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Hyperhomocysteinemia: a potential risk factor for cervical artery dissection following chiropractic manipulation of

Alessandro Pezzini1, Elisabetta Del Zotto, Alessandro Padovani

  • 1Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1, 25125 Brescia, Italia. ale_pezzini@hotmail.com

Journal of Neurology
|October 17, 2002
PubMed

Insights

Elevated homocysteine levels may increase the risk of cervical artery dissection (CAD) after chiropractic manipulation. This finding suggests hyperhomocysteinemia could predispose arteries to damage from neck adjustments.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Genetics

Background:

  • Cervical artery dissection (CAD) incidence is rising, particularly following chiropractic manipulation.
  • Risk factors for manipulation-related CAD remain largely unidentified.

Purpose of the Study:

  • To investigate potential risk factors for manipulation-related CAD.
  • To assess the role of plasma homocysteine levels and specific genetic factors in CAD.

Main Methods:

  • Measured fasting total plasma homocysteine (tHcy) in patients with manipulation-related CAD, spontaneous CAD (sCAD), and controls.
  • Determined C677T MTHFR and 844ins68bp CBS genotypes.

Main Results:

  • Significantly higher median tHcy levels were found in manipulation-related CAD patients compared to controls (P = 0.002).
  • tHcy levels in manipulation-related CAD were not significantly different from sCAD patients (P = 0.129).
  • No significant differences in MTHFR or CBS genotype distributions were observed across groups.

Conclusions:

  • Hyperhomocysteinemia may be a risk factor for manipulation-related CAD.
  • Elevated tHcy could lead to arterial wall abnormalities, increasing susceptibility to mechanical stress from cervical manipulation.

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