Neurophysiological facts

The polysynaptic reflex: The neuron-neuron connections are synaptic, where there are axon-axon, axon-dendrite and dendrite-dendrite connections all of them through the synapses. If one take into account that there are less neurons then dendrites and synapses, it follows that every neuron could be connected with less or more other neurons, what is confirmed by the existence of so called polysynaptic reflexes. The polysynaptic reflex, as that one which is presented on Fig 1., consists of single sensory afferent neurone A, which diverges on more spinothalamic polysynaptic pathways B, C, D and E. These polysynaptic pathways, in general case, consist of dif-ferent numbers of neurones, i.e. each pathway contains more synaptic neurone connections. These spinothalamic polysynaptic pathways could converge on a single (Fig 1.a) or on more ef-ferent neurones (Fig. 1.b). In the case when more pathways converge on a single efferent neurone there is prolonged reaction of the efferent neurone, because it is prolonged the arriving of the afferent nervous impulses along the pathways. Namely, the nervous impulse which drives along the pathway with smallest number of neurones and synaptic neurone connections will arrive first at the synaptic connection with the efferent neurone, while the time delays of the impulses from other pathways depend on the number of neurones which they contain.

The segmental therapy is developed on the base of the findings concerning the referred pain phenomenon. It is a pain therapy, which aim is to blockade the pain of inner body structure by the treatment of the Head’s zones on which the referred pain is projected. The treatment is accomplished by the local injections of subcutaneous depots of particular medicaments into the appropriate dermotom (Head’s zone) of pain projection. Taking into account its evident functional similarity with acupuncture, the segmental therapy could be considered as an embryo of the some future Western variant of scientifically based acupuncture, which has a completely satisfactory scientific description. An embryo because, although it is known more then one century, the segmental therapy is practically still at its beginning. This means that there is not an evident relevant interest for serious investigations of segmental therapy in the Western medicine. Taking into account that it is scientifically confirmed, with description which is based on the description of the referred pain phenomenon, it follows that the development of the segmental therapy in fact lies in the development of its medical practice.

The divergence and convergence effect: Due to the existence of the multiple connections, every nervous impulse driving along the particular neuron could diverge on more neurons (the divergence effect), as well as impulses from many neurons could converge to a particular single neuron (the convergence effect). Therefore it is possible the situation where numerous afferent neurons from the different viscera and different peripheral dermotomes or other somatic structures converge to a particular spinothalamic neuron. In this case, where a lot visceral and somatic nervous fibbers are served by a single spinothalamic neuron, it is possible the “false” allotting of the visceral pain, which could be projected on some somatic -structure as referred pain. The referred pain phenomenon will be considered later.

The facilitation effect: On the figure 3 are represented two spinothalamic neurones (a,b), one peripheral afferent neurone arriving from a particular dermotom (c) and one afferent neurone arriv-ing from a particular viscera (d), which diverges on both spinothalamic neurones through the terminations (e) and (f). The pre-sence of the nervous impulses in the termination (f) decrease the activation threshold potential of spinothalamic neurone (b) for the impulses arriving along the peripheral neurone (c), i.e. the impulses in the afferent neurone (d), arriving from the viscera, facilitates the activities of the afferent neurone (c). Therefore, if the neural impulses are present in the visceral neurone (c), an underthreshold neural activities in the peripheral neurone (c) excites the impulses in the spinothalamic neurone (c), which transferred into the brain give a perception of referred pain, mentioned above, which is false allotted to the dermotom instead of to the viscera.

The referred pain phenomenon arises in the case when the viscera (inner somatic structure) and the dermotom are innervated and supplied by the same spinal cord segment. This cutaneous-viscera functional connection on the neural level arises between the dermotom and viscera which develop from same embryonic segment in the embryogenesis. For example, the traditional example of referred pain is the projection of the myocardial infarction pain on the left hand, which explanation as basic assumption has the fact that the hart and the left arm arise from the same embryonic segment. This allows to conclude that the particular inner organ and the corresponding Head’s zone, which are supplied by the same spinal cord segment, can be seen as a functional unit - the viscero-somatic reflex. The activation of the somatic part of this reflex is enabled due to the convergence and facilitation effect, which will be described later. The convergence effect is responsible for referred pain when the visceral and somatic neurons converge to same spinothalamic neuron. As the somatic pain is more frequently then the somatic pain, the brain makes the false allotting of the visceral pain as somatic pain. On other side, the facilitation effect is responsible for referred pain when the visceral neuron converge to two spinothalamic neurons, where one of them is connected with the somatic afferent. In this case the activation of the visceral neuron facilitates the activation of the somatic neuron, even in the case when it receives under threshold stimulation.

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Neurophysiological Basis of ABEFIT

By prof. Lj. R. Malnik

ABEFIT is transcutaneous therapy. Generally, the accomplishment of any transcutaneous therapy includes three main steps: the stimulation of the particular skin (cutaneous) segments - dermotomes, the transfer of the stimulation toward the particular parts of central nervous system (CNS in the further), and the reactions of these parts which result by the pain blockade or by the regulation of irregular functions caused by some diseases. The most known such therapies are segmental therapy, where so called Head’s zones are stimulated, and many different acupuncture doctrines (the classical acupuncture, auriculo, oral, nasal, Su Jok, acupuncture etc.), all of them based on the stimulation of the particular acupuncture points on the body skin. The finding of any satisfactory scientific explanation of the segmental therapy and acupuncture is obviously very complicate problem, because it is impossible without perceiving the unknown mechanism of health and homeostasis control, which involves the most complicate systems of our organism, like the central and vegetal nervous system, all viscera and glands, etc. Many collected empirical data show that it is the multidisciplinary scientific problem and therefore the subject of investigation in medicine, biology, chemistry, physics etc.
The transfer of the external cutaneous stimulus toward the internal CNS centers, which is manifested as a pain or painless perception, has a few stages. The first one corresponds to the activation of the sensory nervous terminations (receptors), i.e. to the creation of the nervous impulse, due to the transformation of the energy of the initially stimulus (mechanical, electric, chemical etc.) in the chimio electric energy. The transmission of the created nervous impulse toward the CNS centers is along the sensory pathway which usually consists of three neurons. The first neuron transfers the impulse from the stimulated dermotom toward the spinal cord, the second neuron is connection between the marrow with the cerebral trunk and thalamus and, finally, the third neurons brings the impulse in the cortex. This mechanism is responsible for the transduction of the acupuncture point or dermotom stimulation, independently of that is it painful or not.
As it can be seen, the function of the nervous system is not only to register the stimulus, which is caused by the changes of the external conditions in the environment, but also to answer to it using the efferent neurons and effectors. This answer means the accomplishment of the basic function of the nervous system: handling of the changes of external conditions and accommodation to these changes. All these activities are functionally accomplished through the particular reflex arches (reflexes only in the farther), which include the following parts: sensory receptor, afferent neuron, neurons which connect the afferent neuron with spinal cord or brain control centers, efferent neuron and effector. As the functions of the nervous systems could be completely accomplished on different levels, the reflexes could be less or more complicate, where the level depends on the type of the control centers included in the reflex. The simple reflexes are accomplished on the spinal cord level, the more complicate includes the hypothalamic control centers, while the most complicate reflexes include the cortical control centers as well.
Every neural reflex could be considered as a closed neuron loop, which consists of a different number of neurons. However, the particular reflex does not contains always the same set of neurons, because the closure of the particular neuron loop is determined by the synapses states on the way of the nervous impulse, which passes through the most ready synapses, i.e. through the synapses which are in the most appropriate state for impulse transfer. Therefore, the different closing of the particular reflex, which is activated by the stimulation of the particular dermotom, could be effectuated through the different neuron loops with different neurons and, even more, with different number of neurons end synapses in the loop.
ABEFIT is transcutaneous therapy which aim is to activate the polysynaptic reflex with short and well defined spinothalamic neuron pathways toward the homeostatic control centers in CNS. The essential facts about all transcutaneous therapies (acupuncture, segmental therapy and this one) are not in that what happen on the stimulated dermotomes but in the process between them and the control centers in the CNS. Namely, there are a lot empirical data which show that the transcutaneous therapy could be successfully applied as pain therapy (analgesia effects), having the aim to blockade the pain only, but there are also the evidences that it is a kind of homeostatic therapy which, acting on the homeostatic centers in CNS, drives the organism into the homeostatic state. The pain is often the secondary manifestation of the health problem, it even more must not be present, and its blockade does not means that the health problem is solved. Therefore, the most important and impressive results of any transcutaneous therapy is not the analgesia effect, which demonstrates the efficiency of its symptomatic therapeutic possibilities, but the healing effects which are the evidence of the influence of acupuncture on the homeostatic control system - the set of control systems which are responsible for the homeostasis. Even more, the traditional five energies theory of acupuncture, which talks about the harmonization of the five vital energies, is an attempt to describe the homeostatic effects of acupuncture, where the homeostatic state is recognized as an energetically balanced state. Therefore, or in accordance with this, it is important to analyze the processes of the spinothalamic divergence of the transcutaneous stimulation from the particular dermotomes (acupuncture points, Head’s zones), i.e. the processes in which the stimulation of the sensory neuron diverges in a polysynaptic reflex which activate more spinothalamic neurons and transfer the nervous impulses toward more control centers of CNS.
Any health problem or dysfunction in some particular part of the human body is followed by the biochemical and physical processes, which lead to the change of the local electric field potential. If this change is equal or larger then the neuron threshold potential, the neuron will be activated, i.e. the nervous impulse will be created and the information toward the control centers in CNS will be transferred. These impulses bring the informations about the health problem, which is felt as pain or as some uneasiness, and alarm the self-defense system of CNS, responsible for homeostasis, to solve the problem using the efferent nerves, or some other yet unknown mechanism. However, if the change of the local electric field potential is smaller then the neuron threshold potential, the neuron will be not activated and the control centers in CNS will be not informed about the health problem. In this way, when the self-defense system remains slipping, the cumulative effects of such small changes could result in a grate health problems. In the first case, the activated nervous impulses inform us, by pain or uneasiness, that we have a health problem, while in the second case we have, but we do not know that we have a health problem. In accordance with this, one could conclude that there are two kind of illnesses: 1)
Talkative illness, which talks, announces itself by pain or uneasiness transferred in the CNS by the activated neuron reflexes; 2) Silently illness, which is silent and hidden for CNS, because of the underthreshold changes of the local electric field potential. This means that the most complete transcutaneous treatment, which is prevention and healing in the same time, is that one which enable the activation of the control centers of CNS to scan and correct any dysfunction, independently of the changes of the local electric field potential caused by it.
Thus, the question is:
is it possible to activate the control centers of CNS by the transcutaneous stimulation, in order to scan and heal the talkatives and silentlies illnesses and to return back the organism in a homeostatic state, or as near as it is possible? The answer is obviously positive, what could be supported by the neurophysiological facts. The most important neurophysiological proof lies in the possibility of exciting the polysynaptic reflexes, where the transcutaneous stimulation diverges in more spinothalamic neurons, what enables the transfer of the nervous impulses toward more control centers in CNS. These polysynaptic reflexes could be excited due to the spinothalamic divergence effect of the transcutaneous stimulation.
There are not the neurophysiological obstacles that polysynaptic reflexes with the spinothalamic divergence of the transcutaneous stimulation could appear, but the question is how to determine acupuncture points or skin zones which stimulation obviously excite such reflexes? As it is practically impossible to find the answer on this question remaining in the frames of neurophysiology, it is worth to look for it considering the empirical results, among others the practical results of the traditional alternative medical doctrines. In spite of the millenniums which are behind, many results and recipes of these doctrines, including the acupuncture, must be taken with suspicion. Thus, taking into account that is very complicate to investigate all possible interconnections and combinations of 400 acupuncture points, and the effect of multiple referred pain projections, it is quite plausible to assume that some of these acupuncture point are functionally equivalent. The neurophysiological findings, like the polysynaptic reflexes, as well as the divergence and/or facilitation effect show that the answer should be positive. The next supports to the positive answer are the results and the efficiency of microacupuncture doctrines which use more less then 400 acupuncture
points, even more not included in the mentioned WHO nomenclature. The illustrative example is the efficiency of the Su Jok 6 Qi energies therapy, where the complete energy balance (homeostasis!) could be achieved by the stimulation of these 6 acupuncture points only which are on the hands. What we would like to do here is neither to discuss the acceptance or refusing of this doctrine, nor to explore its theoretical background, but to try to find the neurophysiological explanation of its practical efficiency and to modify it in a way which will enable the effective activation of the homeostatic control centers in CNS. There are some scientific - neurophysiological data, as well as many scientifically unsupported empirical results to pay the attention to this doctrine, which is, even more, not traditional but the new one, because it is founded a couple decades ago In fact, the searching for the most appropriate way of transcutaneous stimulation which could activate the polysynaptic reflex with spinothalamic neuron pathways being able to reach up and to activate the homeostatic control centers in CNS brought in my field of interest the Su Jok 6 Qi energies therapy.
From the neurophysiological point of view, the hands are very reach with nervous ends, what procures very effective transcutaneous stimulation, which is transferred toward the spinothalamic nerves in the spinal cord by the nerves
radialis, medianis and ulnaris (on the Fig. 4. the skeen zones inervated by these nerves are presented). As these nerves enter in the sacral part of the spinal cord, that means very near to the brain, it is maximal the possibility that the polysinaptic reflex, consisting of more spinothalamic neurons and activated by the nervous impulses which bring these three nerves, will be able to reach up and to activate the control centers in CNS. Namely, the divergence and facilitation effects make possible the creation, but also the partial or complete extinguishment of the polysynaptic reflex. Therefore the shorter pathways of the polysynaptic reflex in spinal cord increase the possibility that they will reach up and activate the control centers. If one accept that the dermotomes on the hands are probably the most appropriate for transcutaneous stimulation which could activate the polysynaptic reflex with short and well defined spinothalamic neuron pathways toward the homeostatic control centers in CNS, then the practice rules and the empirical results of the Su Jok 6 Qi energies therapy must not be neglected. That therapy is in fact a correspondent Hindu chakra system, because the correspondences between 6 chakras and 6 particular acupuncture points on the hand have been established. The main aim of the therapy is the energy balance (homeostasis) which could be achieved by the appropriate stimulation of these points, what is equivalent to the stimulation of the corresponding chakras. More precisely, the Su Jok 6 Qi energies therapy uses 24 acupuncture points, 6 points on the palm sides and 6 points on the opposite sides of the hands, what means that 4 points correspond to each energy and to each chakra. Which 6 points, i.e. which hand and which side should be stimulated is determined by the practice rules which will be omitted here as doubtful with no hope to be scientifically supported. However, the practical results show that the positions of these points coincide with the positions of dermotomes which we are looking for, enabling the activation of the polysynaptic reflex with well defined neuron pathways toward the homeostatic control centers in CNS.