ADHD as a model of functional disorders.

It has been known for some time that “head injuries” can produce a pattern clinically indistinguishable from ADHD. In his book “Total Concentration” the psychiatrist Harold Levinson discusses this and cites some very clear case histories. The medical profession has been slow to catch up on this- but we are now seeing some talk about head injuries and subsequent ADHD symptoms.

What is usually neglected is that head injuries are usually accompanied by injuries to the upper neck and that the upper neck houses the lower brainstem- important for vital functions and also for orienting reflexes. Equally brain injuries are often torsional and mostly involving axonal rupture in the midline structures- so not what we thought.

Upper neck injuries tend to be difficult to resolve because they scramble the proprioceptive (body position) information coming from the neck- causing each side to differ and neither side to match the other senses.
About 80% of that body position information comes from the small muscles innervated by the second cervical vertebra. The basic set of information our brain needs to construct even a crude map of the outside world is proprioception +vestibular+ vision ( see my earlier blog post titled “Upper Cervical Subluxation and the Reality Hologram).

What complicates matters further is that the scrambled proprioceptive information makes it harder to co-ordinate eye movements, and once they are a little out of sync, you get what the behavioural optometrists call “convergence insufficiency”.

The lack of convergence then creates a situation where the images from each eye do not match and that means that the brain has to suppress one for vision, and the other for balance. This maintains the loop by maintaining the eye muscle co-ordination problem.
Eventually that leads to all sorts of knock on effects in activation of other brain areas- but usually ends up with a lack of drive to the L prefrontal cortex.

Now the symptoms of convergence insufficiency and of ADHD are virtually inseparable.

We now have a significant literature that shows that oculomotor problems are usual in ADHD, and also literature that this symptom is responsive to stimulants.
That fits with reports I have had from ADHD individuals that they note an improvement in visual acuity after starting stimulants.

Now the bottom line of this is that serious brain tissue damage is relatively uncommon.
Most of these problems are what is called “functional brain disorders”- which means that they are effectively self maintaining loops of unhelpful activation patterns.

We have not had effective treatments for these problems until recently, but there is now a field growing called “functional neurology” or applied “neuroscience”. It has been pioneered by a chiropractor called Ted Carrick in the US. His major interest focus around serious head injuries, but his team are working with a wide range of disorders, getting substantial improvements in functioning in conditions clinically intractable.

This work has been gradually improving me over several years– but my situation has been complicated by decades of neglect – leading to significant spinal issues- widespread osteoarthritis and instability; severe clumsiness and oculomotor problems, episodic and unpredictable severe fatigue and a chronic pain syndrome involving my right upper back.

Now 2 weeks ago I was taught (as a practitioner) an attentional gating exercise for chronic pain. That worked so well that I was able to largely unlock my back and adopt a straighter posture, then within a week able to re-stabilise my neck, with massive improvement in visual clarity, and in co-ordination and spatial perception.– all due to that improved proprioceptive input. Strength at the gym improved enormously because of the better muscle co-ordination.

There are still a few kinks to be ironed out- but they are now manageable.

It has taken 7 years from the initial neck treatment, and a great deal of patience to source the right sort of treatment.

However, I am now juggling with a model of ADHD as a functional problem involving a series of self maintaining feedback loops- some of them operating across a number of levels:
ie neurological-musculoskeletal behavioural-interpersonal autonomic- behavioural etc.

the next step becomes one of formalising a way to systematise looking at the feedback loops.



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Sensory Mismatch and Vestibular Dysfunction

This post follows on my ” Sensory Mismatch and persistence of symptoms” post. Interestingly the authors here are looking at more dramatic symptoms that can be caused by sensory mismatch and vestibular dysfunction:

Most significantly the post mentions distorted body schema and body image, leading to de-personalisation and de-realization experiences, including out of body experiences, with associated changes in mood and loss of sense of personal agency.

It is also arguable that sensory mismatch may drive symptoms such as dystonias ( ie writers cramp or spasm in the hands of musicians who lose the  ability to play with a high level of speed and skill.

The hypothesised explanation for this one is relatively simple: – even instability in the upper neck could produce a shift in the mapping of sensory representations of the fingers on to the cerebral cortex and to deeper subcortical structures. That may be enough to produce symptoms in itself, though there may also be involvement of the vestibular  system due to the disturbed inputs caused by neck malalignment.

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Electromagnetic Radiation and Human Health, some evidence.

EMF and Blood Brain Barrier, and their relevance to atlas subluxations

There have been concerns about electromagnetic radiation for some time. While studies looking at exposure and cancer have been inconclusive this is not the best way to look at this problem.

Identifying a causal association in a population which is so saturated with EMF would be like trying to find a needle in a haystack, let alone correcting for the unknown variations in EMF exposure between individuals.

These three papers show a clear link between blood brain barrier permeability and EMFs used in wireless communication.

This permeability is not a good thing, as, as we have seen our blood often contains toxins from the metabolism of gut bacteria which should be excluded from the brain to allow efficient neurological function. This  becomes particularly relevant to the maintenance of spinal malalignment problems though, as the vestibular system, which is responsible for relating our body to our head and the whole to the environment, is one of the hardest working parts of the nervous system, and is most vulnerable to problems which impair brain efficiency. Clearly when factors such as these impair brain function, the chances of maintaining correct spinal alignment diminish rapidly.

The following 3 papers are significant and are worth reviewing. No doubt there is plenty more to be found, but I was satisfied with finding 3 papers. The “completeness freaks” amongst us are free to go hunt some more out and I would be grateful for any further papers to review.


Wireless Networks 3(1997) 455-461

Blood Brain Barrier Permeability in Rats Exposed to Electromagnetic Fields Used in Wireless Communication.

Bertil R.R. Persson, Leid G. Salford and Arne Brun

(Blood-brain barrier and electromagnetic fields: effects of scopolamine methylbromide on working memory after whole-body exposure to 2.45 GHz microwaves in rats).

Exposure to 900 MHz electromagnetic fields activates the mkp-1/ERK pathway and causes blood-brain barrier damage and cognitive impairment in rats.

The first study shows that EMFs caused slight permeability to albumin ( a protein), but the issue is that the substances that are of concern in leaky bowel (ammonia, lactic acid, tyramine, histamine, gluten, gluteomorphin and caseomorphin, and glutamate (MSG) to name a few) are much smaller and would pass through a much smaller breach in the blood brain barrier.

Since becoming aware of this information I have changed my practices around EMF substantially. Wherever possible I use speaker phone. I try and shorten phone calls, and I also look to minimise contact with sources of emissions such as screens and wiring in the walls- especially near my bedhead. I prefer to turn wifi off overnight. I also sleep on a grounded bedsheet. However more of that in a later post.






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ADHD and Suffering, the International Consensus Statement

Despite the ADHD denialaists and other fringe thinkers, ADHD is real , and it can be very troublesome:

For most of us who are classifiable as ADHD, life can be pretty hard.

The many disadvantages and harms associated with ADHD are well described and have been thoroughly researched. There is no controversy about the reality of these correlations.

In short ADHD, which causes a lack of the application of attention to moment to reality – is statistically strongly associated with suffering. ( It is associated with lots of good things too- but more about that in another post).

Now here is the tricky bit.

About 500 BC, shortly after his awakening Shakyamuni Buddha (formerly known as the prince Siddhartha Gautama said much the same thing in his four noble truths.We suffer needlessly because we do not attend carefully to the true nature of reality.

( That is a rough paraphrase- but it is good enough for this post).

A good summary of those disadvantages  can be found here:

Clin Child Fam Psychol Rev. 2002 Jun;5(2):89-111.

International consensus statement on ADHD. January 2002.

Barkley RA1.

The full text is here:

( Now there are lots of Barkley’s ideas that I think are just plain wrong– but he is often very helpful and this statement is one example. I have read most of the criticissm of this staement and they really leave me concerned about one thing more than anything else- the literacy of the authors- but that is another story).

This is Barkley’s website- it ids full of practical management tools.

All freely available

Everything is science based- but there is much science of which he is not yet aware- so don’t take what he says about genetics and so forth as gospel. It is not.

However he has been a great contributor and continues to do great good for all of us and I respect and admire him even when I disagree with him.


So yes- ADHD is strongly associated with suffering:

Here I quote heavily (  though I have tidied up some of his bad English 🙂

As attested to by the numerous scientists signing this document, there is no question among the world’s leading clinical researchers that ADHD involves a serious deficiency in a set of psychological abilities and that these deficiencies pose serious harm to most individuals possessing the disorder.

There is no doubt that ADHD leads to impairments in major life activities, including social relations, education, family functioning, occupational functioning, self-sufficiency, and adherence to social rules, norms, and laws. Evidence also indicates that those with ADHD are more prone to physical injury and accidental poisonings. This is why no professional medical, psychological, or scientific organization doubts the existence of ADHD as a legitimate disorder.

ADHD is not a benign disorder. For those it afflicts, ADHD can cause devastating problems. Follow-up studies of clinical samples suggest that sufferers are far more likely than normal people to drop out of school (32–40%), to rarely complete college (5–10%), to have few or no friends (50–70%), to underperform at work (70–80%), to engage in antisocial activities (40–50%), and to use tobacco or illicit drugs more than normal. Moreover, children grow- ing up with ADHD are more likely to experience teen pregnancy (40%) and sexually transmitted dis- eases (16%), to speed excessively and have multiple car accidents, to experience depression (20–30%) and personality disorders (18–25%) as adults, and in hundreds of other ways mismanage and endanger their lives.

Yet despite these serious consequences, studies indicate that less than half of those with the disorder are receiving treatment. The media can help substantially to improve these circumstances. It can do so by portraying ADHD and the science about it as accurately and responsibly as possible while not purveying the propaganda of some social critics and fringe doctors whose political agenda would have you and the public believe there is no real disorder here. To publish stories that ADHD is a fictitious disorder or merely a conflict between today’s Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud. ADHD should be depicted in the media as realistically and accurately as it is depicted in science—as a valid disorder having varied and substantial adverse impact on those who may suffer from it through no fault of their own or their parents and teachers.




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Gut dysbiosis and sympathetic dominance

This weeks discovery:
I have been picking up on some information about gut dysbiosis, and, as i was not getting well as fast as I thought I should be, I went off to have a full faecal aerobe/anaerobe test.

The context of this is that about a fortnight ago I had 2 days of acute and quite severe illness, both brought about by tyramine rich foods. I had had a suspicion about this item for some years, but the reactions were always inconsistent- so there was never enough reason to systematically avoid them ( and yes, I like blue cheese, red wine and salami– a lot).

As it turns out my gut was loaded with bugs that produce amines (including tyramine- and ammonia- which causes most of the cognitive symptoms in hepatic encephalopathy, and with bugs which cause lactic acid- which causes muscle pains, and has kept re-activating my neck problem. However they were there largely because of the pattern of sympathetic dominance ( and the secondary dysfunctional eating habits) caused by my upper neck malalignment. That was a birth injury, and it would have responded nicely to a chiropractic intervention in the first few weeks of my life.

The solution was simple- but not pleasant:- a dose of picoprep to reduce the total load of bugs in my gut- then a planned program of erythromycin (which will kill the nasties without harming the E.Coli- the “good guys”) and then a combination of 4 weeks of carbohydrate avoidance to starve any remaining streptococci to death, and of taking a supplement to alkalinise my body- as the streptococci produce lactic acid and they thrive in an acidic environment.

This morning, after taking the picoprep yesterday, and after recovering from a truly hideous tyramine withdrawal headache, I feel good. My mind is clear, I feel better than I can ever recall having felt- calm comfortable and clear, and I am ready for action.

That is a good thing- much action is required.

I am not the only victim of this ignorance. Another patient of mine turns out to have a sky high serum ammonia, consistent with toxicity from his gut bugs. This lovely, kind, creative young man has been given multiple psychiatric labels for decades- and has been stuck on Seroquel- because it was the only thing my  colleagues could think of to help him sleep. He could not sleep because he was in pain- but psychiatrists have forgotten that they are doctors and don’t think of that sort of thing– apparently they thought he had an “attachment problem” !

This issue of gut dysbiosis had been well known and routinely treated in Russia for about thirty years- but the medical establishment in the West has resisted this knowledge with all its considerable might. It has set enormous barriers to research, ( mostly through exploiting the labyrinthine rules around ethics committees and making this sort of research very difficult to get off the ground).

Not only that the core problems were well documented in a  book called “The Ultramind Solution” by Dr Mark Hyman 7 years ago.

I highly recommend reading pages  199 through 206 for some clear cut case histories re gut dysbiosis and psychiatric presentations.


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Sensory Mismatch and the persistence of symptoms in upper neck problems

The following information is likely to be relevant to all individuals with a chronic neck pain problem or with any history of ADHD, or a number of other chronic problems such as migraine or fibromyalgia. It will not provide a complete solution to any of these problems but is likely to help management of them very much.

Our ability to perceive the world accurately is dependent upon the capacity to accurately integrate the different sensory data received by our brain.

In particular the three senses of vision, balance (vestibular apparatus) and somatosensory proprioceptive information need to be matched accurately in real time.

Somatosensory information is derived from stretch receptors in each muscle, but a very large proportion of this information comes from muscles in the upper neck.

It is now proven that tension and fatigue in muscles causes distortion of the somatosensory information coming from that muscle such that it no longer accurately reports body position.

This leads to a series of downstream effects in the nervous system that include impaired balance, impaired co-ordination, impaired eye muscle co-ordination leading to loss of depth perception and difficulty with eye tracking that makes reading difficult, error prone and stress provoking.

The balance impairments also lead to an increase in muscle tension as the brain responds by puling the head down harder on the neck to minimise the risk of

The major problem that we face is that the fatigued muscles are usually not obvious except by direct palpation– if you do not poke them you will not know they are causing trouble.

Equally, the balance problems caused by neck muscle tension are subtle and usually long standing, and not obvious except to direct questioning. Equally an affected individual might have mastered a sport and have good balance in the context of that sport but not elsewhere.

These unrecognised balance problems though do generate a chronic stress response and a chronic sense of anxiety in most affected individuals. Being unaware of the true cause of the anxiety , most individuals attribute it to situational issues such as the perceived behaviour of those around them

Since the start of 2014 my practice has focussed on management of ADHD and chronic pain syndromes, and all my patients have been initially assessed with questionnaires that look specifically for issues with neck and back pain, headaches, balance, coordination, reading ability and sensory integration. There is also a careful assessment for a history of head injury and upper cervical birth trauma. This has been followed with specific physical examination that reviews posture, postural stability, balance, cerebellar function, and eye tracking, and more recently with detailed questionnaires usually used by behavioural optometrists.

The conclusion of my observations is as yet unpublished but several common themes arise.

Virtually all ADHD patients have issues with balance, co-ordination and eye tracking and usually neck or back pain. Most ADHD adults are dissociated from their bodies and score very poorly on assessment of interoceptive ability when I introduce them to body canning meditation. Most also have immense difficulty in mirroring me when I teach them basic exercises to help their posture. This reflects an impairment in visuospatial awareness- which often drives much of the disorganisation and many of the incidents of losing personal effects so common in ADHD. Virtually all have poor posture- dominated by a functional kyphoscoliosis and postural instability. Most have abnormally high muscle tone in superficial muscle groups. Equally the majority of adults presenting to my practice with ADHD have noted a deterioration in the context of changed circumstances with require that they spend more time sitting reading (ie promotion, or taking on extra study).

These observations fit well with the observations made by Stray et al in 2009 in their study of co-ordination problems in a cohort of Norwegian children diagnosed with ADHD.

Ref: The Motor Function Neurological Assessment (MFNU) as an indicator of motor function problems in boys with ADHD

Stray LL et al: Behavioral and Brain Functions 2009, 5:22 doi:10.1186/1744-9081-5-22

While causation of ADHD is complex and multifactorial I am formally proposing that in the overwhelming majority of ADHD patients the final common pathway generating and maintaining ADHD symptoms involves a positive feedback loop between neck muscle tension causing distorted somatosensory perception, and leading to sensory mismatches between somatosensory, visual and vestibular inputs. The nature of this problem is that it then creates such postural instability and such negative impact on vestibular function and eye coordination that the actual sensory mismatch is in a state of continuous change. This instability is an essential part of the equation as it prevents any recovery through passive learning.

The downstream effects include (but are not limited to) impaired balance, a chronic stress response, asymmetric cerebellar activity (and downstream asymmetric cerebral hemispheric activity), and impaired eye co-ordination leading to a loss of stereopsis, and making reading difficult, stressful, and likely to be experienced as “boring”. A thorough neurological examination will reveal clear physical signs that correlate with all of these problems.

I am also formally proposing that this feedback loop is involved in maintaining other difficult to treat syndromes like anxiety, whiplash, migraine, chronic fatigue and chronic pain syndromes (and probably most syndromes labelled as psychosomatic).

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Creativity and Brain Networks in ADHD

One characteristic of ADHD that can be annoying and frustrating is “having a head full of thoughts”.

This phenomenological description though, is correlated with clear patterns of neural network activity.


It is common for ADHD individuals to have much more co-activation of networks that are usually run in isolation:

The “Default Mode Network” (DMN), is associated with planning or reviewing previous actions. if overactivated it may be associated with rumination or anxiety. The highest DMN activity is found in depression, and the lowest DMN activity so far has been found in senior Tibetan monks, with thousands of hours of meditation experience.

It is usually much less active when an individual is engaged in a task, but one characteristic of ADHD is that it is often not deactivated when one of the Task Positive Networks  (TPN) is active.

Equally there is much co-activation of TPNs in ADHD.

However, recent research shows a clear link between these sort of patterns of multiple network activation and creativity and this now provides a clear neurologically based understanding of just why ADHD is likely to be associated with higher levels of novel idea generation.


The researchers hypothesized that for a creative idea to be produced, the brain must activate a number of different – and perhaps even contradictory – networks. In the first part of the research, respondents were give half a minute to come up with a new, original and unexpected idea for the use of different objects. Answers which were provided infrequently received a high score for originality, while those given frequently received a low score. In the second part, respondents were asked to give, within half a minute, their best characteristic (and accepted) description of the objects. During the tests, all subjects were scanned using an FMRI device to examine their brain activity while providing the answer.

The researchers found increased brain activity in an “associative” region among participants whose originality was high. This region, which includes the anterior medial brain areas, mainly works in the background when a person is not concentrating, similar to daydreaming.

The link to the paper is here:


 Neuroimage 2015 Aug 1;116:232-9. doi: 10.1016/j.neuroimage.2015.05.030. Epub 2015 May 20.

Generating original ideas: The neural underpinning of originality.

Mayseless N, Eran A, Shamay-Tsoory SG






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