{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:42:49Z","timestamp":1775184169032,"version":"3.50.1"},"reference-count":47,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jom-2020-0100_abs_001_w2aab3b7c21b1b6b1aab1c16b1Aa\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Osteopathic manipulative treatment reduces symptoms in patients with headache disorders, but the underlying mechanisms are unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2020-0100_abs_002_w2aab3b7c21b1b6b1aab1c16b2Aa\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate blood flow in the intracranial and extracranial vasculature before and after occipitoatlantal decompression (OAD) using Doppler ultrasonography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2020-0100_abs_003_w2aab3b7c21b1b6b1aab1c16b3Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Healthy, first-year osteopathic medical students from A.T. Still University\u2019s Kirksville College of Osteopathic Medicine participated in a randomized, single-blinded, two-period, two-treatment crossover study. The participants were randomly assigned to 1 of 2 treatment interventions: OAD or sham touch. After one week, participants returned to have the other intervention performed. Blood flow parameters\u2014peak systolic velocity (PSV) and end-diastolic velocity (EDV)\u2014in the middle cerebral artery (MCA), internal carotid artery (ICA), and vertebral artery (VA) were evaluated before, immediately after, 5\u00a0minutes after, and 10\u00a0minutes after treatment. Differences in PSV, EDV, heart rate (HR), and blood pressure (BP) for both interventions were analyzed for the four time points using mixed-effects models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2020-0100_abs_004_w2aab3b7c21b1b6b1aab1c16b4Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty healthy medical students (11 men, 19 women; mean age, 24\u00a0years) participated in this study. EDV increased after OAD in the MCA, ICA, and VA (all p&lt;0.001); no change occurred after sham touch (all p&gt;0.05). EDV was greater for all post-treatment timepoints after OAD in the MCA, ICA, and VA than after sham touch (all p&lt;0.001). Although baseline PSV in the MCA measured before treatment was different between treatment interventions (p=0.01), no difference was found between interventions at any post-treatment time point (all p&gt;0.59). Changes in PSV in the ICA and VA and for HR and BP did not depend on treatment intervention (p&gt;0.06).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2020-0100_abs_005_w2aab3b7c21b1b6b1aab1c16b5Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Increases in EDV occurred in major cranial arteries after OAD but not after sham touch, indicating that OAD improves blood flow to the brain. The exact mechanism of this increase is unknown; however, it can be explained by either parasympathetic stimulation through the secretion of vasodilating neurotransmitters or by a decrease in external tissue pressure on ICA and VA, with the resulting flow causing further dilation in the MCA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jom-2020-0100","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T03:42:46Z","timestamp":1613878966000},"page":"171-179","source":"Crossref","is-referenced-by-count":8,"title":["Effect of occipitoatlantal decompression on cerebral blood flow dynamics as evaluated by Doppler ultrasonography"],"prefix":"10.1515","volume":"121","author":[{"given":"Bryan","family":"Roberts","sequence":"first","affiliation":[{"name":"Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew E.","family":"Makar","sequence":"additional","affiliation":[{"name":"Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Canaan","sequence":"additional","affiliation":[{"name":"Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Pazdernik","sequence":"additional","affiliation":[{"name":"Department of Research Support , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatyana","family":"Kondrashova","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Preventive Medicine, and Community Health , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"2021022021102624467_j_jom-2020-0100_ref_001_w2aab3b7c21b1b6b1ab2b2b1Aa","unstructured":"DeStefano, LA. Greenman\u2019s principles of manual medicine: Lippincott Williams & Wilkins; 2017."},{"key":"2021022021102624467_j_jom-2020-0100_ref_002_w2aab3b7c21b1b6b1ab2b2b2Aa","unstructured":"Kimberly, PE, Dickey, J, Halma, KD. Outline of Osteopathic Manipulative Procedures: The Kimberly Manual. Marceline, MO: Walsworth; 2008."},{"key":"2021022021102624467_j_jom-2020-0100_ref_003_w2aab3b7c21b1b6b1ab2b2b3Aa","unstructured":"Seffinger, MA, Hruby, RJ, Rogers, FJ, et al.. Philosophy of osteopathic medicine. In: Seffinger, MA, ed. Foundations of Osteopathic Medicine: Philosophy, Science, Clinical Applications, and Research. 4th ed. 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