Chiropractic and MS
Elster, Erin. “Eighty-One Patients with Multiple Sclerosis and Parkinson’s Disease Undergoing Upper Cervical Chiropractic Care to Correct Vertebral Subluxation: A Retrospective Analysis” Journal of Vertebral Subluxation Research (2004): 1-9.
From the Abstract:
The objective of this article is threefold: to examine the role of head and neck trauma as a contributing factor to the onset of Multiple Sclerosis (MS) and Parkinson’s disease (PD); to explore the diagnosis and treatment of trauma-induced injury to the upper cervical spine through the use of protocol developed by the International Upper Cervical Chiropractic Association (IUCCA); and to investigate the potential for improving and arresting MS and PD through the correction of trauma induced upper cervical injury. Data from 81 MS and PD patients who recalled prior trauma, presented with upper cervical injuries, and received care according to the above protocol are reviewed. Each patient was examined and cared for in the author’s private practice in an uncontrolled, non-randomized environment over a five-year period. Of the 81 MS and PD patients, 78 recalled that they had experienced at least one head or neck trauma prior to the onset of the disease. In order of frequency, patients reported that they were involved in auto accidents (39 patients); sporting accidents, such as skiing, horseback riding, cycling, and football (29 patients); or falls on icy sidewalks or down stairs (16 patients). The duration between the traumatic event and disease onset varied from two months to 30 years. Intervention and Outcome: Two diagnostic tests, paraspinal digital infrared imaging and laser-aligned radiography, were performed according to IUCCA protocol. These tests objectively identify trauma-induced upper cervical subluxations (misalignment of the upper cervical spine from the neural canal) and resulting neuropathophysiology. Upper cervical subluxations were found in all 81 cases. After administering treatment to correct their upper cervical injuries, 40 of 44 (91%) MS cases and 34 of 37 (92%) PD cases showed symptomatic improvement and no further disease progression during the care period. A causal link between trauma-induced upper cervical injury and disease onset for both MS and PD appears to exist. Correcting the injury to the upper cervical spine through the use of IUCCA protocol may arrest and reverse the progression of both MS and PD. Further study in a controlled, experimental environment with a larger sample size is recommended.
Damadian, Raymond V., and David Chu. "The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis Physiological Chemistry and Physics and Medical NMR September 20, 2011; 41: 1–17." Physiol Chem Phys Med NMR 41 (2011): 1-17.
KEY POINTS FROM THIS ARTICLE:
1) Eight MS patients and 7 normal volunteers were MRI scanned on a 0.6 T scanner with a quadrature head-neck combination coil to visualize the overall CSF flow pattern. The scans were performed in both the upright and recumbent positions using the FONAR UPRIGHT Multi-Position MRI.
2) An important benefit of MRI technology is the ability to visualize the plaque lesions of Multiple Sclerosis.
3) The advent of phase coded MR imaging has made it possible to visualize and quantify the dynamic flow of the cerebrospinal fluid (CSF) within the cranial vault and spinal canal.
4) UPRIGHT Multi-Position MR scanning has uncovered a key set of new observations regarding Multiple Sclerosis (MS), which observations are likely to provide a new understanding of the origin of MS.
5) “The UPRIGHT MRI has demonstrated pronounced anatomic pathology of the cervical spine in five of the MS patients studied and definitive cervical pathology in the other three. The pathology was the result of prior head and neck trauma.”
6) Seven of 8 MS patients in this study had a history of serious prior cervical trauma which resulted in significant cervical pathology. The cervical pathology was visualized by UPRIGHT MRI.
7) “Upright cerebrospinal fluid (CSF) cinematography and quantitative measurements of CSF velocity, CSF flow and CSF pressure gradients in the upright patient revealed that significant obstructions to CSF flow were present in all MS patients. The obstructions are believed to be responsible for CSF ‘leakages’ of CSF from the ventricles into the surrounding brain parenchyma which ‘leakages’ can be the source of the MS lesions in the brain that give rise to MS symptomatology.”
8) The CSF flow obstructions are believed to result in increases in intracranial pressure (ICP) that generate ‘leakages’ of the CSF into the surrounding brain parenchyma.
9) In 7 of 8 MS patients, anatomic pathologies and CSF flow abnormalities were found to be more severe in the upright position than in the recumbent position.
10) “Traditionally the symptom-generating lesions in the brain and spinal cord of Multiple Sclerosis (MS) patients are ascribed to tissue specific autoimmune interactions.”
11) Abnormal CSF flows were found in all eight MS patients. “The abnormal CSF flows corresponded with the cranio-cervical structural abnormalities found on the patients’ MR images.
12) “Every MS patient exhibited obstructions to their CSF flow when examined by phase coded CSF cinematography in the upright position.”
13) “All MS patients exhibited CSF flow abnormalities that were manifest on MR cinematography as interruptions to flow or outright flow obstructions somewhere in the cervical spinal canal, depending on the location and extent of their cervical spine pathology. Normal examinees did not display these flow obstructions.”
14) “Trauma may have a causative role in the onset of MS.”
15) “All seven patients had distinct cervical anatomic pathology on their current MR images that corresponded with their trauma histories, thereby establishing that the historical trauma events contributed directly to their permanent pathologies of the cervical spine and that their cervical trauma histories were not immaterial.”
16) “Four had received neck injuries in motor vehicle accidents, three of which were whiplash injuries, and the fourth a “reverse whiplash” (neck flexion preceding neck extension) injury. A fifth, patient was involved in a severe motor vehicle accident at age 2–3 that “totaled” the car in which she was riding without a seat belt or infant seat.”
17) “In all but two of the patients the trauma preceded the onset of MS symptoms by more than 8 years.”
18) “The abnormal CSF flow dynamics found in the MS patients of this study corresponded to the MR cervical pathology that was visualized.”
19) “The findings raise the possibility that interventions might be considered to restore normal intracranial CSF flow dynamics and intracranial pressure (ICP).”
20) The elevated peak CSF velocities measured in the MS patients indicate elevated intracranial pressures (ICP) in these MS patients. The elevated ICP is the origin of the CSF “leaks” that appear in MS patients.
21) “The most important finding of this study is that cerebrospinal fluid ‘leaks’ from the ventricles of the brain into surrounding brain parenchyma, possibly secondary to trauma induced blockages of CSF flow and resulting increases in ICP, may be playing an important etiologic role in the genesis of Multiple Sclerosis.”
22) Protein is the principal ingredient, other than water, of the cerebrospinal fluid. These authors suggest that the “leakage” of these CSF antigenic proteins, could be the source of the antigens generating the autoimmune reactions known to be the origin of MS lesions.
23) Trauma induced “leakage” of CSF antigenic proteins into the surrounding brain parenchyma is contributing to the formation of MS plaques.
24) “The findings further suggest that going forward, victims of Motor Vehicle Whiplash injuries with persisting symptoms, e.g., headache, neck pain, should be scanned by UPRIGHT(R) MRI to assure that their CSF hydrodynamics and cervical anatomy (C1-C7) are normal. Should their CSF hydrodynamics prove abnormal, they should be monitored by UPRIGHT(R) MRI to assure they are restoring to normal over time, or ultimately decompressed by expansion stenting or cervical realignment if they are not.”
25) “In conclusion, the results of our investigation suggest that Multiple Sclerosis may be biomechanical in origin wherein traumatic injuries to the cervical spine result in cervical pathologies that impede the normal circulation of CSF to and from the brain.” “The obstruction to CSF outflow would result in an increase in ventricular CSF pressure (ICP) which in turn could result in ‘leakage’ of cerebrospinal fluid and its content antigenic proteins (e.g., tau proteins) into surrounding brain parenchyma. The attachment of antigenic proteins to surrounding brain nerve fibers would stimulate the antigen-antibody reactions that produce the axon demyelinations characteristic of MS.”
Flanagan, Michael F. "The role of the craniocervical junction in craniospinal hydrodynamics and neurodegenerative conditions." Neurology Research International 2015.1 (2015): 794829.
“The craniocervical junction (CCJ) is a potential choke point for craniospinal hydrodynamics and may play a causative or contributory role in the pathogenesis and progression of neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, MS, and ALS, as well as many other neurological conditions including hydrocephalus, idiopathic intracranial hypertension, migraines, seizures, silent-strokes, affective disorders, schizophrenia, and psychosis.”
“The CCJ comprises the base of the skull, atlas (C1), and axis (C2), as well as muscles and connective tissues that connect the skull to the cervical spine. It further includes the dura mater and dentate ligament attachments of the brain and cord to the foramen magnum and upper cervical spine. Moreover, the CCJ links the vascular and cerebrospinal fluid (CSF) systems in the cranial vault to those in the spinal canal. Craniospinal hydrodynamics refer to the relationship between blood and CSF volume, pressure, and flow in the relatively closed confines of the compartments of the cranial vault and spinal canal. Malformations and misalignments of the CCJ cause deformation and obstruction of blood and CSF pathways and flow between the cranial vault and spinal canal that can result in faulty craniospinal hydrodynamics and neurological and neurodegenerative disorders.”
“Classic hydrocephalus is an increase in CSF volume coupled with ventriculomegaly. In children, hydrocephalus is typically, but not always, associated with an increase in intracranial pressure (ICP) and head size. For the most part, hydrocephalus is considered a childhood condition. Normal pressure hydrocephalus (NPH) is seen mostly in adults but it is sometimes seen in children as well. NPH is associated with increased CSF volume, ventriculomegaly, and normal or slightly elevated ICP. The size of the head is unaffected in adults. The decrease in compliance of the skull most likely puts a damper on ICP in adults with NPH compared to the highly compliant skulls seen in infants and young children. Despite the development of shunts, decades of research, and recent advances in brain imaging we know very little about the role of faulty craniospinal hydrodynamics in hydrocephalus. In 1988 this author proposed that neurodegenerative diseases may be due to obstruction and back pressure in the accessory drainage system of the brain as it passes through the CCJ to connect to the vertebral veins. Obstruction can occur due to many types of malformations and misalignments of the CCJ.”
“Manual methods for correcting obstructions, as well as manipulation of blood and CSF flow, may help to restore or improve faulty craniospinal hydrodynamics in certain cases and decrease the prevalence, progression, and severity of neurodegenerative and other neurological conditions.”
