Tuesday, June 5, 2018

Chiropractic Neurology (Functional Neurology)

I was sent this article:  http://www.cbc.ca/news/canada/windsor/anthony-lemmo-chiro-brain-injury-windsor-1.4682825

 At first I didn't know what to make of it.  I had never heard of the term chiropractic neurology.   The only thing I knew is that it had to be a pseudoscience in some way because of being linked to chiropractors.  I also knew just from the name that Chiropractic Neurologist is not even a recognized medical profession. 

Most chiropractors fall into one of two categories; straights and mixers.  Straights strictly follow the basis of chiropractic medicine which is that ALL disease is caused by misalignment (subluxations) of the spine.  Mixers, as the name suggests, also dabble in other pseudoscience practices and services and they vary in the amount which they believe in the subluxation/disease mantra.

Some chiropractors call it "Functional Neurology" (probably to make it sound more scientific).  They claim to be able to help many neurological conditions including ADHD, autism, Asperger's, Alzheimer's, Stroke and much more.  This is done through diet, massage, muscular-skeletal manipulations and brain training.     

Diet of course is important to any person's health.  Some diet tips given out by woo peddlers can be reasonable, but that doesn't mean that any other advice is sound.   Some of the diet advice though, simply goes against any evidence that exists.  For example this blackboard I saw at a clinic with homeopathy and other woo.

There is simply no evidence that gluten (or lackthereof)  has any effect, causal or therapeutic, on Autism.

I can't even begin to guess how massage and adjustments of the spine can help with neurological conditions.  Any proposed mechanism just would not make sense to me. 

To make a diagnosis, special goggles are worn.  These track eye movements.  This somehow gives "a map" of the problems in the brain.  I'm sorry, but eye movement can only give a very small amount of information about brain function.  An fMRI would be a better option.  See more options for neuroimaging  
In using EEG, it is hard to figure out where in the brain the electrical activity is coming from.  It is hard to find the "pathways" that are mentioned in the CBC article.  To see more about its limitations:

So now we come to brain training, which seemed to be at the core of the CBC article.  While I am happy for the mother that her son is getting some much needed attention, and that seems to be helping him in controlling his ADHD, I am of the position that it has nothing to do with "chiropractic neurology."   Neurological symptoms can be susceptible to the placebo effect.  So depending on the degree of the problem, some good old attention can help.  As a child with hyperactivity (what it was just called back in the 80s), I personally learned to focus and channel my "energy".  Here with this child, I think some of the same thing is happening.  Stimulation of the brain is better than no stimulation, but it does not follow that an increase in stimulation will increase brain recovery.  Daniel Simmons (of the Monkey Business Selective Attention Test fame) and team did a review on more than 130 studies about brain games and cognitive training.  They found the evidence was lacking, especially when considering the quality of the studies.   http://journals.sagepub.com/doi/abs/10.1177/1529100616661983

You'll note in the CBC article that it states "there is not a lot of research evidence that shows that it works."  To me, to offer a service without the backing of evidence is dubious.  I went to Mr. Lemmo's website to see if he offered any research.      

Two of the articles presented were done by Carrick, who is mentioned in the article (and who has been criticized much for the pseudoscience).  

In this one: https://www.researchgate.net/publication/291557243_Eye-Movement_Training_Results_in_Changes_in_qEEG_and_NIH_Stroke_Scale_in_Subjects_Suffering_from_Acute_Middle_Cerebral_Artery_Ischemic_Stroke_A_Randomized_Control_Trial 
It does state: "The HIHSS is a scale of stroke severity and does not provide any insight as to functional changes"   So really sharing this research shows that it doesn't provide much evidence in it actually working.

In another study provided https://www.drlemmobraincentre.com/research/Concussion-Carrick.pdf
"Many of the C3 Logix are subjective and may be associated with reporting error that can limit interpretation. This is a retrospective review and no control group has been included in this study."  These are huge limitations and in turn provides no real evidence.

Mr. Lemmo said "There's only one thing that I care about and that's results and if I'm getting them over and over that's all that I care about."   This is problematic as it relies solely on testimonial and flawed feedback.  It is the same type of excuse that I've heard from another chiro who was peddling nonsense.  This was was featured on CBC Marketplace (in an episode I appeared in):  https://youtu.be/P-Kl0XkZuCw?t=13m49s  .  Mr. Lemmo is doing exactly the same in selling a service where the research supporting it just isn't there.

So with all of these factors and red flags, it does concern me that this service is being promoted.  It does not come from a neurologist, so the claims are suspect.  The evidence of it working is thin or simply non-existent.  I guess buyer beware would be prudent.