Trial reportNeuroImage. Clinical2019
Evidence for decreased Neurologic Pain Signature activation following thoracic spinal manipulation in healthy volunteers and participants with neck pain.
Trial report in NeuroImage. Clinical, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- The immediate effects of thoracic spine manipulation in patients with neck pain: a meta-analysis of randomized controlled trials.Frontiers in medicine · 2026Pooled it
- Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Clinical Efficacy of Epidural Injections of Local Anesthetic Alone or Combined with Steroid for Neck Pain: A Systematic Review and Meta-Analysis.BioMed research international · 2022Pooled it
- Ketamine-induced analgesia and dissociation show distinct behavioral and neural correlates.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Neurophysiological Response of Spinal Mobilization and Manipulation in Individuals With and Without Musculoskeletal Spine Disorders: A Scoping Review.The European journal of neuroscience · 2026Article
- Technologies to investigate the mechanisms of force-based manipulations: a narrative methods review.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Short-Term Effects of Spinal Manual Therapy on the Nervous System in Managing Musculoskeletal Pain: A Systematic Review.Journal of clinical medicine · 2025Review
- Multimodal Correspondence between Optogenetic fMRI, Electrophysiology, and Anatomical Maps of the Secondary Somatosensory Cortex in Nonhuman Primates.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025Article
- The interactive effect of external rewards and self-determined choice on memory.Psychological research · 2023Article
- Mediation Analysis in Manual Therapy Research.Journal of chiropractic medicine · 2023Article
- Mindfulness-Based Stress Reduction, Cognitive Behavioral Therapy, and Acupuncture in Chronic Low Back Pain: Protocol for Two Linked Randomized Controlled Trials.JMIR research protocols · 2022Article
- Effect sizes and test-retest reliability of the fMRI-based neurologic pain signature.NeuroImage · 2022Article
- Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome.Clinical biomechanics (Bristol, Avon) · 2021Article
- Metabolite activity in the anterior cingulate cortex during a painful stimulus using functional MRS.Scientific reports · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
Abstract
background contextSpinal manipulation (SM) is a common treatment for neck and back pain, theorized to mechanically affect the spine leading to therapeutic mechanical changes. The link between specific mechanical effects and clinical improvement is not well supported. SM's therapeutic action may instead be partially mediated within the central nervous system. PURPOSE: To introduce brain-based models of pain for spinal pain and manual therapy research, characterize the distributed central mechanisms of SM, and advance the preliminary validation of brain-based models as potential clinical biomarkers of pain. STUDY
designSecondary analysis of two functional magnetic resonance imaging studies investigating the effect of thoracic SM on pain-related brain activity: A non-controlled, non-blinded study in healthy volunteers (Study 1, n = 10, 5 females, and mean age = 31.2 ± 10.0 years) and a randomized controlled study in participants with acute to subacute neck pain (Study 2, n = 24, 16 females, mean age = 38.0 ± 15.1 years).
methodsFunctional magnetic resonance imaging was performed during noxious mechanical stimulation of the right index finger cuticle pre- and post-intervention. The effect of SM on pain-related activity was studied within brain regions defined by the Neurologic Pain Signature (NPS) that are predictive of physical pain.
resultsIn Study 1, evoked mechanical pain (p < 0.001) and NPS activation (p = 0.010) decreased following SM, and the changes in evoked pain and NPS activation were correlated (r
conclusionsThe findings provide preliminary evidence that SM may alter the processing of pain-related brain activity within specific pain-related brain regions and support the use of brain-based models as clinical biomarkers of pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.