This comes from a discussion I was having on an ADHD users forum.
It is clear to me that the oculomotor problems contribute to many of the specific ADHD symptoms, especially in academic and workplace environments, and they effectively suck up a lot of working memory.
So I was asked whether I thought the eye problems caused ADHD or the ADHD caused the eye problems.
Ultimately there is an upstream problem in the brainstem and cerebellum.
This can be identified on physical examination once you know how.
The issue is the nosology of this problem.The old term minimal brain dysfunction was maybe more helpful- as it incorporated dyslexia, dyspraxia, ocular convergence issues, sensory processing disorder and ADHD under the one umbrella.
Now those things are seen as “co-morbids’ with little thought given to why they are comorbid, or what was the reason for the old classification.
The Swedish have proposed another good reclassification called “Deficits of attention Motor Control and Perception”.
Another very powerful brain based model is called cerebellar cognitive affective syndrome- and that provides the clue to some of the linkages between these conditions.
There is a little said here but the article is well out of date:
The list of associated disorders is interesting: depression, bipolar, ADHD, autism, dyslexia, schizophrenia.
So here comes the association with these neck subluxations. As of 5 years ago we now have hard proof of exactly the kinds of impairments to the craniocervical junction that these chiropractic ‘subluxations” can cause.
This is due to pioneering work by Dr Ralph Demadian (inventer of the MRI and the upright MRI) and several other neurosurgeons, radiologists and chirpractors.
I have put a list of the readily available evidence (from things like talks given to the Cranio Cervical Syndrome Symposium) on my blog. These talks are not papers but they are based on peer reviewed papers. This page is a bit of a mess, because there is just so much of it. Im grabbing as many papers as I can get without having to pay for them and will put it all up very soon.
Now so far as the cerebellum is concerned I would say that the now proven intermittent interference in vertebral artery blood flow in subluxations will directly compromise cerebellar blood flow via the Posterior inferior Cerebellar Artery – depending on your personal anatomy and your personal spine issues.
|“The posterior inferior cerebellar artery (PICA) is the vessel that perfuses the lateral medulla, and is usually occluded due to thrombosis or embolism in its parent vessel, the vertebral artery.”|
However its anatomy is highly variable- and many people will have a better functioning circle of Willis that will compensate better for compression of the Vertebral artery. Those sorts of anatomical variants are heritable traits– another possible target for genetic investigations.
So what is showing up is that these subluxations cause amongst other things a reversible, highly individual cluster of symptoms- for which the name “Cervical Medullary Syndrome is proposed.
This syndrome is interesting as it includes most of the symptoms of most psychiatric disorders and is highly associated with neuropsychiatric as well as “soft” neurological signs.
Looking at the cluster of symptoms I note that virtually anything in the “Affective Spectrum Syndrome” (a familial clustering of disorders that includes fibromyalgia, bipolar and ADHD) could be fully explained by this “Cervical Medullary syndrome”
Affective Spectrum Disorder:
Family Study of Affective Spectrum Disorder
James I. Hudson, MD, ScD; Barbara Mangweth, PhD; Harrison G. Pope, Jr, MD, MPH; Christine De Col, MD; Armand Hausmann, MD; Sarah Gutweniger, MA; Nan M. Laird, PhD; Wilfried Biebl, MD; Ming T. Tsuang, MD, PhD, DSc
(REPRINTED) ARCH GEN PSYCHIATRY/VOL 60, FEB 2003
|Affective spectrum disorder (ASD) represents a group of psychiatric and medical conditions, each known to respond to several chemical families of antidepressant medications and hence possibly linked by common heritable abnormalities. Forms of ASD include major depressive disorder (MDD), attention-deficit/ hyperactivity disorder, bulimia nervosa, cataplexy, dysthymic disorder, fibromyalgia, generalized anxiety disorder, irritable bowel syndrome, migraine, obsessive- compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social phobia. Two predictions of the ASD hypothesis were tested: that ASD, taken as a single entity, would aggregate in families and that MDD would coaggregate with other forms of ASD in families.
Now what I am proposing is that affective spectrum disorder is one of the presentations of cervicomedullary syndrome, and ADHD is a subset of both affective spectrum disorder and cervicomedullary syndrome- one which has more cerebellar effects than some other variants.
I believe that the saccading issue is one of the major generators of symptoms in the classroom, because if you have got it and nobody notices you experience reading in the classroom as “boring” and wont do it.
So the oculomotor problem generates many of the symptoms that are characteristically ADHD.
Other symptom clusters are generated by sympathetic dominance, a degree of learned helplessness, and direct brain fog so characteristic of ADHD PI and also fibromyalgia and depression, and CFS) probably represents a direct energy supply issue to the brainstem.
These issues are less severe if your posture is more upright- and that is a real benefit of exercise and meditation.
The last issue to bae addressed is “dopamine” and this popular idea that ADHD is a dopamine deficiency disorder, or an issue with the transporters or something like that.
I suspect the dopamine issue in ADHD is that the need to constantly adjust and adapt to an unstable body means that multiple fast re-fixations of attention are needed- and those neurones just get a bit fatigued. Stimulants do help, a lot, but lets face it- retrofitting an explanation on to a serendipitous discovery that stimulants worked, especially at a time when we had such little knowledge of neurology, might be superficially attractive but it is not intellectually justifiable.