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Acupoint injection of onabotulinumtoxin A for migraines.

Abstract
Onabotulinumtoxin A (BoNTA) has been reported to be effective in the therapy for migraines. Acupuncture has been used worldwide for the treatment of migraine attacks. Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture. The purpose of this study was to evaluate and compare the effectiveness of fixed (muscle)-site and acupoint-site injections of BoNTA for migraine therapy in a randomized, double-blinded, placebo-controlled clinical trial extending over four months. Subjects with both episodic and chronic migraines respectively received a placebo (n = 19) or BoNTA (2.5 U each site, 25 U per subject) injection at fixed-sites (n = 41) including occipitofrontalis, corrugator supercilii, temporalis and trapeziue, or at acupoint-sites (n = 42) including Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20) and Tianzhu (BL10). The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures. BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01). The efficacy of BoNTA for migraines in the acupoint-site group (93% improvement) was more significant than that in the fixed-site group (85% improvement) (p < 0.01). BoNTA administration for migraines is effective, and at acupoint-sites shows more efficacy than at fixed-sites. Further blinded studies are necessary to establish the efficacy of a low dose toxin (25 U) introduced with this methodology in chronic and episodic migraines.
AuthorsMin Hou, Jun-Fan Xie, Xiang-Pan Kong, Yi Zhang, Yu-Feng Shao, Can Wang, Wen-Ting Ren, Guang-Fu Cui, Le Xin, Yi-Ping Hou
JournalToxins (Toxins (Basel)) Vol. 7 Issue 11 Pg. 4442-54 (Oct 30 2015) ISSN: 2072-6651 [Electronic] Switzerland
PMID26529014 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Acupuncture Points
  • Adolescent
  • Adult
  • Botulinum Toxins, Type A (administration & dosage, adverse effects, therapeutic use)
  • Double-Blind Method
  • Facial Muscles
  • Female
  • Humans
  • Injections
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Migraine Disorders (drug therapy, psychology)
  • Neuromuscular Agents (administration & dosage, adverse effects, therapeutic use)
  • Pain Measurement
  • Treatment Outcome
  • Young Adult

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