EAR PIERCING IN REGIONS ASSOCIATED WITH AURICULOTHERAPY: NEUROPHYSIOLOGICAL PERSPECTIVES ON MIGRAINE MODULATION

• DOI: https://doi.org/10.22533/at.ed.51572132624063

• Palavras-chave: Migraine; Auriculotherapy; Neuromodulation; Vagus Nerve; Daith Piercing; Chronic Pain.

• Keywords: Migraine; Auriculotherapy; Neuromodulation; Vagus Nerve; Daith Piercing; Chronic Pain.

• Abstract:

  Migraine is one of the most prevalent and disabling neurological disorders, characterized by complex mechanisms involving neuronal hyperexcitability, activation of the trigeminovascular system, neuroinflammation, and autonomic changes. Given the limitations associated with conventional pharmacological treatments, complementary neuromodulation strategies have attracted growing scientific interest. In this context, ear piercing in regions traditionally associated with auriculotherapy—especially daith piercing—has been investigated based on the hypothesis that continuous mechanical stimulation could influence neural pathways related to pain control. The objective of this study was to discuss, from a neurophysiological and translational perspective, the possible mechanisms involved in the modulation of migraine through auricular piercing. This is a narrative literature review conducted using the PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases, encompassing studies on migraine, auriculotherapy, auricular acupuncture, transcutaneous auricular vagal stimulation, and peripheral neuromodulation. The analyzed literature demonstrates that certain regions of the outer ear are innervated by the auricular branch of the vagus nerve, establishing connections with brain structures involved in autonomic and nociceptive modulation. Although there is evidence supporting the biological plausibility of auricular neuromodulation, specific studies on permanent auricular piercing remain limited, consisting predominantly of case reports and clinical observations. It is concluded that auricular piercing in areas associated with auriculotherapy has a neuroanatomical basis consistent with pain modulation mechanisms; however, current evidence is insufficient to validate its therapeutic efficacy in the treatment of migraine, necessitating controlled clinical trials and more robust neurophysiological investigations.