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Скачать бесплатно! Научная работа на тему MESODIENCEPHALIC MODULATION AND ADAPTATION MEDICINE. Аудитория: ученые, педагоги, деятели науки, работники образования, студенты (18-50). Minsk, Belarus. Research paper. Agreement.

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Опубликовано в библиотеке: 2021-11-09
Источник: Science in Russia, №5, 2013, C.13-18

by Vladimir KAREV, Oksana KAREVA, Cands. Sc. (Med.), research assistants of the RAS Central Clinical Hospital, Alexander MELERZANOV, Cand. Sc. (Med.), Dean of the Faculty of Medical and Biological Physics, Moscow Physico-Technical Institute


The human body is an intricate autonomous system, which would not yield to mathematical modelling. It can be presented as a pyramid with a structure on top responsible for total control--the neuro-endocrino-immune complex. Below are systems of organs, then the organs proper, then come the cells which form them, and at the base of the structure are molecules and atoms. Modern biomedicine is far from complete understanding how all these elements of the puzzling construction created by nature (including the smallest ones), interact. Today we can just analyze it. But the more data are accumulated, the more distant their synthesis seems to be. The modern mathematical methods fail to generalize and compare the tremendous scope of information to see the entire organism. Therefore, search for methods of disease treatment is now mainly guided by symptoms--i.e., it is aimed at correction of individual disorders. On the other hand, each of us has a potent mechanism protecting us from injuries and repair if they emerge--an adaptation system. Its adequate work determines the quality and duration of our life. This process is regulated by the neuro-endocrino-immune complex. What factors determine its stable work and can they be corrected?

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Time course of stress and adaptation biochemical markers in patients with acute disease:


1--dienic conjugates (free radicals), 2--hydrocortisone, 3--somatotropic hormone, 4-insulin, 5--immune system status (evaluated by 1-2 level parameters), 6 --β-endorphin.


Scientists have established that the neuro-endocrino-immune complex very sensitively reacts to stress stimuli and its failures start when they are repeated regularly. However, stress has become a common event under conditions of modern urbanization. No wonder that as a result of the reduced adaptation potential, the organism passes from the state of health to that of a stable pathology (up to 75 percent of the population of developed countries suffer from one or several chronic diseases).


For more than 25 years the authors of this paper are developing a new trend--normalization of the functions of the neuroendocrine centers of the brain in order to stimulate the activity of the adaptation system for disease treatment, training of sportsmen, and for life span prolongation. Mesodiencephalic modulation is a method for transcranial (through the scull integument) electrotherapy selectively stimulating the neuroendocrine centers in the midbrain, or mesencephalon*, and diencephalon**. This method improves the reaction of the organism to overwork and injuries.


The concept of adaptation medicine is new. This science studies methods for comprehensive modulation of


* Mesencephalon is a part of the brain stem with vision and hearing subcortical centers; it is located under the cerebral hemispheres.--Ed.


** Diencephalon is located above the mesencephalon and controls sensory, motor, and vegetative reactions essential for integral work of the organism.--Ed.


the adaptation system. The absence of adequate methods for evaluation of the latter largely inhibits development of this promising trend of research.


What is adaptation? Adaptatio from Latin means adjustment, accommodation. From the evolutionary viewpoint it is an essential mechanism of life's development in all its diversity. From medical viewpoint it is a complex of processes enabling the organism to adapt to the state of injury. In sports it implies formation of changes allowing to endure regular physical overwork.


It may seem that we speak about different processes in the above-mentioned cases, but this is not so. The appropriate response is universal and is given at all levels (from systems of organs to molecules).


The notion of the "general adaptation syndrome", i.e. the sum of common protective reactions emerging in animals and humans in response to rather strong and lasting external and internal stimuli, was introduced by Hans Selye from Canada in 1960. In the 1980s the science of adaptation was developed by Felix Meerson, Dr. Sc. (Med.), a national pathophysiologist (Institute of General Pathology and Pathophysiology, Academy of Medical Sciences of the USSR). According to the theory, the adaptive changes are triggered by stress. The urgent adaptation reaction is triggered irrespective of the nature of stress. This reaction is mainly functional and transitory. On the other hand, the destructive com-

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Time course of stress and adaptation biochemical markers in patients with an acute pathology, treated by MDM.


ponents of stress may negatively tell on the work of organs and systems. Repeated exposure to these stimuli results in the formation of long-term adaptation with a serious morphological base.


At the present time we know that the quality of life, i.e., ability to resist destructive factors, as well as normal working capacity and mental status are determined by the level of functioning of the adaptation system. The state of human organism in extreme situations (mental and physical overwork, exposure to toxic and ecological factors, acute diseases or exacerbations of chronic processes) depends on the quality of adaptive response. If this system has sufficient reserves and its components work normally, its readiness to reaction is high, which allows to endure intensive work. By contrast, if the activity of this system is poor (the extreme degree of its manifestation is a disadaptation syndrome), the capacity to cope with even relatively insignificant loads is inadequately lowered.


The quality of urgent and long-term adaptation formation is determined first of all by the activity of functioning of the neuroendocrine systems located in the median structures of the brain. One of the main ones is the opioid system, producing neurohormones (including opioid peptides). Its main task is protection from stress, injuries, analgesia, and coordination of the activities of organs and tissue systems at the body level as a whole. The second system determining the quality of adaptation response is the hypothalamo-pituitary system (connecting hypothalamic* and pituitary** structures). Its main function is rearrangement of the endocrine gland activities and of all types of tissue metabolism to adapt them to the changing environmental and inner conditions.


Both these systems are functionally closely connected. The immune system (working in the common cellular and humoral structure), in its turn, closely cooperates with them.


Thus, the neuro-endocrino-immune complex serves as the main regulator of adaptation response. The centers controlling this complex are located in the mesodiencephalic region, including the mesencephalon and the diencephalon. It has been shown that the activities of these centers can be modified, thus normalizing the adaptation system work. One of these methods and presumably the most effective today is mesodiencephalic modulation (MDM)--a variant of transcranial electrotherapy.


The base for this approach was created by Stéphane Leduc, a French physiologist. He studied for the first time the effects of electronarcosis in 1902. Later on search for parameters of electric signals to attain the


* Hypothalamus is a diencephalon compartment in which the vegetative system centers are located; it regulates metabolism, activities of cardiovascular, gastrointestinal, secretory systems, and endocrine gland secretions.--Ed.


** Pituitary is an endocrine gland located at the base of the brain. It is closely connected to the hypothalamus and regulates mainly growth, development, metabolic processes, and activities of other endocrine glands.--Ed.

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maximum analgesia and sedative effect was carried out in the USA and European countries, including Russia. The scientific school of transcranial electric stimulation in St. Petersburg is headed by Valery Lebedev, Dr. Sc. (Med.), a neurophysiologist (I. Pavlov Institute of Physiology, the Russian Academy of Sciences). Cooperation between this Institute and N. Sklifosovsky Research Institute of Ambulance Service in Moscow led to the development of a new method for the treatment of many diseases, which received the name of mesodiencephalic modulation and was suggested in the middle of the 1980s.


According to modern concepts, the MDM effect is based on modulation of the activities of the opioid and hypothalamo-pituitary centers. This leads to a cascade of processes eventuating in improvement of the neuroendocrino-immune complex functioning.


The peripheral blood concentrations of stress reaction markers (free radicals, hydrocortisone*) and the opioid system activity increase during the very first hours of disease or stress exposure (acute disease or exacerbation of chronic ones, physical and mental loads, etc.). Later on (days 2-3) the increase of concentrations of hydro-


* Hydrocortisone is a vital steroid hormone, involved in regulation of metabolism; secreted by the adrenal cortex. It is involved in the regulation of many biochemical processes and plays a key role in defense reactions to stress and hunger.--Ed.


cortisone and products indicating active free radical oxidation, leading to overall damage of cell membranes, is paralleled by a sharp drop of β-endorphin* concentration, reflecting exhaustion of the endogenous antistress and analgesic systems. At the same time we observe inhibition of functions of the immune system. The renewal of the opioid and immune system activities is rather slow, normalizing only by day 10.


These processes are paralleled by an increase in the concentrations of somatotropic hormone (growth hormone) and insulin, potent stimulants of the protein synthesis. These events take place mainly during the first 3 days after the challenge situation and serve as an indicator of urgent adaptation formation (which implies immediate response to an external factor). The efficiency of this stage determines long-term adaptation processes and eventually the state of the organism in immediate and distant periods of the disease or after intensive physical or mental work. For example, the condition called "disadaptation syndrome" is observed in case of minimum concentrations of the somatotropic hormone and insulin during the first three days or in case of complete absence of their increase. In this case the overwork tolerance is much lower, some reactions are inadequate, while in case of an acute pathology, as a rule, a lethal outcome is registered.


The course of MDM therapy--daily sessions during 10-15 days starting from the first hours after the disease--modulates significantly dynamics of stress reaction and adaptation system parameters. Blood concentrations of hydrocortisone and free radicals reduce after the first session (antioxidant effect), indicating an antistress effect of therapy. At the same time we observe stimulation of urgent adaptation processes, which is shown by increasing concentrations of anabolic hormones (somatotropic and insulin). Moreover, the functioning of the opioid and immune systems normalizes more rapidly, the differences between the basal level of parameters (before a regular MDM procedure) in the main and control groups of patients are statistically trustworthy already on the 3rd day of therapy. Such dynamics of parameters indicates that the MDM effect consists not only in stimulation of neurohormone release, but also in stimulation of their synthesis (transition of functioning of neuroendocrine systems to a higher level).


Changes in the adaptation system during a course of MDM therapy are accompanied by restructuring of the activities of the whole organism at different levels. In


* β-endorphin is a neurohormone produced in the central nervous system cells. It is involved in regulation of many physiological functions.--Ed.

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particular, the quality of interaction and synchronism of the systems (nervous, cardiovascular, endocrine, digestive, etc.) improve, as well as the functioning of individual organs, primarily those with abnormalities or pathologies. In addition, some biochemical processes are modulated at a cellular level. For example, energy metabolism is rearranged under conditions of total and local hypoxia, due to which production of appropriate substrates under conditions of oxygen deficiency is optimized (antihypoxic effect).


Thus, we can speak about MDM effects on the common biological mechanisms, as the adaptation system response is largely nonspecific and does not depend on the etiology of the pathological process. Correction of response at the level of regulation centers leads to stimulation of the complex of defense reactions and to changes in the body state in general. Clinically this shows in a more benign course of acute diseases and real prevention of exacerbations of chronic pathological processes.


Let us emphasize that this therapeutic approach differs from the accepted medical standards. In fact, the patient receives a correcting signal sent to the neuroendocrine centers of the brain, while the result is a better state of the organism as a whole, without harmful effects. Normalization of functions of the system in question is the base of adaptation medicine.


The adaptive potentials of human organism are far from being amply studied. It is known that after special training, man can survive under conditions lethal for untrained people. Cases of spontaneous recovery in case of incurable diseases (metastatic cancer, AIDS, etc.) have been described in medicine. Up to 5,000 harmful mutations take place in the organism daily, and the adaptation system effectively controls them.


Returning to our works, let us note that the first commercial devices for mesodiencephalic modulation MDM-1 was manufactured in 1990. These devices are intended for simultaneous exposure of 10 patients. The MDM-101 device, intended for the therapy of 4 patients simultaneously, is manufactured since 1992. One more device, MDM-3, is intended for medical research. Based on the data obtained with the use of this device, scientists from the Moscow Radiotechnical Institute of the Russian Academy of Sciences suggested in 2000 Medapton MDMK-4--a transcranial electrostimulator of the brain. There are used digital technologies in this system and it is controlled by a microprocessor, while it is fed through a battery. The technological solutions realized in this device maintain the maximum frequency of electric signal in the electrodes. Permanent and pulsed current is used in the 0.5-1:1 proportion by amplitude, the frequency of the latter (70-90 Hz) changes cyclically within 1 min, 6 pulse forms correspond to 6 programs, duration of pulses--4 msec.


The MDMK-5 device is intended for medical studies. And MDMK-6 is intended for simultaneous procedure in 2-6 patients and is computer-programmed. The latest generation MDMK-7 device has a real time feedback.


How are MDM procedures carried out? Let us say at once--no special premises are needed. The patients just sit in comfortable armchairs. An elastic band is put onto the forehead for electrode fixation. The electrodes are

стр. 17


fixed as follows: anode to the forehead, cathode to the back of the neck under the occipital tubercle. Pads wetted in warm tap water are put between the electrode and skin.


After the device is switched on by hand or automatically (in case of a feedback), a program is selected, corresponding to a certain day of the therapeutic course. The "on" button triggers the procedure. The current is released individually till emergence of sensations of any kind on the forehead or back of the neck (pricking, burning, etc.). These sensations as a rule disappear in 5-10 min. There is no need to increase the current during the procedure. After the session is over (the timer counts the minutes in inverse order), the device automatically gradually reduces the current to zero and produces an acoustic signal.


The standard duration of the procedure is 30 min. It is better to carry it out in the evening--from 19.00 to 21.00, close to spontaneous stimulation of the neuroendocrine centers. The procedure is carried out once a day in a majority of cases. The standard course takes 10 days. Repeated courses to prevent exacerbations of chronic diseases are prescribed 1-3 months after the previous course, depending on the treatment results.


The MDM therapy is widely used at medical institutions of Russia since 1988. More than 3,000 MDM-101 devices have been manufactured up to the present time.


Let us enumerate the spheres of effective use of MDM: cardiology, pulmonology, gastroenterology, endocrinology, rheumatology, surgery, gynecology, urology, traumatology, neurology, psychiatry, and dermatology. It is also used in diseases of the immune system, dentistry, as well as in the medicine of disasters, ambulance, pediatrics, and sports.


Practical use of MDM for more than 20 years has confirmed high clinical efficiency of the method, which is reflected in the norm-setting documents of the Ministry of Health of Russia. Methodological recommendations have been prepared. The priority of MDM development is confirmed by 3 patents and an author's certificate. The materials have been published in the monograph and 30 papers. Five dissertations of candidates of sciences on the problem have been defended. The MDM method and its potentialities have been presented at Russian and international conferences. The method is awarded medals and diplomas at Russian and international exhibitions. Thus, a wide-scale introduction of the method Mesodiencephalic Modulation in clinical institutions of the Russian Federation has been carried out. The economic effect of the use of this technology amounts to more than 100 mln rubles annually.


Clinical studies aimed at MDM development are now carried out at the Central Clinical Hospital of the Russian Academy of Sciences in collaboration with the leading medical research institutions of Russia. Technical studies are unfolding primarily at the Moscow Physico-Technical Institute and continue at the Moscow Radio Engineering Institute of the Russian Academy of Sciences. The next step is creation of therapeutic and diagnostic complexes with a real feedback mechanism for normalization of functions of the human adaptation system.


The team of scientists, headed by Vladimir Karev, was awarded the Prize of the Government of the Russian Federation in Science and Technology, 2012, for the development of theoretical base, introduction into clinical practice, and development of the technological basis of the method "Mesodiencephalic Modulation".


Illustrations supplied by the authors

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© Vladimir KAREV, Oksana KAREVA, Alexander MELERZANOV () Источник: Science in Russia, №5, 2013, C.13-18

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