Can upper cervical manual therapy affect the blink reflex in subjects with migraine and neck pain?

Neck pain is a common complaint among migraineurs possibly due to the anatomic connections between cervical and trigeminal afferents in the trigeminocervical complex (TCC). Manual therapy (MT) is used in the management of headache disorders, with demonstrable neurophysiological effects. The blink re...

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Published in:Journal of Manual & Manipulative Therapy (Taylor & Francis Ltd) Vol. 32; no. 2; pp. 190 - 198
Main Authors: Jafari, Mehdi, Bahrpeyma, Farid, Togha, Mansoureh, Hall, Toby, Vahabizad, Fahimeh, Jafari, Elham
Format: research tables/charts randomized controlled trial Journal Article
Published: Taylor & Francis Ltd Apr2024
Online Access:View this record in EBSCOhost
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      dt: Apr2024
      vid: 32
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/10669817.2023.2250172
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        atl: Can upper cervical manual therapy affect the blink reflex in subjects with migraine and neck pain?
      aug:
        au:
          Jafari, Mehdi
          Bahrpeyma, Farid
          Togha, Mansoureh
          Hall, Toby
          Vahabizad, Fahimeh
          Jafari, Elham
        affil: Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
      sug:
        subj:
          Migraine Therapy
          Neck Pain Therapy
          Manual Therapy Methods
          Cervical Vertebrae
          Blinking Physiology
          Reflex Physiology
          Treatment Outcomes
          Funding Source
          Human
          Descriptive Statistics
          Data Analysis Software
          T-Tests
          Randomized Controlled Trials
          Male
          Female
          Adult
          Middle Age
          Electrophysiology
          Neurophysiology
          Trigeminal Nerve
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Neck pain is a common complaint among migraineurs possibly due to the anatomic connections between cervical and trigeminal afferents in the trigeminocervical complex (TCC). Manual therapy (MT) is used in the management of headache disorders, with demonstrable neurophysiological effects. The blink reflex (BR) is one method of analyzing neurophysiological effects in headache patients. The purpose of this study was to investigate the effect of upper cervical spine MT on BR in subjects with migraine and neck pain. Twenty subjects were assigned to a medication plus MT (MedMT) group (n = 10) and medication plus sham MT (sham MT) group (n = 10). After random assignment, all patients underwent testing for the BR (R1, R2, R2c responses). Then, subjects in group MedMT and group sham MT received either 4 sessions of MT or sham MT to the upper cervical spine. After completion of the intervention, BR testing was repeated. There were no significant differences in both side R1 latency between group MT and group sham MT (P > 0.050). For both sides, R2 latencies were significantly prolonged in MedMT group compared with sham MT group (P < 0.050). Subjects in MedMT group showed significant prolongation in right and left R2c latency compared with sham MT group (P < 0.050). The present study demonstrated that upper cervical MT affected trigeminal nociceptive neurotransmission in subjects with migraine and neck pain as reflected by changes in the BR. The increase in BR late response latencies of BR indicates an inhibitory effect of upper cervical spine MT on the TCC in these subjects. Trial Registration: The trial design was registered at the Iranian Registry of Clinical Trials (IRCT ID: IRCT20160621028567N2, url: ) before the first patient was enrolled.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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