{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:57:11Z","timestamp":1792000631359,"version":"4.4.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.82274669"],"award-info":[{"award-number":["No.82274669"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Municipal Health Commission, Traditional Chinese Medicine Research Project","award":["No.2024QN118"],"award-info":[{"award-number":["No.2024QN118"]}]},{"name":"Cultivation of Major Achievements in Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Emotional Disorders","award":["G624290514"],"award-info":[{"award-number":["G624290514"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Cervical rotatory manipulation (CRM) is commonly used for neck-related symptoms and is often accompanied by a cracking sound. Whether a simulated cracking sound can reproduce the short-term subjective and neurophysiological responses to the complete CRM remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study compared short-term subjective and electroencephalography (EEG) responses to CRM with those following sham manipulation with or without a simulated cracking sound.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this randomized controlled trial with three parallel groups and a single intervention session, 54 healthy volunteers were allocated to CRM, sham manipulation, or sham\u2009+\u2009simulated sound. Positive affect, negative affect, comfort, satisfaction, and eyes closed resting state EEG were assessed before and after the intervention. Prespecified EEG derived outcomes included frontal alpha power, frontal alpha\/beta ratio, occipital individual alpha frequency, and alpha band frontoparietal and frontotemporal functional connectivity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n CRM produced greater improvements in positive affect, comfort, and satisfaction than sham manipulation or sham\u2009+\u2009simulated cracking sound, whereas no clear difference among groups was observed for negative affect. Differences among groups were also observed in frontal alpha\/beta ratio and alpha band frontoparietal and frontotemporal functional connectivity. Sham\u2009+\u2009simulated sound did not reproduce the overall pattern of subjective and EEG responses observed after CRM.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CRM produced greater improvements over the short-term in positive affect, comfort, and satisfaction and was accompanied by differences in selected resting state EEG outcomes compared with sham manipulation with or without simulated cracking sound. Adding simulated cracking sound to sham manipulation did not reproduce this pattern. Because CRM differed from the control conditions in several procedural components, the specific component or combination of components responsible for these differences could not be determined.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n The trial was registered with the International Traditional Medicine Clinical Trial Registry (URL:\n https:\/\/itmctr.ccebtcm.org.cn<\/jats:ext-link>\n ; ITMCTR2025001112).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0352526","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:34:53Z","timestamp":1791999293000},"page":"e0352526","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term subjective and EEG responses following cervical rotatory manipulation are not reproduced by simulated cracking sound: A randomized controlled study"],"prefix":"10.1371","volume":"21","author":[{"given":"Yuanxun","family":"Lin","sequence":"first","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixing","family":"Zhong","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Yu","sequence":"additional","affiliation":[{"name":"The Fifth Affiliated Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["Department of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoshuai","family":"Yu","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixin","family":"Tang","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6406-7245","authenticated-orcid":true,"given":"Fan","family":"Xue","sequence":"additional","affiliation":[{"name":"Shanghai Municipal Hospital of Traditional Chinese Medicine","place":["Shanghai, China"],"department":["Department of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jundan","family":"Wei","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhua","family":"Li","sequence":"additional","affiliation":[{"name":"The Affiliated TCM Hospital of Guangzhou Medical University","place":["Guangzhou, Guangdong, China"],"department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-6051","authenticated-orcid":true,"given":"Yikai","family":"Li","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"],"department":["School of Traditional Chinese Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"21","key":"pone.0352526.ref001","doi-asserted-by":"crossref","first-page":"5011","DOI":"10.3390\/jcm10215011","article-title":"Spinal manipulative therapy for acute neck pain: A systematic review and meta-analysis of 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