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David Harshfield M.D., M.S., interventional radiologist -College of Integrative Medicine

"Knowledge is fixed in time, where as knowing is continual. Knowledge comes from a source an accumulation, a conclusion. Where as knowing is a movement." Bruce Lee

You move!

Sheridan - MS patient

Neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis are some of the most costly and critically important health care issues of the day. Yet, despite decades and billions of dollars in research their causes remain a mystery. All three, however, as well as other serious neurological conditions, may have similar root causes related to design changes in the skull, spine and circulatory system of the brain due to upright posture.

Upright posture caused significant changes in the anatomy of the skull, spine and circulatory system of the brain. For the most part those changes were beneficial but they also caused some negative consequences that sometimes show up as we age.

In addition to Alzheimer's disease, Parkinson's disease and mutliple sclerosis other neurological conditions that share suspiciously similar roots include: migraine headaches, seizure disorders, transient ischemic attacks (mini strokes), normal pressure hydrocephalus (NPH) Chiari malformatons, tethered cord syndromes, amyotrophic lateral sclerosis (ALS), and primary lateral sclerosis (PLS) to name a few.

The problem with upright posture is that it stacks the skull on top of the nearly vertical segements of the spine. This decreases the tension loads that typically pull on the spine for support in four legged species. At the same time it increases the compression loads stacked up on the spine. The cervical spine or neck for example gets compressed by the weight of the head above. Likewise the lower segments, especially the low back, get compressed by the weight of the entire spine above it. The increased compressive forces cause us to lose a little height over the course of a day. Over the course of a lifetime it can do far more irreparable damage.

Upright posture also puts the foramen magnum of the skull directly over the spinal canal which houses the spinal cord. The foramen magnum is the large hole in the base of the skull through which the brainstem passes and becomes the spinal cord. This arrangement predisposes the brainstem to sinking into the foramen magnum resulting in a Chiari malformation. Among other things, Chiari malformations have been associated with mutliple sclerosis. In fact, Chiari malformations are probably far more common than we realize and play a role in other conditions as well.

The vertical arrangement of the spine also pulls on the brainstem from below. The pull comes from the attachment point at the tailend of cord, called the filum terminale, to the tailbone of the spine, called the coccyx. A short spinal cord can cause excessive tension in the lower cord, called tethered cord syndrome. Abnormal curvatures of the spine also cause tension on the cord, as do abnormal head and neck tilts. Consequently, short cords, scoliosis and head tilts can lead to Chiari malformations. Lastly, the design of the skull, particularly the length and slope of its base, likewise predispose humans to Chiari malformations.

The upper cervical spine is the critical link between the brain and cord. In addition to the cord, the upper cervical spine also contains the vertebral arteries, the vertebral veins and the subarchnoid space of the cord. Although they only supply about twenty percent of total brain circulation, the vertebral arteries supply the most critical structures that run the operating system of the brainstem. This includes the cerebellum, thalamus and hypothalamus, as well as the inner lobes of the temporal and occipital lobes of the brain.

The cerebellum controls muscle coordination, balance and gait (walking). It is closely connected to the inner ear and muscles related to maintaining balance during upright posture. Cerebellar problems are some of the earliest signs seen in Alzheimer's and Parkinson's disease. Loss of balance is also a common complaint in multiple sclerosis.

The thalamus is the router or great sensory switchboard of the brain. The hypothalamus controls all vegetative autonomic functions in the body. Autonomic signs and symptoms, especially incontinence are commonly seen in Alzheimer's, Parkinson's and multiple sclerosis patients. The occipital lobe is related to vision. Among other things, the inner portion of the temporal lobe is important to long-term memory. So despite its smaller capacity when it comes to total brain blood flow, the vertebral arteries are vitally important.

The vertebral veins play a unique role in humans in that upright posture increases blood flow to the brain which requires an increase in drainage capacity in order to prevent backups of venous blood in the brain. The vertebral veins also play a role in transmitting respiratory waves to the brain, which helps move cerebrospinal fluid (CSF) through the brain. CSF plays an important role in the cushioning, protection and support of the brain. Venous drainage and CSF flow problems may play a role in the cause of Alzheimer's, Parkinson's and multiple sclerosis.

The subarachnoid space of the cord passes through the upper cervical spine and contains CSF on its way back from the lower cord to the brain. Congestion or blockage of CSF flow can lead to a condiiton called hydrocephalus. In adults it is called normal pressure hydrocephalus (NPH). Among other things, NPH has been associated with Alzheimer's and Parkinson's disease. Certain unusual cases of underdeveloped skulls can also result in NPH and symptoms similar to multiple sclerosis.

The health of the upper cervical spine is thus critically important to both blood and CSF flow and that makes it important to overall health. It is especially important to the health of the brain and cord. In addition to Alzheimer's, Parkinson's and multiple sclerosis this site discusses many common and important health conditions related to upright posture.

For further information about the book "The Downside of Upright Posture - The Anatomical Causes of Alzheimer's, Parkinsons, and Multiple Sclerosis" go to the book.

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