2022 VCOM Research Retreat Program

Abstracts

Osteopathy in the Cranial Field as a Method to Enhance Brain Injury Recovery: A Preliminary Study Presenters: P. Gunnar Brolinson, DO, and Pamela VandeVord, PhD Co-Authors: Susan Murphy, PhD; Michelle Dickerson; Caiti-Erin Talty Traumatic brain injury (TBI) continues to be a serious problem with approximately two million occurrences annually in the United States, and accounts for 30.5% of all injury related deaths according to the Centers for Disease Control and Prevention. There is a critical need for a greater understanding of the long term and debilitating impairments in cognition, psychological health, and sensorimotor abilities. Cranial OMM (cOMM) involves the gentle application of manual force to address somatic dysfunctions. This technique enhances motion of the tissue and fluid and restores flexibility of the autonomic response by means of manipulation of the bones and sutures of the skull.cOMM disperses the CSF through natural channels and regulates the tissue fluids of the body in general. cOMM is used clinically to improve the quality of life for several pathological conditions including TBI; however, limited data is available on the brain’s response to this innovative treatment. Evidence on the clinical efficacy of cOMM is heterogeneous and insufficient to draw definitive scientific conclusions. Promising results discovered from clinical studies have reported on changes in pain, quality of life, sleeping habits, visual and gross motor function and autonomic nervous system function, with fewer headache days for those suffering chronic headaches. Recently, cOMM was reported to improve cerebrovascular hemodynamics and has been discussed as a noninvasive technique to mitigate neurovascular diseases, such as Alzheimer’s disease. However, questions remain due to the lack of scientific preclinical evidence of effectiveness and mechanism of response. Our study focused on investigating the use of cOMM as a treatment following repeated blast TBI in a rat model. Behavioral and neuropathological assessments were conducted to determine the effects of cOMM as a treatment for blast TBI. We previously reported significant decreases in OFT parameters indicating increased anxiety-like behavior in the Blast-touch group which correlated to neuropathology indicating inflammation and edema and BBB compromise were also significant in the Blast-touch group compared to blast-cOMM and the sham-touch groups indicating that cOMM enhances recovery following blast TBI. We also showed that cOMM significantly enhances the clearance of fluorescent tracers from an uninjured rat brain 1 hour after treatment. In addition to this data we performed interstitial fluid flow (IFF) analysis using MRI in the rat brain 24 hours after a single blast TBI. This showed that blast altered IFF with a lower velocity seen in the blast animals compared to sham (however this was not statistically significant, n=4 per group). To further the BBB compromise study, IHC for fibrinogen revealed trending increases in the motor cortex of the blast-touch group compared to blast-cOMM and sham-touch. This suggests that receiving cOMM treatment reduces BBB dysfunction in animals 7 days post bTBI, but not significantly.