title: Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study.
abstract: Introduction. In a migraine case study, headache symptoms significantly decreased with an accompanying increase in intracranial compliance index following atlas vertebrae realignment. This observational pilot study followed eleven neurologist diagnosed migraine subjects to determine if the case findings were repeatable at baseline, week four, and week eight, following a National Upper Cervical Chiropractic Association intervention. Secondary outcomes consisted of migraine-specific quality of life measures. Methods. After examination by a neurologist, volunteers signed consent forms and completed baseline migraine-specific outcomes. Presence of atlas misalignment allowed study inclusion, permitting baseline MRI data collection. Chiropractic care continued for eight weeks. Postintervention reimaging occurred at week four and week eight concomitant with migraine-specific outcomes measurement. Results. Five of eleven subjects exhibited an increase in the primary outcome, intracranial compliance; however, mean overall change showed no statistical significance. End of study mean changes in migraine-specific outcome assessments, the secondary outcome, revealed clinically significant improvement in symptoms with a decrease in headache days. Discussion. The lack of robust increase in compliance may be understood by the logarithmic and dynamic nature of intracranial hemodynamic and hydrodynamic flow, allowing individual components comprising compliance to change while overall it did not. Study results suggest that the atlas realignment intervention may be associated with a reduction in migraine frequency and marked improvement in quality of life yielding significant reduction in headache-related disability as observed in this cohort. Future study with controls is necessary, however, to confirm these findings. Clinicaltrials.gov registration number is NCT01980927.
authors.affiliation: Upper Cervical Research Foundation, 5353 Wayzata Boulevard, Suite 350, Minneapolis, MN 55416, USA.
authors.forename: H Charles
authors.initials: HC
authors.lastname: Woodfield
authors.affiliation: The Britannia Clinic, 5005 Elbow Drive SW No. 201, Calgary, AB, Canada T2S 2T6.
authors.forename: D Gordon
authors.initials: DG
authors.lastname: Hasick
authors.affiliation: University of Calgary and Alberta Health Services, Foothills Hospital, 1403 29 Street NW, Calgary, AB, Canada T2N 2T9.
authors.forename: Werner J
authors.initials: WJ
authors.lastname: Becker
authors.affiliation: Rho Sigma Scientific Consultants, 119 Valencia Road NW, Calgary, AB, Canada T3A 2B7.
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Rose
authors.affiliation: Departments of Diagnostic Imaging and Clinical Neurosciences, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4.
authors.forename: James N
authors.initials: JN
authors.lastname: Scott
mesh_terms: D000328:Adult; D000368:Aged; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D011788:Quality of Life; D011859:Radiography; D012720:Severity of Illness Index; D016896:Treatment Outcome