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Use of Osteopathic Manipulative Medicine in Treating Migraines

Journal: Journal of Osteopathic Medicine Date: 2022/12, 122(12):Pages: A20-A21. doi: Subito , type of study: animal experiment

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2022-2000/html)

Keywords:

animal experiment [36]
migraine [57]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Statement of Significance: Headache disorders, especially migraines, are among the leading causes of disability worldwide. Many people use medications such as triptans and NSAIDs (non-steroidal anti-inflammatory drugs) to mitigate their pain which are prone to induce medication overuse headaches that promote transition of episodic to chronic migraines. Thus, efficacious non-pharmacological treatments such as Osteopathic Manipulative Treatment (OMT) would be advantageous and highly desirable. Research Methods: To induce migraines in rats, we utilized a monoterpene ketone known as umbellulone that can elicit migraines in susceptible individuals (migraineurs). Umbellulone was administered via inhalation to induce migraines in rats primed with an inflammatory reagent, CFA (Complete Freund’s Adjuvant). The OMT procedure we created involves soft tissue techniques applied to the paraspinal muscles in the cervical region, and articulatory release techniques to the cervical spine. We used a variety of behavioral tests to determine the effectiveness of our treatment. All tests were performed in female Sprague-Dawley rats which were divided randomly into the following groups: rats induced with migraines with OMT provided, rats induced with migraines with sham treatment, rats given a control reagent without migraine with OMT provided, and rats given a control reagent without migraine with sham treatment. In the first part of our study, we determined the effectiveness of OMT in the prevention of migraines. We first primed the animals with CFA on day 0 and performed OMT on days 1, 3, and 5. On day 6 we induced migraines using umbellulone inhalation and measured the behavioral changes including the cutaneous allodynia and the spontaneous wheel-running activities In the second part of our study, we looked at the effectiveness of OMT in aborting acute migraines. OMT was performed immediately after the administration of the migraine trigger on day 6, and the cutaneous allodynia was assessed. Von-Frey filaments were applied to the periorbital and hindpaw regions to detect cutaneous allodynia using “up-and-down” method. We also allowed the animals to voluntarily run on a wheel that rotates freely to assess the energy output over a 3 hour period. In addition, we measured the change of plasma levels of an important neuropeptide, CGRP (calcitonin gene- related peptide), using ELISA (Enzyme-Linked Immunoassay) kits to gauge the molecular impact of OMT on migraine pathophysiology. Data Analysis/Results: The results of our von-Frey behavioral testing showed a significant decrease in both periorbital and hind paw withdrawal threshold, i.e., tactile allodynia developed, after umbellulone inhalation only in rats with CFA pre-treatment, suggesting both the priming and trigger are required for the naive rats to develop migraine-like pain. The application of OMT before migraine induction was able to prevent the development of cutaneous allodynia completely. When given after the migraine trigger umbellulone, OMT partially abolished the development of periorbital and hindpaw tactile allodynia. In terms of wheel-running activities, umbellulone reduced the number of rotations in rats with CFA priming. OMT produced a similar trend of efficacy, in which rats treated with OMT tended to have maintained the wheel-running activities over a 3 hour period rather than reduction of this activity seen in the sham-treated animals. We did not find any significant change in CGRP levels among different groups of rats either treated with or without OMT. Conclusion: Our study has shown that the use of OMT as a preventative or abortive treatment significantly reduces the tactile hypersensitivity in the periorbital and hindpaw regions induced by CFA and umbellulone, confirming the efficacy of OMT in migraine management. Since this model is not CGRP-dependent, we will further study the potential mechanisms underlying this effect in the trigeminal systems.


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