Ogura Takeshi, Tashiro Manabu, Masud Mehedi, Watanuki Shoichi, Shibuya Katsuhiko, Yamaguchi Keiichiro, Itoh Masatoshi, Fukuda Hiroshi, Yanai Kazuhiko
Division of Cyclotron Nuclear Medicine, Tohoku University, Sendai, Japan.
Altern Ther Health Med. 2011 Nov-Dec;17(6):12-7.
Chiropractic spinal manipulation (CSM) is an alternative treatment for back pain. The autonomic nervous system is often involved in spinal dysfunction. Although studies on the effects of CSM have been performed, no chiropractic study has examined regional cerebral metabolism using positron emission tomography (PET).
The aim of the present study was to investigate the effects of CSM on brain responses in terms of cerebral glucose metabolic changes measured by [18F]fluorodeoxyglucose positron emission tomography (FDG-PET).
Twelve male volunteers were recruited. Brain PET scanning was performed twice on each participant, at resting and after CSM. Questionnaires were used for subjective evaluations. A visual analogue scale (VAS) was rated by participants before and after chiropractic treatment, and muscle tone and salivary amylase were measured.
Increased glucose metabolism was observed in the inferior prefrontal cortex, anterior cingulated cortex, and middle temporal gyrus, and decreased glucose metabolism was found in the cerebellar vermis and visual association cortex, in the treatment condition (P < .001). Comparisons of questionnaires indicated a lower stress level and better quality of life in the treatment condition. A significantly lower VAS was noted after CSM. Cervical muscle tone and salivary amylase were decreased after CSM. Conclusion The results of this study suggest that CSM affects regional cerebral glucose metabolism related to sympathetic relaxation and pain reduction.
整脊脊柱推拿术（CSM）是一种治疗背痛的替代疗法。自主神经系统常与脊柱功能障碍有关。尽管已经开展了关于CSM效果的研究，但尚无整脊学研究使用正电子发射断层扫描（PET）来检查局部脑代谢情况。
本研究旨在根据[18F]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）测量的脑葡萄糖代谢变化，研究CSM对脑反应的影响。
招募了12名男性志愿者。对每位参与者在静息状态和接受CSM后各进行两次脑部PET扫描。使用问卷进行主观评估。参与者在整脊治疗前后进行视觉模拟评分（VAS），并测量肌张力和唾液淀粉酶。
在治疗状态下，观察到前额叶下回、前扣带回皮质和颞中回的葡萄糖代谢增加，而小脑蚓部和视觉联合皮质的葡萄糖代谢减少（P <.001）。问卷比较表明，在治疗状态下压力水平较低且生活质量较好。CSM后VAS显著降低。CSM后颈部肌张力和唾液淀粉酶降低。结论：本研究结果表明，CSM影响与交感神经放松和疼痛减轻相关的局部脑葡萄糖代谢。
