Harmonizing Autonomous Innervation of Cerebral Arteries
  
  
    Can the Medical Resonance Therapy Music® affect Autonomous Innervation of Cerebral Arteries?
      
      Alexei V. Shemagonov, M.D.
      Valentina N. Sidorenko, M.D., Ph.D.
    
    
      -  Belorussian State Medical Institute for Postgraduate Education,
        3, P.Brovki Str., Minsk 220714 Belarus. E-mail: alexum009@mail.ru
        
       
      -  Mother and Child Health Institute of the Ministry of Health,
        Orlovskaya St., 66. Minsk 220000 Belarus. 
    
    
    Abstract
    
    To investigate the effects of Medical Resonance Therapy Music
® (MRT-Music) upon autonomous innervation of cerebral arteries we studied  slow spontaneous oscillations of cerebral blood flow (SSO) by  transcranial Doppler ultrasound (TCD). TCD notices SSO with 3-9 cycles  per minute (M-waves) and 0.5-2 cycles per minute (B-waves).
    The SSO are caused by rhythmic diameter changes of the medium and small  cerebral arteries. Six patients aged 24-65 years suffering from  tension headache were treated with MRT-Music
®. Twelve further patients were examined with TCD only to register SSO for further spectral analysis.
    
    After fast Fourier transformation we registered four groups of peaks on the SSO
    spectra, divided into four rhythms:
    
    
    
      - 0.01 – 0.02Hz
        
       
      - 0.02 – 0.033Hz
        
       
      - 0.06 – 0.09 Hz
        
       
      - 0.091 – 0.15 Hz and
        an intermediate diapason of
        0.034 – 0.059 Hz. 
    
    Spectral analysis of the SSO showed changes between initial and final  amplitude peaks in all patients. In contrast to A-, B- and D-rhythms the  reduction of peaks in the C-diapason was statistically significant
    (31-60%, P=0.04, CI=95%) during listening to the MRT-Music
®. All patients treated with the MRT-Music
® reported a relief of headache while and after treatment.
    
    
    
Conclusion
    
    The MRT-Music
® affects  the functioning of the brain structures concerning autonomous  nervous system and works as a non-chemical sympatholythic.
    Registration of the SSO is a useful tool to prove an influence of the MRT-Music
® upon the autonomous regulation of cerebral vessels.
    
    
    
Introduction
    
    Alteration in cerebral arterial tonus frequently underlies many types of  headache. It is interesting to note that the cerebral arteries are  less open to pharmacological interference than the other vessels in  human organism. However, the cerebral arteries are plenty innervated  with perivascular autonomous nervous plexus. The sympathetic part of  the autonomous nervous system represents mainly cerebral vascular  effects.
    There are numerous intracerebral nuclei originating vasomotoric nerves,  for instance, hypothalamus nuclei, locus coeruleus, substantia nigra,  periaqueductal nuclei, etc. Various types of mediators are implicated  in the creation of vasomotoric impulses [4,5]. Undoubtedly, such a  complex autonomous tonus regulation of cerebral arteries may scarcely be  adjusted pharmacologically in a simple way.
    
    But how can we modify an activity of the cerebral vasomotoric nuclei?  Are there any alternative methods except chemical drugs?
    
    In 1964 the classical composer and musicologist Peter Huebner started to perform research into the microcosm of music.
    In 1987 the Medical Resonance Therapy Music
® was developed by him for medical purpose on the basis of this more than  20 years of musicological research and under the inspiration of the  ancient music medicine of Pythagoras, who stated that the harmony laws  of the microcosm of music are also the harmony laws of biological life.  Since then medical experts of different disciplines have found wide  and successful clinical application of this Medical Resonance Therapy  Music
®.
    
    Most of the periodic processes in nature as well as in human organism  are under the influence of the law of harmony. As chronomedicine  shows even many processes considered to be sporadic are actually  periodic. Finding the harmony law of human brain activity and  correcting undesirable or “disharmonious” rhythms is a possible way  to relieve some psychosomatic illnesses and some neurological  diseases.
    
    To investigate the effects of MRT-Music
® upon the autonomous innervation of cerebral arteries we decided to  study the so called slow spontaneous oscillations of cerebral blood flow  (SSO).
    
    
    
What are SSO? 
    
    In 1982 Rune Aaslid has put transcranial Doppler ultrasound (TCD) into  clinical practice. This method allows to measure blood flow velocity in  basal cerebral arteries non-invasively without any harmful effect for a  long period. While monitoring arterial blood flow velocity we can see  the waves in velocity trend with an amplitude of about 10-30% of the  mean velocity. These waves are named slow spontaneous oscillations  (SSO). Some investigators notice SSO with 3-9 cycles per minute  (M-waves) and 0.5-2 cycles per minute (B-waves) [1]. They are convinced  of the SSO being caused by physiological rhythmic diameter changes of  the medium and small cerebral arteries [2].
    The origin of these rhythms is supposed to be some brain stem nuclei.  The curve of cerebrospinal fluid pressure also shows the so called  B-waves within 30-120 seconds periods. The SSO are synchronized with  intracranial pressure waves. The cause of fluctuating of intracranial  pressure is suggested to be the oscillation of the diameter of cerebral  vessels [3]. The wider the vessels diameter the higher is the level of  intracranial pressure. The physiological purpose of SSO hitherto is not  fully explored.
    The aim of our study was to elucidate whether MRT-Music
® can affect tonus and functioning of the cerebral arteries via their autonomous innervation.
    
    
    
Patients and Methods
    
    Six patients aged 24-65 years (2 males and 4 females) suffering from  tension headache were enrolled in this study. The patients were treated  with the music preparation RRR 931 of the Medical Resonance Therapy  Music
®. All these  patients were examined by transcranial Doppler to exclude cerebral  artery diseases and to monitor peak blood flow velocity in the middle  cerebral artery while they were listening to the music preparation.  None of them had any neurological disease. Twelve patients suffering  from different neurological diseases excluding severe cerebrovascular  diseases and stroke were also examined with transcranial Doppler only  to monitor cerebral blood flow velocity and to register the slow  spontaneous oscillations for further spectral analysis.
    Right middle cerebral artery (M1-segment) was selected for monitoring in  all patients. We are convinced of the fact that a peak velocity  reflects the diameter of the vessels better than a mean velocity. We  used Trans-Link 9900, Rimed Ltd. and Intra-View, Rimed Ltd. transcranial  Doppler systems. Doppler monitoring has been performed for 10 minutes  in six patients who underwent the MRT-Music
® treatment as well as in the other monitored patients. Doppler monitoring was started in the 10th minute of the MRT-Music
®.  Spectral analysis of SSO has been performed by means of Microsoft Excel  fast Fourier transform tool (sample size – 1024). Differences between  groups were analyzed using t-test with 95% confidence interval (CI). 
    
    
    
Results
    
    In both groups of patients transcranial Doppler showed no evidences  of occlusive and stenotic arterial diseases. All the patients have  revealed the slow spontaneous oscillations of peak and mean  velocities. After the fast Fourier transformation we have seen several  groups of peaks on the SSO spectra (Fig.1.), which may be divided into  four rhythms A,B,C, D and intermediate diapason
    (Tabl. 1) 
    
    Frequency of A- and B-diapasons corresponds to well known B-waves.  Frequency of D- and C-diapasons corresponds to the above mentioned  M-waves. Intermediate diapason lies between B- and C-diapasons.  Amplitude of peaks in the A- and B-diapasons prevails over the other  peaks. Spectral analysis of the SSO has shown changes between initial  and final peaks amplitude in all patients, where reduction of peaks  in C-diapason during the MRT-Music
® listening was statistically significant in contrast to A-, B- and  D-rhythms. (Fig.2.; Table 2.) No significant changes in heart rate,  breath rate and blood pressure level have been revealed while  transcranial Doppler monitoring. Moreover, the patients complaining  of headache before the MRT-Music
® course had a headache relief after.
    
    
    
Discussion
    
    Since it is not quite clear what the pace-maker of SSO rhythms is, we consider that the Medical Resonance Therapy Music
® affects the functioning of some brain struc/pictures concerning the autonomous nervous system.
    
    It is possible that the MRT-Music
® affects these struc/pictures by means of cortex activity regulation.  Our previous study revealed augmentation of C-rhythm during smoking.  Taking into account the activation of sympathetic nervous system during  smoking we suppose that the C-rhythm increase is a sequela of imbalance  between parasympathetic and sympathetic innervation and predominance of the sympathetic activity.
    
    In contrary to nicotine the MRT-Music
® induces the modification in the opposite direction.
    
    Thus, we cautiously suppose that the MRT-Music
® affect the autonomous regulation of the cerebral vessels as non-pharmacological sympatholythic. The MRT-Music
® regulates the tonus of the cerebral vessels by means of strengthening  of equilibrium between the parasympathetic or sympathetic activity.  Taking into account the significance of the imbalance of the autonomous  nervous system in some neurological diseases, especially in some forms  of headache, the MRT-Music
® may be widely used in clinical practice. Moreover, registration of the  SSO is a useful tool to explain positive effects of the MRT-Music
® and to prove the influence of the MRT-Music
® upon the autonomous regulation of cerebral vessels.
    
    Further investigations are needed to clarify MRT-Music
® effects on the SSO. We are also going to try various types of the MRT-Music
® courses for the SSO and to compare them with some pharmacological tests.
    
    
    
Conclusion
    
    
    
      - The slow spontaneous  oscillations may represent an equilibrium in a cerebral part of  autonomous nervous system concerning an innervation of the cerebral  arteries.
        
       
      - The Medical Resonance Therapy Music® affects the functioning of the brain struc/pictures concerning the autonomous nervous system.
        
       
      - The MRT-Music® works as a non-chemical sympatholythic.
        
       
      - Registration of slow spontaneous oscillations is a useful tool to explain positive effects of the MRT-Music® and to prove the influence of the MRT-Music® upon the autonomous regulation of the cerebral vessels.
        
       
    
    
    References
    
    
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        Spontaneous oscillations in cerebral blood flow velocities in middle cerebral arteries in control subjects and patients with epilepsy. Stroke 28: 2457-2459.
        
       
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        Spontaneous oscillations in cerebral blood flow velocity in normal humans and in patients with carotid artery disease. Neuroscience Letter 127: 5-8.
        
       
      - Mautner, D, Haberl, R.L., Dirnagl, U. et al. (1989).
        B-waves in healthy persons. Neurological Research 11:194-196.
        
       
      - Motavkin, P.A., and Tchertok, V.M. (1980).
        Gistofiziologia sosudistykh mekhanizmov mozgovogo krovo'obraschienia.
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    Alexei V. Shemagonov, M.D.
    Belorussian State Medical Institute for Postgraduate Education, 3, P.Brovki Str., Minsk 220714 Belarus. E-mail: alexum009@mail.ru
    
    Valentina N. Sidorenko, M.D., Ph.D.
    Mother and Child Health Institute of the Ministry of Health Orlovskaya St., 66. Minsk, 220000 Belarus.