Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Acute and chronic effects of acupuncture on radial artery: A randomized double blind study in migraine

Artery Research volume 4, pages 7–14 (2010)Cite this article

Abstract

Background

Acupuncture is an accepted treatment for migraine. Palpation of the radial pulses is one of the most important techniques in traditional Chinese medicine both for diagnosis and monitoring of treatment efficacy. The objective of the present study was to investigate the acute and chronic effects of acupuncture on the radial artery of patients suffering from severe migraine.

Methods

A double-blind parallel group study was conducted in 31 patients never exposed to acupuncture and randomized in two groups: real acupuncture versus sham acupuncture, applied 3 times at one month interval. At baseline and after 2 months, radial artery diameter was measured with a high resolution echotracking system before and during a 20 min’s acupuncture session. Migraine severity was assessed by self administrated questionnaires and visual analogic scale for pain at each visit. Patients and investigators (not acupuncture physician) were blinded as to the treatment allocation.

Results

During the first session, radial artery diameter significantly increased after real acupuncture, (+3.1% IQR [-3.2–8.5], P = 0.03 vs 0.9% IQR [-5.3–5.8], P = NS), and remained significantly higher after the two months treatment course 5.2% IQR [-3.9–14] vs. -4.4% IQR [-10.0–3.5], respectively; P < 0.01). Patients with the most severe pain at baseline were less prone to dilate their arteries during follow-up (P < 0.05). A larger arterial vasodilatation after real acupuncture was observed for any given level of pain intensity (P < 0.01).

Conclusion

an acupuncture-induced vasodilatation was observed at the site of the radial artery in patients suffering from severe migraine and naïve to acupuncture. The vasodilatation was maintained after chronic treatment.

Condensed abstract

This double-blind randomized, controlled trial aimed at showing the acute and chronic vasodilatory response to acupuncture in migrainers naïve to acupuncture. We show that real acupuncture is accompanied by acute and chronic vasodilation of the radial artery, the chronic vasodilation is inversely related to the level of pain at baseline.

References

  1. Skrabanek P. Acupuncture and the age of unreason. Lancet 1984;1(8387):1169–71.

    Google Scholar 

  2. Kessler RC, Davis RB, Foster DF, Norlock FE, Calkins DR, Delbanco TL. Long-term trends in the use of complementary and alternative medical therapies in the United States. Ann Intern Med 2001;135(4):262–8.

    Google Scholar 

  3. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993; 328(4):246–52.

    Google Scholar 

  4. No Authors listed. NIH consensus conference. Acupuncture. JAMA 1998;280(17):1518–24.

  5. Boutouyrie P, Corvisier R, Azizi M, Lemoine D, Laloux B, Hallouin M, et al. Effects of acupuncture on radial artery hemodynamics: controlled trials in sensitized and naive subjects. Am J Physiol Heart Circ Physiol 2001;280(2):H628–H633.

  6. Wonderling D, Vickers AJ, Grieve R, McCarney R. Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care. BMJ 2004;328(7442): 747–50.

  7. Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith CM, Ellis N, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ 2004;328(7442): 744–50.

  8. Dodick DW. Examining the essence of migraineeis it the blood vessel or the brain? A debate. Headache 2008;48(4):661–7.

    Google Scholar 

  9. Olesen J, Lipton RB. Migraine classification and diagnosis. International headache society criteria. Neurology 1994;44(6 Suppl. 4):S6–S10.

  10. Lipton RB, Bigal ME, Steiner TJ, Silberstein SD, Olesen J. Classification of primary headaches. Neurology 2004;63(3):427–35.

    Google Scholar 

  11. Boutouyrie P, Bussy C, Lacolley P, Girerd X, Laloux B, Laurent S. Association between local pulse pressure, mean blood pressure, and large-artery remodeling. Circulation 1999; 100(13):1387–93.

    Google Scholar 

  12. Boutouyrie P, Bussy C, Hayoz D, Hengstler J, Dartois N, Laloux B, et al. Local pulse pressure and regression of arterial wall hypertrophy during long-term antihypertensive treatment. Circulation 2000;101(22):2601–6.

    Google Scholar 

  13. Girerd X, Giannattasio C, Moulin C, Safar M, Mancia G, Laurent S. Regression of radial artery wall hypertrophy and improvement of carotid artery compliance after long-term antihypertensive treatment in elderly patients. J Am Coll Cardiol 1998;31(5):1064–73.

    Google Scholar 

  14. Girerd X, London G, Boutouyrie P, Mourad JJ, Safar M, Laurent S. Remodeling of the radial artery in response to a chronic increase in shear stress. Hypertension 1996;27(3 Pt 2):799–803.

  15. Tfelt-Hansen P, Block G, Dahlof C, Diener HC, Ferrari MD, Goadsby PJ, et al. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia 2000;20(9):765–86.

    Google Scholar 

  16. Fleiss J. The design and analysis of clinical experiments. New York: John Wiley; 1986.

    Google Scholar 

  17. Joannides R, Haefeli WE, Linder L, Richard V, Bakkali EH, Thuillez C, Luscher TF. Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation 1995;91(5):1314–9.

    Google Scholar 

  18. Azizi M, Boutouyrie P, Bissery A, Agharazii M, Verbeke F, Stern N, et al. Arterial and renal consequences of partial genetic deficiency in tissue kallikrein activity in humans. J Clin Invest 2005;115(3):780–7.

    Google Scholar 

  19. Goadsby PJ, Lipton RB, Ferrari MD. Migraine e current understanding and treatment. N Engl J Med 2002;346(4):257–70.

    Google Scholar 

  20. Woods RP, Iacoboni M, Mazziotta JC. Bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. N Engl J Med 1994;331(25):1689–92.

    Google Scholar 

  21. de Hoon JN, Smits P, Troost J, Struijker-Boudier HA, Van Bortel LM. Forearm vascular response to nitric oxide and calcitonin gene-related peptide: comparison between migraine patients and control subjects. Cephalalgia 2006;26(1):56–63.

    Google Scholar 

  22. de Hoon JN, Willigers JM, Troost J, Struijker-Boudier HA, Van Bortel LM. Vascular effects of 5-HT1B/1D-receptor agonists in patients with migraine headaches. Clin Pharmacol Ther 2000; 68(4):418–26.

    Google Scholar 

  23. Langevin HM, churchill DL, Fow JR, Badger GJ, Garra BS, Krag MH. Biomechanical response to acupuncture needling in humans. J Appl Physiol 2001;91(6):2471–8.

    Google Scholar 

  24. Langevin HM, churchill DL, Yandow JA, Badger GJ, WU JUNR, Yandow JA, et al. Evidence of connective tissue involvement in acupuncture. FASEB J 2002;16(8):872–4.

    Google Scholar 

  25. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec 2002; 269(6):257–65.

    Google Scholar 

  26. Chao DM, Shen LL, Tjen AL, Pitsillides KF, Li P, Longhurst JC. Naloxone reverses inhibitory effect of electroacupuncture on sympathetic cardiovascular reflex responses. Am J Physiol 1999;276(6 Pt 2):H2127–H2134.

  27. Zhou W, Fu LW, Tjen ALS, Li P, Longhurst JC. Afferent mechanisms underlying stimulation modality-related modulation of acupuncture-related cardiovascular responses. J Appl Physiol 2005;98(3):872–80.

    Google Scholar 

  28. Zhou W, Fu LW, Guo ZL, Longhurst JC. Role of glutamate in the rostral ventrolateral medulla in acupuncture-related modulation of visceral reflex sympathoexcitation. Am J Physiol Heart Circ Physiol 2007;292(4):H1868–H1875.

  29. Han JS, Terenius L. Neurochemical basis of acupuncture analgesia. Annu Rev Pharmacol Toxicol 1982;22:193–220.

    Google Scholar 

  30. Ohsawa H, Okada K, Nishijo K, Sato Y. Neural mechanism of depressor responses of arterial pressure elicited by acupuncture-like stimulation to a hindlimb in anesthetized rats. J Auton Nerv Syst 1995;51(1):27–35.

    Google Scholar 

  31. Bossut DF, Mayer DJ. Electroacupuncture analgesia in rats: naltrexone antagonism is dependent on previous exposure. Brain Res 1991;549(1):47–51.

    Google Scholar 

  32. Bucinskaite V, Lundeberg T, Stenfors C, Ekblom A, Dahlin L, Theodorsson E. Effects of electro-acupuncture and physical exercise on regional concentrations of neuropeptides in rat brain. Brain Res 1994;666(1):128–32.

    Google Scholar 

  33. Wilbert-Lampen U, Trapp A, Barth S, Plasse A, Leistner D. Effects of beta-endorphin on endothelial/monocytic endothelin-1 and nitric oxide release mediated by mu1-opioid receptors: a potential link between stress and endothelial dysfunction? Endothelium 2007;14(2):65–71.

    Google Scholar 

  34. Lassen LH, Christiansen I, Iversen HK, Jansen-Olesen I, Olesen J. The effect of nitric oxide synthase inhibition on histamine induced headache and arterial dilatation in migraineurs. Cephalalgia 2003;23(9):877–86.

    Google Scholar 

  35. Hjorth LL, Klingenberg IH, Olesen J. A dose-response study of nitric oxide synthase inhibition in different vascular beds in man. Eur J Clin Pharmacol 2003;59(7):499–505.

    Google Scholar 

  36. Flachskampf FA, Gallasch J, Gefeller O, Gan J, Mao J, Pfahlberg AB, et al. Randomized trial of acupuncture to lower blood pressure. Circulation 2007;115(24):3121–9.

    Google Scholar 

  37. Macklin EA, Wayne PM, Kalish LA, Valaskatgis P, Thompson J, Pian-Smith MC, et al. Stop hypertension with the acupuncture research program (SHARP): results of a randomized, controlled clinical trial. Hypertension 2006;48(5):838–45.

    Google Scholar 

  38. Vickers A, Rees R, Zollman C, Smith C, Ellis N. Acupuncture for migraine and headache in primary care: a protocol for a pragmatic, randomized trial. Complement Ther Med 1999;7(1):3–18.

    Google Scholar 

  39. Jambrik Z, Chunzeng L, Santarcangelo EL, Sebastiani L, Ghelarducci B, Picano E. Traditional acupuncture does not modulate the endothelial dysfunction induced by mental stress. Int J Cardiovasc Imaging 2004;20(5):357–62.

    Google Scholar 

  40. Edvinsson ML, Edvinsson L. Comparison of CGRP and NO responses in the human peripheral microcirculation of migraine and control subjects. Cephalalgia 2008;28(5):563–6.

    Google Scholar 

  41. Yetkin E, Ozisik H, Ozcan C, Aksoy Y, Turhan H. Increased dilator response to nitrate and decreased flow-mediated dilatation in migraineurs. Headache 2007;47(1):104–10.

    Google Scholar 

  42. Napoli R, Guardasole V, Zarra E, Matarazzo M, D’Anna C, Sacca F, et al. Vascular smooth muscle cell dysfunction in patients with migraine. Neurology 2009;72(24):2111–4.

    Google Scholar 

  43. De Roos NM, Bots ML, Schouten EG, Katan MB. Within-subject variability of flow-mediated vasodilation of the brachial artery in healthy men and women: implications for experimental studies. Ultrasound Med Biol 2003;29(3):401–6.

    Google Scholar 

  44. Linde K, Scholz M, Melchart D, Willich SN. Should systematic reviews include non-randomized and uncontrolled studies? The case of acupuncture for chronic headache. J Clin Epidemiol 2002;55(1):77–85.

    Google Scholar 

  45. White P, Lewith G, Hopwood V, Prescott P. The placebo needle, is it a valid and convincing placebo for use in acupuncture trials? A randomised, single-blind, cross-over pilot trial. Pain 2003;106(3):401–9.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Université Paris-Descartes, Paris, France

    Pierre Boutouyrie, Robert Corvisier, Kim-Than Ong, Michel Azizi, Brigitte Laloux & Stéphane Laurent

  2. INSERM U970, Paris, France

    Pierre Boutouyrie, Robert Corvisier, Kim-Than Ong, Brigitte Laloux & Stéphane Laurent

  3. Assistance Publique-Hôpitaux de Paris, Hoˆpital Européen Georges Pompidou, Paris, France

    Pierre Boutouyrie, Robert Corvisier, Kim-Than Ong, Claire Vulser, Michel Azizi, Brigitte Laloux & Stéphane Laurent

  4. Fondation Ophtalmologique Rothschild, Paris, France

    Catherine Lassalle

  5. Département de Pharmacologie et Unité INSERM U 970, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 20 rue Leblanc, 75015, Paris, France

    Pierre Boutouyrie

Authors
  1. Pierre Boutouyrie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert Corvisier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kim-Than Ong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claire Vulser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Catherine Lassalle
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michel Azizi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Brigitte Laloux
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Stéphane Laurent
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pierre Boutouyrie.

Rights and permissions

This is an open access article distributed under the CC BY-NC license https://doi.org/creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Cite this article

Boutouyrie, P., Corvisier, R., Ong, KT. et al. Acute and chronic effects of acupuncture on radial artery: A randomized double blind study in migraine. Artery Res 4, 7–14 (2010). https://doi.org/10.1016/j.artres.2009.12.003

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.artres.2009.12.003

Key Words

Artery Research

ISSN: 1876-4401

Contact us