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Migraines Accepted Laser Acupuncture Compared in Blood Test of MMP2 and CGRP: A Single Blind RCT.

Not Applicable
Recruiting
Conditions
Headache, Migraine
Interventions
Device: Laser Pen
Other: Observation
Registration Number
NCT06584409
Lead Sponsor
Taichung Veterans General Hospital
Brief Summary

Aims:

To investigate the efficacy of laser-acupuncture for the severity of primary headache and comorbidities, and the Lab data examination.

Methods:

In this hospital-based prospective single blind randomized sham-controlled study, patients over 18 years old with primary headache will be randomly divided into two treatment arms including laser-acupuncture and sham-controlled group. The expected laser-acupuncture protocol will be bilateral BL2, GB20, EX-HN5, GB8, LI4, LR3 and midline EX-HN3 in totally eight sessions at the first month. In the sham-laser-acupuncture group, patients will receive eight sessions of laser-acupuncture for free after unblinding. We expected to track patients for at least half year. The diagnosis and classification of headache was evaluated using the ICHD-3 criteria. The severity of headache was evaluated using Migraine Disability Assessment (MIDAS) and headache diary provided by Taiwan Headache Society. The co-primary efficacy end points are change in migraine days per month and variation of MIDAS. The secondary end point is the reducing of the severity of comorbidities including headache related anxiety and depression, and both of the quality of life and sleep.

In addition, patients' characteristics will be investigated as follows:

1. Sociodemographic factors (ethnicity, age, sex, body weight, BMI, blood pressure)

2. Headache related parameters (onset, duration, pain scale, current medication for headache, menstrual cycle)

3. Anxiety, evaluate by Hospital Anxiety and Depression Scale (HADS)

4. Depression, evaluate by Beck's Depression Inventory

5. Quality of life, evaluate by 36-Item Short Form Survey (SF-36)

6. Quality of sleep, evaluate by Pittsburgh Sleep Quality Index (PSQI)

7. Aura of headache

8. Episodic or chronic headache (If patient diagnosed as migraine.)

9. Nausea, vomiting, photophobia, phonophobia (If patient diagnosed as migraine.) During the following time, we will need the patient's blood samples four times, each times 20cc, all need 80cc for Lab test of MMP2, CGRP, substance P, beta-endorphin.

Importance:

In our hospital, we perform laser-acupuncture for patients with headache for several years. A prospective randomized controlled study is the key tools to establish the efficacy of laser-acupuncture for primary headache, and the Lab data with MMP2, CGRP, substance P, beta-endorphin for approval. Look forward to help improve therapeutic strategies in clinical practice.

Detailed Description

Headache is one of the most common complaints encountered in medical institution as known as an almost universal human experience. Approximately 65% of headaches are classified as primary, which was a composite of migraine, tension-type headache, trigeminal autonomic cephalalgia and other primary headaches according to the third edition of the International Classification of Headache Disorders (ICHD-3). Primary headaches encompass a heterogeneous group of neurologic disorders and might be bothersome for patients.

It's well established that acupuncture can be considered a treatment option for migraine prevention. The efficacy of laser-acupuncture is similar to acupuncture, and laser-acupuncture is a non-invasive therapeutic approach and safety. It could reduce the risk of hemorrhage, infection and needle phobia. However, the efficacy of laser-acupuncture in primary headache remains inconclusive.

MMP2, CGRP, substance P, beta-endorphin are new Lab examination for following up the patients suffered from migraine.

Aims:

To investigate the efficacy of laser-acupuncture for the severity of primary headache and comorbidities, and the Lab data examination.

Methods:

In this hospital-based prospective single blind randomized sham-controlled study, patients over 18 years old with primary headache will be randomly divided into two treatment arms including laser-acupuncture and sham-controlled group. The expected laser-acupuncture protocol will be bilateral BL2, GB20, EX-HN5, GB8, LI4, LR3 and midline EX-HN3 in totally eight sessions at the first month. In the sham-laser-acupuncture group, patients will receive eight sessions of laser-acupuncture for free after unblinding. We expected to track patients for at least half year. The diagnosis and classification of headache was evaluated using the ICHD-3 criteria. The severity of headache was evaluated using Migraine Disability Assessment (MIDAS) and headache diary provided by Taiwan Headache Society. The co-primary efficacy end points are change in migraine days per month and variation of MIDAS. The secondary end point is the reducing of the severity of comorbidities including headache related anxiety and depression, and both of the quality of life and sleep.

In addition, patients' characteristics will be investigated as follows:

1. Sociodemographic factors (ethnicity, age, sex, body weight, BMI, blood pressure)

2. Headache related parameters (onset, duration, pain scale, current medication for headache, menstrual cycle)

3. Anxiety, evaluate by Hospital Anxiety and Depression Scale (HADS)

4. Depression, evaluate by Beck's Depression Inventory

5. Quality of life, evaluate by 36-Item Short Form Survey (SF-36)

6. Quality of sleep, evaluate by Pittsburgh Sleep Quality Index (PSQI)

7. Aura of headache

8. Episodic or chronic headache (If patient diagnosed as migraine.)

9. Nausea, vomiting, photophobia, phonophobia (If patient diagnosed as migraine.) During the following time, we will need the patient's blood samples four times, each times 20cc, all need 80cc for Lab test of MMP2, CGRP, substance P, beta-endorphin.

Importance:

In our hospital, we perform laser-acupuncture for patients with headache for several years. A prospective randomized controlled study is the key tools to establish the efficacy of laser-acupuncture for primary headache, and the Lab data with MMP2, CGRP, substance P, beta-endorphin for approval. Look forward to help improve therapeutic strategies in clinical practice.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Migraine patient under the diagnosis and classification of headache was evaluated using the ICHD-3 criteria.
Exclusion Criteria
  • Age under 18 years old
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Laser treatmentLaser PenCM patients with unsatisfactory pharmacological effects receive laser acupuncture for 8 sessions that spanned 4 weeks. Laser stimulation energy of 4.5 J for 30 seconds at each of the following acupoints: bilateral Cuanzhu (BL2), Fengchi (GB20), Taiyang (EX-HN5), Shuaigu (GB8), Hegu (LI4), Taichong (LR3) and midline Yintang (EX-HN3)
Sham treatmentObservationCM patients with unsatisfactory pharmacological effects receive sham treatment for 8 sessions that spanned 4 weeks. Sham treatment had no laser output.
Primary Outcome Measures
NameTimeMethod
cGRP12 weeks, 24 weeks, 36 weeks

change in cGRP from baasline and each follow-up time point

MMP212 weeks, 24 weeks, 36 weeks

change in MMP2 from baasline and each follow-up time point

Secondary Outcome Measures
NameTimeMethod
Difference in the number of headache days per month12 weeks, 24 weeks, 36 weeks

change in monthly migraine days (MMD) from baseline and each follow-up time point

Difference in the of headache attacks lasting hours per month12 weeks, 24 weeks, 36 weeks

change in acute headache medications usage days per month from baseline and each follow-up time point

Difference in the headache pain intensity (NRS)12 weeks, 24 weeks, 36 weeks

changes in the headache severity (based on NRS) between baseline and each follow-up time point

Difference in the number of days with acute headache medication intake per month12 weeks, 24 weeks, 36 weeks

change in acute headache medications usage days per month from baseline and each follow-up time point

Difference in the Migraine Disability Assessment12 weeks, 24 weeks, 36 weeks

changes in the Migraine Disability Assessmen between baseline and each follow-up time point.

Title: Migraine Disability Assessmen Maximum value:450 Minimum value:0 Higher scores mean: worsen outcome

Difference in the Beck's Depression Inventory12 weeks, 24 weeks, 36 weeks

change in Beck's Depression Inventory between baseline and each follow-up time point

Title:Beck's Depression Inventory Maximum value:63 Minimum value:0 Higher scores mean: worsen outcome

Difference in the Hospital Anxiety and Depression Scale12 weeks, 24 weeks, 36 weeks

change in Hospital Anxiety and Depression Scale between baseline and each follow-up time point

Title:Hospital Anxiety and Depression Scale Maximum value:21/21 Minimum value:0/0 Higher scores mean:worsen outcome

30% reduction in migraine days12 weeks, 24 weeks, 36 weeks

≥ 30% reduction in migraine days between baseline and each follow-up time point

Substance P12 weeks, 24 weeks, 36 weeks

change in Substance P from baasline and each follow-up time point

beta-endorphin12 weeks, 24 weeks, 36 weeks

change in beta-endorphin from baasline and each follow-up time point

Trial Locations

Locations (1)

Taichung Veterans General Hospital

🇨🇳

Taichung, Taichang, Taiwan

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