Virginia Research Day 2021

Faculty Research Biomedical

06 Osteopathy in the Cranial Field as a Method to Enhance Brain Injury Recovery: A Preliminary Study

Susan Murphy, PhD 2 ; Gunnar Brolinson, DO 1 ; Michelle Dickerson 2 ; Pamela VandeVord, PhD 2 Corresponding author: murphysf@vt.edu

1 Via College of Osteopathic Medicine-Virginia Campus 2 Department of Biomedical Engineering & Mechanics, Virginia Tech

Traumatic brain injury (TBI) continues to be a serious problem with approximately two million occurrences annually in the United States, accounting 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 (i.e. as impaired or altered functions of related components of the somatic (body framework) system. It can include the musculoskeletal, nervous, or lymphatic systems of the head and the axial spine, subsequently affecting the patient by releasing articular and soft tissue restrictions and normalization of the PRM. 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. Cranial OMM disperses the CSF through natural channels and regulates the tissue fluids of the body in general. Cranial OMM

is used clinically to improve the quality of life for several pathological conditions; 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 were 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 about 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. Behavioral and neuropathological assessments were conducted to determine the effects of cOMM as a treatment for blast TBI. Open Field Tests (OFT)

are a behavioral assessment which were conducted two and seven days following injury. This test can help measure anxiety-like behaviors typically seen following neurotrauma. Astrocyte reactivity and BBB compromise were the histological methods that were used to investigate the consequences of blast injury. There were significant decreases in OFT parameters distance travelled and maximum velocity 7 days following injury for the Blast-touch group in comparison to the Sham-touch and Blast-OCF groups. Pathology of the hippocampus, motor cortex and pre-frontal cortex, showed activation of microglia as there were significant decreases in area fraction, integrated density of fluorescence, and mean area per cell of IBA-1 in the Blast-touch group, in comparison to the Sham-touch and Blast-OCF groups. Astrocyte reactivity in the specified brain regions was not found as there were no significant differences in GFAP. Collectively, this data indicates that OCF enhances recovery following blast TBI.

This study was funded in part by the VCOM REAP Seed Grant.

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