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Can Upper Cervical Manual Therapy Affect the Blink Reflex in Subjects With Migraine and Neck Pain? Publisher Pubmed



Jafari M1 ; Bahrpeyma F1 ; Togha M2, 3 ; Hall T4 ; Vahabizad F2, 3 ; Jafari E2
Authors
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Authors Affiliations
  1. 1. Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
  2. 2. Headache Department, Neurology Ward, Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Curtin School of Allied Health, Curtin University, Perth, Australia
  5. 5. Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Manual and Manipulative Therapy Published:2024


Abstract

Background: 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. Methods & Materials: 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. Results: 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). Discussion: 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: https://www.irct.ir/) before the first patient was enrolled. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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