Autonomic nervous system responses in the intermediate band to cranial cutaneous stimulation

Q: What are the key findings of this study?

Osteopathic cranial vault hold significantly decreased the mean momentary frequency of highest amplitude to 0.096 Hz compared to 0.119 Hz during the eyes-closed resting state.

Q: What is the clinical evidence from this study?

Population: Healthy adults (n=38). Intervention: Osteopathic cranial vault hold (CVH) vs. Within-subject hands-off resting states (eyes closed). Primary outcome: Mean momentary frequency of highest amplitude (MFHA) in forehead skin perfusion (p=<0.001).

Q: What question did this study set out to answer?

Investigate whether incorporating an intermediate frequency band (0.12–0.18 Hz) into autonomic nervous system analysis captures cardiovascular and skin microcirculation responses to cranial cutaneous stimulation.

Micha Keller; Holger Pelz; Gero Müller; Štefan Borik; Klaus Mathiak; Johannes Mayer; Ines Repik; Armin Geilgens; Volker Perlitz

doi:10.14814/phy2.15891

January 1, 2024Physiological ReportsOpen Access

Autonomic nervous system responses in the intermediate band to cranial cutaneous stimulation

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Key result

Osteopathic cranial vault hold lowers skin perfusion peak frequency by ~0.02 Hz versus rest.

P<0.001
n=38

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Why the study?

Does osteopathic cranial vault hold stimulation alter autonomic nervous system cardiovascular rhythms in healthy adults?

Key Points

Investigate whether incorporating an intermediate frequency band (0.12–0.18 Hz) into autonomic nervous system analysis captures cardiovascular and skin microcirculation responses to cranial cutaneous stimulation.
Evaluated 38 healthy adults (N=38) measured at baseline (T0) and one week later (T1) before, during, and after osteopathic cranial vault hold (CVH) stimulation delivered by four practitioners.
Continuously monitored forehead skin perfusion via photoplethysmography, electrocardiography, and respiration to derive momentary frequencies of highest amplitude and heart rate variability metrics across low, intermediate, and high frequency bands.
During CVH, low-frequency interval durations significantly increased, whereas intermediate- and high-frequency interval durations decreased compared to control sections (all p < 0.001).
Forehead skin microcirculation amplitudes significantly increased in low (p < 0.001), intermediate (p < 0.05), and high frequency bands (p < 0.001) during CVH, whereas standard heart rate variability metrics showed no significant changes.
Cluster analysis identified two distinct response patterns: an intermediate-responder group (47% of participants) displaying a stable 0.08 Hz oscillation during CVH, and a low-frequency-responder group starting at 0.10 Hz.

Structured PICO

Does osteopathic cranial vault hold stimulation alter autonomic nervous system cardiovascular rhythms in healthy adults?

P

Population

38 healthy adults, mean age 40.7 years, evaluated for autonomic nervous system responses before, during, and after osteopathic cranial vault hold stimulation.

I

Intervention

Osteopathic cranial vault hold (CVH) applied manually to the scalp for 300 seconds.

C

Comparator

Within-subject control consisting of hands-off eyes open and eyes closed resting states (300 seconds each).

O

Outcome

Changes in autonomic nervous system functional states measured via photoplethysmography (PPG) momentary frequencies of highest amplitude (MFHA) and frequency band interval durations (LF, IM, HF).surrogate

Main Result

Absolute Event Rate: 0.096% vs 0.119%

p-value: p=<0.001

Osteopathic cranial stimulation evokes measurable shifts in peripheral microcirculatory autonomic rhythms, supporting physiological mechanisms related to baroreceptor pathways rather than purely respiratory artifacts.

Limitations

Averaging data across subjects may conceal, suspend, or falsely insinuate physiological synchronization mechanisms such as n:m coordination.
Averaging data may conceal individual physiological coupling or subharmonic coordination
Biological systems vary dynamically, complicating strict frequency boundary application

Implication

CVH was associated with autonomic rhythm shifts in healthy adults; hypothesis-generating and should not yet change practice.

Abstract

Cardiovascular rhythms representing functional states of the autonomic nervous system (ANS) are insufficiently reflected by the current physiological model based on low and high frequency bands (LF, HF, resp.). An intermediate (IM) frequency band generated by a brainstem pacemaker was included in systemic physiological ANS analyses of forehead skin perfusion (SP), ECG, and respiration. Data of 38 healthy participants at T0 and T1 (+1 week) before, during, and following osteopathic cranial vault hold (CVH) stimulation were analyzed including momentary frequencies of highest amplitude, amplitudes in low (0.05-0.12 Hz), IM (0.12-0.18 Hz), and high (0.18-0.4 Hz) frequency bands, and established heart rate variability (HRV) metrics. During CVH, LF interval durations increased, whereas IM/HF band durations decreased significantly. Amplitudes increased significantly in all frequency bands. A cluster analysis found one response pattern dominated by IM activity (47% of participants) with highly stable 0.08 Hz oscillation to CVH, and one dominated by LF activity (0.10 Hz) at T0, increasing to IM activity at T1. Showing frequency ratios at ≈3:1, respiration was not responsible for oscillations in PPG during CVH. HRV revealed no significant responses. Rhythmic patterns in SP and respiration matched previous findings on a reticular "0.15 Hz rhythm". Involvement of baroreflex pathways is discussed as alternative explanation.

Discussion

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Cite This Study

Keller et al. (2024) studied Healthy adults (n=38). Osteopathic cranial vault hold (CVH) vs. Within-subject hands-off resting states (eyes closed) was evaluated on Mean momentary frequency of highest amplitude (MFHA) in forehead skin perfusion (p=<0.001). Osteopathic cranial vault hold significantly decreased the mean momentary frequency of highest amplitude to 0.096 Hz compared to 0.119 Hz during the eyes-closed resting state.

synapsesocial.com/papers/6a2273cdf1cd006d1cff765e https://doi.org/10.14814/phy2.15891

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Autonomic nervous system responses in the intermediate band to cranial cutaneous stimulation

Figures

Key Points

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Autonomic nervous system responses in the intermediate band to cranial cutaneous stimulation

Figures

Key Points

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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