Acupressure Not Effective as Adjunctive Therapy to Sodium Valproate for Chronic Migraine With Aura

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The primary outcome of the trial was the intensity of chronic migraine with aura pain measured using a Numeric Rating Scale.
The primary outcome of the trial was the intensity of chronic migraine with aura pain measured using a Numeric Rating Scale.

The treatment of chronic migraine with aura may not benefit from acupressure as an adjunctive therapy to sodium valproate, according to results from a study recently published in Medicine.1 

Ji-Hua Xu, MM and He-yin Mi, MM, from the department of neurology at the Beijing ChaoYang Hospital in China, conducted a randomized controlled trial from February 2015 to January 2017. A total of 98 patients were randomly assigned to either into an intervention group or a control group. Patients in both groups were administered sodium valproate 800 mg/day for 8 weeks, and the intervention group was also given acupressure.

The primary outcome of the trial was the intensity of chronic migraine with aura pain, measured using a Numeric Rating Scale (NRS). Differences from baseline levels were similar after 8 weeks of treatment in both the intervention and the control groups (n=49 for each; NRS, ˗3.5 vs ˗3.3, respectively; P =.37; migraine attacks, ˗2.0 vs ˗1.9, respectively; P =.67).

In a similar fashion, other outcome measurements, such as physical functioning and body pain, were not significantly improved by the treatment. Migraine-related nausea was the only treatment-related adverse event improved by acupressure, with only 1 vs 8 study participants affected in the intervention group (P =.04).  

“No significant differences were found in the pain associated with [chronic migraine with aura], as measured using the NRS, the frequency of migraine attacks, and the consumption of analgesics in the intervention group than in the control group,” concluded Dr Xu. “However, we found that [sodium valproate combined with acupressure] significantly reduced the frequency of migraine-related nausea.”

Summary & Clinical Applicability

Acupressure can neither reduce the intensity of the pain in chronic migraine with aura nor improve quality of life, but may prove beneficial for patients experiencing migraine-related nausea.

Limitations & Disclosures

  • This study examines the effect of acupressure with sodium valproate as participants were unable to interrupt their pain medications, so the effects of acupressure on chronic migraine with aura alone may differ
  • The study is limited to a single-center and includes only participants of Chinese Han ethnicity
  • A possible bias was introduced as participants were not blinded in the study

 

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Reference

  1. Xu JH, Mi HY. A randomized controlled trial of acupressure as an adjunctive therapy to sodium valporate on the prevention of chronic migraine with aura. Medicine (Baltimore). 2017;96(27):e7477. doi:10.1097/MD.0000000000007477.

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