Reed William R, Pickar Joel G, Sozio Randall S, Long Cynthia R
Associate Professor, Palmer Center for Chiropractic Research, Davenport, Iowa.
Professor Emeritus, Palmer Center for Chiropractic Research, Davenport, Iowa.
J Manipulative Physiol Ther. 2014 Jun;37(5):277-86. doi: 10.1016/j.jmpt.2014.04.001.
High-velocity low-amplitude spinal manipulation (HVLA-SM), as performed by doctors who use manual therapy (eg, doctors of chiropractic and osteopathy), results in mechanical hypoalgesia in clinical settings. This hypoalgesic effect has previously been attributed to alterations in peripheral and/or central pain processing. The objective of this study was to determine whether thrust magnitude of a simulated HVLA-SM alters mechanical trunk response thresholds in wide dynamic range (WDR) and/or nociceptive specific (NS) lateral thalamic neurons.
Extracellular recordings were carried out in the thalamus of 15 anesthetized Wistar rats. Lateral thalamic neurons having receptive fields, which included the lumbar dorsal-lateral trunk, were characterized as either WDR (n=22) or NS (n=25). Response thresholds to electronic von Frey (rigid tip) mechanical trunk stimuli were determined in 3 directions (dorsal-ventral, 45° caudalward, and 45° cranialward) before and immediately after the dorsal-ventral delivery of a 100-millisecond HVLA-SM at 3 thrust magnitudes (control, 55%, 85% body weight).
There was a significant difference in mechanical threshold between 85% body weight manipulation and control thrust magnitudes in the dorsal-ventral direction in NS neurons (P=.01). No changes were found in WDR neurons at either HVLA-SM thrust magnitude.
This study is the first to investigate the effect of HVLA-SM thrust magnitude on WDR and NS lateral thalamic mechanical response threshold. Our data suggest that, at the single lateral thalamic neuron level, there may be a minimal spinal manipulative thrust magnitude required to elicit an increase in trunk mechanical response thresholds.
由使用手法治疗的医生(如脊椎按摩师和整骨疗法医生)进行的高速低振幅脊柱推拿(HVLA-SM),在临床环境中会导致机械性痛觉减退。这种痛觉减退效应此前被归因于外周和/或中枢疼痛处理的改变。本研究的目的是确定模拟HVLA-SM的推力大小是否会改变宽动态范围(WDR)和/或伤害性特异性(NS)丘脑外侧核神经元的躯干机械反应阈值。
对15只麻醉的Wistar大鼠的丘脑进行细胞外记录。将具有包括腰背部外侧躯干在内的感受野的丘脑外侧核神经元分为WDR(n = 22)或NS(n = 25)两类。在以3种推力大小(对照、体重的55%、85%)进行背腹向100毫秒的HVLA-SM之前和之后,立即在3个方向(背腹向、尾向45°、头向45°)测定对电子von Frey(硬尖端)躯干机械刺激的反应阈值。
在NS神经元中,85%体重的推拿与对照推力大小在背腹向的机械阈值存在显著差异(P = 0.01)。在任何一种HVLA-SM推力大小下,WDR神经元均未发现变化。
本研究首次调查了HVLA-SM推力大小对WDR和NS丘脑外侧核机械反应阈值的影响。我们的数据表明,在单个丘脑外侧核神经元水平上,可能存在一个引发躯干机械反应阈值升高所需的最小脊柱推拿推力大小。