Additionally, studies have examined how spinal damage and misalignment can impede glymphatic fluid flow and pulsatility, leading to altered fluid dynamics in the brain and increased risk or cause of neurodegenerative disease. This 2011 study looked at patients with multiple sclerosis (i.e., another neurodegenerative disease, but one marked by demyelination of the nervous system) and found that there was an average of eleven years between physical trauma and the onset of neurodegenerative disease.13 This study also found that there was severe abnormal spinal alignment in the cervical spine of 100% of the patients who had been medically diagnosed with multiple sclerosis. The 2011 study went on to use upright multi-position MRI to show that the spinal damage was causing: 1) blockages to the glymphatic system in either the anterior, posterior, or both anterior and posterior channels in the cranial-cervical junction and 2) leakages of cerebral spinal fluid into surrounding parenchyma spaces due to increased intracranial pressures. The study then provided a chiropractic intervention, and it was noted that the M.S. symptomology was “aggressively reduced” as spinal alignment was corrected and glymphatic flow returned to more normal limits.13


Another study along this same focus at C1-C2 radiographic parameters and saw statistically significant differences in severe anterior intrusion and laterality of the uppermost two bones of the spine in patients with multiple sclerosis and CCSVI, which stands for “chronic cerebrospinal venous insufficiency”, which is another way to communicate blocked glymphatic flow and damaged spinal fluid mechanisms.14


in this study, it was


observed that spinal damage was 2-3x more frequent in the neurodegenerative disease study participants as compared to non-symptomatic controls.


Another study found that after 4 months of a specific chiropractic intervention targeting the upper cervical spine, there were changes in radiographic findings of spinal abnormality and a statistically significant change in clinical symptomatology in a cohort of patients with multiple sclerosis.15


Again, another upright MRI


study showed significant obstructions to cerebral spinal fluid flow and brain glymphatics due to upper cervical compromise of the cranial-cervical junction in all patients in the study who have been diagnosed with multiple sclerosis.16


Additionally, research


indicates that chiropractic care to improve or reverse abnormal spinal alignment is very safe; a 2025 study of nearly 90,000 patient cases found no significant association between spinal adjustments and cerebrospinal fluid leaks.17


These studies, the


design of the human anatomy, and common sense seem to indicate that chiropractic care, aimed at improving upper cervical alignment towards normal limits, plays a positive role in the landscape of options for those suffering from neurodegenerative disease, especially if the cervical spine or the cranial cervical junction are damaged via trauma or slow degenerative decline.


Spinal damage is not the only subclinical finding that is playing a role in the development of neurodegenerative disease. Several studies show a connection between nutritional deficiencies and neurodegenerative diseases, specifically a deficiency of omega-3 fatty acids. This 2025 study analyzed dried blood spot data from 590,000 people worldwide and found disturbing trends of


If you are a DC and would benefit from more information and training on neurodegenerative disease from structural, chemical, and nutritional perspectives, Dr. Kotlerman will be holding three more training opportunities in 2026:


Mount Vernon, WA • June 13th (4 CEUs) Chicagoland, IL • October 17th (6 CEUs)


All of the above can be registered for through the Standard Process website or by contacting your local SP rep.


omega-3 fatty acid deficiency, with the average American showing the lowest blood levels globally, at 2.7%.18


Now it would be


easy to shrug off this data off and say, “I am not at risk for this because I take fish oil,” but this study reviewed data from those who supplemented with fish oil as well and found that those who supplemented with fish oil only had a .6% increase in blood omega 3 fatty acids levels over those who did not. This shows a severe deficiency in both Americans who supplement with fish oil and those who do not, as the normal range for omega-3 fatty acids is 8-12%.19


As well as this


Several recent meta-analyses and large-scale studies have shown that omega-3 fatty acid intake is associated with a reduced risk of cognitive decline, improved blood-brain barrier function, and improved glucose regulation in the brain.20, 22, 23


stunning 2023 study published in the Journal of Clinical Nutrition, which examined 1135 participants with a mean age of 73 over 6 years and found that consistent long-term omega-3 fatty acid supplementation was associated with a 64% reduction in Alzheimer’s dementia.21


These numbers indicate that there is a


connection between nutritional density in the blood, especially in anti-inflammatory fatty acids, and how well our brains are allowed to function and age over time.


In summary, Alzheimer’s disease and neurodegenerative diseases in general are rising, and these disease presentations are affecting the American population more than the global population at the same age. Scientific literature over the last decade has shown that spinal alignment and nutritional sufficiency are two important players in reducing the risk of presenting with neurodegenerative disease and likely play a significant role in reversing the active presentation of neurodegenerative disease.


For a list of citations in this article, visit: https://chirohealth.org/wp-content/uploads/2026/04/Citations.pdf


Ple x us April/May 20 26 23


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32