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Migraine with visual aura, unilateral mydriasis and Takotsubo Syndrome. Random coincidence or common pathogenesis? The precarious balance of the autonomic nervous system and the complex relationship b

Authors: Messina S, Colombo E, Doretti A, Ungaro D, Corti S, Ticozzi N, Sciacco M
Journal: Frontiers in neurology
anxiety disorders mental health open access

Abstract

Chronic nonspecific neck pain (CNNP) is a highly prevalent musculoskeletal disorder worldwide [] and a major contributor to pain, disability, reduced quality of life, work absenteeism, and healthcare burden []. In addition to pain, individuals with CNNP commonly demonstrate cervical muscle weakness, neuromuscular control deficits, impaired proprioception, and reduced sensorimotor function, all of which may contribute to symptom persistence and functional limitations [, ]. Current conservative management approaches typically include exercise therapy, physiotherapy, motor control training, postural correction, and ergonomic education [, ]. Exercise therapy—particularly cervical muscle strengthening and cervical spine stabilization exercises—is considered one of the most commonly prescribed and evidence‐based treatments for neck pain, with several studies reporting its beneficial effects on pain reduction, functional improvement, and enhanced muscular endurance [, , , ]. Recent randomized controlled trials have also demonstrated beneficial effects of structured exercise‐based interventions, including elastic resistance exercise and back school‐based programs, on pain reduction and functional improvement in individuals with nonspecific neck pain [, , ]. However, responses to exercise therapy are not uniform across patients, and some studies have highlighted variability in treatment outcomes, limited long‐term effects, and the need for adjunctive strategies to enhance therapeutic efficacy []. In recent years, whole‐body vibration (WBV) has emerged as a novel rehabilitative modality []. WBV is suggested to enhance deep mechanoreceptor stimulation, increase muscle spindle activity, facilitate neuromotor pathways, and improve motor unit recruitment, potentially leading to improved strength, endurance, motor control, and proprioception []. Evidence from lower‐limb and lumbopelvic studies indicates that WBV can improve muscle strength, balance, and pain [, ], and several systematic reviews have confirmed that adding WBV to exercise therapy may yield additional benefits in individuals with chronic low back pain [, ].