Title	Acupuncture Therapy Beneficial For Migraine
Clinical Question	In dental patients with migraines, how does acupuncture compare to no treatment in the patients treatment management?
Clinical Bottom Line	Randomized controlled trials support the use of acupuncture therapy in reducing patients’ pain, and improving overall quality of life.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 21717781 Zhen/2011 60 aura-absence migraine outpatients ( 30 oral administration of Flunarizine medication and 30 acupuncture) RCT Key results Acupuncture therapy can raise patients with migraine’s life quality, lessen the times and severity of headache attack, provides a superior therapeutic effect to that of medication. The cure rate and the total effective rate of the acupuncture group were significantly higher than those of the medication group (P < 0.05). 22894176 Yang/2012 30 (3 groups: Traditional Acupuncture Group (TAG), Control Acupuncture Group (CAG), and Migraine Group (MG). RCT Key results Acupuncture stimulation of different points on similar body regions in migraine patients reduces pain and induces different levels of cerebral glucose metabolism in pain-related brain regions. Positron emission tomography along with computed tomography (PET-CT) were used to test differences in brain activation. 22888768 Wallasch/2012 35 (18 acupuncture and 17 placebo) RCT Key results Preventive treatment of migraines by standardized acupuncture may positively influence the dysfunction of the cerebrovascular response to autonomic stimuli, but not the cerebral vasotonus during rest. Pre-/post-acupuncture treatment comparisons showed a significant decrease of days with migraine headache (-52.5%; p<0.001), and significantly diminished cerebrovascular response patterns to Valsalva stimulus in the acupuncture group ( p<0.001), as compared to insignificant decrease in placebo-acupuncture patients’ migraines.
Evidence Search	Search ("Acupuncture Therapy"[Mesh]) AND "Headache Disorders"[Mesh]
Comments on The Evidence	According to the current evidences reviewed above, acupuncture treatment does improve patients’ treatment management and overall quality of life. The study design of these randomized clinical trials include standardized acupuncture methods along with validated testing techniques such as: (PET-CT), Transcranial Doppler ultrasound (TCD), and the SF-36 Quality-of-Life Instrument (SF-36). All of these testing methods combine to provide solid clinical evidence. The randomized cerebrovascular trial also provides strong evidence by being a quasi double-blinded, placebo-controlled study.
Applicability	Alternative acupuncture therapy reviewed in this short-term study may be appropriate for TMD patients diagnosed with migraines. Continued acupuncture therapies may be needed to maintain the achieved benefits.
Specialty	(General Dentistry) (Dental Hygiene)
Keywords	Acupuncture Therapy, TMD, Headache Disorders, Migraines, TMD therapy
ID#	2443
Date of submission	03/01/2013
E-mail	tamia@livemail.uthscsa.edu
Author	Alexandria Tami
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Edward F. Wright, DDS, MS
Faculty mentor e-mail	wrightE2@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available