Investigating the Effect of Osteopathic Manipulative Treatment on Brain Microstructure In Individuals with Primary Headaches
Abstract
Purpose
Primary headache (PH) disorders are diverse, but many patients continue to suffer because the underlying causes remain unclear. Diffusion MRI is sensitive to micro-structural brain changes and may therefore serve as an objective marker of pain-related alterations. Empirical evidence suggests that Osteopathic Manipulative Treatment (OMT) reduces the frequency and intensity of headaches. The goal of this study is to determine whether diffusion tensor MRI (DTI) biomarkers are sensitive to OMT.
Methods
A group of 15 patients with PH underwent DTI on 7T scanner. Each participant received four OMT sessions and was rescanned within one week after final treatment. Pre- and post-treatment diffusion data were processed for ROI-based assessment of micro-structural changes in both white matter (WM) and gray matter (GM). DTI metrics were computed and compared between pre- and post-treatment scans, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Analyses were performed separately for the left and right hemispheres to identify any lateralized differences.
Results
The most notable change was observed in the right occipital white matter, where FA increased following OMT sessions. Statistical analyses showed that, across the five PH relevant regions examined, FA increases were most evident in the right occipital and left parietal regions, suggesting a region-specific effect of treatment. MD values were assessed in both WM and GM, and no significant differences were observed in these regions. Likewise, other diffusion metrics (AD, RD, and ADC) showed no significant pre- to post-treatment changes.
Conclusion
These findings suggest that OMT may confer region-specific benefits in headaches, reflected in post-treatment diffusion MRI changes. They also support diffusion MRI as a potential objective biomarker for monitoring therapeutic response. The results also support the notion that somatic dysfunction in the craniocervical region may be connected to headache pathophysiology.