{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:37:00Z","timestamp":1786653420785,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"129","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Environmental noise exposure is a potential trigger, potentially exacerbating migraine through stress-related activation of phosphorylated protein kinase C epsilon (PKC\u03b5)-mediated nociceptive pathways. Warmth acupuncture therapy offers a potential complementary treatment. This study investigates the effect of nocturnal noise on PKC\u03b5 markers and the efficacy of warmth acupuncture in patients with migraine.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A retrospective cohort study of 220 patients with migraine was conducted. The patients were divided into two groups based on nocturnal noise exposure: low noise [\u226445 dB(A),\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009110] and high noise [&gt;45 dB(A),\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009110]. Both groups received warmth acupuncture. Pain, sleep, anxiety, and biochemical markers (p-PKC\u03b5, phosphorylated cyclic adenosine monophosphate (cAMP) response element binding protein and phosphorylated signal transducer and activator of transcription 1) were evaluated before and after 1 month of therapy. Continuous variables were compared using independent\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    -tests, and categorical variables were compared using chi-square tests. Pearson\u2019s correlation analysis was used to assess relationships between noise levels and PKC\u03b5 pathway markers.\n                    <jats:bold>Results:<\/jats:bold>\n                    After 1 month, the low-noise group was associated with significantly more favorable distribution of migraine symptom severity, lower visual analog scale pain scores, better sleep quality, lower anxiety levels, and lower PKC\u03b5 pathway marker expression than the high-noise group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05 for all). Correlation analysis revealed that higher noise levels were significantly associated with increased PKC\u03b5 pathway markers.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Lower nocturnal noise levels were associated with greater treatment response to warmth acupuncture and reduced PKC\u03b5 pathway activation, suggesting that environmental noise may play an important role in migraine pathophysiology.\n                  <\/jats:p>","DOI":"10.4103\/nah.nah_148_25","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T12:00:17Z","timestamp":1767441617000},"page":"842-852","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Nocturnal Environmental Noise on Phosphorylated Protein Kinase C Epsilon Pathway and Warmth Acupuncture Efficacy in Patients with Migraine"],"prefix":"10.4103","volume":"27","author":[{"given":"Qiang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaoGuang","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChengLin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZhongTing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WangJun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Functional, Second People\u2019s Hospital of Gansu Province, Lanzhou 730000, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaoZheng","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Massage College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, 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