Ya.Z. Grinberg.  EFFECTIVENESS OF SCENAR THERAPY.  PHYSIOLOGICAL ASPECTS

This article [1,2] discusses the peculiarities of SCENAR therapy (SCENAR action) which sets it apart from other methods of electro-therapy.

The main area of focus was the difference between the SCENAR signal and signals normally used in electro-therapy.

Therapeutic mechanisms have in general been observed in the light of what is known in physiotherapy [3,4].   It has been found that due to the fact that SCENAR action activates tissues in the somatic or autonomic nervous system, it is possible to achieve a considerable therapeutic effect compared with other methods of electro-therapy.

 So how and by which physiological mechanisms is that effect achieved?  This paper aims to provide an answer to this question on the basis of modern ideas about the functions, structure and chemical reactions involved in providing the passage of excitation within  the nervous system.

 First, however, let us recall:

The peculiarities of SCENAR action [1,2]

1.     High amplitude and, at the same time, non-damaging (short) action. [1,2]

2.     Absence (or almost complete absence)of adaptation process.  Due to biofeedback, each new impulse differs from the previous one.

3.     Neutralisation of the possible effect of accommodation (powerful first peak of the action signal).

The methodological peculiarities in SCENAR therapy

1.         Moving the device over the skin surface at the time of action.

2.         Activation of numerous areas connected to the mass of nerve endings.

3.         Choice of special zones (of small asymmetry, etc.)

SCENAR action applies electrical current on the skin surface.  The degree of excitation of the nerve tissue depends on the type of nerve fibres that it consists of.  According to classification by Gasser and Erlanger, there are various types of nerve conductors [3] which differ by their diameters, speed of action and presence of myelin cover.  These are: 

- Fibres of type A:  A alpha (15-20; 90-120);  A beta (10-15; 50-100);   A gamma (5-10 ;          5-30);  A sigma (1-10; 5-30);

- Fibres of type B:    (1-3; 3-15); and

- Fibres of type C:    (0,5-1; 0,6-20). 

The figures in brackets indicate the diameter is in mkm and the speed of passage of an impulse in M/c.   Of the fibres listed, type C are non-myelinated.

It is known that C-fibres have a high threshold of excitement.  There is an existing rule  (for the fibre), according to which the value of the threshold of electrical excitation is in inverse proportion to the diameter of the fibre.  [6]

The force of current required to activate C-fibres should therefore be 15-40 times higher than for A alpha-fibres.  However, it should be noted that during the action, current from the electrode flows  through the tissues . The current should be proportional to the volume of the conductor (all other conditions being equal) and at set length to the square of the conductor. Thus, the force of current in C-fibres should be 225-1600 times less than in A-fibres.  Correspondingly, the force of current necessary to excite C-fibres should be at a level equal to the critical membranous potential, so as to keep the corresponding proportion: - in this instance at most 16OO times higher.   (A-fibres have a diameter of equal to 20 mkm; that of C-fibres is 0.5 mkm). 

It should be recalled here that the SCENAR generates a high amplitude current impulse.  Accordingly, the potential for exciting thin fibres, including C-fibres, is considerably higher than with other methods of electro-therapy.

Quantity correlation between the fibres mentioned is also essential.  To give a few examples [7,8]:

 The cranial cervical sympathetic node has been the subject of considerable study.  The following shows numbers of nerve cells found :

- in rats       :         42,OOO

- in guinea-pigs:   16,OOO

- in cats      :       1OO,OOO

- in man     :        911,OOO nerve cells

Of all the types of fibres, 80% relate to sensory fibres, particularly in cats. 20% of fibres are myelinated and the rest – i.e. C-type fibres – are thin, non-myelinated, with a diameter of 1-2 mkm.

In the study of celiac nerves in cats, it was established that out of approximately 13,500 fibres, nearly ll,000 were non-myelinated.  The presence of B-afferents was discovered which were small in diameter and had a correspondingly high threshold of excitement.  B-fibres and also pelvic nerves were discovered in the parasympathetic vagus.  The quantity of C-fibres in these nerve tracts was, 90% and 50% respectively.  Hence thin, non-myelinated or weakly-myelinated fibres make up the biggest part of the main nerve tracts.

Let us take a further look at the modern concept of chemical passage.  The basis for this was established at the beginning of the 20^th century.  It was demonstrated that the passage of the signal in the neuro-effector connections was due to the release of acetylcholine or adrenaline in the nerve endings.  Up to the l950’s, two groups of chemical compounds were known as neuromediators (NM), namely:

-         amines  : acetylcholine (AC), noradrenaline (NA), adrenaline, dopamine, serotonin; and

-         amino acids : glicin, glutamin, asparginate acid and gamma-aminobutyric acid.

A third group of neuromediators (purine/neucleitides)  was discovered in the l960’s.

In the mid-l950’s, it was suggested that a peptide – compound P (CP) - had a role of neuromediator.  Since then, neuropeptides (NP) have been established as the most numerous group of neuromediators. The co-existence of the representatives of various groups of compounds was traced in the same neurones of the central and peripheral nervous systems [9] i.e. - a few classical NM, classical NM + NP.  Purines were subsequently added to this combination.

In the context of the subject under discussion, we above all are interested in the properties that can influence the therapy.  The bioactive properties of the classical NM are widely known [3,6].  We will therefore focus to the properties of NP.

Table 1 [9,10] sets out the most general characteristics of the bioactivity of neuropeptides.

The following are the abbreviations used for neuropeptides  (NP) :

CCK – choliecystokinin;

VIP – vasoactive intestinal peptide;

ACTH – adrenal-corticotrophin;

CGRP – Ca-gene relative peptide.

Analysis of the table shows that each of the NP represented (or group of NP) does not completely match the bioactivities listed but has a clearly expressed specific property or complex of properties.  Some physiological functions are under control of not only one but a whole range of NP, where each NP has evolved into a “package of programmes” for triggering or modulating a certain set of functions.  NP, together with the other humor regulators, form a functional continuity (or continuum) assuring compatibility of biological activities. 

Table 2 sets out a list of given functions on which neuropeptides have their main influence.  At this point, it makes sense to move from the notion of NP to the notion of regulative peptide (RP), which is used as a synonym when referring to given properties of NP. The concept of RP [9] is slightly wider, as a whole range of RP is produced by neurones.  Persistence in the search for peptide-producing neurones (previously considered to be non-neurones) has in many cases been rewarded with success. The next important peculiarity of NP is its long life span in the liquids of the organism.  If the average duration of the effective concentration of AC is split seconds (l0^-2), for catecholamines, serotonin, histamine and GABA from 10^-1 to 5 seconds, then for small peptides it will be tens of minutes and, for medium and large peptides, tens of hours.

Another peculiarity of the NP which differentiates it from regular NM is the fact that its breakdown is not just a simple act of decomposition of the regulator but the creation, or synthesis, of a new bioactive compound. The end activity of the chemical compounds resulting from the cascade reaction breakown of the original NP, differs from the activity of the starting NP and this is a valuable difference: the formation of complex chains and cascades is taking place.  Each of the peptides studied demonstrated the ability to induce certain other NP to appear in the blood and interstitial liquor of the organism.  Each of the peptides mentioned, in turn, is capable of the same inducing effect.  The long-lasting effects of NP with a short life-span may be explained by the existence of such regulative chains.

It seems logical, therefore, that the likelihood of  chains and cascades appearing essentially increases if the dosage of NP exceeds a certain threshold, i.e. when the effective dose of NP is being released.

Distant effect is a logical continuation of the aforementioned peculiarities (formation and duration of the complex chains and cascades).  NP come from the synapse area and act on the less remote receptors.  The majority of NP is recognized as regulators, transferred by blood and/or CSLiquid in any area of the organism.  For some distantly-acting NP, special carrier-proteins are described, which stabilise them in the process of transportation.  With distant action of NP, the ability of the NP to induce the release of other NP is an important property.

The next important property of NP, which differentiates them from regular NP, is connected to their high numbers and therefore to the possibility of many new functional combinations in the synapse and intersynapsis interactions.

Finally, it should be noted that exhaustive study of each NP always leads to the discovery of its action on the genome activity.  The triggering or increase of the activity of given genes under the influence of NM, especially RP, is an typical process.  The process can even be caused by the mediators, whose action is so short and seems to be focused on quick synaptic reactions.

To sum up.   There are biologically-active compounds in the organism consisting basically of RP. Together with other humor regulators, they ensure compatible biological activity.  RP are characterised by their ability to create complex regulative chains and cascades, their long life-span, their distant effect and action on the genome activity.

The last question to be cleared up is related to the localisation of NP.  The short answer to this question is: NP are present in all parts of the central and peripheral nervous system, somatic and autonomic.  (Refer to the list of various NP that co-exist with each other [9]) cerebral pons, cerebrum, cortex of hemispheres, striatum, cerebro-spinal ganglions, parasympathetic neurones, sympathetic neurones, enthral ganglions, spinal cord, peripheral vegetative nerves, retina cells, preganglion sympathetic nerves, hypocampus formation, medullar of the adrenal glands, hypothalamus hypocampus, cerebral trunk, olivo-cochlear neurones, suture nucleus, blue macular, primal afferent neurones.)

Let us examine the modern idea of chemical reactions involved in the passage of  excitation in the peripheral autonomic reflex [7] .The main mediator in the pre-ganglion sympathetic and parasympathetic structures is AC.    In the post-ganglion, AC prevails in the parasympathetic structures and NA in the sympathetic.  In the post-ganglion sympathetic pathways, together with adrenergic cells, there is a certain quantity of cells which are choilinergic.  Classical mediators, as mentioned earlier, exist in combination with various peptides.  These are: vasopressin (VP), CHRP, Bom/HRP, VIP, SOM, pancreatic peptide (PP), RFLH, NT, neurotensin A (AT), galonino-like peptide (GAL), petid-gystidin-siolicin (PGI), gastroliberin (GLB), ENK, CCK, NPU and others.

It is always a surprise to researchers studying the distribution of visceral fibres innervating the internal organs (vagus, celiac, pelvic nerves) to find that there is a prevalence of sensory fibres over motor fibres [8].  In the vagus nerve, the ratio is 9:1; in the celiac nerve – 3:1 and in the pelvic nerve – 1:1.  The efferent sensory  fibres transfer information about the condition of an object and create their own local control for the object.  In response to adequate stimulation or irritation by electrical current, bioactive compounds are released (mainly RP) which act specifically on the surrounding tissue and beyond, as follows from the above.  The process of effective regulation by sensory endings is seen especially clearly in regulation of the immune process, the inflammatory trophic process, healing of wounds [7] and in regulation of the gastro-intestinal mechanism, where ulcer formation is prevented [8].

Traditionally, neurosecrete cells were studied mainly through the hypothalamo-hypofisis-adrenal connections.  Today, it is clear that large quantities of neuosecrete cells are spread around the various  parts of the nervous system and their activity is closely connected to the production of the peptide regulators.

Based on these explanations, let us look at some postulates and reports received on the practical effects of SCENAR therapy.

SCENAR treats everything. (Ref also “The Principle of Universality “ [4]). 

This statement very often makes medical doctors and scientists wary when first faced with the device and treatment method.  Results from SCENAR therapists (at present the device is being used by medical doctors in over 30 specialities), publications of compilations of SCENAR therapy, multiple trials, including trials at five departments of I.M.Sechenev MMA (ref. Supplement to the second compilation) have, to a considerable degree, served to reassure them.

The main modality of SCENAR therapy.  This phenomenon is explained as follows:

Due to the peculiarity of its action, SCENAR activates thin peptide-containing fibres to a higher degree than other methods of influence. This enables the effective dosage of RP to be created and, consequently, RP with other humoral factors which are also subjected to the essential influence of RP, thus creating a regulator continuum  - i.e. a full set of biological activities which are capable of managing practically any disease.

There are numerous publications describing the influence of RP on regulation of vessel tone [7], heart rhythm [11], respiratory system [13], degree of epileptic activity [14], integrative brain action [15] and pain mechanism [16] (see below).

SCENAR – regulator.  This statement is repeatedly corroborated by practice.  Regardless of the direction of the disease (a characteristic example:  hypertonia – hypotonia), the same zones of action are used for the therapy.  This is natural, as SCENAR only activates the release of regulative peptides stored in the body and which, as a result of genetic programming , substantiates the therapy.  In common electrotherapy this, as a rule, cannot be achieved due to limitations connected to its peculiarity [1] and also bearing in mind the main functions of the afferent fibres of the A-type which are involved in high-speed transference of chemical supply.  NP are not suited as chemical mediators to the process of transferring the impulse to A-type fibres endings [8].  Therefore, when they are activated  - which is a characteristic of the common methods of electrotherapy - the likelihood of peptic chains and cascades appearing is small, compared to SCENAR therapy.

Treatment of children is better. Practice has time and again corroborated this statement.  It is relatively simple to explain in the light of the above.  Myelinisation of fibres is complete by the age of 1^1/₂ – 2 years. The quantity of endocrine cells in the foetus and neonate is considerably higher than in adults.

Here, I would like to mention the successful experience of SCENAR use in the treatment of respiratory asphyxia in neonates, practically with a single touch of the device.  This took place at the 2^nd City Hospital in Tanganrog.  It is known that more than 10 RP synthesize in the neuroendrocrine cells of the lungs [12].

False, true SCENAR complications.  It is characteristic that, following treatment of osteochondrosis, for example, women unexpectedly become pregnant.  There have been numerous positive results in the treatment of infertility.  The explanation for this effect is obvious, as 30 NM take part in the functioning of the reproductive system [13]. They also provide a chemical structure for an autonomic reflex [7].  Here, I should also make a reference to the effect of the distant properties of RP.

Absence of contra-indications.  This statement claims that SCENAR therapy is different from other methods of electrotherapy [1] which, to a great extent, can be ascertained from the reaction of the organism to the introduction of RP.

It is known that the pharmacological (physiological) effect depends on the functional status of the system being tested.  When introducing moderate dosages of RP into a “normally”-functioning organism, i.e. in equally balanced relations, the exogenous factor will be subject to intensive influence and these peptides will be destroyed, in order to conserve homeostasis.  In pathological conditions, the opposite is true: balanced relations between chemical and physiological systems, cells, tissues and the organism are disrupted.  The links which are susceptible to the corrective action of the regulator, are revealed.

Pain-killing effect.  The success of SCENAR action in analgesia is well known (ref. [18]).   According to the existing concept [16], regulation of pain sensation in the organism is based on the mechanism of interaction between nociceptive and anti-nociceptive endogenous systems.  They form a functional  variable pain threshold.  Both these systems have a multiple chemically- heterogeneous make-up,  and both have in their basis neuro-chemical reactions.  Some of the reactions are called peptide-ergic reactions.  Besides opioid peptides, there is: neurotensin, AT-2, CHRP, SP, BOM, SOM, CCK and others involved in the mechanism regulating pain sensation.  Peptic mechanisms possess a certain selectivity, confirmed by the activity of extremely small dosages of certain peptides.  The pain sensitivity mechanisms occur through interaction of the functions of various peptides.  As mentioned earlier, it is clear to see how complicated it is to develop medical drugs for anaesthesia.  The optimal solution can only provided by the organism itself, which only needs a little help.

The experience acquired from the application of SCENAR therapy shows that this treatment tackles all three tasks involved in combating pain:

- anaesthesia without  a change in the general pain sensation;

- therapy; and

- reduction in intake of narcotic drugs (refusal of these).

Participation of the peptic mechanisms in this process confirms, from the effect of the increase of pain (aggravation), the obvious improvement of the functional condition (via aggravation to recovery).  A patient expresses anxiety and the SCENAR therapist endeavours to persuade him/her to hang on.  This effect promotes essential progress in the distribution of RP. The restoration of the function occurs against a background of change in  the RP which are responsible for anaesthesia, which consequently leads to an increase in pain sensitivity.

When treating one disease – cures another as well.  This is a phenomenon familiar to all SCENAR therapists and is easily explained as follows: a regular continuum of biological activity and distant effect of RP.   Positive results achieved after a single SCENAR session [17] are connected to the long duration of RP and their ability to form new biological compounds on decomposition.

Quick effect, acceleration of recovery.  (Ref. Reply from I.M.Sechenev MMA, compilation 2).  Fast action of RP (different from that of steroid hormones) is due to activation of earlier synthesised ferments and proteins [15].  This property is used in certain peptic drugs for the correction of functions in extreme conditions.

Let us list briefly some of the SCENAR  “fairy tales”:

- Restoration of the reproductive function;

- Treatment of a brain tumour by action on the appendages (uterine or epididymis): distant property of RP;

-   Treatment of  ileus.  Essential influence of CCK, BOM, VIP on the secretion of the grastro-intestinal tract (ref. [19] in this compilation);

- Emergency effects (ref above: fast effects);

-  Reversal of Growth retardation.  CCK stimulates excretion of the growth hormone;

-  Reversal of Mental development retardation.  Essential stimulation of VAZ, ACTH and alphamelanotropin on ability to study and memory;

- Correction of  disturbance in motor activity and tactile sensitivity.  Effective application of the device in this case follows from analysis of the table.

- There are positive cases of treatment of epilepsy.  It is know that black substance, neuromediators and peptidergic systems of the brain halt epileptic activity [14].

In conclusion, let us examine to what extent certain SCENAR techniques correspond to what has been stated.

- Action on the projection of the lesion of the injury.  In this case, distant effects occur more quickly and a fast therapeutic effect can be expected to take place in practice.

- Action on the three pathways, 6 points, collar zone, projection of the gastro-intestinal tract, active points and zones activates a great number of nerve cells containing practically the whole range of RP, leads to the desired effect.

The fact that SCENAR therapy is based on the mechanisms of peptide activation makes it possible to look upon the system “organism-device” as a generator of Regulative Peptides.

Reference

1.       Grinberg Ya.Z. SCENAR therapy: the effectiveness from the point of view of methods        of electrotherapy.  SCENAR therapy and SCENAR expertise.  Compilation of articles, issue 2, p 18-33.  Tangarog, 1996.

2,       Grinberg Ya.Z. Question of the substantiation of the effectiveness of SCENAR therapy. SCENAR therapy and SCENAR expertise.  Compilation of articles, issue 3, p.17-23.  Tangarog, 1997.

3.       Bogolubov V.M., Ponomarento G.N.  General physiotherapy.  M.; compilation 1996 – 480 pp.

4.       Revenko A.N. Adaptation –adaptive regulation (SCENAR).  Theoretical and practical substantiation.

5.       Gorfinkel Yu.V. Theoretical and practical basis for the increase in effectiveness of SCENAR therapy.  SCENAR therapy and SCENAR expertise.  Compilation of articles, issue 2.

6.       Nozdrachev A.D.  Physiology of the nervous system. L.: “Medicine”, 19238, p.296.

7.       Nozdrachev A.D. Chemical structure of the peripheral autonomic (visceral) reflex.  Usp.physiol. science, 1996, v.27, No.2, p.28-60.

8.       Nozdrachev A.D.  Axon-reflex.  New point of view in the old area. I.M.Sechenev Physiol.magazine, 1992, v.11, p.135-142.

9.       Ashmarin I.P., Kamenskaya M.A. Neuropeptides in the synaptic passage. Results of science and technique. Ser. “Physiology of humans and animals”, v.34, 1988, p. 183.

10.     Ashmarin I.P., Obuchova M.F.  Content of regulative peptides in the brain cortex and their central activity.  M. “Highest nervous activity”, v.35, No.2, p. 211-221.

11.     Osadchyi O.E., Pokrovskyi V.M.  Peptidergic mechanism in the parasympathetic regulation of the cardiac rhythm.  UFN, v.24, No.3, 1993, p. 71-85.

12.     Belyakov N.A., Solovieva I.E., Meshkova M.E.  Regulative peptides in the lung.  UFN, v.23, No.2, 1992, p.74-87.

13.     Babichev V.N.  Neuroendocrine regulation of the secretion of gonadotrophins and prolactin and the role of neuromediators in it.  UFN, v.26, No.2, 1995, p.44-59.

14.     Shandra A.A., Godlevskyi L.S., Tkachenko I.V., Servetskyi K.L.  The role of black substance in mechanisms stopping epileptic activity. UFN, v.26, No.2, 1996, p.90-102.

15.     Malyshenko N.M., Popv N.S.  Hormones and neuropeptides in the integrative processes.  UFN, v.21, No.2, 1990, p.94-106.

16.     Kaluzhnyi L.P., Heterogeneity of nociceptive and anti-nociceptive peptic mechanisms and their correlation with the genesis of pain. UFN, v.21, No.4, p.68-84.

17.     Zavitaev Y.A. SCENAR examples of single SCENAR application.  SCENAR therapy and SCENAR expertise.  Compilation of articles, issue 2,c.81-82.  Tangarog 1996

18.     Bogdanova E.P., Zaidiner B.M. Anti-pain SCENAR therapy in oncologic practice.

19. Lyashedko P.P.  Usage of bio-regulative electrostimulation in the treatment of complications in the gastro-intestinal tract in patients suffering from sever multiple-injury.  SCENAR therapy and SCENAR expertise.  Compilation of articles, issue 4, 1998.

In the table, the following abbreviations are used :

Table to be inserted…

…

CE     Complex effect that cannot be generalised or simplistically explained;

Blank areas indicate the absence of data [or] absence of interpretation of the results.

(NB Harry: please note that the top line of the table with all the abbreviations is missing)