A.Yu. Molchanov, A.Ya. Cherchago RITM OKB ZAO, Taganrog, Russia

On physiological mechanism of SCENAR-therapy

Investigations of SCENAR-therapy effectiveness

Chronic coronary heart diseaseDuodenal ulcerAcute myocardial infarction Early post-infarction angina Neurocirculatory astheniaNonorganic sleep disorders Acute renal failure in compression injury (renal failure that accompanies crushing, crushsyndrome)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. prooxidant-

antioxidant 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

A1

A2

RR-интервал

Heart rate variability indices being investigated

HR – shows the average performance level for the circulatory systemTP – 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 partLF – 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 optimal zones

n=24

No action

n=24

Stimulation of the lumbosacral zone

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 recommended zones

n=24

No action

n=24

Stimulation of the lumbosacral zone

n=72

Exercise load

n=18

HR, min-1 -2.5 3 -1.4 3.5* -0.3 2.4** -1.7 3.5

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