Somatosympathetic reflexes from the low back in the anesthetized cat

Comparison of spinal column alignment and autonomic nervous activity using the intersegmental tenderness test in the segment above

[Purpose] The thoracolumbar supraspinous intersegmental tenderness test (ITT) in the segment above was performed to compare spinal alignment and autonomic activity in the presence or absence of pain. [Participants and Methods] Thirty young males were grouped into Th1–4 (Cardiopulmonary visceral nerves), Th5–9 (Large visceral nerve), and Th10–12 (Small visceral nerve) by ITT for the presence of pain. Measurements of the spinal alignment and autonomic function were performed. [Results] Those with ITT pain had a significantly lower range of motion in the sagittal plane at Th12, Th12–L1, and L2–3 and in the frontal plane at Th1–2, Th4–5, Th6–7, and L3–4 than those in the no pain group. On autonomic function tests, the pain group had significantly lower Total Power, LF (Low Frequency), and CVRR (Coefficient of variation of R-R interval). [Conclusion] In ITT, patients with pain at Th5–9 have a mixture of reduced sagittal tilt angle and autonomic hypofunction of the adjacent upper and lower thoracic to lumbar vertebrae.

Short-term effects of manipulation to the upper thoracic spine of asymptomatic subjects on plasma concentrations of epinephrine and norepinephrine-a randomized and controlled observational study

OBJECTIVE

The purpose of this study was to investigate the short-term effects of spinal manipulation applied to a hypomobile segment of the upper thoracic spine (T1-T6), on plasma concentrations of norepinephrine (NE) and epinephrine (E) in asymptomatic subjects, under strictly controlled conditions.

METHODS

Fifty-six asymptomatic subjects were randomly assigned to receive either a chiropractic manipulative intervention or a sham intervention in the upper thoracic spine. A 20-gauge catheter fitted with a saline lock was used to sample blood before, immediately after, and 15 minutes after intervention. Plasma NE and E concentrations were determined using an enzyme-linked immunosorbent assay. Changes in plasma catecholamine concentrations were analyzed within and between groups using 1- and 2-sample t tests, respectively.

RESULTS

The plasma samples of 36 subjects (18 treatment, 18 control) were used in the analysis. Mean plasma concentrations of NE and E did not significantly differ between the 2 groups at any time point and did not change significantly after either the manipulative or sham intervention.

CONCLUSIONS

The results of this study indicate that a manipulative thrust directed to a hypomobile segment in the upper thoracic spine of asymptomatic subjects does not have a measurable effect on the plasma concentrations of NE or E. These results provide a baseline measure of the sympathetic response to spinal manipulation.

Basic Science Research Related to Chiropractic Spinal Adjusting: The State of the Art and Recommendations Revisited

OBJECTIVE

The objectives of this white paper are to review and summarize the basic science literature relevant to spinal fixation (subluxation) and spinal adjusting procedures and to make specific recommendations for future research.

METHODS

PubMed, CINAHL, ICL, OSTMED, and MANTIS databases were searched by a multidisciplinary team for reports of basic science research (since 1995) related to spinal fixation (subluxation) and spinal adjusting (spinal manipulation). In addition, hand searches of the reference sections of studies judged to be important by the authors were also obtained. Each author used key words they determined to be most important to their field in designing their individual search strategy. Both animal and human studies were included in the literature searches, summaries, and recommendations for future research produced in this project.

DISCUSSION

The following topic areas were identified: anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system. A relevant summary of each topic area and specific recommendations for future research in each area were the primary objectives of this project.

CONCLUSIONS

The summaries of the literature for the 6 topic sections (anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system) indicated that a significant body of basic science research evaluating chiropractic spinal adjusting has been completed and published since the 1997 basic science white paper. Much more basic science research in these fields needs to be accomplished, and the recommendations at the end of each topic section should help researchers, funding agencies, and other decision makers develop specific research priorities.

Influence of innocuous cervical vertebral movement on the efferent innervation of the adrenal gland in the rat

In general, in central nervous system intact anesthetized animals, adrenal sympathetic efferent nerve activity and catecholamine secretion increase in response to noxious somatic stimulation, and decrease in response to innocuous somatic stimulation. In anesthetized rats, noxious chemical stimulation of the thoracic and lumbar interspinous tissues is associated with large increases in adrenal sympathetic efferent nerve activity and catecholamine secretion, with a clear segmental organization to the reflex apparent in spinalized animals. However, the adrenal sympathetic nerve responses to mechanical stimulation in the form of pressure applied laterally to the lower thoracic and lower lumbar vertebrae do not display segmental organization, and the depressor response is more characteristic of responses to innocuous somatic stimulation despite the use of large forces (up to 3.0 kg). Therefore, we sought to determine whether innocuous movements of the mechanoreceptor-rich deep tissues of the neck modulate the sympathetic outflow to the adrenal gland. We performed experiments in 14 anaesthetised (Urethane 1 g/kg and Chloralose 0.1 g/kg) adult rats. Rats were intubated and breathed spontaneously. A computer driven small animal manipulator was used to impose ramp and hold rotational displacements (12 degrees /s, hold duration 2 s) of the 2nd cervical vertebra (range 2-30 degrees ) while recording multi-unit activity from sympathetic nerves innervating the adrenal gland. While noxious forepaw pinch elicited an increase in sympathetic nerve activity to the adrenal gland, there was no significant change in sympathetic nerve activity with small (2 degrees or 6 degrees ) rotations. Significant changes (P<0.05) in sympathetic activity were observed in only 7% (n=21) of all trials at larger displacements (12 degrees , 20 degrees , 25 degrees , 30 degrees n=287 trials). Our data suggest that although noxious stimuli may modulate sympathetic outflow, it is rare for afferents signalling innocuous cervical vertebral movements to modulate sympathetic nerves innervating the adrenal gland.