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Brain Microstructural and Functional Connectivity Changes After Chinese Manual Therapy in Chronic Neck Pain: A
Yu Jiang1, Zhaohui Chen2, Xiaoyun Hu1
1The First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, China (Y. J., Z.C., X.H., Y.Z., Y.Z., X.G., Z.S., Z.C.).
Academic Radiology
|June 9, 2026
Summary
Chinese manual therapy effectively reduces chronic neck pain and disability by altering brain structure and function. This treatment normalizes brain connectivity and microstructural changes, offering a central neural explanation for its benefits.
Area of Science:
- Neuroscience
- Integrative Medicine
- Pain Management
Background:
- Chronic neck pain (CNP) involves persistent pain and disability, with known alterations in brain structure and function.
- Chinese manual therapy shows clinical benefits for CNP, but its central neural mechanisms are not well understood.
Purpose of the Study:
- To investigate the central neural mechanisms underlying the therapeutic effects of Chinese manual therapy in patients with CNP.
- To examine microstructural and functional brain changes associated with Chinese manual therapy in CNP.
Main Methods:
- 30 CNP patients and 32 healthy controls (HCs) underwent 5.0-T MRI, including neurite orientation dispersion and density imaging (NODDI) and resting-state functional MRI (rs-fMRI).
- Patients received 12 sessions of Chinese manual therapy over 4 weeks.
- Clinical outcomes (VAS, NDI, PCS) and neuroimaging data were analyzed for within-group and between-group differences.
Main Results:
- Chinese manual therapy significantly reduced pain (VAS), disability (NDI), and pain catastrophizing (PCS) scores.
- Baseline brain scans showed decreased neurite density index (NDI) and increased orientation dispersion index (ODI) in specific brain regions (thalamus, posterior cingulate cortex, precuneus) in CNP patients compared to HCs.
- Post-treatment, NDI and ODI normalized, and functional connectivity (FC) within thalamocortical and default-mode networks showed significant changes, with reduced thalamus-anterior cingulate FC and increased thalamus-medial superior frontal FC, correlating with pain reduction.
Conclusions:
- Chinese manual therapy alleviates CNP symptoms and is associated with significant microstructural and functional brain reorganization.
- The findings suggest that Chinese manual therapy's effectiveness in CNP involves central neural mechanisms beyond peripheral effects.
- Neuroimaging provides evidence for a central neural correlate of Chinese manual therapy in chronic neck pain management.
