Functional neurology

Functional neurology is the rebranding of chiropractic neurology, a field pioneered by Canadian chiropractor Frederick "Ted" Carrick. Practitioners claim to be able to treat a multitude of conditions (e.g. ADHD, Alzheimer's, Asperger's, and autism, just among those diseases starting with A) by using electroencephalography (EEG) to diagnose "weak" areas of the brain, and then treating these weak areas through a combination of diet control, massage and brain training.

Rationale
Although not based in any accepted scientific field, functional neurology uses jargon to portray an image of scientific respectability. For example, a common definition of functional neurology follows:

Functional neurology is the study of the inter-relationships of an individual's neuronal systems within the context of their wider health. Using anatomical and embryological relationships the functional neurologist diagnoses dysfunctions within the systems and uses those relationships to effect change within the neuraxis.

While every one of the words in the definition above do have a specific meaning, it is impossible to determine what message the word salad above is trying to convey.

A translation of this tortuous definition reveals that functional neurology identifies areas of the brain as being related to specific body parts and organs either directly through the nervous system, or indirectly through a proposed link established during childhood development (later severed or lost). Thus most illnesses, if they are conceptualised to be linked to one body part, can be diagnosed as reflecting a neurological dysfunction in the brain. Normal pharmacological or surgical neurological treatments are seen to address only the symptoms of most problems rather than the root cause which is invariably a weak area of the brain being overpowered by a stronger area. Some functional neurologists also consider psychological maladies to be a consequence of localised nerve atrophy due to underuse.

Typically the functional neurologist will diagnose the weak areas of the brain by administering an EEG and then, using freshly spilled chicken guts, they will identify which areas of the brain are malfunctioning. Sometimes other methods need to be used to identify malfunctioning areas in the brain such as electrocardiography, skin conductivity or eye functioning. These "malfunctioning" areas of the brain are envisioned to be the cause of most illnesses and thus need to be strengthened.

Treatment
Treatment generally starts with chiropractic adjusting which presumably: …results in the stimulation and production of immediate early genes and second messengers within the neuron that stimulate DNA transcription of appropriate genes and the eventual production of necessary cellular components such as proteins and neurotransmitters.

The practitioner also generally recommends that the patient avoids certain foods which further weaken the malfunctioning areas of the brain by not delivering enough/too much glucose and other compounds. Finally brain training is usually prescribed which involves performing repetitive tasks (e.g. squeezing a ball) to exercise the weakened area of the brain.

Treatment generally aims to balance the left and right side of the brain, as the general consensus is that most maladies are caused by hemispheric dominance. This is seen as especially critical for balance related illnesses (e.g. vertigo); presumably the functional neurologist perceives this condition as being caused by one side of the head being weighed down by a larger brain.

As with many alternative medicines, there is little consensus on the mechanism of action for functional neurology treatments among its practitioners. However, one common theme is the misapplication of the concept of neuroplasticity. In the world of a functional neurologist, the brain is moldable enough to adapt to almost any injury. There's a grain of truth to this idea; the brain can recover from certain types of damage, particularly in the hippocampus or olfactory bulb. This helps explain how survivors of car crashes, or other accidents, are often able to regain many of their physical abilities just through repetitive practice. However, it is abundantly clear that performing repetitive tongue moving exercises, or walking in a straight line for ten minutes a day is not likely to cure your bed-wetting problem (seriously). It will help you move your tongue and walk in straight line though. If you need help with either of these activities feel free to consult with a functional neurologist.

Between practitioners there is likely to be wild disagreement about treatment plans &mdash; what one practitioner views as self-evidently helpful another will see as way off the mark. Without a central theoretical underpinning or any substantial research you are likely to get as much agreement from separate practitioners as you are from separate astrologers. This is particularly frustrating when you are debating; defendants will often proclaim that they would never prescribe such an asinine treatment plan as the one you are currently arguing about.

Risks of treatment
According to practitioners there is considerable risk associated with functional neurology, to illustrate: Consideration of the current metabolic state of the target area must be considered and monitored as the intervention is instituted and as it progresses so that no damage occurs as a result of over stimulation, which may result in free radical formation and ultimately neuronal necrosis.

While the risk of free radical formation and brain death due to repetitively squeezing a stress ball seems unlikely there are probably real risks associated with functional neurology treatment plans. Firstly, all of the risks associated with chiropractic massages will accompany treatment. It is also highly unlikely that the diet plans prescribed by functional neurologists are informed by any nutritional science, consequently they are unlikely to provide any real benefit, and may even lead to nutritional deficiency. Finally there is the obvious risk that the treatment will probably not solve the initial malady; anyone considering a functional neurologist's treatment plan should be strongly advised to consult a real neurologist to determine that their condition will not deteriorate further and is not easily treatable by scientifically endorsed medical methods.

Claims of efficacy
The following list is a non-exhaustive attempt to document some of the conditions which functional neurologists claim to be able to treat: ADD/ADHD, Alzheimer's, Anxiety disorders, Asperger's Syndrome, Autism, Balance disorders, Blackouts, Blindness, Brain Aging issues, Canal stenosis, Cerebellar disorders,Chronic pain disorders, Cervical myelopathy, Coma, Complex regional pain syndromes, Concentration issues, Depression, Diplopia, Dizziness, Double vision, Dyslexia, Dystonia, Epilepsy, Fainting, Headaches, Heart arrhythmias, Irritable bowel syndrome, Learning difficulties, Memory issues, Mental Health, Migraines, Motion sickness, Movement disorders, Multiple sclerosis, Neglect syndromes, Numbness, Parkinson's disease, Peripheral neuropathies, Radicular/nerve root conditions, Reflex sympathetic dystrophy, Sexual dysfunction, Sleep apnea, Sleep problems, Snoring, Speech problems, Spinal cord compression, Squints/skew deviations of the eyes, Strokes, Syncope, Tinnitus, Tics, Tourette's, Tremors, Vertigo and Visual disturbances.

Published claims of efficacy are scarce but a few studies have been conducted which purport to have found evidence in favour of functional neurology. One study found that spinal manipulation can treat blind spots in a patient's eye. James Randi allegedly rang Carrick (the lead author) personally to offer him the JREF one million dollar prize if he could successfully reproduce this study. Unsurprisingly Carrick refused to accept the challenge. Another study found that listening to music can be used to treat balance disorders, in particular the music of Nolwenn Leroy. In an interesting twist, the lead researcher for the study (Carrick again, isn't he a sly old dog) was advertising Nolwenn's music in France a few years before the release of his seminal study. Obviously these studies were published in third tier journals and have been largely ignored by legitimate researchers.

Scientifically established efficacy
The following list is an exhaustive attempt to document the conditions which functional neurologists actually are able to treat:


 * Having too much money

In conclusion
Functional neurologists are definitely practicing pseudoscience. Neuropsychologists admit to an imperfect understanding of the functional impact of injuries to regions of the brain. However, they only claim to be able to treat a narrow range of conditions for which they can point to objective evidence of damage and scientific evidence of treatment efficacy.

In contrast, functional neurologists claim to treat areas of the brain that don't have any identifiable physical damage, but nevertheless are assumed to have impaired function. Attempts to elucidate criteria from practitioners for their definition of what constitutes impaired function has been unfruitful. Studies into the efficacy of their methods are non-existent even within chiropractic journals. Some theories on the mechanism of action in treatment are not even wrong, but many are blatantly wrong. Considering that the practitioners claim to able to treat such a stunningly wide array of diseases, one might expect a glut of publications or even a strong theoretical underpinning. This is not the case. However, the lack of evidence for the efficacy of functional neurology has not stopped legitimate universities from providing tenure to practitioners, a move that has conferred a level of credibility they don't deserve.