Reflexo-therapy research results and possible approaches to its mechanisms

Related:

A theory of acupuncture, spinal cord, and endorphins

There is only a couple direct research on the reflexo-therapy devices in use since 1979s (Kuznetsov’s applicator, Panacea, Shaktimattan) but in fact dating thousands years back in history. The first is a pilot study conducted in 1995 at the community holistic health center in North Carolina by Zilberter T. and J. Roman, titled “Reflexo-Therapy with Mechanical Skin Stimulation: Pilot Study” and reported to the International Symposium on Integrative Medicine in 1999 (1). In this outpatient study, a 20” x 9” mat designed and manufactured for this study and called “Panacea”, was tested on 126 subjects, who reported after 30 days of using the Panacea: pain relief (98%), relaxation (96%), improvement in the quality of sleep (94%), and an increase in perceived energy level (81%).

Very recently, in Sweden, using a slightly modified version of the initial Applicator designed by I. Kuznetsov in 1970s and now called Shaktimattan, E. Olsson and B. von Scheele reported that 32 healthy participants were able to subjectively relax resulting, among other measured parameters (e.g., increased blood flow to the affected skin areas), in a greater variability of heart rate – an indicator of the prevalence of the parasympathetic nervous system (2).

Skin is the largest organ of the body and the first line of defense against physical and chemical xenobiotic insults. Recent data on skin physiology and endocrinology allow to suppose that the Applicator’s spikes trigger beneficial physiological and endocrinological effects. For example, a new hypothesis based on experimental data has been recently offered, the hypothesis of cuteneous-hypothalamic-pituitary-adrenal axis (3, 4). It was shown that practically all elements of the hypothalamic-pituitary-adrenal axis are expressed in skin including receptors of corticotropin-releasing hormone, proopiomelanocortin, ACTH, beta-endorphin, and the glucocorticoid.

This information can offer a separate aspect of hypothetical mechanisms and explain the effects of skin stimulation by the Applicator shown in five clinical trials in 1980s in Moscow: State Institute of Physical Culture (2450 sessions) Institute of Neurosurgery (1000 sessions on 30 patients), Institute of Experimental Surgery (75 patients, 750 sessions), Central Institute of Trauma (176 patients), Department of Facultative Surgery of the Second Moscow Medical School (120 patients with heart diseases) where stress-protective, cardio-protective, immune, respiratory, anti- nociceptive, anti-inflammatory and anti-insomniac effects were reported.

Manipulations with the skin, an organ closest to the environment, is a noninvasive therapeutic approach known for at least 3 thousand years as acupuncture. Recently, it is getting recognition as more controlled research becomes available. Since there is evidence that acupuncture exerts both specific and non-specific effects (5-7), the non-specific aspect of mechanism of acupuncture can be applicable to other types of skin stimulation. For instance, there is evidence that both acupuncture and intensive skin stimulation similar to that produced by the Applicator cause the release of endogenous opioids exerting powerful effects on numerous physiological functions many of which are considered adaptogenic since the effect mode depends on the initial physiological state. Scientific literature concerning this topic is overwhelming and a review of recent research is underway. As an example, see (8,9).

Skin stimulation of different than acupuncture kinds is reported to have beneficial health effects (10,11) and recently, an old concept of skin projection of viscera has been revived to explain the connection of certain areas on the skin with specific internal organs. Initially, this concept was offered independently by Russian physician Grigori Zakharin in 1860s and by Sir Henry Head in 1990s. They both discovered certain areas of the skin that become  tender  when a disease of an internal organ develops. These areas were later termed “Head zones” (“Zones of Zakharin-Head” in Russia). A comparison of Head’s papers with the Yellow Thearch’s Inner Classic manual on acupuncture revealed parallels between acupoints and points of maximal sensitivity in within Zakharin-Head zones (12).

Last decade brought forward the idea that came from radiology, pharmacology and toxicology, the one, which is based on the dual character of action of many substances, drugs, and physical influences. It is observed that physical and physiological stressors, when repeatedly applied in a weaker concentration or strength, work as specific or non-specific protectors from the harmful impacts. We can expect with reasonable probability that this approach can be useful in research into the mechanism of Applicator’s effects.

Edward J. Calabrese is one of the pioneers in the filed and one of the post persistent author broadening the applicability of hormesis from pharmacology and toxicology (13, 14) to neuroscience, e.g., including the areas of neuroprotection, neurite outgrowth, and drugs for Alzheimer’s disease, Parkinson’s disease, anxiety, pain, seizures, stroke, as well as in the areas of behavioral pharmacology, addictive drugs, stress biology (15). Most directly related to our interests is hormesis research concerning  stress-response pathways (16 for review).

Coincidentally, the weak interactions wing of the U-shape dose-response curve is currently one of the directions in the “Neuroprotection and neuroprotectors” project steamed from the neuroprotection effects of brain energy substrates (e.g., 17, 18) with promising preliminary results concerning epilepsy and Alzheimer’s disease (in press).

References (see also further reading below)

1. Zilberter T, Roman J. Reflexo-Therapy with Mechanical Skin Stimulation: Pilot Study. International Symposium on Integrative Medicine. New York: Omega Institute, 1999.
2. Olsson E.M.G. and von Scheele B. Relaxing on a Bed of Nails: An Exploratory Study of the Effects on the Autonomic, Cardiovascular, and Respiratory Systems, and Saliva Cortisol. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE. Volume 17, Number 1, 2011, pp. 5–12
3. Slominski A, Wortsman J. Neuroendocrinology of the skin.  Endocr Rev. 2000 Oct;21(5):457-87.
4. Skobowiat C, Dowdy JC, Sayre RM, Tuckey RC, Slominski A.Cutaneous hypothalamic-pituitary-adrenal axis homolog: regulation by ultraviolet radiation. Am J Physiol Endocrinol Metab. 2011 Sep;301(3):E484-93. Epub 2011 Jun 14. doi: 10.1152/ajpendo.00217.2011
5. Klaus Linde, Karin Niemann, Antonius Schneider, Karin Meissner. How large are the nonspecific effects of acupuncture? A meta-analysis of randomized controlled trials. BMC Medicine 2010, 8:75, 114
6. Howard H. Moffet. Traditional acupuncture theories yield null outcomes: a systematic review of clinical trials. Journal of Clinical Epidemiology 61 (2008) 741e747
7. Ji-Sheng Han. Acupuncture analgesia: Areas of consensus and controversy. PAIN

152 (2011) S41–S48

1. Edward S. Yang & Pei-Wen Li & Bernd Nilius & Geng Li. Ancient Chinese medicine and mechanistic evidence of acupuncture physiology. Pflugers Arch – Eur J Physiol (2011) 462:645-53
2. Jan M Keppel Hesselink, David J Kopsky. Enhancing acupuncture by low dose naltrexone. Acupunct Med June 2011 Vol 29 No 2, 127-130
3. Roland Staud, Michael E. Robinson, Casey T. Goldman, Donald D. Price. Attenuation of experimental pain by vibro-tactile stimulation in patients with chronic local or widespread musculoskeletal pain. European Journal of Pain 15 (2011) 836-42
4. Geng Li & Jie-Ming Liang & Pei-Wen Li & Xiaoqiang Yao et al. Physiology and cell biology of acupuncture observed in calcium signaling activated by acoustic shear wave. Pflugers Arch – Eur J Physiol (2011) 462:587-597
5. Florian Beissner, Christian Henke, and Paul U. Unschuld. Forgotten Features of Head Zones and Their Relation to Diagnostically Relevant Acupuncture Points. Evidence-Based Complementary and Alternative Medicine, 2011, Article ID 240653, doi:10.1093/ecam/nen088
6. Calabrese EJ, McCarthy ME, Kenyon E. The occurrence of chemically induced hormesis. Health Physics 1987, 52(5):531-41
7. Calabrese EJ. Hormesis: Why it is important to toxicology and toxicologists. Environmental Toxicology and Chemistry Volume 27, Issue 7, pages 1451–1474, July 2008.
8. Calabrese EJ. Neuroscience and Hormesis: Overview and General Findings. Critical Reviews in Toxicology, 38:249–252, 2008
9. Suresh IS Rattan and Taru Deva. Testing the hormetic nature of homeopathic interventions through stress response pa. Hum Exp Toxicol 2010 29: 551.
10. Rheims S, Holmgren CD, Chazal G, Mulder J, Harkany T, Zilberter T, Zilberter Y. GABA action in immature neocortical neurons directly depends on the availability of ketone bodies. J Neurochem. 2009 Aug; 110(4):1330-8
11. Zilberter Y, Zilberter T, Bregestovski P. (2010) Neuronal activity in vitro and the in vivo reality: the role of energy homeostasis. Trends Pharmacol Sci., 31(9):394-401

Further reading

Zilberter, T. Another theory available for explaining acupuncture. Altern Ther Health Med. 1996 May;2(3):17

Zilberter, T. Reflexo-therapy From Kuznetsov’s Applicator to Shakti Mat. Create Space publishing (2010)