Clinical Trial: Vertebral Artery and Cerebral Hemodynamics After Various Head Positions & Manipulation in Patients With Neck Pain

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: Changes in Vertebral Artery and Cerebral Hemodynamics Following Various Head Positions & Cervical Manipulation in Patients With Chronic/Recurrent Neck Pain

Brief Summary: The Investigators are performing a study to determine, in patients with chronic/recurrent neck pain, the cerebrovascular hemodynamic consequences of cervical spine movements, including manipulation, in vivo using fMRI technology on vertebral and cranial blood flow dynamics affecting brain perfusion, and extend the current data set on these variables

Detailed Summary: The goal of the study is to further investigate in patients with chronic/recurrent neck pain, the cerebrovascular hemodynamic consequences of cervical spine positions, including manipulation, in vivo under clinically relevant circumstances using two advanced MRI technology on the vertebral and posterior cerebral and cerebellar blood flow dynamics affecting brain perfusion. According to the knowledge of the investigators, a study utilizing MRI and functional blood oxygen level dependent (fBOLD) imaging to examine blood flow and perfusion, turbulence and evidence of micro-trauma within these blood vessels has yet to be conducted.
Sponsor: Canadian Memorial Chiropractic College

Current Primary Outcome: Changes in blood flow through the vertebral artery and posterior cerebral and cerebellar circulation will be assessed using phase contrast MRI. [ Time Frame: The series of fMRI sequences will be performed on each participant immediately after each condition. Through study completion, data will be presented after an average of 1 year. ]

Phase contrast MRI provides additional velocity measurements that can be used for analysis of the blood flow and tissue motion.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Changes in tissue perfusion in the posterior cerebrum and cerebellum will be assessed using arterial spin labeling (ASL) MRI technique. [ Time Frame: The series of ASL sequences will be performed on each participant immediately after each condition. Through study completion, data will be presented after an average of 1 year. ]
    ASL allows one to separate the blood flow from the BOLD effect, thus giving clear measures of perfusion. More specifically ASL will be used to measure blood perfusion and allow extraction of metabolic difference from flow differences in BOLD imaging. It is a quantitative technique, yielding values with units of ml/(100g of tissue)·min-1.
  • Changes in tissue oxygenation in the posterior cerebrum and cerebellum will be assessed using fMRI BOLD technique. [ Time Frame: The series of fMRI BOLD sequences will be performed on each participant immediately after each condition. Through study completion, data will be presented after an average of 1 year. ]
    Using fMRI BOLD changes in the microvascular ratio of oxyhaemoglobin (oxyHb) to deoxyhaemoglobin (deoxyHb) will be measured in regions of interest above the vertebral artery. The changes are typically observed in T2*-weighted functional MRI scans which are sensitive to blood volume, hematocrit, and oxygenation BOLD contrast. Functional images will be acquired with the following parameters: 24-cm field of view, 5 mm thick, TE/TR = 35 ms/2sec, 1 NEX.


Original Secondary Outcome: Same as current

Information By: Canadian Memorial Chiropractic College

Dates:
Date Received: January 18, 2016
Date Started: June 2016
Date Completion: June 2017
Last Updated: February 4, 2016
Last Verified: February 2016