ISSN 1612-3352

Editors in Chief

Prof. Dr. Claus F. Claussen, Neurootological Research Institute of the Research Society for Smell, Taste, Hearing and Equilibrium Disorders at Bad Kissingen (4-G-F). Bad Kissingen, Germany.
Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.

Production Managers

Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.


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Competitive kinaesthetic interaction therapy (kkit) of neurootological tinnitus patients with and without applying additional os

Abstract

In Germany tinnitus patients reporting, that their ringing, hissing, bussing, humming etc. noise continuously goes on, are classified as severe disabling tinnitus, when this very much interferes also with their personal and professional life. Therefore these patients can be sent to a stationary rehabilitation therapy for instance in the Nordsee Rehaklinik at St. Peter-Ording, Schleswig-Holstein, Germany.
Due to the knowledge, which is achieved by the differential neurootometric diagnostics about the kind of the disturbance (exogenous Tinnitus, endogenous tinnitus, combined exogenous and endogenous tinnitus) and the side of the irritating focus leading to tinnitus within the central nervous system, the patients undergo a specific treatment scheme. Included into this systematic treatment at the Nordsee Rehaklinik at St. Peter-Ording regulary are: psychotherapy and a special physiotherapy being called “competitive kinaesthetic interaction therapy (KKIT)”.

In a split study with the regular therapy for stationary tinnitus treatment, which we call “placebo” 18 tinnitus patients were treated, each of them with a program lasting for 4 weeks. Additionally 20 patients receiving the regular psychotherapy and physiotherapy with KKIT also received an additional treatment with oscillating electromagnetic fields (CellVAS).

So this study refers to the results in a sample of totally 38 patients.

After 1 week, 2 weeks, and at the end of the treatment with regular application of electrically fluctuating low frequency fields, the cardio vascular and the peripheral vascular parameters have been derived and analysed by a special NIRP-measurement system.

It is well known, that electrical, as well as electromagnetical fields can provoke many and very different reactions within the biological systems.
All human cells have a difference in charge either side of the cell-membrane, which is called the resting membrane potential.tThus the membrane is said to be polarized. All cells carry this charge difference, but when a stimulus of adequate strength and rhythm is applied to a neuron, a unique event occurs. First, the properties of the membrane change and the cell membrane becomes less permeable to potassium and many times more permeable to sodium, which rapidly enters the cell and induces a net positive charge inside the neuron. This causes the electrical potential of the membrane to change, by which it is depolarized.

However, such an action does not only occur within the neuronal cells, but also within other cell tissues of the body, inclusiding the red and white blood cells. Special attention should also be paid to the tissues of the walls of the vessels. The standard of the unit of electromagnetical frequency is defined as Hz. 1 Hz is equal to one repetition or cycle per second. Every electrical charged particle is surrounded by a field of force. Electromagnetic oscillations can be adapted to the human rhythms, which for instance are derived from the brain as electroencephalograms. Electromagnetic waves are propagated through space. These oscillations also can penetrate the human tissue.

CellVAS is a stimulator, which can apply ultra low intensity and very low frequency-electro magnetic fields through electrodes being fixed for instance at the extremities of the human body.

The modulation of the frequency of the electromagnetic fields has been set up for an oscillating range between 7,8 Hz until 35 Hz. These fields when containing mainly the frequency spectrum of alpha and beta rhythm of the electroencephalogram (EEG) are preferrably applied in this study. A special micro current–tinnitus-CellVAS-therapy program has been electronically installed and applied through electrodes to the extremities of the patients body.

All the 38 tinnitus patients thoroughly underwent several times a tinnitus questionnaire, which was filled in by questions and answers by the investigator. Secondly all the patients have received a pure tone audiometry.
Thirdly the patients underwent an equilibriometry with an ultrasound computer cranio-corpo-graphy (USCCG) of the stepping test.

The micro current-tinnitus-CellVAS-therapy applied micro currents with densities of about 5 micro ampere/cm_ with an amplitude of 8 Volt from pique to pique with changing irregular but still characteristic signal patterns, which were preferably limited to 8 to 15 Hz. The duration of one session of stimulation amounted to 24 minutes. The frequency band was chosen in this range as the resonance frequency of the vegetative nerve system has its best between 7 and 20 Hz.

This biological-physical model is adapted to the knowledge that the endothelium of the blood vessels, but also blood cells, like erythrocytes, thrombocytes, leucocytes and others are known to respond to this electromagnetical signal.

For measuring the effect on the cardio vascular, as well as the peripheral vascular regulation in the tinnitus patients, a special sensor was placed above the supra-trochlear artery, i.e. above the upper rim of the human orbit. This NIRP sensor uses pulsed near infrared light being lead into the tissue, so that from a depth of 3 -4 mm backfire signals can be electronically recorded and measured. This so called remission principle creates the possibility to measuring a micro- and a macro-vascular perfusion. Especially at a wave length of 840 nm haemoglobin, as well as oxidised haemoglobin within the supra-trochlear artery can be measured and evaluated over the time independent of oxygenation. However, with a second wave length of 640 nm the degree of oxygenation can measured in parallel. Thus the NIRP method allows to derive also the oxygenation of the blood, running through the overflow from the brain towards the supra-trochleary artery. Also frequency parameters, like periods of pulses interrelated to the cardiac propulsions can be evaluated in the far periphery distant from the heart. Further wave lengths are able to analyse other parameters, like for instance nitrates etc. within the blood.

During 3 weeks 20 verum and 18 placebo patients underwent regularly during 5 days from Monday until Friday every day 20 minutes therapy with CellVAS electrical fields.

Two parameters were especially evaluated at the level of the supra trochlear artery in front of the brain after the blood had perfused already the skull and brain. These are:

A.) Arterial blood flowrate change
B.) Fibre stretching-rate in the blood vessel endothelium elevated.

There exists an inverse proportional interrelation between the two parameters. When the fibre stretching of the elastic fibres within the endothelium are stretched, the vessel is longitudinally expanded. This leads to a lowering of the arterial perfusion. By this action the peripheral perfusion resistance is elevated.

When applying verum, i.e. true CellVAS therapy, a negative correlation is found of R = – 0,47, which still lays in the normal range. When not applying CellVAS, but only a placebo, an abnormal correlation was found amongst our patients of R = – 0,67.

The fibre stretching parameter in placebo amounts to FS = 1,27. This is bigger than in the verum patients with FS = 1,19. This parameter allows judgements about the quality of blood streaming outward from the inside of the skull to the frontal part of the face.

When evaluating the self rating of the success of the therapy in the 38 patients we find, that the 20 verum patients are showing better results, than the 18 placebo patients.

Presentations of typical cases are underlining the first observations in this orienting study about the influence of a treatment with fluctuating electromagnetic fields of low intensity upon tinnitus during an ongoing evaluation of this specific study. A next field study is underway by now.

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