Impact of Nocturnal Environmental Noise on Phosphorylated Protein Kinase C Epsilon Pathway and Warmth Acupuncture Efficacy in Patients with Migraine.

BACKGROUND: Environmental noise exposure is a potential trigger, potentially exacerbating migraine through stress-related activation of phosphorylated protein kinase C epsilon (PKCε)-mediated nociceptive pathways. Warmth acupuncture therapy offers a potential complementary treatment. This study investigates the effect of nocturnal noise on PKCε markers and the efficacy of warmth acupuncture in patients with migraine. METHODS: 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 [≤45 dB(A), n = 110] and high noise [>45 dB(A), n = 110]. Both groups received warmth acupuncture. Pain, sleep, anxiety, and biochemical markers (p-PKCε, 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 t-tests, and categorical variables were compared using chi-square tests. Pearson's correlation analysis was used to assess relationships between noise levels and PKCε pathway markers. RESULTS: 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 PKCε pathway marker expression than the high-noise group (P < 0.05 for all). Correlation analysis revealed that higher noise levels were significantly associated with increased PKCε pathway markers. CONCLUSION: Lower nocturnal noise levels were associated with greater treatment response to warmth acupuncture and reduced PKCε pathway activation, suggesting that environmental noise may play an important role in migraine pathophysiology.