic treatment, which was carried out through clinical observations, behavioral questionnaires, and magnetic resonance techniques on migraine patients.

In Experiment 1, a clinical observation experiment was conducted to evaluate the changes in pain cognition as well as sensory perception of non-aural migraine patients and the clinical efficacy of acupuncture treatment on non-aural migraine patients. Data on clinical indicators, psychological questionnaires, and behavioral scores of patients before and after acupuncture treatment were collected, and by analyzing these collected data, the goal of this study was to evaluate the actual efficacy of acupuncture treatment on non-migraine patients with aura and to explore the potential link between this efficacy and the initial condition characteristics of the patients. The results of the study indicate that migraine attacks not only impair patients' pain perception and cognitive abilities, but also lead to functional limitations in daily life. Acupuncture treatment effectively relieved patients' pain perception and cognitive impairment and improved their daily functioning. In addition, it was found that patients' daily dysfunction was associated with changes in pain perception, and the improvement in pain perception after treatment showed a correlation with a reduction in headache duration. In addition, daily dysfunction mediated the relationship between patients' empathy and pain fear. These findings reveal the positive impact of acupuncture treatment in patients with migraine without aura and provide a scientific basis for further treatment strategies.

In Experiment Two, using magnetic resonance imaging technology, we explored the changes in brain structure of migraine without aura patients after acupuncture treatment. By comparing the pre- and post-treatment changes in gray matter density and white matter structures, we preliminarily revealed the potential impact of acupuncture on brain structure. The results showed significant atrophy of the precuneus gray matter in migraine patients, suggesting that the precuneus may be involved in the pathogenesis of migraine. After treatment, there was a significant reduction in the gray matter density of the thalamus in migraine patients, indicating that the primary target of acupuncture in improving migraine attacks may be located in the thalamus. Migraine episodes caused damage to the integrity of the corona radiata pathways, and acupuncture treatment improved the white matter pathway damage.

In Experiment Three, employing functional magnetic resonance imaging technology, we studied the changes in brain function of migraine without aura patients after acupuncture treatment. Through the analysis of blood oxygen level-dependent signal changes, we discussed the effects of acupuncture on brain functional networks, cognitive functions, and emotional states. The results showed that migraine attacks affected the functional connectivity between the precuneus and the anterior cingulate cortex (ACC), as well as between the precuneus and the thalamus. The functional connectivity between the precuneus and the ACC was significantly correlated with patients' quality of life, pain cognition, and pain sensitivity. Meanwhile, the functional connectivity between the precuneus and the thalamus was significantly associated with the number of migraine episodes, pain anxiety, and sleep conditions. Acupuncture primarily altered the functional connectivity between the precuneus and the somatosensory area, as well as between the precuneus and the thalamus, and these changes were significantly correlated with alterations in patients' pain cognition.

In Experiment Four, based on brain functional connectivity maps, we explored the possibility of distinguishing migraine patients. By constructing patterns of brain functional connectivity between healthy controls and migraine patients and analyzing their differences, we attempted to establish a diagnostic model for migraine based on brain functional connectivity, providing new ideas and methods for clinical diagnosis. The results demonstrated that using a whole-brain functional connectivity matrix could differentiate between migraine patients and healthy individuals, as well as between migraine patients before and after treatment. The results showed that the whole brain functional connectivity matrix could be utilized to differentiate migraine patients from healthy people and from migraine patients before and after treatment, and the model had a classification accuracy of 75% for healthy people and patients, and 69% for data before and after patient treatment. Meanwhile, the precuneus had significantly high weight values in whole-brain functional connectivity.

In summary, this research comprehensively investigates the neural imaging mechanisms of acupuncture treatment in patients with migraine without aura through a series of neuroimaging experiments. It provides scientific evidence for clinical application and offers new directions and insights for future research.