Osteopathic Manual Therapy (OMT) and Brain Structure and Function in Primary Headache Patients: A Pilot Study

Edward Via Virginia College of Osteopathic Medicine31 enrolled

Overview

Chronic headaches are associated with changes in brain structure and function that may be associated with increased suffering and disability. Understanding how Osteopathic Manipulative Therapy (OMT) affects these changes would reveal new insight into how the brain processes pain and returns to normal function. Also, demonstrating these changes would provide evidence regarding how OMT causes a reduction in pain and disability, supporting the recommendation for OMT as a primary treatment option for headaches.

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Primary Headaches (Migraines, Tension, Cluster Headaches)

Interventions

Evaluation looking for Somatic Dysfunction (SD) involving the head, neck, upper thoracic spine, rib cage and sacroiliac joint. OMT techniques will include a mix of the following: Osteopathic Cranial Manipulative Medicine, Muscle Energy Technique, Facilitated Positional Release, Indirect Myofascial Release, and Counterstrain.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * current diagnosis of primary headache (migraine, tension-type, cluster) from a healthcare provider * have experienced at least one headache episode a month for the previous 1 year (or longer) * age of PH onset was less than 50 years, currently taking medication for headaches. Exclusion Criteria: * presence of headaches due to some other underlying medical condition (secondary headaches) * traumatic brain injury * fibromyalgia, epilepsy * diagnosis of a neurodegenerative disorder * history of brain tumor or cancer * history of cervical radiculopathy (pinched nerve in the neck) * currently undergoing manual therapy type treatment or have a a treatment within 2 weeks of enrollment(chiropractic, OMT, massage, PT) * currently pregnant * have had an injection to treat headaches within the previous 3 months from study enrollment * contraindications to MRI.

Outcomes

Primary Outcomes

Brain Structural and Functional Changes

Structural MRI will assess physical changes in brain anatomy, including differences in the size, shape, or density of specific brain regions. For example, changes in gray matter volume or white matter integrity may indicate neuroplasticity changes response to an OMT. Functional MRI (fMRI) will measure brain activity by detecting changes in blood flow within the central pain network. When a specific brain region becomes more active, it requires more oxygen, which fMRI can detect. This will help determine whether the intervention alters brain function, such as increased activation in areas involved in movement, memory, or pain processing. Magnetic Resonance Spectroscopy (MRS), unlike standard MRI, which provides images of brain structures, will analyze chemical changes in the brain. It detects levels of important brain metabolites involved in neural signaling neuronal health.