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Changes in Intracranial Compliance in Migraine Subjects Following a National Upper Cervical Chiropractic Association Atlas Correction

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01980927
Recruitment Status : Completed
First Posted : November 11, 2013
Last Update Posted : December 12, 2014
Information provided by (Responsible Party):
Dr. Werner Becker, University of Calgary

Brief Summary:
A small number of chiropractors, who align only the atlas C-1, or "top" vertebra in the spine, practice the National Upper Cervical Chiropractic Association (NUCCA) atlas correction procedure. This procedure uses a precise, non-invasive, gentle touch technique to correct misalignment of the atlas. Although NUCCA practitioners have long used this procedure in the treatment of headache, it has not been formally studied using clinical trials. There is some data indicating that NUCCA correction can increase intracranial compliance. This intracranial compliance can be measured by a magnetic resonance imaging (MRI) study before and then after a NUCCA procedure. In this study, the investigators hope to show that the correction of an atlas misalignment will increase intracranial compliance in subjects with migraine.

Condition or disease Intervention/treatment Phase
Migraine Procedure: NUCCA atlas correction Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 11 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Changes in Intracranial Compliance in Migraine Subjects Following a National Upper Cervical Chiropractic Association (NUCCA)Atlas Correction Intervention - a Pilot Study
Study Start Date : November 2011
Actual Primary Completion Date : January 2013
Actual Study Completion Date : November 2014

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Migraine

Arm Intervention/treatment
Experimental: NUCCA atlas correction
NUCCA atlas correction for migraine patients
Procedure: NUCCA atlas correction
A chiropractic procedure involving correcting a misalignment of the atlas or "top" vertebra in the spine.

Primary Outcome Measures :
  1. Change in intracranial compliance; comparing the baseline period to one month post treatment, 4 weeks after initiation of NUCCA care and maintained correction of atlas misalignment, as measured by phase contrast magnetic resonance imaging. [ Time Frame: At baseline, at 4 weeks, at 8 weeks ]

Secondary Outcome Measures :
  1. Days with headache per month [ Time Frame: At baseline, at 4 weeks, at 8 weeks ]
    Patients use headache diaries to track the number of days with headaches.

  2. Average headache intensity on headache days [ Time Frame: At baseline, at 4 weeks, at 8 weeks ]
    Patients rate headache pain from 0-10 on 3 segments of the day (morning, afternoon, evening) using headache diaries. These numbers are used to calculate the average intensity of the headache on headache days.

Other Outcome Measures:
  1. Quality of life measurements - comparing quality of life scores by using various questionnaires at baseline and at 8 weeks [ Time Frame: At baseline, at 8 weeks ]
    Using MIDAS, Migraine QOL, and HIT-6 questionnaires to score patients' quality of life in measurable terms.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients must be 18-65 years of age.
  • Be naive to Upper Cervical Chiropractic care. Other forms of chiropractic care in the past are permitted.
  • Have migraine with or without aura.
  • Have between 10-26 headache days per month over the last 4 months.
  • Have at least 4 separate headache episodes per month, with episodes separated by at least 4 hours of painfree time.
  • Have at least 8 days per month with pain of levels greater than or equal to 4/10 for part of the day, or have attacks successfully treated with migraine specific medication.
  • Be candidates suitable for NUCCA therapeutic intervention because of atlas displacement as assessed by NUCCA investigator.
  • Subjects on acceptable pharmacological prophylaxis must either remain on a stable dose throughout the study, or stop the prophylactic medication one month before entering the baseline period.

Exclusion Criteria:

  • Any medical or psychiatric condition which in the opinion of the investigator would make the subject unsuitable for enrolment, because of inability to comply with study requirements or possible confounding of the results.
  • Headache on more than 26 days per month.
  • Acute medication overuse as defined by the International Classification of Headache Disorders.
  • Pregnancy or lactation
  • Severe cervical spine degeneration as assessed by cervical spine x-ray.
  • Claustrophobia or any condition that contraindicates an MRI scan
  • A history of cardiovascular disease, cerebrovascular disease, brain surgery, or other central nervous system disorder.
  • Other chronic pain disorder which might interfere with headache assessment or study procedures.
  • A history of significant hypo- or hypertension as determined by the investigator.
  • Subject on a beta-blocker, calcium channel blocker, or other medication which the investigator considers might alter cerebral vascular regulation. Triptans are allowed, but must not be taken within 24 hours (48 hours for frovatriptan) before an MRI study.
  • A history of substance abuse or dependence within 1 year.
  • Current participation in a research study or within the last 30 days.
  • Any spinal chiropractic care outside of the study protocol is prohibited during the baseline and treatment period.
  • Use of botulinum A within 4 months of study entry.
  • A history of significant head or neck trauma (as judged by the investigator) within the year prior to study entry.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01980927

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Canada, Alberta
Foothills Hospital
Calgary, Alberta, Canada
Sponsors and Collaborators
University of Calgary
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Principal Investigator: Werner Becker, MD, FRCPC University of Calgary
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Dr. Werner Becker, Dr. Werner Becker, MD, FRCPC, University of Calgary Identifier: NCT01980927    
Other Study ID Numbers: 24116
First Posted: November 11, 2013    Key Record Dates
Last Update Posted: December 12, 2014
Last Verified: December 2014
Keywords provided by Dr. Werner Becker, University of Calgary:
National Upper Cervical Chiropractic Association atlas correction
Additional relevant MeSH terms:
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Migraine Disorders
Headache Disorders, Primary
Headache Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases