Treating Scoliosis With Botox, The Role of Acetylcholine

Using Botox to treat scoliosis seems like sheer idiocy. Isn’t Botox used for cosmetic procedures?

So how does it manage scoliosis?

It seems botox contains botulinum toxin that inhibits the release of acetylcholine (ACh) in the neuro-muscular junction (NMJ). The NMJ is the point where your nervous system and muscles connect. Acetylcholine is the neurotransmitter or chemical messenger that motor neurons of the nervous system release to activate muscles.

Thus according to the experimental treatment, blocking ACh helps unwind the tightened myofascial system in our bodies. It seems hard to believe. Because botulism poisoning causes paralysis of the entire body.

But wait, hasn’t Andrew Huberman, the trending neuroscientist talked about the important role acetylcholine plays in neuroplasticity? You need ACh to change your brain but you have to block ACh to heal scoliosis.

It was all so confusing. And so again I went journeying into the unknown world of idiopathic scoliosis searching for connections.

Acetylcholine helps us focus, move, and change our brains

The first thing I discovered is unlike other neurotransmitters that have specific roles, acetylcholine, does not fall into any coherent category. It can be both excitatory and inhibitory depending on where it is released and the receptor type.

Where Is It In The Brain

Acetylcholine is found in two major places in the brain: 1) the basal forebrain and 2) the mesopontine tegmentum area in the brainstem.

It was the very first neurotransmitter discovered by two pharmacologists Henry Dale and Otto Loewi. Originally, it was termed vagusstoff as it is the chemical the vagus nerve releases to slow the heart.

Like all the other neurotransmitters, acetylcholine needs to be in proper balance. Too much as in traumatic situations when the vagus nerve dumps excess ACh causing us to faint or collapse. This is referred to as vasovagal syncope. We go into a freeze-flop state.

Additionally, too much acetylcholine is linked with increased salivation, muscle weakening, blurred vision, and paralysis.

While, too little leads to anhedonia, ADHD, learning problems, memory issues, dementia, and Alzheimer’s.

Diverse Roles of Acetylcholine In The Brain and Body

ACh influences various networks within the brain and body. It is synthesized from dietary choline and tyrosine.

Every time you move your muscles, acetylcholine is involved. These can be voluntary movements like walking/moving or unconscious ones like your heartbeat or the contraction of the GI tract.

It is critical for focus, learning, and memory consolidation. Proper hippocampal memory function depends on ACh. Without it, you cannot encode new memories.

Furthermore, it plays an important role in rapid eye movement sleep( REM ) This sleep stage is critical in the processes of restoration, learning, and the formation of memory.

Acetylcholine Both Excitatory and Inhibitory

Acetylcholine is a neurotransmitter found in both branches of the nervous system – the central nervous system (brain and spinal cord) and the peripheral nervous system ( autonomic and somatic nervous system).

The automatic nervous system that we cannot voluntarily control like heart rate, breathing, etc, and the somatic nervous system which controls the skeletal muscle. The autonomic system is further divided into two branches sympathetic system and the parasympathetic system.

Our fascia is connected to both the sympathetic and parasympathetic branches since it encapsulates all muscles and internal organs.

The Two Acetylcholine Receptors

Whether ACh stimulates an organ (like GI) or inhibits it (such as cardiac muscle) depends on the receptor type those target cells possess.

There are two types of cholinergic receptors – muscarinic and nicotinic. In total, there are 7 different ACh receptor types in the human body. Five are muscarinic receptors (M1–M5) and two main nicotinic receptors (Nm and Nn, or N1 and N2).

M1 receptors are found in CNS, M2 receptors are found in the myocardium, smooth muscle, and some presynaptic sites, M3 receptors are found in exocrine glands, smooth muscle, and endothelium, M4, and M5 are found in CNS (striatum, substantia,) and eye.

Nm receptors are found in skeletal muscle ( neuromuscular junction), and Nn is found in the nerves and Renshaw cells in the spinal cord.

Muscarinic receptors act slowly compared to nicotinic receptors.

Sympathetic system and the Parasympathetic system

The sympathetic branch (fight-flight system) relays messages through the release of epinephrine, norepinephrine, and ACh. The parasympathetic nervous system via the vagus nerve releases ACh to switch to rest and digest mode.

Any time the fight-or-flight response has been triggered, acetylcholine helps bring the body back into homeostasis by dilating blood vessels and slowing heart rate.

Acetylcholine does not exert its effects in a vacuum. It works in concert with other inhibitory and excitatory neurotransmitters, such as GABA norepinephrine, serotonin, dopamine, etc.

However, no other neurotransmitter other than acetylcholine has such an undulating effect on both branches of the stress response system.

Encodes Fear Memories

In response to the threat, acetylcholine is released in the basal lateral amygdala. This encodes the fear memory within the hippocampus.

What happens when we live in chronic danger as in living in a dysfunctional family? Our nervous system is unable to get back to homeostasis. There is a continuous drip-drip of ACh along with other stress chemicals which further strengthens the fear memory leading to PTSD symptoms of hypervigilance and hyper-arousal.

Locked in Dysfunctional State

Under normal circumstances, the sympathetic and parasympathetic systems maintain a reciprocal relationship and return to baseline after a stressful situation mediated by our core response network (CRN). However, if the stressor is ongoing our CRN is unable to return to baseline.

The CRN becomes locked into a dysfunctional state of extremely high activation of both the sympathetic and parasympathetic systems and may oscillate erratically between extremes.

This may manifest as alternating depressive shutdown and extreme anxiety or rage.

Stress, Fascia, and ACh Leakage

When our nervous system is in a state of constant hyperalert, our nervous system will be triggered to release acetylcholine which causes our muscles to tense bracing for danger.

Now for motor nerves to enter the muscle and form the NMJ, they must penetrate the fascia first. Each muscle is covered by fascia. The superficially and deeply located muscles are covered by superficial and deep fascia respectively.

Due to this tension, the fascia will shorten, and it starts to slightly irritate the motor nerve before it forms the NMJ. Fascial tension compresses the NMJ and elevates pressure within the NMJ. This extra pressure within the NMJ becomes a critical force that triggers spontaneous leakage of ACh which in turn causes muscles to become tighter and rigid.

Botox Effects

Botulinum toxin works by blocking the acetylcholine receptors on the muscle side of the junction. This means that when acetylcholine is prevented from being released, the contracting muscles relax.

Botox injections containing diluted botulinum toxin are administered to a target area or neuromuscular tissue. It then works its way to the nerve cells where it breaks down synaptosomal proteins to prevent acetylcholine from
being released.

According to a recently published study by the University of Zurich, botox can have detrimental effects on the brain.

How Botox affects Our Brain

Botox Is Not The Solution

Using Botox to block acetylcholine in the NMJ is not a permanent solution to anything, let alone scoliosis. Like cosmetic botox, it could be a temporary fix to a complex mind-body problem.

Moreover, it would take 100s of botox injections to alleviate scoliosis. If you are young and still growing maybe like the brace it could re-route your neuronal firings and may change the curve of your spine. However, to keep them up, you’ll need to return for booster shots every three to four months.

And, of course, there are side effects, after all, it is a poison. Side-effects include skin reaction, and bone loss (not yet confirmed). And there is botox resistance where the results last shorter.

Additionally, anytime one modifies the level of one neurotransmitter by blocking it or increasing it, it impacts the levels of other neurotransmitters.

Our bodies when in homeostatic balance can automatically modulate our neurochemical levels. So the aim should be to get our hypervigilant, trauma-focused brain to shift focus from danger to calm, joyous states.

First Step To Change – Finding Safety

Unless we begin to feel some level of safety within ourselves, we will continue to be on high alert, resulting in an inefficient release of acetylcholine and an inability to return to homeostasis.

The protective armoring will not release until you know that you are safe. We cannot cognitively force ourselves to think we are safe, we have to feel it somatically.

We have to slowly build within our environment a safety oasis – petting a dog, going for a massage, chatting with a friend, having a warm soothing bath, or watching funny movies. ( I am re-watching the Mind your Language series and the belly laughs I experience make me feel warm and relaxed). Humor activates the release of endorphins and relieves muscular tension,

In his book Waking the Tiger: Healing Trauma, psychologist Peter A Levine explains that coming out of a shutdown response requires shaking or tremoring to discharge the stuck energy of fight or flight.

I have found standing on my balance ball, shaking, and putting my tongue out as in mocking has released a lot of held-in trauma memories in my body. Also, sitting under the shower and slapping the water in a tub while saying the things I had repressed has been very helpful.

Doing these physical activities revives our felt sense of being alive. After years of having to repress my emotions, needs, and feelings, I am learning to express myself instead of bottling them in.

Neuroplastic Change

Neuroscientist, Andrew Huberman in his podcast on Focus, discusses how 2 neuromodulators are needed to bring about neuroplastic changes in the brain. Epinephrine which makes us alert and acetylcholine which helps us focus – it acts as a spotlight amplifying the signal to the thalamus(the relay center).

Huberman further postulates that without alertness and focus, there is no neuroplasticity.

He states that incorporating newer and better behaviors along with a positive mindset will undoubtedly bring about neuroplastic changes.

Simply taking acetylcholine and other nootropics are not going to change your brain. Change can only happen when we consistently do the work with the belief that we will improve.

The way you use your mind affects your biochemistry which in turn changes your brain, body, and life.

Eustress – Shifting Focus – Resetting Acetylcholine

Endocrinologist Hans Selye coined the term eustress meaning beneficial stress.

Physical activity that takes all of one’s concentration, especially sports where inattention can be dangerous – windsurfing, skiing, mountain bike riding, surfing, skating, etc. definitely helps one be super present If danger isn’t your poison – dance lessons, especially couples or group dance routines that require synchrony and attention can also be very helpful in changing the epinephrine-acetylcholine dysfunctional pathways.

We need to shift our focus from our past to the present. The best way to do so is to focus on something else, preferably something that we find pleasurable like a hobby or activity. Something that requires us to be alert, and focused, which is rewarding. Neuroplasticity happens more easily when there is dopamine in the norepinephrine and acetylcholine mix.

Do you like dancing? Join a dance class, and strive at becoming a skilled dancer. Or do you like baking, work at becoming an expert baker. (Baking has helped me shift my mindset immensely). Furthermore, becoming skillful in something really improves your confidence and self-esteem.

Quite a few health practitioners talk about the benefits of yoga. Unfortunately, it has not worked for me as my mind keeps wandering during poses.

Any activity whether it requires focused active movement or fine hand-eye coordination which we find enjoyable releases the 3 neurochemicals norepinephrine, acetylcholine, and dopamine.

Remember, don’t fall into the rut of doing things a certain way. Once you have mastered a skill, introduce novelty in your activities. Our brain changes only when it is learning.

Repetition and Focussed Action

To replace the old negative pathways with newer positive ones we need to persevere towards our goal. Consistency and daily repetition will override old pathways to forge newer better pathways. New actions/behaviors become habits which when they become automatic become our personality. Rewiring our brains takes diligent work.

You don’t need expensive props or nootropic supplements to change your brain. Doing novel activities that you like with focus can overwrite the old you. The only natural supplement to my diet is fermented veggies. They improve gut health which translates into better brain function. Fermented beet juice or chunks are an especially potent natural supplement. They contain good nitrates, which your body converts to nitric oxide which increases blood flow to the brain and body.

Furthermore, Huberman emphatically states that neuroplastic changes in one part of the brain lead to cascading neuronal changes in other brain areas.

After nearly 5 years of trying to heal my childhood trauma and scoliosis, at 55, I am in a better state than I was in my teens.

From my personal experience, an old dog can learn new tricks and become a sprightly dog. And you definitely don’t need Botox for that.

Image Source: Pexels

References:

The whole truth about botulinum toxin

Acetylcholine as a Neuromodulator: Cholinergic Signaling Shapes Nervous System Function and Behavior

Learning and Unlearning Fear

Muscarinic Acetylcholine Receptor M1’s Impact on Fear Extinction Learning

Acetylcholine and Posttraumatic Stress Disorder

The Circularity of the Embodied Mind

Cholinergic Regulation of Mood: From Basic and Clinical Studies to Emerging Therapeutics