Abstract: Migraine is a clinically common cerebrovascular disorder of the central nervous system with a complex pathological mechanism involving changes in multi-omic features such as imaging genomics and genomics. Acupuncture has a long history of safe and effective use in migraine treatment, yet its precise mechanism of action remains incompletely elucidated. Neuroimaging research over the past two decades has shown that acupuncture primarily alleviates migraine through two pathways: blocking the ascending transmission of trigeminal nerve pain signals and activating the descending analgesic system, reflecting the general mechanism of acupuncture analgesia. However, it remains unclear whether acupuncture can specifically modulate neuroimaging phenotypes associated with the pathological core or etiology of migraine. In recent years, Mendelian randomization (MR) has seen increasingly widespread application in causal inference. Researchers have utilized MR to explore the clinical causal relationships between migraine and structural neuroimaging phenotypes, preliminarily identifying core neuroimaging phenotypes linked to migraine pathology. Building on this, this study aims to integrate neuroimaging omics, Mendelian randomization analysis, and traditional Chinese medicine acupuncture theory to explore the research approach of acupuncture's effects on the pathophysiological specificity mechanisms of migraine.

Key words: Migraine disorders, Acupuncture, Mendelian randomization, Research framework, Mechanistic investigation

摘要： 偏头痛是一种临床常见的中枢神经系统血管性疾病，其病理机制复杂，涉及影像组学、基因组学等多组学特征的变化。针刺治疗偏头痛历史悠久，安全有效，但其具体作用机制尚未完全阐明。近二十余年的神经影像组学研究表明，针刺治疗偏头痛主要通过阻断三叉神经疼痛信号的上行传导和激活下行镇痛系统这两条途径发挥作用，体现了针刺镇痛的普适性机制。然而，针刺是否能针对偏头痛病理核心或病因相关的特定神经影像表型进行调节，目前仍不明确。近年来，孟德尔随机化（MR）方法在因果推断中的应用日益广泛，已有研究者利用 MR 技术探索了偏头痛与神经影像结构表型之间的临床因果关系，初步识别出偏头痛病理变化的核心神经影像表型。基于以上背景，本研究旨在结合神经影像组学、MR 分析与传统中医针灸理论，探讨针刺对偏头痛特异性病理机制作用的研究思路。

关键词: 偏头痛, 针刺, 孟德尔随机化, 研究思路, 机制探讨