P02.33
Purpose: This observational case series followed eleven migraine subjects investigating consistency and sustainability of previously observed changes in cerebrospinal and venous outflow parameters. Using Phase Contrast MRI (PC-MRI) imaging, craniospinal flow changes were measured before-after subjects received a National Upper Cervical Chiropractic Association (NUCCA) atlas correction.
Methods: After screening by a neurologist, potential subjects signed a consent form, completed baseline migraine-specific measures, and returned in 30-days with a headache diary. Determination in need for NUCCA indicated inclusion, permitting subjects to obtain baseline PC-MRI measures. Subjects received NUCCA care for eight weeks. Follow-up imaging occurred at week four and eight. Adverse reactions were surveyed one week after intervention. Headache diaries were maintained throughout the study. Neurologist end-of-study exit interviews allowed for final outcomes collection.
Results: Of eighteen initially screened candidates, eight females, and three males, average age 41 years, met inclusion criteria. Headache days/month decreased from a baseline mean of 14.5 (SD=5.7) by a mean, 5.7 days, 95% CI [2.0, 9.4] at week eight. Migraine Specific Quality of Life-Preventive scores increased a mean of 32.7, 95% CI [21.0, 44.5] at week eight from a baseline mean, 54.1. Ten subjects reported mild neck pain occurring 24 hours after intervention. Four subjects with secondary paravertebral venous outflow, showed an increase of intracranial compliance, from 7.96 (SD=4.82), 6.81 (SD=2.3) at week four, to 9.82 (SD=4.64) at week eight. Seven subjects exhibiting jugular venous outflow patterns, showed unchanged intracranial compliance from 5.50 (SD=1.52), 5.94 (SD=1.49) at week four, to 5.88 (SD=2.05) at week eight.
Conclusion: All patients reported a clinically relevant improvement in headaches as revealed by the MSQL–Preventive scores, and on at least one of five migraine-specific outcomes used. Literature reports a secondary venous outflow pattern exists for many migraine patients. The significance of increase in compliance with this study group remains unknown requiring further study.
Contact: H Charles Woodfield, III, chuckwoodfield@yahoo.com
