This Is MS Multiple Sclerosis Knowledge & Support Community

Dr. Flanagan,

Thanks for again giving me your synopsis of my case -- perhaps I should start ambulating on all fours to help with stopping my brain stem and cerebellum from descending into my foramen magnum.

As far as ambulation is concerned, the link below is to a recent article in Medscape regarding gait as an early indicator of Alzheimer's. It's a topic I cover in my book.

http://www.medscape.com/viewarticle/767 ... &src=nldne
http://www.usatoday.com/news/health/sto ... 56223518/1

Hi everyone, Dr F as time goes on I am getting more and more aware of the implications of these findings and my plan to see Dr Rosa and Dr Sclafani in one journey has me thinking that the learning could be huge.

** Do you know if the Fonar MRI/Cine studies will or do cover areas lower in the neck and even to the chest?

My reading tells me that Dr Damadien is looking outside the box on this and is also commercially motivated for his company to expand and learn.

As I think through the diagnosis side of this my work experience tells me that every opportunity with technology needs to be taken. If the Fonar MRI/Cine study does image the areas that were the original targets of flow as well as the new targets at the base of the Skull there is learning to be done.
Rumour has it that there is interest from other people involved in PTA treating as well as MRI imaging.
Once again getting everyone's minds together will move this along.

The risks are that Ego's, financial interest and sabotage from other 'interested Commercial operations' feeding off MS and other associated diseases will make linking everyone for the greater good a greater challenge. As I believe you have experienced in the past Dr F.

What I want to do to help is make some of these links happen. My thoughts are that we are going to see Dr Rosa and then Dr Sclafani for their individual treatments and the new thought is to arrange having a follow up Fonar scan after the 3-5 days rest period following Dr Sclafani's PTA treatment to image the total outcome before Neava and I return to NZ.
Neava and I spoke today for some time mostly about how we are going to find the finance for this and we are wanting for Neava to be tested for blockages/reflux by Dr Sclafani. I don't recall any one with Chiari being tested for CCSVI issues in the usual neck and chest and I am again wanting to push the learning while we can.
So for myself on welfare and Neava a married mother of three amazing children, we are needing to think big for the benefit to science and suffers in what we are proposing so that we can get public and other Society financial support to make this a reality rather than life long debt for the pair of us.

Could you please let me know about the Fonar Imagining of the neck and chest please and if we are able to go back for a follow up scanning of the Dr Sclafani PTA treatments.

Thanks and Regards,
Nigel

Hi Nigel,
I would like to see studies done but as far as I know neither FONAR nor Dr. Rosa are doing cine CSF flow studies in the lower spine. Studies of the lower spine are important to many cases such as yours and Neava's.

It is my opinion that spondylosis (degeneration) and scoliosis of the lower spine effect CSF flow in the cord. The cervical spine also effects CSF flow in the brain. Furthermore, I suspect that spondylosis and scoliosis can effect blood and CSF flow with or without causing actual stenosis (narrowing) of the spinal canal to the point that it contact the cord. Stenosis of the epidural space between the canal and cord compresses the VVP (vertebral venous plexus).

Your plan for pre and post AO/PTA upright MRI and Cine CSF flow studies sounds interesting but lining it all up will be challenging. You will have to work it out with the treating doctors and upright MRI facility.

The link below is to a post in an ALS forum regarding a Chiari malformation and spondylosis without or mild myelopathy (contact with cord) causing symptoms many of you are familiar with. The MRI and cine CSF flow study were most likely done supine. It is my opinion that structural abnormalities of the craniocervical junction, spondylosis, scoliosis/kyphosis and stenosis play a significant role in the cause of ALS similar to MS. Upright posture makes flow problems worse. I touched on ALS in my first book. I will cover more on ALS as my website grows.

http://www.alsforums.com/forum/do-i-hav ... -long.html

Thanks Dr F, I am shattered now from a big day of thinking and planning.
It would be interesting to know from the Fonar imagers to what level of the spine their tests are 'recording'.
IMO the torturous veins of the spine that are spoken of and shown in Autopsy are of huge interest and haven't been explored in regard to there flow ability. This is IMO an other area of interest that Dr S is also interested in but unable to access with IVUS.
Night,
Nigel

uprightdoc wrote:As far as ambulation is concerned, the link below is to a recent article in Medscape regarding gait as an early indicator of Alzheimer's. It's a topic I cover in my book.

http://www.medscape.com/viewarticle/767 ... &src=nldne
http://www.usatoday.com/news/health/sto ... 56223518/1

Dr. Flanagan, you might be interested in this new article titled, "IVIG Stops Alzheimer's in its Tracks." As you might know, IVIG is sometimes used for MS:
http://www.medpagetoday.com/MeetingCove ... aking-news

Hi everyone,
I have a question that has sparked from reading another thread.

** When the Dr Rosa team do there imaging do they check in several positions of rotation and forward or backward tilt of the head to get the readings regarding CSF flow and hopefully artery and vein flow?
Happy Poet are yo able to help with this please?

I am going to look for the earlier studies on blood pressure if any one has a link please could you let me know. What I recall is that the BP for people with high BP changed when they had an Altas adjustment.

My understanding from watching Dr S thread is that the flow readings will change with head rotation and neck position, which is natural and makes perfect sense. I am wondering if this is taken into account and publicised in the Dr Rosa and the other study on BP changes.

If Dr S is finding positive and negative readings purely because of rotation and position in the jugulars for instance with position and rotation then it will correspond with readings in the flows of all fluids in and out and CSF higher up. Its simply a case of where the hose is crimped, it won't matter where down stream for the testing only up stream position and finding it to check for pressure before and after so that you find the pressure point and the same corresponding zero pressure on the other side of the 'crimp'.

The Fonar study on CSF flow changes because of an AO adjustment;
http://www.fonar.com/pdf/PCP41_damadian.pdf
Quote;
"The first important observation of this study of eight MS patients was that every MS
patient exhibited obstructions to their CSF flow when examined by phase coded CSF
cinematography (ciné) in the upright position (Table 2A, col. 10 & 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 (Table 2A, col.
10, 11 & 13). Normal examinees did not display these flow obstructions (Table 2B, col.
10 & 11)."
And from Dr CHU in the same publishing
"If trauma induced “leakage” of CSF proteins into the surrounding brain parenchyma,
and particularly “leakage” of antigenic proteins, is contributing to the formation of MS
plaques, then the vascular expansion stenting of the Azygous and Internal Jugular Veins
recommended by Zamboni et al. (16) could be monitored after installation by UPRIGHT
®
phase coded MRI measurements of CSF flow. Upright phase coded imaging of
CSF flow would assure that installed expansion stents are achieving the corrections of
CSF flow dynamics and intracranial pressure (ICP) that are needed to terminate plaque
generating CSF “leaks”.

Nigel, the study last year investigated only CSF flow changes in only the upright (vertical) position with the head positioned looking only straight ahead.

Thanks HP I am thinking that what Dr S is saying may not be relevant but I am reading the article to try and see what is understood of what Dr S has found. It must have an effect its how that I am interested in.
The way I guess is for the U/R MRI study to rotate the head in the positions to see what difference is found, although the region C5/C6 is a common area of concern for the injury group (my spot too) it must be checked when that area rotates as it may open the cord passage and improve the CSF flow. That may also change with the AO adjustment?
If the blood flow is what pumps the CSF then both need to be assessed rather than make an assumption that it is only an effect on the CSF, therefore does the blood flow change as well?

Thanks HP for the rapid reply,
Nigel

Found the article that imo goes hand in hand with the jig saw, Dr Zamboni, Dr Schelling, Dr Flanagan, Dr Damadian, Dr Rosa, Dr Zivadinov et tal , in relationship of all flows Blood in/out and CSF. And the crossing of the BBB and CSF is being pumped into the white matter.

http://www.nucalispinalcare.com/pdf/1.pdf
Quote;
"Secondary efficacy end points
A summary of the X-ray changes both pre- and postprocedure throughout the study is noted in Table 3.
It is noteworthy that the difference in both rotational
and lateral positioning persisted for 8 weeks, as did
the reduction in BP, Table 3."

Thought fodder,
Nigel

**Dr F after reading the article above I am interested to hear how the adjustment process went in Dr Rosa's Study.?
Quote,
"X-ray measures of ATLAS position
Pre-and post-adjustment measures of both lateral
and rotational orientation of the Atlas were performed at baseline. In addition it is assessed if the
treatment was persistent and whether there is a
significant difference between treatment and control
groups at baseline, after baseline adjustment and at
8 weeks. The critical factor in each case was not
the direction of Atlas orientation but rather its
magnitude (absolute value), as this indicated how
far the C1 vertebra was from its desired anatomical
position."

**Is the adjustment achieved accurately in a one time event?

**HP you may be able to give feed back on this for us please. I am wondering if the machine, skill and method provide the outcome first time or do they need to try several times and check for the best outcome?

I am coming from the angle that I am on an Island in the South Pacific where I have tried to find a provider. I have had experiences with our 'best' as well. The Director of Technique for the NZ Chiropractic College as well as Osteopaths and others over time.

Ever cautious, and wanting to learn the truth,
Nigel

Nigel,
Blood and CSF flow change with flexion, extension, rotation and lateral flexion (side bending/tilt) of the head and neck. Those changes are temporary. Blood and CSF flow also change with structural abnormalities such as flexion, extension, rotation and lateral cervical misalignments. Unless they are corrected, those changes are permanent. More importantly, blood and CSF flow change significantly from the supine to the upright position.

Strutural abnormalities of the upper cervical spine can effect the vertebral-basilar arteries, the accessory drainage system (vertebral venous plexus) and CSF pathways between the brain and cord causing chronic ischemia, edema and NPH. The current upright MRI cine flow studies are primarily focused on the impact of structural abnormalities of the craniocervial junction on CSF flow. More studies need to be done to check the impact on blood flow in vertebral-basilar arteries and vertebral veins. The challenge will be to develop the imaging techniques.

Correction of the upper cervical spine is part of the solution and shows promise just like venoplasty. Just like venoplasty, however, it doesn't work in every case. When it does work the correction can be dramatic and long lasting even after just one treatment. In the vast majority of cases full correction is rarely achieved due to many limiting factors such as pre-existing degenerative changes in the spine (spondylosis, scoliosis etc.). In most cases the correction doesn't last and needs to be redone periodically by a properly trained upper cervical doctor. Over time the effect of correction tends to last longer.

Dr Flanagan, I have had multiple angioplasties,developed scar tissue and eventually my jugular veins died. Had jugular vein bypass surgery with improvements that also disappeared.The surgeon discovered I have infantile veins, very tiny. I am trying to think of my next step and I am wondering if I have a problem with my CSF flow.For years to have more strength I have to tilt my chin way up. When I was still able to walk I always had my head tilted backwards. If I placed in a normal position I would stop dead in my tracks, unable to move. Frozen. And to continue I would have to tilt my head up again. I am thinking my problem is not just blood flow but,CSF flow too. What would be my best way of getting the most accurate info on my problem?

Hello Dania,
I suspect you have spondylosis (degeneration) of the cervial spine that is effecting the ventral (belly) side of the spinal cord such as bone spurs similar to what Blossom has. Spondylosis of the connective tissues and vertebral segments, as well as degeneration of the discs, narrows the space between the front side of the spinal canal and the front (ventral) surface of the cord which is called stenosis. Flexing your head and neck foward further narrows the space and even cause contact between the spinal canal and cord. The front (ventral) or belly side of the cord contains the motor tracts which control the muscles in the arms and legs. Keeping your chin up or tilting your head backwards relieves the pressure. The best place to start in cases like yours is plain view x-rays of the spine, specific upper cervical x-rays and upright MRI. If you are interested I can get you into the study being done on Friday July 27 but you must let me know as soon as possible.

uprightdoc wrote:Hello Dania,
I suspect you have spondylosis (degeneration) of the cervial spine that is effecting the ventral (belly) side of the spinal cord such as bone spurs similar to what Blossom has. Spondylosis of the connective tissues and vertebral segments, as well as degeneration of the discs, narrows the space between the front side of the spinal canal and the front (ventral) surface of the cord which is called stenosis. Flexing your head and neck foward further narrows the space and even cause contact between the spinal canal and cord. The front (ventral) or belly side of the cord contains the motor tracts which control the muscles in the arms and legs. Keeping your chin up or tilting your head backwards relieves the pressure. The best place to start in cases like yours is plain view x-rays of the spine, specific upper cervical x-rays and upright MRI. If you are interested I can get you into the study being done on Friday July 27 but you must let me know as soon as possible.

I am very, very interested. Where is the study?