ADHD, really?

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ADHD is trendy and some specialists question themselves on the number of children diagnosed. It is the case of Benoît Hammarrenger, neuropsychologist.

In the US, we consider that it’s 25% of the children that are tagged with a questionable ADHD diagnosis.

According to M. Hammarrenger, we rely too heavily on the Conners questionnaire when the time comes to do a variety of tests. The Conners test is not supposed to be, relatively speaking, the determinant test leading to a diagnosis.

Not only does M. Hammarrenger consider that the diagnosis is often done too early, he also considers that other conditions that are similar to ADHD can be mistaken for it. Those actually include anxiety and pervasive developmental disorder.

In functional neurology, it’s been known for many years that these different issues brought up by M. Hammarrenger often affect the same brain pathways. fMRI studies have many times revealed that networks involving the cerebellum, the basal ganglia and the frontal areas were affected in the cases of ADHD, anxiety as well as other cognitive and emotional challenges.

It is these networks that are optimized in the context of an intervention in posturology. By optimizing the balance and movement system, the networks responsible for learning are stimulated. As well, by integrating primitive reflexes that create the tone of the muscles of the organism, we are literally positioning the body for comfort and overall efficiency.

For your eyes only

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Recently, researchers have studied the following question: is there a connection between the papillary reflex, stress and auditory issues.

What about the pupil reflex?

The pupil reflex represents the change in the size of the pupil as it responds to a luminous source that lands on the retina. When light hits the retina, the autonomic nervous system that is responsible to manage that kind of situation does so by allowing contraction of the constrictor muscle of the pupil. This mechanism contributes to a reduction of light that hits the retina.

The reverse scenario is also possible. If the body perceives that there is not enough light, it can see it as a threat and the pupil then dilates to allow more light to contact the retina.

The pupil reflex as a means to assess the nervous system

Clinicians in functional neurology have been using the pupil reflex as a means of evaluation of the autonomic nervous system. This is the system responsible for keeping us alive while we are busy living our lives.

For example, an individual that is stressed, generally speaking, can have a weaker pupil reflex, which means that, at rest, its pupils are more dilated than someone who is more relaxed.

It has been many years that the pupil reflex has been used as a component of the assessment of the autonomic nervous system in the cases where patients suffer from Parkinson, Alzheimer and diabetes.

In the context of this study, 36 studies speaking of the pupil reflex and the autonomic nervous system were read. 30 of them made the link between the pupil reflex and a dysfunction of the autonomic nervous system.

What about posturology?

With posturology, we assess the body as a whole with the purpose of evaluating the expense of energy an individual is responsible for to stand upright and move. This evaluation includes motility of the eyes, as in how both eyes work together to allow us to focus on the horizon, as we need to do so to stabilize our body to do anything!

Ocular convergence is interesting for the posturologist. It attests of the capacity of the two hemispheres to work together, which is necessary for all motor tasks to take place.

Since we know that, for ocular convergence to take place, pupil constriction is necessary, if this mechanism is weak, ocular convergence pays the price and the final resultant is postural compensations and, in the worst of cases, instability disorders.

Specific exercises can be suggested as to improve the pupil reflex, which can potentially have positive consequences on the entire balance system.

Nocturnal enuresis and bed wetting

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A recent study made some links between the development of equilibrium strategies and nocturnal enuresis.

What was noticed was that the children that suffer from enuresis also present with postural imbalances.

In a study, 171 children were recruited. 111 of them suffered from enuresis. 60 did not. We analyzed their equilibrium and their posture.

What was found was that the children that suffered from enuresis were unstable and their pelvis showed more tilted forward.

A hypothesis that comes to mind is that the motor aspect of the nervous system depends on the maturity of the central nervous system. We can therefore think that the same can apply for the autonomic component of the system. Is it possible that sphincter control is more difficult in children that suffer from postural imbalances and from being unstable?

Strabismus and posture

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Strabismus is a default of eye alignment. We diagnose strabismus mainly in children that are 6 years old and less and it is about 5% of the children that are affected by strabismus. It is not rare that parents are the first ones to recognize the eye deviation.

It is recommended to have a full eye exam as of the age of 3. The thing is, by the age of 3, the visual system has already developed quite a bit.

It is true that if the strabismus is of congenital nature, the environment of the child will not be a considerable factor in resolving the issue. That being said, if the strabismus appeared during the first years of life, non-invasive solutions do exist.

Certain optometrists will recommend visual exercises. And that’s good. Yet, it’s incomplete. We develop our vision as we develop our entire body. We do so by navigating our environment. In my opinion, we have to address the body as a whole to get optimal results.

Take the Doman brothers, for example. They recognized early on (in the 1960s) that ocular pursuit was developed in the context of crawling, belly on floor.

It is with this in mind that, at Clinique VI, we offer a service entitled Motor Development for 0-6 years old.

As Dr. Ezane, MD and associates say: we associate equilibrium difficulties with strabismus. More so, we know that these children must spend more energy to stand upright that children that do not have strabismus.

Good feet… good eye?

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How true is it that the feet are somewhat connected to the eyes?

What we do know is that it is vision, proprioception and the sensation of the plantar sole that contribute to postural equilibrium.

The goal of a recent study was to see if ocular movement (saccades) could improve the sensation of the foot sole in specific individuals.

Here, 104 women aged 75 years old (average) were studied. 52 of them were selected to perform ocular saccades while 52 performed ocular pursuits.

If it’s true that ocular movement participates in the elaboration of equilibrium strategies, it is also true that saccades offered a bigger payoff.

In the context of Posturology, we focus on the efficiency of the ocular pursuit before we address the saccade. This is because, on a neurodevelopmental level, pursuits are simply more accessible.

The winning strategy, for a better posture, according to posturologists, is to stimulate the feet with a postural insole, which turns on the sensory areas of the brain. The sensory areas connect to the motor areas in order to create optimal recruitment of the muscular chains in order to stand upright as economically as possible.

We also train or retrain ocular movement patterns (pursuits and saccades). To do so, specific exercises are suggested!

The cerebellum and migraines

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According to the WHO, 10-12% of worldwide population is affected by migraines.

What defines a migraine?

– Duration: 4-72 hours.
– Unilateral.
– Affects specifically the anterior part of the cranium.
– Can be intense enough to get in the way of professional activities.
– Can be associated to nausea, vomiting and photophobia.
– There can be an aura preceding the migraine.

If it’s true that no one knows the origin of migraines, some studies show that the issue could be of cerebral origin. There is, to this day, a debate as to whether migraines are of vascular or neurological nature.

That being said, it seems that the possibility that migraines are caused by cerebral hyper excitability is generally accepted.

The role of the cerebellum in cases of migraines with and without an aura

Published force plate measurements have revealed that migraine sufferers had less balance. As well, it was revealed that individuals afflicted by migraines had ocular saccades that were less precise. Finally, it was mentioned that individuals that suffer from migraines tend to have less fine motor coordination.

These findings seem to highlight the role of the cerebellum in migraines. To add to it, it is apparently 2/3 of migraine sufferers that are sensitive to movement!

The role of the cerebellum in basilar type migraines

Some think that basilar type migraines find their origin in the brainstem and/or in the brain hemispheres and are sometimes accompanied by motor deficits.

Some of its symptoms, again, make you think of the cerebellum:

– Dysarthria: difficulty with the TMJ for speech.
– Vertigo: difficulty with organ of equilibrium.
– Diplopia: double vision.
– Visual symptoms.
– Ataxia: lack of coordination of movements.

The role of the cerebellum with familial hemiplegic migraines

Familial hemiplegic migraines are characterized by the presence of an aura and motor weaknesses. We can also find ataxia. As it is the case for other types of migraines, we recognize, for familial hemiplegic migraines, symptoms that belong to the cerebellum.

Conclusion

Based on the information herein provided, we can think that the cerebellum is involved in different types of migraines.

In Posturology, the fact that we improve proprioceptive information that is captured by the cerebellum and that we decrease the quantity of work that the vestibular system needs to accomplish to stand us upright (the inner ear connects to the cerebellum), it is quite possible that we can have a positive effect on the probability of developing migraines.

Clinically, we often find that these migraines are on the side of the hypo convergent eye, where facial muscles show less tone. These clinical findings can be a reflection of the postural system. If we improve that system, it is possible to have results on migraines.

Righty lefty: to be skilled in mathematics?

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There is controversy surrounding the topic of handedness and the ability to do well in mathematics.

Some studies demonstrated that left-handed individuals are gifted for umbers while it’s also been shown that right-handed individuals aren’t so great at math!

More recently, a study demonstrated that ambidextrous individuals were the ones who were the most disadvantaged when it came to performing in mathematics.

In 2016, researchers from Liverpool University found that, when children were well lateralized, they actually did not do so well in math.

That being said, in teenagers, being well lateralized was actually beneficial for performing in mathematics.

To be lateralized means you are developing one side of your body more than the other one for purposes of fine motor skills.

This is well known to cognitive neuroscientists: lateralization is a process that takes place between 0-7 years old. If this lateralization develops too early, fundamental stages of brain development can be compromised, which could play against performing in mathematics.

When the stages of brain development are respected, we have a tendency to stimulate and develop the brain optimally, allowing it to perform complex tasks more easily, whether it be mathematics or any other cognitive task.

In conclusion, in the context of Posturology, the goal is to refine this development for motor gains. It would be normal to expect cognitive gains from a methodology that targets areas of the brain that are responsible for both motor contributions and learning.

Eyes and Alzheimer

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Let’s not lie to each other… in posturology, eyes are pretty important! The posturologist assesses ocular motility in order to evaluate coordination and so much more.

Actually, Posturology borrowed from orthoptics the notion of testing the efficacy of eye movement with the idea of assessing more than how we see.

Knowing this, in 2013, researchers sought to find out if specific eye movements were affected in patients suffering from Alzheimer’s. We already knew that patients who suffered from Alzheimer have affected horizontal saccades. We wanted to know, here, if vertical saccades were also affected.

The study concludes, indeed, that vertical saccades are also affected in patients with the illness.

Saccades are eye movements where we go from looking at one target to another, very quickly.

Saccades are initiated in an area of the brainstem called the midbrain and the motor visual areas.

When calibrating with Posturology, via specific exercises, we stimulate the pathways that link the midbrain to the motor visual pathways.

To activate the brain via specific eye exercises such as the ones we suggest to improve saccades is as essential for the brain’s health as it receiving enough glucose and oxygen.

Posturology can be seen, therefore, as a tool to improve brain function and hopefully decrease the likelihood of neural degeneration and neurodegenerative diseases such as Alzheimer’s.

How does the brain control movement?

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In neurosciences, we have long thought that if it is possible to accelerate movement with one part of the brain, it is possible to decelerate movement with another component.

Simply put, we have considered that the brain had one pedal for accelerating and one pedal for breaking.

Researchers from the Howard Hughes medical institute have demonstrated that this break pedal was a little bit more than a break pedal.

What they were able to demonstrate is that when we put less pressure on the break pedal, not only did we stop breaking, per se… the speed of movement actually increased!

The opposite was also shown. If we release the accelerator, movement actually slows down.

You will tell me that this all makes sense when it comes to a car. Thing is, up until now, we thought this was not commonplace for the brain. We thought that it was only possible to accelerate… when accelerating, for example.

This study demonstrates that we use these two systems simultaneously in the context of movement production.

The pedal and the break, at the brain level, are the basal ganglia. The cortex and the cerebellum activate them. An optimal posture, because it is a reflection of high quality inputs to the cerebellum, can be one way to improve the quality of our movements.

The brain and cellphones

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We’ve been hearing about this for years… are cell phones risky for our brains?

A study published in 2013 gives us a bit more perspective on the ordeal. The right ear of 18 participants was tested for radiation from a phone for a total of 30 minutes. The source of radiation was 1cm away from the ear.

Results showed that exposition to an LTE phone had an impact on the neuronal activity of the brain. Both brain hemispheres were affected!

That being said, if it’s true that cerebral activity was modified, LTE technology is too recent for us to know if this type of activity can lead to health concerns over the long haul.

Clinically, I can say that it is not rare that I have seen patients perform poorly on balance tests and structural tests when carrying their cells phones. As we know, since it is the central nervous system that manages posture and balance, one can question the effects of the cell phone in the light of these findings.

If this is a concern for you, as it can be with my patients, a frequency resonator can be used. It is positioned on the cell phone and converts the electromagnetic waves into frequencies that the body seems to manage in a way where balance and postural tests are normalized.

Another solution consists of leaving your phone on Airplane mode when it is on you and that you are not actively using it. Another way of diminishing the effects of the electromagnetic waves is to wear headphones as to keep the phone away from you as much as possible.