title: 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.
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. sunny_smile_824@163.com.|Department of Anatomy, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China. sunny_smile_824@163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Hou
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. xiejfan@163.com.
authors.forename: Jun-Fan
authors.initials: JF
authors.lastname: Xie
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. kongxp530@163.com.|Department of Human Anatomy, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Changsha 410013, China. kongxp530@163.com.
authors.forename: Xiang-Pan
authors.initials: XP
authors.lastname: Kong
authors.affiliation: Department of Neurology and Pain Treatment, Gansu Province People Hospital, Lanzhou 730000, China. zhangyi9310@21cn.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. shaoyf@lzu.edu.cn.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Shao
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. wangc2012@lzu.cn.
authors.forename: Can
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. renwt13@163.com.
authors.forename: Wen-Ting
authors.initials: WT
authors.lastname: Ren
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. cgf0204@163.com.
authors.forename: Guang-Fu
authors.initials: GF
authors.lastname: Cui
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. xinle9058@163.com.
authors.forename: Le
authors.initials: L
authors.lastname: Xin
authors.affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. houyiping@lzu.edu.cn.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Hou
mesh_terms: D015669:Acupuncture Points; D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005152:Facial Muscles; D005260:Female; D006801:Humans; D007267:Injections; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000523:psychology; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: acupoint-sites injection; botulinum toxin type A; fixed-sites injection; migraine; randomized and placebo-controlled trial