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On physiological mechanism of SCENAR-therapy A.Yu. Molchanov, A.Ya. Cherchago RITM OKB ZAO, Taganrog, Russia Investigations of SCENAR-therapy effectiveness Chronic coronary heart disease Duodenal ulcer Acute myocardial infarction Early post-infarction angina Neurocirculatory asthenia Nonorganic sleep disorders Acute renal failure in compression injury (renal failure that accompanies crushing, crush syndrome) Tubo-peritoneal infertility etc. Proven Facts Irrespective of disease SCENAR-therapy normalizes - function of the autonomic nervous system (ANS) disturbed by the disease; - redox balance of the body, i.e. prooxidantantioxidant ratio Hypothesis Methods of experimental validation of the hypothesis Investigation of the ANS function using the RISTA-EPD complex Finger photoplethysmography (PPG) Investigating the ANS function using the RISTA-EPD complex Assessing the level of functional activity and tone of the ANS, balance of the segmental apparatus function Localizing optimal treatment zones Finger Photoplethysmography (PPG) Investigation of changes of systemic and tissue regulators of oxygen transport: - Relative changes of stroke volume (inotropic function of the heart) and vascular resistance - Absolute values of the heart rate variability indices – rhythmothropic function of the heart RR-интервал A1 A2 Heart rate variability indices being investigated HR – shows the average performance level for the circulatory system TP – shows the cooperative effect of the autonomic regulation of the circulation and allows to estimate the activation degree of all links of the regulatory mechanism. Sharp decrease in TR is provided by a significant tension of regulatory systems HF – characterizes the activity of the ANS parasympathetic part LF – describes mainly the status of the sympathetic center of the vascular tone regulation VLF - is a sensitive indicator of change in the level of brain metabolism. Growth of the VLF-component indicates the increasing involvement of higher autonomic centers in adaptation to the action of the investigated factor. LF/HF allows to estimate the degree of the tone shift. SI - Stress Index – characterizes the degree of regulation mechanism stress. The higher the index is, the more intensely the regulation mechanisms are working. VLF-component The index shows the functional state of the brain. An increase in the power of the VLF-component of the spectrum in response to stress (load) indicates hyperadaptive behaviour and increased brain metabolism, and a decrease in it indicates the afterload deficiency of energy supply or decreased metabolism level. Growing VLF-component of the HRV spectrum indicates the development of a regular stage of adaptation and the increasing involvement of higher autonomic centers in adaptation to the action of the investigated factor. Investigation Design 1.Investigation of the ANS initial state with the patient in lying position using the RISTA-EPD system, recording the finger photoplethysmography during 10-15 mins. 2. Continued PPG recording simultaneously with the intervention. 3. Continued PPG recording for 10-15 mins after the intervention is completed, investigation and classification of the ANS initial state with the patient in lying position using RISTA-EPD. Factors under Investigation 1. Being at rest, i.e. no action applied. 2. Standard SCENAR electrode. 3. Electric heating pad at a comfortable temperature level. 4. Kuznetsov multipin applicator. 5. Multiple (12-segment) electrode with SCENAR- DE device. 6. Add-on ‘rotating’ zone electrode with SCENAR-DE device. 7. Add-on ophthalmologic electrode. Research results: first stationary interval of PPG after SCENAR stimulation Index Stimulation of No action optimal zones Stimulation of the lumbosacral zone n=24 n=24 n=72 HR, min-1 -1.4 3.4* 0.4 1.9** -2.6 2 SI 1.2 65** -23 83* -17 82* VLF, ms2 536 1069* 420 677 93 658** Research results: second stationary interval of PPG after SCENAR stimulation Index Stimulation of No action recommende d zones Stimulation of the lumbosacral zone Exercise load n=24 n=24 n=72 n=18 -1.4 3.5* -0.3 2.4** -1.7 3.5 HR, min-1 -2.5 3 SI -17 33** -52 83 -46 94* -70 43 VLF, ms2 364 1213* 184 375** 402 537 478 530 Typical body response to the action At rest (no action applied): Stimulation of recommended zones by the standard device’s electrode: Stimulation of periorbital zones by the ophthalmologic electrode The response can be either neutral or positive! Normal response at TP=500 – 1500, SI=90 – 262, LF/HF=0.9 – 2.5. After stimulation, FA decreases by 5-10 units, the ANS functional activity becomes normal or moderately decreased at eutonia or parasympathicotonia. At TP=200-500 the ANS functional state does not improve. After SCENAR stimulation, FA does not change. Stimulating the lumbosacral area with different types of electrodes - Standard device’s electrode – 130 sec; - Add-on ‘rotating’ zone electrode with the SCENAR-DE device – 160 sec; - Multiple (12-segment) electrode with SCENAR-DE device - 330 sec; - Kuznetsov multipin applicator – no longer than 30 sec; - Electric heating pad – no response. Findings Irrespective of treatment zone location, a single 10-15 minute SCENAR-session extends the limits of the brain metabolism physiological change. Maximum extension of the limits of the brain metabolism physiological change after a single session is achieved provided that the zones used for treatment are those recommended by RISTA-EPD Using dynamic electrodes for treating the lumbosacral zone provides a stronger effect on brain metabolism as compared with that from treating the zone with a standard device’s electrode by application method. The effect of the ophthalmologic electrode on the ANS functional state can be either neutral or positive. To provide the effectiveness of SCENAR-stimulation, before using the electrode, 5-10 minute treatment of the lumbosacral area with the ‘rotating’ zone or multiple (12-segment) electrode is recommended. Right diagnosis implies successful treatment