Figure 3: Regional activation (left) and deactivation (right) after spinal manipulation therapy (SMT) using an activator adjusting instrument. Glucose metabolism is increased in regions including the anterior cingulate cortex and cerebellar vermis but is relatively reduced in many sites, including the prefrontal cortex, after SMT. The voxel height threshold is p<0.05, corrected for multiple comparisons; the extent threshold is 10 voxels minimum
The aim of this study was to investigate changes in brain and muscle glucose metabolism that are not yet known, using positron emission tomography with [
18F]fluorodeoxyglucose ([ 18F]FDG PET). Methods
Twenty-one male volunteers were recruited for the present study. [
18F]FDG PET scanning was performed twice on each subject: once after the spinal manipulation therapy (SMT) intervention (treatment condition) and once after resting (control condition). We performed the SMT intervention using an adjustment device. Glucose metabolism of the brain and skeletal muscles was measured and compared between the two conditions. In addition, we measured salivary amylase level as an index of autonomic nervous system (ANS) activity, as well as muscle tension and subjective pain intensity in each subject. Results
Changes in brain activity after SMT included activation of the dorsal anterior cingulate cortex, cerebellar vermis, and somatosensory association cortex and deactivation of the prefrontal cortex and temporal sites. Glucose uptake in skeletal muscles showed a trend toward decreased metabolism after SMT, although the difference was not significant. Other measurements indicated relaxation of cervical muscle tension, decrease in salivary amylase level (suppression of sympathetic nerve activity), and pain relief after SMT.
The findings of the present study demonstrate how stimuli to the mechanoreceptors of the joints and skin during SMT are processed in the brain. Brain processing after SMT may lead to physiological relaxation via a decrease in sympathetic nerve activity.
Evidence-Based Complementary and Alternative Medicine, Volume 2017 (2017)
Author information: Akie Inami, Takeshi Ogura, Shoichi Watanuki, Md. Mehedi Masud, Katsuhiko Shibuya, Masayasu Miyake, Rin Matsuda, Kotaro Hiraoka, Masatoshi Itoh,
Arlan W. Fuhr, Kazuhiko Yanai, and Manabu Tashiro. Tohoku University, Sendai, Japan. Full Text Article More in this category: Resolution of Lower Limb Sensory Polyneuropathy In A 63-Year-Old Male Receiving Activator Methods Chiropractic Technique For The Correction Of Vertebral Subluxation » Spinal Tissue Loading Created by Different Methods of Spinal Manipulative Therapy Application. » Manual and Instrument Applied Cervical Manipulation for Mechanical Neck Pain: A Randomized Controlled Trial. » Manual and Instrument Applied Cervical Manipulation for Mechanical Neck Pain: A Randomized Controlled Trial. » Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series » Resolution of Cervicalgia, Paraesthesia and Chronic Adhesive Capsulitis in a 67-Year-Old Male: A Case Study » Neural Response During a Mechanically Assisted Spinal Manipulation in an Animal Model: A Pilot Study » In Vitro Biomechanical Evaluation of Single Impulse and Repetitive Mechanical Shockwave Devices Utilized for Spinal Manipulative Therapy » Neural responses to the mechanical parameters of a high-velocity, low-amplitude spinal manipulation: effect of preload parameters. » Effects of thrust amplitude and duration of high velocity low amplitude spinal manipulation on lumbar muscle spindle responses to vertebral position and movement. » Changes in pressure pain thresholds and Basal electromyographic activity after instrument-assisted spinal manipulative therapy in asymptomatic participants: a randomized, controlled trial. » Evaluation of Mechanical Allodynia in an Animal Immobilization Model using the Von Frey Method » Cerebral Metabolic Changes in Men After Chiropractic Spinal Manipulation for Neck Pain » Immediate Effects of the Audible Pop from a Thoracic Spine Thrust Manipulation on the Autonomic Nervous System and Pain: A Secondary Analysis of a Randomized Clinical Trial » Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain. » Relative effectiveness and adverse effects of cervical manipulation, mobilisation and the activator instrument in patients with sub-acute non-specific neck pain: results from a stopped randomised trial. » Resolution of Breech Presentation Using an Activator Adjusting Instrument to Administer Webster’s Technique in Three Women Undergoing Chiropractic Care » Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in Pain » Effects of a Manually Assisted Mechanical Force on Cutaneous Temperature » Spinal Manipulation Reduces Pain and Hyperalgesia after Lumbar Intervertebral Foramen Inflammation in the Rat » Chiropractic Treatment of Temporomandibular Disorders Using the Activator Adjusting Instrument and Protocol » Spinal Manipulation Alters Electromyographic Activity of Paraspinal Muscles: A Descriptive Study » Active Trunk Extensor Contributions to Dynamic Posteroanterior Lumbar Spinal Stiffness » Neuromechanical Characterization of in Vivo Lumbar Spinal Manipulation. Part II. Neurophysiological Response » Neuromechanical Characterization of In Vivo Lumbar Spinal Manipulation. Part I. Vertebral Motion » Chiropractic Management of Ehlers-Danlos Syndrome: A Report of Two Cases » Chiropractic Treatment of Temporomandibular Disorders Using the Activator Adjusting Instrument: A Prospective Case Series » Lateral Cervical Curve Changes in Patients Receiving Chiropractic Care After A Motor Vehicle Collision: A Retrospective Case Series » Chiropractic Management Of Chronic Chest Pain Using Mechanical Force, Manually Assisted Short-Lever Adjusting Procedures » Chiropractic Treatment of Postsurgical Neck Syndrome With Mechanical Force, Manually Assisted Short-Lever Spinal Adjustments » Stiffness and Neuromuscular Reflex Response of the Human Spine to Posteroanterior Manipulative Thrusts In Patients With Low Back Pain » A Pilot Randomized Clinical Trial on the Relative Effect of Instrumental Versus Manual Thrust Manipulation in the Treatment of Cervical Spine Dysfunction. » Muscular and Soft-Tissue Contributions of Dynamic Posteroanterior Spinal Stiffness » Lumbar Erector Spinae Reflex Responses to Mechanical Force, Manually- Assisted Thoracolumbar and Sacroiliac Joint Manipulation in Patients with Low Back Pain » Neurophysiological Response to Intraoperative Lumbosacral Spinal Manipulation » Electromyographic Responses To Mechanical Force, Manually Assisted Spinal Manipulative Therapy » Mechanical Force Spinal Manipulation Increases Trunk Muscle Strength Assessed By Electromyography: A Comparative Controlled Clinical Trial » Reflex Responses Associated with Activator Treatment » Chiropractic Treatment of Coccygodynia via External Instrumental Adjusting Procedures utilizing Activator Methods Chiropractic Technique. » Muscular and Mechanical Behavior of the Lumbar Spine in Response to Dynamic Posteroanterior Forces » Treatment of Cervical Disc Protrusions Via Instrumental Chiropractic Adjustment. » Treatment of Symptomatic Lumbar Disc Herniation Utilizing Activator Methods Chiropractic Technique » Safety in chiropractic practice. Part II: Treatment to the upper neck and the rate of cerebrovascular incidents. » Letters to the Editor | Safety in chiropractic practice. Part II: Treatment to the upper neck and the rate of cerebrovascular incidents. » Comparison of Two Chiropractic Techniques on Pain and Lateral Flexion in Neck Pain Patients: a Pilot Study » Manipulation and mobilization of the cervical spine. A systematic review of the literature. » Three-Dimensional Head Kinematics and Cervical Range of Motion in the Diagnosis of Patients with Neck Trauma. » Instantaneous Helical Axis Estimation From 3-D Video Data in Neck Kinematics for Whiplash Diagnostics. » Biomechanical Characterization (fingerprinting) of Five Novel Methods of Cervical Spine Manipulation » Relationship between Preload and Peak Forces during Spinal Manipulative Treatments » Three-Dimensional Head Axis of Rotation During Tracking Movements: A Tool for Assessing Neck Neuromechanical Function » Three-dimensional Head Kinematics and Clinical Outcome of Patients with Neck Injury Treated with Spinal Manipulative Therapy: a Pilot Study » Cervical spine: manipulative skill and performance considerations » Spinal learning: central modulation of pain processing and long-term alteration of interneuronal excitability as a result of nociceptive peripheral input. » Interexaminer Reliability of an Isolation Test for the Identification of Upper Cervical Subluxation » Reliability of the Derifield-Thompson test for leg length inequality, and use of the test to demonstrate cervical adjusting efficacy. » Effects of altered afferent articular input on sensation, proprioception, muscle tone and sympathetic reflex responses. »