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Evid Based Complement Alternat Med. 2015;2015:148285. doi: 10.1155/2015/148285. Epub 2015 Jun 14.

Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial.

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Madrid Osteopathic School, Avenida Dr. Heitor Penteado 815, Taquaral, 13075-185 Campinas, SP, Brazil.
Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, C/Avicena s/n, University of Sevillla, 41009 Sevilla, Spain.
Department of Nursing and Physiotherapy, University of the Balearic Islands, Carrera de Valldemossa, km 7'5, 07122 Palma, Spain ; University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Carrera de Valldemossa, km 7'5, 07122 Palma, Spain.
Madrid Osteopathic School, C/San Félix de Alcalá 4, Alcalá de Henares, 28807 Madrid, Spain.



Dysfunction of the autonomic nervous system is an important factor in the development of chronic pain. Fourth ventricle compression (CV-4) has been shown to influence autonomic activity. Nevertheless, the physiological mechanisms behind these effects remain unclear.


This study is aimed at evaluating the effects of fourth ventricle compression on the autonomic nervous system.


Forty healthy adults were randomly assigned to an intervention group, on whom CV-4 was performed, or to a control group, who received a placebo intervention (nontherapeutic touch on the occipital bone). In both groups, plasmatic catecholamine levels, blood pressure, and heart rate were measured before and immediately after the intervention.


No effects related to the intervention were found. Although a reduction of norepinephrine, systolic blood pressure, and heart rate was found after the intervention, it was not exclusive to the intervention group. In fact, only the control group showed an increment of dopamine levels after intervention.


Fourth ventricle compression seems not to have any effect in plasmatic catecholamine levels, blood pressure, or heart rate. Further studies are needed to clarify the CV-4 physiologic mechanisms and clinical efficacy in autonomic regulation and pain treatment.

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