Investigating Cerebral Circulation, Cranial Compliance,
Trepanation and the Aging Process

Prof. Yuri Moskalenko , Head of the Brain Circulatory Laboratory,
Sechenov Institute of Evolutionary Physiology and Biochemistry
Russian Academy of Sciences, Saint Petersburg
Amanda Feilding & Peter Halvorson, Beckley Foundation, Oxford

Latest:
We have just completed the publication of our monograph entitled 'Non-Invasive Evaluation of Human Brain Fluid Dynamics and Skull Biomechanics in Relation to Cognitive Functioning', which you can download from here!

[Further details]
[List of Publications]

In 2004 Amanda set up a collaboration with Prof. Yuri Moskalenko, Head of the Laboratory of the Sechenov Institute of Evolutionary Physiology and Biochemistry in St. Petersburg, and a world-recognized pioneer in cerebral circulation. The Beckley Foundation's collaboration in Russia over the last five years has produced new and important findings on the dynamics of cerebral blood and cerebrospinal fluid (CSF) circulation, on how these dynamics change with age, and on how these changes relate to alterations in cognition and the health of the brain, with particular reference to vascular forms of dementia, and so far the findings of our work have been presented in 18 peer-reviewed scientific publications

Recent developments have 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. It 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:

Research Outcomes to Date:

•  The development of a unique method of non-invasively obtaining new data on the functioning of the cerebral circulatory system, named the Moskalenko Method (MM);

•  The development of a new systemic understanding of the dynamic interrelation of the three inter-dependent systems which together determine cerebral circulation and the health of the brain, namely the blood, the CSF and the physical properties of the nearly-rigid cranium;

•  New data indicating the importance of cranial compliance in assessing changes in intra-cranial circulation, and its direct effect on cognitive functioning;

•  The discovery of important new information about age-related declines in cerebral sufficiency and mental functioning around middle age, and about a direct correlation between declines in cranial compliance and progressively worsening symptoms of dementia;

•  The development of possible pre-emptive interventions and treatments for insufficient cerebral circulation, and of methods to assess their effectiveness;

•  The first physiological explanation of the effects of trepanation, i.e. an increased elasticity of the cranium that brings with it significant improvements in cerebral circulation;

•  The investigation of other methods of counteracting deteriorating indices of cranial compliance, such as yogic deep breathing, extreme exercise and cranial osteopathy.

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.

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.