Functional neurology (FN) is a specialized approach focused on assessing and rehabilitating the human nervous system through non-invasive methods, without pharmaceutical drugs or surgery. This field operates on the idea that the brain and nervous system can change and improve function, a concept known as neuroplasticity. Practitioners aim to identify and correct imbalances in neurological function using targeted sensory and motor stimulation. Determining the legitimacy of FN requires examining its theories, practitioner credentials, and available scientific data.
Defining Functional Neurology
Functional neurology is a healthcare specialty concerned with functional imbalances of the nervous system, distinct from structural pathology or disease. The discipline focuses on identifying areas of the brain or nervous system that are under-performing or experiencing a breakdown in communication. This disruption is sometimes called a “functional lesion,” describing under-activity in a brain region without detectable tissue damage on standard imaging like MRI.
The premise is that lack of input or injury can weaken a specific brain pathway. Functional neurologists use detailed examinations of motor skills, sensory processing, balance, and coordination to pinpoint these areas. Practitioners address conditions including chronic dizziness, vertigo, persistent post-concussion symptoms, balance disorders, and movement challenges. The goal is to enhance the nervous system’s ability to self-regulate and perform optimally.
Proposed Mechanisms of Action
The theoretical foundation of functional neurology rests on neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections. Functional neurologists believe that providing precise, controlled stimulation can drive this plasticity to restore function in under-active brain regions. Interventions are designed to be specific to the patient’s individual neurological deficits, tailoring stimulation to affected pathways.
A variety of non-invasive sensory and motor exercises are employed for this stimulation. Techniques include specific eye movements, such as those used in vestibulo-ocular reflex training, which challenge pathways connecting the eyes and inner ear. Other common methods are balance and gait training, specialized auditory or visual input manipulation, and various forms of physical medicine. The theory suggests that stimulating a compromised pathway, like those involving the cerebellum or brainstem, can strengthen its connection to the rest of the brain.
Practitioner Training and Certification
Most professionals practicing functional neurology are Doctors of Chiropractic (DC) who have pursued extensive post-doctoral training. The primary credentialing body is the American Chiropractic Neurology Board (ACNB). To become board-certified, a chiropractor must complete a minimum of 300 post-doctoral credit hours in clinical neurology coursework.
After completing the coursework and passing a comprehensive written and performance examination, the practitioner earns the designation of Diplomate of the American Chiropractic Neurology Board (DACNB). This specialized training covers advanced topics like neuroanatomy, neurophysiology, and neurodiagnostics. This qualification differs from that of a medical neurologist (MD or DO), who focuses primarily on the diagnosis and pharmacological or surgical management of neurological diseases after completing medical school and residency.
Scientific Research and Clinical Outcomes
Legitimacy depends on the scientific evidence supporting the comprehensive protocols used in functional neurology. While some individual techniques employed by functional neurologists are well-established in mainstream rehabilitation, the collective approach often lacks large-scale, high-quality randomized controlled trials (RCTs). For example, vestibular rehabilitation, using specific eye and balance exercises, is a widely accepted treatment for dizziness following a concussion. However, this acceptance applies only to the specific technique, not the entire functional neurology paradigm.
Reviews of the literature, particularly within the chiropractic context, have noted a significant lack of robust scientific documentation. One critical review of a journal associated with the practice concluded it contained “no acceptable evidence” on the effect or benefit of the FN approach for various conditions. Another systematic review investigating spinal manipulation effects on brain function found that while changes may occur, their clinical relevance remains unknown. The available evidence suggests that studies on specific functional neurology interventions often have low methodological quality, making it premature to promote their broad use to improve brain function.
Regulatory Standing and Mainstream Acceptance
Functional neurology is often categorized as complementary and alternative medicine (CAM) by the broader medical community. Practitioners, typically DCs, are licensed healthcare professionals, and ACNB certification is recognized within the chiropractic profession. However, the specific practice of functional neurology is not universally regulated or defined by state medical boards outside chiropractic licensure.
Major organizations like the American Academy of Neurology (AAN) do not formally endorse the functional neurology model. The practice operates outside the standard medical model, which relies heavily on a disease-based, diagnostic approach supported by extensive RCTs. Although Functional Neurological Disorder (FND) is a recognized medical condition, the practice of Functional Neurology is a distinct form of rehabilitation. The consensus is that while the field uses scientific principles like neuroplasticity, its specialized protocols lack the high-level evidence needed for full acceptance in mainstream medicine.