Year: 2010
Type: dissertation
Abstract: Objective: Chiropractic spinal manipulation (CSM) is known as an alternative treatment mainly for back pain.It is included in one of the alternative cares of medicine by world health organization (WHO) and is presently legislated over 20 countries in the world.Although there are around 8,000 chiropractic practitioners in Japan, there is no official licensure system and official educational system unlike other developing countries.Despite clinical evidences for benefits of CSM and apparent wide usage of it, physiological mechanisms underlying the effects of CSM are not clearly known.The aim of the present study is to investigate the effects of CSM on brain responses in terms of cerebral glucose metabolic changes measured by FDG-PET.Methods: Twelve male volunteers were recruited in the present study.Brain PET scanning was performed twice on each subject, the resting condition and the treatment condition, and PET images were compared between those two conditions.Questionnaires were used for subjective evaluations.Visual analogue scale (VAS) was rated by subjects before and after CSM for an evaluation of subjective pain sensation.Muscle tone at the upper trapezius muscle was measured bilaterally in resting and treatment conditions to evaluate a peripheral effect, and salivary amylase was also measured in two conditions to evaluate the autonomic response.The electrocardiogram (ECG) monitoring was also performed in resting and treatment conditions to analyze heart rate variability (HRV) for evaluating autonomic response.Additionally, correlation analyses were performed between PET images and the VAS scores of subjective pain sensation.Results: In the present study, significant differences were observed on some brain areas.Increased glucose metabolism was observed in the inferior prefrontal cortex, anterior cingulated cortex, and middle temporal gyrus whereas decreased glucose metabolism was observed in the cerebellar vermis and the visual association cortex on the PET analysis in the treatment condition (p<0.001).The scores of the questionnaire which indicate stress level was lower in the treatment condition.The comparisons of VAS scores revealed significantly lower values after CSM.Measurements of cervical muscle tone and salivary amylase also indicated reduced values in the treatment condition.The correlation analysis indicated a positive correlation between the regional cerebral glucose metabolism in the orbitofrontal cortex and in the caudate nucleus and VAS scores of subjective pain sensation.Conclusion: Results of the present study might indicate CSM procedure affects on the regional cerebral metabolism related to relaxation and pain reduction which are associated with changes of the autonomic function.Therefore, it is possible to state that a single CSM treatment affects the central nervous system.
Author: 毅 小倉
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2295052975