en Nervous system (others) Others Clinical research article Clinical research article <p><span style="font-size:12px;"><span style="font-family:Arial;"><strong>Introduction: </strong>Given the sensory network dysfunction observed in migraine, this study aimed to investigate the effects of upper cervical mobilization on sensory brain activation using functional magnetic resonance imaging (fMRI) during trigeminal pain stimulation.<br /> <strong>Methods:</strong> Thirty-nine migraine patients were randomized into an intervention group (n = 22), receiving upper cervical mobilization, or a sham group (n = 17). All participants underwent fMRI scans before and after ten sessions. Trigeminal pain was induced using intranasal ammonia, and pain intensity was rated using the Visual Analog Scale (VAS). Brain activity was analyzed in sensory-related regions, including the primary somatosensory cortex (S1), angular and supramarginal gyri, superior parietal lobule (SPL), and thalamus. Outcomes included mean Z-score (statistical strength of brain activation relative to background noise), percent signal change (PSC; percentage change in regional BOLD signal relative to baseline), voxel count (activation volume), and contrast of parameter estimates (COPE; amplitude of the trigeminal pain&ndash;related BOLD response). using ANCOVA (adjusted for baseline), with effect sizes reported using epsilon squared (&epsilon;&sup2;) or partial eta squared (&eta;&sup2;).<br /> <strong>Results: </strong>The mobilization group showed a greater pain reduction (Cohen&rsquo;s d &asymp; 2.60) than the sham group (r &asymp; 0.64). Voxel count in bilateral supramarginal gyri decreased significantly (&eta;&sup2; &asymp; 0.21, 0.11), as did BOLD signal in right SPL (&epsilon;&sup2; &asymp; 0.08). Right S1 activation deviation correlated with pain reduction (r = 0.69). Pain reduction also correlated negatively with thalamic PSC (&rho; &asymp; &ndash;0.36) and right angular gyrus COPD (&rho; &asymp; &ndash;0.35).<br /> <strong>Conclusion: </strong>Upper cervical mobilization significantly reduced migraine pain and modulated activity in brain regions associated with pain and sensorimotor processing, suggesting a potential neurofunctional mechanism of action.</span></span></p> Migraine,fMRI,Cervical mobilization,Sensory brain network,Trigeminal pain 48 69 http://ppj.phypha.ir/browse.php?a_code=A-10-2534-1&slc_lang=en&sid=1 Jaleh Farahmand Farzaneh jaleh.farahmand@modares.ac.ir 3200319475328460039104 3200319475328460039104 No Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Farid Bahrpeyma bahrpeyf@modares.ac.ir 3200319475328460039105 0000000285227858 Yes Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Mehrzad Lotfi lotfimz@yahoo.com 3200319475328460039106 3200319475328460039106 No Department of Radiology, School of Medicine, Medical Imaging Research Center, ShirazUniversity of Medicine Sciences, Shiraz, Iran Sadegh Masjoodi sadeghmasjoodi@gmail.com 3200319475328460039107 3200319475328460039107 No Shiraz Neuroscience Research Center, Shiraz University of Medicine Sciences, Shiraz, Iran