Neurovascular Connections Conference

Dr. Paolo Zamboni

Noted vascular surgeon and researcher, Dr. Paolo Zamboni recently broke open the field of neurovascular science with a renewed focus on the role of venous outflow and waste removal in the brain. He detailed his ongoing work with NASA, in which Dr. Zamboni was intrigued by astronaut reports of headaches and other neurological symptoms in Space and felt this may be related to the absence of gravity acting on blood flowing through the cerebral veins. Unlike the rest of the body, where muscle pumps squeeze veins to return blood to the heart, the brain lacks muscle and relies on gravity to clear de-oxygenated and waste-filled blood from the head. This research, titled DrainBrain, seeks to accurately measure haemodynamics of cerebral blood flow in astronauts while they are in Space. Dr. Zamboni's NASA research has implications for long term Space travel (NASA hopes to launch manned missions to Mars by 2030), and has potential benefits down on Earth to help patients with impaired venous flow and chronic neurological conditions. Due to an urgent personal and familial matter, Dr. Zamboni appeared via an interactive video link..

 

 

Dr. Terry Wahls

Dr. Terry Wahls is a clinical professor of medicine at the University of Iowa and a staff physician at the Iowa City Veterans Affairs Hospital, where she teaches medical students and resident physicians, sees patients in traumatic brain injury and therapeutic lifestyle clinics with complex chronic health problems that often include multiple autoimmune disorders, and conducts clinical trials.

 

She is also a patient with a chronic progressive neurological disorder, secondary progressive multiple sclerosis, which confined her to a tilt-recline wheelchair for four years. But thanks to the power of the Wahls Protocol™, which is based on Functional Medicine and the Wahls Paleo™ diet, Dr. Wahls restored her health and now pedals her bike five miles to work each day.

 

 

Dr. John Cline

JOHN CLINE, MD, BSc, IFMCP is a medical doctor who utilizes a Functional Medicine/Integrative approach in his practice. He obtained a BSc in Biochemistry, followed by his MD and residency training in family medicine at the University of Calgary, Alberta, Canada. Dr. Cline has a particular interest in using various detoxification strategies and has taken extra training through the American Board of Chelation Therapy and the American Academy of Neural Therapy. He has received his certification in Functional Medicine and is a faculty member with the Institute for Functional Medicine. He is an international speaker, has participated in research and published a number of articles in the peer-reviewed literature.   He is Medical Director of the Cline Medical Centre in Nanaimo, located on Vancouver Island, British Columbia, Canada.

 

Title: “Novel” Inflammatory Modulators In Clinical Practice

One of the most challenging aspects of practicing medicine in the 21st century is the treatment of chronic diseases. We understand that one of the key underlying factors driving chronic disease is poorly controlled inflammation. The available treatment approaches often do not deal effectively with the upregulated, feed-forward, inflammatory cascades, which are maintained in the “on” position. In his presentation, Dr. John Cline MD, BSc, IFMCP, reviewed “novel” and effective approaches to modulating inflammation and the remarkable impact this has on the chronic suffering of his patients. Several illustrative case studies were reviewed.

.

 

Dr. Michael Arata

A graduate of UCSF School of Medicine, Dr. Arata completed his four year residency at Duke University Medical Center. After completing an Interventional Radiology fellowship at the Hospital of the University of Pennsylvania, Dr. Arata became Board Certified with a certificate of added qualification in Interventional Radiology. Dr. Arata is also certified by the American Board of Venous and Lymphatic Medicine. He is trained in Functional Medicine and has a Fellowship in Endovascular Procedures.

 

Dr. Arata is an accomplished physician internationally respected for his work in venous disease. This experience has resulted in medical journal publications and presentations across the globe.

 

Dr. Arata developed the TVAM procedure to activate the venous distension reflex in order to provide clinically meaningful improvements in autonomic function. He also pioneered efforts to improve patient selection by establishing ANS testing as a prerequisite and laboratory testing of the hypothalamic-pituitary-adrenal axis (HPA). He also provides comprehensive and integrative care incorporating lifestyle changes, hormonal assessment and modification, and structural therapies such as NUCCA and correction of bruxism into the treatment algorithm.

 

TOPIC:

How stem cells influence multiple sclerosis

 

Dr. Teresa Liu-Ambrose

Dr. Teresa Liu-Ambrose, PhD, PT, is a Canada Research Chair, a physical therapist, and a Peter Wall Institute Scholar at the University of British Columbia, Department of Physical Therapy. She directs the Aging, Mobility and Cognitive Neuroscience Laboratory as well as the Vancouver General Hospital’s Falls Prevention Clinic. Moreover, she co-leads the Canadian Longitudinal Study on Aging data collection site located at the University of British Columbia. Her research program focuses on defining the role of exercise to promote healthy aging, with a particular focus on cognitive and neural plasticity, as well as mobility. Various methods are utilized in the Aging, Mobility and Cognitive Neuroscience Laboratory, including randomized controlled trials (RCTs), functional and structural neuroimaging, and actigraphy. Dr. Liu-Ambrose is an investigator with the Centre for Hip Health and Mobility and the Djavad Mowafaghian Centre for Brain Health.

 

TOPIC

Worldwide, Sub-cortical vascular ischaemia (SVCI) is the second most common etiology contributing to cognitive impairment among older adults. Yet, SIVCI may the most treatable form of cognitive impairment as many of its risk factors can be reduced with exercise. Nevertheless, few randomized controlled trials to date have specifically assessed the efficacy of exercise training on cognitive function in this high-risk group. Thus, we conducted a 6-month proof-of-concept randomized controlled trial of thrice-weekly aerobic exercise training (AE) among adults with mild SVCI. Methods: Seventy-one adults (56-96 years) with SVCI were recruited and randomized (1:1) to one of two experimental groups: 1) 3x/week AE or 2) usual care (UC). SVCI was confirmed by: 1) evidence of subcortical white matter lesions from neuroimaging (i.e., CT or MRI); 2) a score of less than 27 on the Montreal Cognitive Assessment (MoCA); and 3) clinical assessment by neurologist. The primary outcome for this study was the Alzheimer’s Disease Assessment Scale (ADAS-Cog). The AE classes were 60 minutes in duration and led by certified fitness instructors. Target heart rates were determined by the Karvonen formula. Participants of the UC group received an education seminar on nutrition once per month. Between-group differences in ADAS-Cog at trial completion was determined by analysis of covariance, with baseline ADAS-Cog and baseline MoCA score included as covariates. Results: At trial completion, 62 of the 71 participants completed the trial. There were 2 drop outs from AE group and 7 from the UC group. Two additional individuals from the AE group were excluded from analyses due to medical reasons. Compared with the UC group, participants in the AE group significant improved their cognitive function, as measured by the ADAS-Cog (p < 0.05). We also observed significant between-group differences in the Six-Minute Walk Test, providing evidence of treatment fidelity. Conclusions: AE may be an efficacious approach to improve cognitive function among individuals with mild SVCI, and thereby, may prolong their functional independence and quality of life.

 

Dr. Bernhard Juurlink

Dr. Bernhard H. J. Juurlink received his PhD in developmental biology from McMaster University in 1975. He then moved to the University of Saskatchewan to do post-doctoral studies in neurosciences and later joined the faculty of the College of Medicine at the U of Saskatchewan. He taught there for 30 years in the College of Medicine and also held administrative positions such as Head of the Department of Anatomy & Cell Biology and Acting Dean of Basic Sciences. In 2008 he moved to Saudi Arabia to help establish a new medical college at Alfaisal University in Riyadh. He and his wife have recently moved to Mill Bay on Vancouver Island.

Dr. Juurlink's research examines how cells and tissues respond to disturbances in their environment. He became very interested in oxidative stress and inflammation and was a founding member of the Saskatchewan Stroke Research Centre (along with Dr. Bill Code) as well as the Cameco Multiple Sclerosis & Neuroscience Research Centre. His applied research focussed on neurological disorders such as stroke & multiple sclerosis, spinal cord injury & brain trauma, overcoming drug resistance in cancer cells, imaging brain cancer and treating brain tumours in animal models using synchrotron-derived x-rays. A major thrust of Dr. Juurlink’s research over the past 15 years has been delineating how dietary phase 2 protein inducing phytochemicals can decrease oxidative stress and inflammation in a variety of disorders including hypertension, dementia and other problems associated with aging. This dietary approach may have relevance to ameliorating multiple sclerosis and other neurological diseases.

In 1998 he published a paper with the hypothesis that multiple sclerosis is caused by localized decreases in blood flow in the brain and spinal cord in individuals that readily upregulate aspects of inflammation, particularly in blood vessels. This idea was ignored until Dr. Zamboni published his hypothesis that a causal factor in multiple sclerosis is a blockage of venous drainage from the central nervous system. Many of the predictions that arose from Dr. Juurlink’s 1998 hypothesis have been subsequently demonstrated by other laboratories such as decreased blood flow in pre-symptomatic white matter, the expression of hypoxia-inducible genes in MS lesions and increased vascular inflammation of MS patients before there are obvious MS lesions. All of these observations are fully in support of Dr. Zamboni’s hypothesis that obstructed venous return from the brain and spinal cord can play a causal role in multiple sclerosis.

 

Dr. Juurlink was our conference co-host and MC.

 

David Utrainen

We are delighted to be joined once again by one of Dr. Mark Haacke's research collaborators to share the latest research coming out of this team's groundbreaking work. Dr. Haacke sends his regrets that he will be traveling out of the country and unable to attend this year's conference. He is, however, enthusiastic about sending David Utrainen in his place.

 

Dr. Bill Code

Dr. Bill Code began his medical career in family practice in rural Canadian prairies. He then completed a residency in anesthesiology and intensive care in Calgary Alberta. Dr. Code subsequently took an academic position at the University of Saskatchewan where he continued his research in conjunction with Dr. Leif Hertz, a world-class researcher and an expert in the culture of both neurons and astrocytes and the research thereof. Initially, Dr. Code studied calcium channels and the effects on neurons and astrocytes with benzodiazepines.

Soon after, in conjunction with stroke neurologists, Dr. Ashvaq Shuaib and Dr. Bernhard Juurlink, Dr. Code formed a collaborative research group to study stroke as a basic science, through cell culture, lab animal, clinical patient and epidemiologic investigation. This group was composed of four basic scientists and four clinicians including a neurologist, an anesthesiologist, a pathologist, and an epidemiologist. This Center of Excellence group was able to receive a million-dollar grant from the Canadian Heart & Stroke foundation. Dr. Code left academia after receiving tenure in 1992. He moved to Vancouver Island to do clinical anesthesia and acute and chronic pain management.

Dr. Code was diagnosed with multiple sclerosis in 1996, which ended his clinical career in anesthesiology. Because of his modest recovery, which has been enhanced by venous angioplasty treatment in November 2010, he is passionate about neurovascular research and treatment possibilities for improved patient quality of life.

 

Dr. Code was our kick-off speaker and conference co-host and MC.

 

Dr. Ernie Murakami

Dr. Murakami's special interest in Lyme disease lead him to seek treatments for this disease for chronic sufferers. When all the standard medications were not helping the severe symptoms of pain, arthritis, fatigue, depression (with suicidal ideation), mental fog with multi organ failure they resorted to smoking marijuana. He directed them to use the cannabidiol since there was no pycho active effects. Initially the low dose THC tetrahydrocannabis combined with the CBD was the only route available until recently. Nabilone, a synthetic extract from marijuana, was used for his M.S. patients with some success mentally and physically. Other anecdotal cases of cannabidiol treating chronic infections resistant to the standard antibiotics convinced Dr. Murakami that there was an antibiotic effect with cannabidiol.Research initiated by his association, in the first stage of testing Cannabidiol on live spirochetes, has now provided him the positive evidence based study needed to continue with further testing.

 

Dr. Rolf Maijer

Rolf trained both as a Pedodontist and Clinical Orthodontist, practicing over 30 years in British Columbia. He taught Material Science at the University of Toronto for nearly two decades, has published extensively and holds a number of patents for dental and orthodontic technologies. His current research interests focus on airway obstruction issues in children and adolescents.

Today, he provides orthodontic services in the Canadian Arctic and lectures internationally on sleep health, interdisciplinary communication and dental interventions for sleep disordered breathing. He is also a certified executive coach and has worked for more than a decade with large companies as well as healthcare providers in both North America and Europe.

TOPIC: Sleep Quality; A Biomarker of Neuro Vascular Health

Sleep apnea, and disordered breathing, and disrupted sleep are related to starvation of the brain of oxygen and increased sensitivity to pain (hyperalgesia) and fatigue, among many other outcomes. Cognitive deficits may result from abnormalities in parts of the brain, specifically the frontal cortex, cerebellum, and hippocampus.

 

 

Matthew Pratt-Hyatt, PhD

 

Matthew Pratt-Hyatt, PhD, received his PhD in cellular and molecular biology from the University of Michigan.  He has trained under Dr. Paul Hollenberg, a prominent researcher on drug metabolism and Dr. Curtis Klaassen, one of the world’s leading toxicologists.  He has over a dozen publications in well-known research journals such as PNAS and Cell Metabolism.   He is currently Associate Laboratory Director at The Great Plains Laboratory, Inc. in Lenexa, Kansas, focused on diagnosis and treatment of mitochondrial disorders, neurological diseases, chronic immune diseases, and more.  He specializes in developing tools that examine factors at the interface between genetics and toxicology.  His work is bringing new insight into how genes and toxicants interact and how that may to lead to mental health disorders, chronic health issues, and metabolism disorders.

 

TOPIC

Snakes, Spiders, Sepsis, and Soap:  Brand New Information on the Possible Root Cause and Treatment of Many Inflammatory Disorders

 

Phospholipase A2 (PLA2), an enzyme found in snake and bee venom, as well as in human tissue, has been found to be elevated in a variety of inflammation-related disorders.  It is considered a good marker for increased risk of developing or worsening inflammatory conditions including allergies, multiple sclerosis, Crohn’s disease, neurodegenerative diseases, bipolar depression, long term depression, schizophrenia, and sepsis.  This presentation reviewed the new information available about PLA2, methods for testing, and treatments that reduce PLA2 levels and inflammation.

.

 

Philip B. James, MB, ChB, DIH, PhD, FFOM (Emeritus Professor of Medicine the University of Dundee)

Dr. Philip James published evidence in 1982 that the pathology underlying a phenomenon common with deep sea divers -- decompression sickness -- is found in many other kinds of brain disorders, including MS, head injury, and stroke. Dr. James rejects the classification of MS as an autoimmune disease and believes it is triggered by even minor external trauma. In his paper published by the Lancet in 1982, he wrote Demyelination [in multiple sclerosis] appears to be a non-specific response to microcirculatory occlusion in the central nervous system."

 

In 2014 Dr. James wrote "Oxygen and the Brain," a noted scientific reference resource that represents over 20 years of his culmulative research and expertise. Due to aqn unexpected personal matter, Dr. James appeared via an interactive video link.