Cranial Compliance

Recent research of the Beckley Foundation with Prof. Yuri Moskalenko, world-recognized pioneer in cerebral circulation, has revealed that the loss of the elastic quality of the skull due to normal bone ossification processes results in a decrease of 8-10% in the supply of blood to the brain, due to the inability of the cranium to accept the full volume of each heartbeat.  Considering that the heart beats at least 60 times a minute this loss of up to 2 ml per pulse stroke is significant, and our study is revealing that over the life span this loss may have an impact on the individual’s mental functioning and thus on society as a whole.

Cranial Compliance

I

Investigating Cerebral Circulation, Cranial Compliance and the Aging Process

Prof. Yuri Moskalenko, Head of the Brain Circulatory Laboratory,

I. Sechenov Institute of Evolutionary Physiology and Biochemistry Russian

Academy of Sciences, Saint Petersburg

Amanda Feilding & Peter Halvorson, Beckley Foundation, Oxford

Recent research of the Beckley Foundation with Prof. Yuri Moskalenko, world-recognized pioneer in cerebral circulation, has revealed that the loss of the elastic quality of the skull due to normal bone ossification processes results in a decrease of 8-10% in the supply of blood to the brain, due to the inability of the cranium to accept the full volume of each heartbeat.  Considering that the heart beats at least 60 times a minute this loss of up to 2 ml per pulse stroke is significant, and our study is revealing that over the life span this loss may have an impact on the individual’s mental functioning and thus on society as a whole.

This new information is derived from a rapidly evolving concept which makes possible the evaluation of cerebral circulation on the basis of the constantly changing pressure/volume interaction between the structural and fluid components of the brain system. The concept is called cranial compliance (CC). Cranial compliance is a measure of the dynamic functioning of the cranial system as a whole: the skull, the brain tissue, and the two liquid volumes that flow through and around this complex system.  It is a measure of the ability of the cranial cavity to accept the additional blood volume of the pulse wave and is measured in milliseconds during the cardiac cycle.

This program of research has developed an inexpensive, non-invasive new technology for measuring intracranial pressure and volume changes simultaneously. This new approach to investigating the dynamic interaction of the fluids within the cranium has already revealed previously unknown aspects of cerebral circulation.

Our data has established an index for each of the three phases of cranial compliance, which reflect blood movement  through the brain during the heartbeat.  The index of each phase (inflow-CCe, compensation-CCc, and outflow-CCo) provides valuable information about the quality and comparative quantity of the fluid movements. These indices provide data showing:

• that the degree of elasticity of the skull is a primary determining factor in cerebral circulation.  Loss of elasticity results in increased resistance of the system to accept the full pulse stroke volume, and thus blood supply diminishes;
• that  age related decline in CC, and thus cerebral circulation, is correlated with a decline in cognitive performance;
• that in old age, the declining index of  CC is correlated to ever worsening symptoms of dementia;
• that the CSF mobility is vital for the removal of large molecular  waste products (free radicals), that otherwise may accumulate in  the brain tissue;
• that respiratory in- and exhalation is one of the driving force of the cerebral circulatory system and that slow fluctuations of CSF mobility are another;
• that a low point in CC measurements in age group 40-50 has been identified, and is accompanied by a decline in cognitive functioning, based on our Prognosis method of evaluation. The symptoms of cerebral insufficiency in this age group have long been recognized by physicians, but without a known reason;
• that additional CSF movement, which supports cerebral circulation, is gained from brain atrophy, known to occur after the age of 50-60.  This results in the indices of CC stabilizing or even improving.

Our research also investigates possible remedies.  Data so far collected indicates that:

• energetic breathing exercises, like Yoga, favourably alters cerebral circulation;
• cranial osteopathic treatment can also activate cerebral circulation;
• simple craniotomy or trepanation, as it was called historically, increases the index of skull elasticity and, consequently pulse volume calculations show blood supply increases of 8-10%.

With this instrument complex and method of analysis we can for the first time easily and non-invasively assess both cranial compliance, and blood and CSF circulation, as part of routine medical examinations. To know and manage one’s cranial compliance is as important for the good health of the brain as managing one’s blood pressure is for the heart.  Because the method is both mobile and inexpensive it can be used in parts of the world where high technology is not available.  The technique has a wide possibility of applications including evaluation of cerebral circulation after head trauma. The development of its use in the “golden hour” could save many lives.  Early detection of those with pathologically low cranial compliance could be vital as a means to combat the predicted increase in age-related disorders in a progressively aging population.

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What our investigation is making increasingly clear is that a better understanding of cerebral circulation is of crucial importance for healthier brains and improved cognitive functioning throughout the whole of one’s life.  We have only just begun using this new technology and have many interesting paths of investigation to follow, which may well shed new light on the complexities of cerebral circulation and the physiology of consciousness.