Functional Neuroscience

Functional Neuroscience comprises the evolving body of knowledge and clinical approach concerned with the recognition, analysis and conservative care of aberrant neurological function in the human nervous system.

Neural plasticity results when changes in the physiological function of the neuraxis occur in response to changes in the internal or external milieu (Jacobson 1991). In other words the development of synapses in the nervous system is very dependent on the activation stimulus that those synapses receive. The synapses that receive adequate stimulation will strengthen and those that do not receive adequate stimulation will weaken and eventually be eliminated.

The organization of the synaptic structure in the neuraxis largely determines the stimulus patterns of the nervous system and hence the way in which the neuraxis functions.

Neural plasticity refers to the way in which the nervous system can respond to external stimuli and adjust future responses based on the outcome of the previously initiated responses. In essence, the ability of the nervous system to learn is dependent on neural plasticity.

The study of brain asymmetry or hemisphericity has a long history in the behavioral and biomedical sciences but is probably one of the most controversial concepts in functional neurology today.

The fact that the human brain is asymmetric has been fairly well established in the literature (Geschwind & Levitsky 1968; LeMay & Culebras 1972; Galaburda et al 1978; Falk et al 1991; Steinmetz el al 1991). The exact relationship between this asymmetric design and the functional control exerted by each hemisphere remains controversial.

The concept of hemispheric asymmetry or lateralization involves the assumption that the two hemispheres of the brain control different asymmetric aspects of a diverse array of functions and that the hemispheres can function at two different levels of activation. The level at which each hemisphere functions is dependent on the central integrative state of each hemisphere, which is determined to a large extent by the afferent stimulation it receives from the periphery as well as nutrient and oxygen supply (Beck 2013). Afferent stimulation is gated through the brainstem and thalamus, both of which are asymmetric structures themselves, and indirectly modulated by their respective ipsilateral cotices (Savic et a1 1994).

Traditionally the concepts of hemisphericity were only applied to the processing of language and visuospatial stimuli. Today, the concept of hemisphericity has developed into a more elaborate theory that involves cortical asymmetric modulation of such diverse constructs as approach versus withdrawal behaviour, maintenance versus interruption of ongoing activity, tonic versus phasic aspects of behaviour, positive versus negative emotional valence, asymmetric control of the autonomic nervous system, and asymmetric modulation of sensory perception, as well as cognitive, attentional, learning, and emotional processes (Davidson & Hugdahl 1995) .

The cortical hemispheres are not the only right- and left-sided structures. The thalamus, amygdala, hippocampus, caudate, basal ganglia, substantia nigra, red nucleus, cerebellum, brainstem nuclei and peripheral nervous system all exist as bilateral structures with the potential for asymmetric function.

Hemisphericity can result in dysfunction of major systems of the body including the spine and nervous system (Carrick 1997). Some spinal signs of hemisphericity include:

  • Subluxation;
  • Spinal stiffness-increased extensor tone;
  • Spondylosis;
  • Intrinsic spinal weakness-decreased postural tone;
  • Decreased A-P curves in cervical and lumbar spine;
  • Increased A-P curves in thoracic spine;
  • Increased postural sway in sagittal or coronal planes; and
  • Pelvic floor weakness.

Several studies have investigated the effect of changes in spinal afferentiation as a result of manipulation on the activity of the sympathetic nervous system (Korr 1979; Sato 1992; Chiu & Wright 1996). Suprasegmental changes, especially in brain function, have demonstrated the central influence of altered afferentiation of segmental spinal levels (Thomas & Wood 1992; Carrick 1997; Kelly et al 2000). Changes in immune system function can be mediated through spinal afferent mechanisms. These mechanisms may operate via suprasegmental or segmental levels by modulating the activity of the sympathetic nervous system (Beck 2003).

References:

Beck, RW., 2003. Psychoneuroimmunology. In: Beiriman R (ed) Handbook of clinical diagnosis. Sydney, p 27-35.

Beck, RW., 2013. Identification and Correction of Asymmetric Cortical Function. Functional Neurology, Rehabilitation, and Ergonomics (Nova Science Publishers, Inc) 3, no. 1: 9-27.

Carrick, FR., 1997. Changes in brain function after manipulation of the cervical spine. Journal of Manipulative and Physiological Therapeutics 20 (8):529-545.

Chiu, T., Wright, A., 1996. To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects. Manual Therapy 1(4):198-203.

Davidson, RJ., Hugdahl, K., 1995. Brain asymmetry. MIT Press, Cambridge. MA/London

Falk, D,. Hildebolt, C., Cheverud, J., et al 1991 Human cortical asymmetries determined with 3D-MR technology. Journal of Neuroscience Methods 39(2): 185-191

Galaburda, AM., LeMay, M., Geschwind, N., 1978. Right-left asymmetries in the brain Science 199:852-856.

Geschwind, N., Levitsky, W., 1968. Human brain Left-right symmetries in temporal speech regions. Science 161:186-187.

Jacobson, M., 1991. Development neurobiology, 3rd edn Plenum Press, New York/London

Kelly, DD., Murphy, BA., Backhouse: DP 2000 Use of a mental rotation reaction-time paradigm to measure the effects of upper cervical adjustments on Cortical processing: A pilot study. Journal of Manipulative and Physiological Therapeutics 23(4); 246-251

Korr, IM., 1979. The spinal cord as organiser of disease processes: III Hyperactivity of sympathetic innervation as a common factor in disease. Journal of the American Osteopathic Association 79(4): 232-237.

LeMay, M., Culebras, A., 1972. Human brain morphological differences in the hemispheres demonstrable by carotid arteriography. New England Journal of Medicine 287: 168- 170

Sato, A., 1992. The reflex effects of spinal somatic nerve stimulation on visceral function. Journal of Manipulative and Physiological Therapeutics 15(1): 57-61.

Savic, I., Pauli, S., Thorell, IO., el al 1994 In vivo demonstration of altered benzodiazcpine receptor density in patients with generalized epilepsy.  Joumal of Neurology, Neurosurgery, and Psychiatry 57:784-797 

Steinmetz, H., Volkmann, J., Lancke, L., et al 1991 Anatomical left-right asymmetry of language-related temporal cortex is different in left handed and right handers. Annals of Neurology 29 (3):315-319.

Thomas, MD., Wood, I., 1992. Upper cervical adjustments may improve mental function. Journal of Manipulative Medicine 6:215-216.

 

Intial Assessment

Your first appointment will take approximately 2-3 hours.  It will involve an interview with a clinician to discuss the nature of your concerns, your symptoms and your medical history.  You may also be asked to perform a few simple physical tasks (eg. Marching on the spot whilst swinging your arms or touching your finger to your nose) and your blood pressure may be taken.

A quantitative electroencephalogram (qEEG) will then be performed. You will put on an elastic cap (it looks like a swimming cap with receptors attached) which will measure the levels of activity in your brain on several different frequencies.  Another receptor is clipped gently to your ear.  The receptors receive information from your brain and send them to the computer.  Nothing is sent back to the cap.  Adults will be asked to sit still with your eyes open and then with your eyes shut whilst these measurements are recorded by the computer.  Three minutes each of recordings with eyes open and eyes shut are required.  Children have 10 minutes of recordings taken with eyes open. This procedure is completely painless.

 

Clinical Report

Senior Clinician’s will consider the information provided during your interview, assessment and your qEEG. Integrating all these sources of information, they will analyse these results and discuss their findings with you. They will be able to show you images of your brain, which are colour coded according to levels of normal, high and low activity.  The images also show whether the different parts of your brain are communicating effectively with each other. Senior Clinician’s will develop a management plan which will probably involve visits to the clinic 3 times a week, home exercises and nutritional supplements. They will discuss the goal of the program for the next 6 weeks and what you may experience in this time. Please allow one hour for this appointment. This is a good opportunity to bring a list of any questions you may have for the Senior Clinician’s.

 

Clinic Appointments

Clinician’s will recommend the frequency of your clinic sessions each week. The average number of sessions is 3 per week.  During these appointments, you will be completing a selection of prescribed non-invasive tasks. These tasks are designed to be very simple and are proven to stimulate specific areas of your brain. You may or may not be seen by the same clinicians during your regular clinic appointments each week. However, please be assured that they will all be adhering consistently to your treatment plan.

 

Home Exercises

You will be given a number of home exercises to do.  These will vary depending on which parts of your brain require stimulating, inhibiting or connecting to other parts.  These may include music therapies, balance and co-ordination exercises.  These exercises should be done up to twice a day and will take no more than 10-15 minutes to complete.

 

Nutritional Supplements

A Senior Clinician will recommend a regime of nutritional supplements which should be taken in addition to a healthy diet.  These supplements will support your brain to develop and sustain healthy activity and connections. Please let us know of any allergies that you might have and any medications that you might be taking at the time.

 

Re-evaluation

After 6 weeks of this program, you will have another qEEG performed and the results will be interpreted by a Senior Clinician and compared to the previous qEEG images.  They will discuss their findings with you and develop your new management plan.

This process will continue until such time as your think you are satisfied with your progress and/or choose to stop.

 

What is qEEG (Brain Mapping)?

During the qEEG assessment, you will be asked to put on an elastic cap with receptors.  The receptors on the elastic caps record the electrical patterns at the surface of your scalp.  These patterns, often referred to as “brainwaves”, reflect the activity in your brain.  The data is statistically analysed, compared to normative databases (a group of normal, healthy people of the same age and gender), then converted into coloured “brain maps” illustrating the functioning of your brain.

The information derived from the qEEG can be interpreted and used to evaluate the functioning of your brain and to identify where the brain is having specific problems.  This information  helps your clinicians to develop an individualized therapy plan and to track changes during the course of therapy.

Dark blue areas represent areas of the brain that are relatively underactive and the red areas represent areas of the brain that are relatively overactive.  The other colours represent areas that are within “normal” limits.

 

In order for you to function well in your daily life, there needs to be good coordinated communication between different areas of your brain.  “Coherence” is a measure of how well one area of your brain is communicating with another area of your brain. If two areas are communicating too much or too little, your brain will function less efficiently.  qEEG provides a brain map of the coherence of your brain.

 

LORETA

Low resolution brain electromagnetic tomography (LORETA) is another functional imaging method based on electrophysiological and neuroanatomical constraints. LORETA is a neuro-imaging technique that allows your clinicians to map your brain activity in a 3 dimensional image.  It also allows your clinicians to locate the area of the brain most in need of intervention.