A Pluri Disciplinary Therapeutical Approach of the Central Nervous System Patology Foundations for Economic Effectiveness

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International Journal of Health Economics (2012), No.2

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A Pluri-Disciplinary Therapeutical Approach Of The Central Nervous System Patology -

Foundations For Economic Effectiveness

Dr. Angel Iulian Popescu

Life Style, Education and Health Association

contact: [email protected]

Abstract

Etiological complexity of neuro-psychiatric disorders both in terms of pathology and in terms of

therapeutics, is given by the very multi-layered structure of the human psycho-emotional functionsand the possible causal interaction between the anatomical and physiological structures (i.e. the

disorder mechanisms of these structures) and its psycho-behavioral ramifications.

Keywords : Central nervous system, neuro-sciences, alternative therapies, psychosomatic medicine,

kinesiology

Reconsidering the functional behavior of the nervous system, we note that the separation of

sensory nervous system functions, into motor and mental ones is artificial and schematic. In reality

there is no sensory activity without motor manifestations and vice versa, and the mental states result

from the integration of the first two. The whole nervous system activity takes place in a unity in its

extraordinary diversity1.

1Personal translation from the Romanian original, separarea funciilor sistemului nervos n funcii senzitive, motorii ipsihice este artificial i schematic. n realitate nu exist activitate senzitiv fr manifestri motorii i viceversa iar


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From the above mentioned aspects we can deduce practical consequences with direct application on

one hand, in the conservation and the optimization of the psycho-physical health, and, on the other

hand, in the therapeutic intervention possessing a double destination - (1) cases of psycho-

somaticness and (2) cases of somato-psyching (Angel Iulian Popescu, Alexandru Paul, Omnivalent

therapeutical approach of the patient2

).

In terms of clinical practice, we can highlight two types of approaches. The first finds it source into

the millennial experience of judicious observation realised on the entire causative chain of a

disorder - Chinese Medical School (Daniel Reid, The Complete Book of Chinese Health and

Healing, Shambhala, 1994). Also in this context stands with necessity the causal link between a

psycho-neuro-physiological disorder, extensive degeneration and use processes of certain

anatomical structures, lifestyle and acquired personal or family history of the patient. From the

above mentioned aspects it results that, on medium and long term, in terms of efficiency and costs

involved in the treatment of systemic disorders, the increasing of the patient awareness is a key

factor.

The second approach ulterior in terms of historical chronology, belongs to Western medicine and is

essentially founded on the continuous deepening of the knowledge of the anatomical and

physiological structures involved into the proper functioning of the body. In the perspective of

improving the analysis of complex interactions realised at the chemical, biochemical andphysiological levels, therapeutic systems have been developed aimed both to resolving the

immediate practical problems, and to reharmonize the physiological mechanisms through

medication and dietary recommendations. The introduction of certain drugs is aimed to normalize,

activate, increase or decrease certain functions of the body, physiological mechanisms, in a

particularlized way and by certain segments. In terms of practical urgency, the direct action on the

body can generally be achieved by surgical (surgery, gypsum, etc.), kinesiological (recovery of

sections, functions, etc.) and metabolic (infusion, hydration, diet, etc.) approaches.

To the second approach it corresponds the principles of respecting the rules of assembly functioning

but by focusing on quick partial solutions with immediate results that cannot be consolidated on

medium and long term. To achieve a consolidation however, is appropriate to involve changes in

the whole (e.g. the treatment with vaso-dilatation of the narrowed arterial sections requires also a

change of the nutrition style to facilitate the process of optimal pressure recovery - a process that

strile psihice rezult din integrarea primelor dou. Toat activitatea sistemului nervos se desfoar ntr-o unitate, ndiversitatea ei extraordinar, Dan Cristescu i al.,Biologie (Biology), Editura Corint, Bucureti, 2008, p.13.2Romanian Journal of Psychopharmacology, Vol.X, Suppliment 2, Editura Medical Universitar, Craiova, 2010,

pp.38-40.


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involves the releasing and the eliminating of the thickening of blood vessels, the restoring of their

flexibility by the introduction into the body of active substances involved in removing the made

deposits).

From the mentioned aspects it results that both in the recovery process and in that of conservation

of the optium state, there are two problematic levels that have to be respected: (1) the daily routine,

(2) the functional and constant maintenance of all essential physiological processes involved both

(a) in the automatic operating body, and (b) in the cyclical recovery of body cells (during periods of

7 years) whose continuity must be maintained constant throughout life.

The decreasing and blocking of any parts of this regenerative cycle leads to the apparition of

gradual degenerative multi-level processes that cannot be stopped by allopathic means. The essence

of preserving the individual psycho-physical health resides in maintaining to an optimal level boththe macro and micro mechanisms that are essential for lifethe parallelism between the breathing

of lung/breathing of cell, macro-nutrition in the digestive tract/micro-nutrition in the anabolic

processes at cellular level, defecation in the digestive tract/catabolic processes at the cellular level,

body level of exercise/ mechanical work in muscle/innervation, contraction in cellular and tissue

level of the body movement/inner secretion of the joint.

Given the complexity of the mechanisms, we can deduce the major role that the procedures of

somatic massage, lymphatic drainage, program resetting and balancing the internal functioning of

organs by reflexology (both vertebral and plantar) stimulation, medical gymnastics and

physiotherapy can play in approaching any type of pathology. To the above mentioned aspects, you

can also add the use of modern technology to stimulate the entire nervous chain.

A very important element to remember is that of coordinating the multi-level approach to existing

structures and processes in the body that has the role to preserve and improve a good condition and

to provide real support for slowing down the degeneration processes and for supporting the

optimum processes into the specific limits of each structure (cell, tissue) the destroyed neurons

cannot be presently regenerated, the death of a brain neuron being followed by its dismantling and

be its replacing by glial cell; a new neuron to replace it cannot be presently produced at the current

level of knowledge, but the improvement of the trophic capacity of glial cells will necessarily

increase the working capacity of the left neurons; this is realised on multiple levels: at the macro-

molecular level it is the result of improving and increasing the arterial blood flow, increase of

multiple of n as a particular, indirect effect of the physical exercise accompanied by the quality

increase of nutrition at the cellular levelaspect which is the result of the coordination between the


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physical effort and the quality of the food intake entering into the digestive system from where they

will be taken and processed in order to reach at the cellular level; the coordination of nutrition with

the appropriate physical exercise, with the mental exercise through various training methods of

logic and image projection will not only improve and optimize the metabolic functioning of brain

neurons, but also it will increase the number of spines of a certain neuron, growth that will cause aqualitative jump of processing order by the increasing of the number of connections between the

same neurons, fact that will replace in an effective way the destruction of some of them. With this

occasion, we must distinguish between the neurons involved in intellectual processes, those

involved in the motor processes and those involved in psycho-emotional processes, all of these

being voluntary processes conducted into the cortical structure, but carried out in different areas

according to Brodmann and Voght cyto-architectonics (creative processes being related to the 10th

area of the frontal lobes correlated with the areas 39 and 40 of the temporal lobes).

Depending on the location of the stroke (CVA), aspect detected by monitoring the troubles specific

to each area (centers of speech, hearing, motility, etc.), we shall detect the injured area of the

cortical brain. The recovery of the affected functions through new neural connections by

kinesiologic and physiotherapeutic means, enjoys many benefits by the use above correlations.

According to the multi-millennial experience of Chinese Medical School, 90% of psychosomatic

and vegetative disorders are initiated and supported by both the malnourishing and undernourishingof the entire nervous system, whether we speak of the central nervous system (CNS) or peripheral

nervous system (PNS).

Malnourishing is produced by the presence into the food consumption of the person of unfit

nutrients, with harmful effects on the body and by the disruption of fundamental metabolic

processes at the cellular level and of digestive processes at the organ level (at the cellular level by

the presence of free hazardous radicals, of toxic substances or of replacing artificial substances

made by chemical synthesis which, although they have the same molecular formula with theoriginal one necessary to the organism, are not recognized by the organism due to variations in the

electronic structure of the chain position; by their exaggerated presence into the body and by their

long time retention lacking the right on time elimination of them ammonia, acetone, acrolein, bad

cholesterol increasing substances, alcohol, tobacco, different medical drugs, drugs of risk, etc.).

This process of malnourishing has also a more complex component, that of processing into the

body, by aerobic or anaerobic way, of certain toxic products (such as chlorine vapors taken from the

steam of the shower water, methyl-parabens parabens from cosmetics which proved to be the cause


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of many breast cancers, fluoridation of the drinking water, pesticides present into the food of

vegetable origin, the antibiotics and the synthetic hormones present into meat, the synthetic

hormones from the birth control pills, more than 600 psycho and neurotropic substances present in

the breathing air and the list can go on).

Poor nutrition takes into consideration both the insufficient presence of essential nutrients into

daily nutrition and also their unproper dosage (proteins, carbohydrates, lipids, minerals, vitamins,

enzymes, water, oxygen) depending on the biological period in which the human individual is

(childhood, adolescence, adulthood, old age) and on the type of specific realised activity

(intellectual, physical one, etc.). One of the fundamental aspects regarding the poor nutrition is

represented by the systematically omitted calculation of the individual minimal amount of food

intake providing the minimum energy for maintaining the vital functions - about 10% of all energy

produced by the ingested nutrients are consumed for digestion; this process can go up to 40% if we

are talking about the digestion of complex food as pork.

One of the main causes that has to be considered as source of the initialization and progression of

the degeneration process of the human body (which is essentially a cell degeneration) is the self-

digestion (auto-digestion) process that is triggered into the body simultaneuosly by malnutrition and

poor nutrition. The process itself is the way through which human biological organism understands

to conserve its vital functions indefinitely until the complete depletion of all the categories ofsubstances essential for its proper functioning (muscle and liver glycogen, lipid reserve areas,

aspects continued by the take-over of skeletal muscle proteins, calcium and magnesium from bones,

etc.).

The issues listed above play a fundamental role not only in the metabolic and structural health of

the human body, but especially in psycho-emotional health of the individual. All matters listed

above are vectors that influence all the parameters of individual existence, thinking and working

capacities. Now it is the right moment to notice the significant importance of the neuro-somatic andneuro-vegetative approach in treating many problems of individual mental and physical health.

As a framework we can start our investigation from the work of Adrian Restian Diagnosticul

medical/Medical Diagnosis, Editura Dacia, Cluj, 1988. It is necessary to realise a comprehensive

and extensive anamnesis of the pacient regarding the entire framework of his existence.Since the

nervous system disorders are often produced by complex psychosomatic causes of psychological

and social etiology, it is necessary to investigate the psychological history of the individual, to

determine the possible interactions between the patient and his family, his work environment, his


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lifestyle, his dominant psychological type, the history of health disorders present both on the

hereditary bloodline and on the acquired line throughout his life.

From this point of view there is a correlation between the categories of troubles, classes of patients

and the possible combinations between them. But the keynote is determined by the definition of

personality and by the type of disorder suffered by the patient (psycho-somatic or somatopsychic

disorder).

It is the moment to introduce into the therapeutical approach three important notions. The notions of

psychosomatic knowledge and education based on the studies and researches of psychosomatic

medicine which gathers into an integrative vision all the informations come from inter and

transdisciplinary research focused on the human being inner and outer dynamics.

Thus we can efficiently approach many types of mental disorders, particularly depression which

are linked to thinking and false beliefs3. From my therapeutical experience, the misinterpretation

of natural manifestations of the body can generate an entire set of psychological anomalies.

Combining the notions of cognitive therapy4 with the psychosomatic teaching applied in the

physical training, the medical intervention gains important and active properties. In the same

direction, behavioral therapy has to implement the somato-physical obtained results into a changed

perspective assimilated and integrated into his ordinary life.

Other items of interest are represented by the principal components of alternative medicine such as

acupuncture, chiropractic approach, herbal medicine, homeopathy, Ayurvedic medicine,

reflexology, metamorphic technique, vertebral therapy.

From this point of view, it is obvious that the importance accorded to preventive medicine and the

focus on the initial hygiene and prophylaxis of the individual lifestyle has to logically and naturally

become a priority.

In this paper I am a supporter of the view that the correlation between the therapeutic approaches is

a must. It is an option for the bio-psycho-social triple paradigm [...] that does not exclude any of

the major ways of understanding the brain pathology and of establishing treatments which

simultaneously attack diseases that actually are neither purely mental and either phenomena

generated by the individual isolated from his peers. By introducing the practical approach of

restoring the normal psycho-neuro-vegetative and psycho-neuro-somatic connections, we try also to

3Valeriu Rusu,Dicionar medical/Medical dictionary, Ediia a-IV-a revizuit i adugit, Editura medical,Bucureti, 2010, p.1121.4Ibidem, p.1121.


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deepen into our research the psycho-genetic, organo-genetic or socio-genetic involvements. We

can thus pursue both the realization of a primary prevention, of a cure and of a secondary

prevention, that ofrelapse prevention.5

On the other hand, we are interested in creating a parallel between the management of cerebral

vascular accidents (CVAs) in which the neurons have been destroyed an occasion that seeks to

restore other cortical nerve connections through the maneuvers performed by the therapist; they

represent from the functional point of view, an outside neuron or neural package which induces into

the patients body, through a reverse, mechanical way, the possibility of creating new cortical

connectionsand the management of neuro-psychiatric disordersin which although the neurons

and the nervous connections are not generally destroyed, the resetting of the first and the

strengthening of the latter is necessary.

This aspect has also correlative implications into the bio-psycho-social recovery and/or

rehabilitation targeted by the specific psychological and psychiatric treatment. In this context, we

have to underline the essential role played by the natures energy, by the natural and unpolluted

environment which aims to reconnect the interrupted link between nature and the individual who

lives into an artifially built society. Another fundamental aspect is the mental presence of the

doctor/therapist whose brain releases an important psychic influence over the patient by

empathizing with his suffering, teaching the patient to empathize himself with the suffering ofothers, process capable of dynamizing regenerative mental energies significant both for the patient

and for the community of patients with which he interacts.

The physical movement and the diversity of certain activities having complex psycho-neuro-

emotional implications are also parts of a comprehensive approach scheme.

Restoring the nervous neuro-vegetative and neuro-somatic balance aims exercise a positive

influence on the reverse, targeting cortical disorders, to the disintegration of their pathological

components. It is noteworthy the fact that all types of stress borne by the patient until the apparition

of the nervous troubles concern the correlation between the psychic manifestation, of recording the

stress factors in pre and unconscious structures which, by their persistence, transfer the stress from

5Personal translation from the Romanian version of Jacques Postel, Larousse Dicionar de psihiatrie i depsihopatologie clinic, Editura Univers enciclopedic, Bucureti, 1998, p.5: Este o opiune pentru tripla paradigmbio-psiho-social [...] care nu exclude nici una din cile majore de nelegere a patologiei cerebrale i de instituire a unortratamente care s atace simultan maladii care de fapt niciodat nu sunt pur mentale i nici fenomene generate deindividul izolat de semenii si. Prin introducerea abordrii practice a refacerii conexiunilor psiho-neuro-vegetative i

psiho-neuro-somatice, ncercm s aprofundm aspectele psiho-genetice, organo-genetice sau socio-genetice.Urmrim att realizarea unei profilaxii primare, a unui tratament curativ, ct i a unei profilaxii secundare, deprevenire a recidivelor.


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the social and psychological level to the neuro-vegetative and neuro-somatic one, becoming thus

even the biological and biochemical cause of illness. The stress interposes himself gradually into

the cortex activity affecting first the voluntary control and than, gradually, the automated

infrastructure of neuro-vegetative and biochemical control mechanisms (e.g. diabetes on nervous

background favored a hereditary etiology, the function disorder of the endocrine pancreas being thefinal manifestation).

Hence it results the importance of understanding the correlation between the physical activity, the

endocrine, immune and the psycho-emotional condition of the patient (see the researches of psycho-

neuro-endocrinology and Jean Du Chazaud, Ces glandes qui nous gouvernent, ou, Limmense

influence des glandes sur le comportement/These glands that govern us or, The enormous influence

of glands on behavior, Equilibres daujourdhui,1990).

In this research we chose to address CNS disorders from the perspective of the integration concept,

a concept introduced by C.S. Sherrington (1906) which first issued the hypothesis that motility

exercices a function into the sensory integration. Motility could be considered an intersensory

mediator because of the similarity of exploratory activities conducted by different perceptual

systems6.

The concept of integration is that which characterizes the psycho-physiological life of the normal

individual both psychically and in neurological, autonomic, musculoskeletal terms. By contrast, we

have the concept oftrouble (disorder) that is either the disturbance or abnormality of a function or

a morbid physical or mental condition or it corresponds to the notion of entropy as a

manifestation of a system disorder, in our case the system being called person with all the

psychological, physiological and physical components. In this context, the notion of entropy reflects

the gradual decline and dissolution of the human living body.

In his turn, the concept of integration is a part of that of anti-entropy referring to the fact that the

living organisms are anti-entropic systems opposing the leveling and disrupting tendency of the

physical environment, trend expressed by the increasing of entropy.7

The complex and judicious approach of the CNS disorders is a necessity for the biological and

psychosocial survival of the human individual.

6care a emis cel dinti ipoteza c motricitatea exercit o funcie n integrarea senzorial. Motricitatea ar putea ficonsiderat un mediator intersenzorial din cauza similitudinii activitilor exploratoare realizate de ctre diferitelesisteme perceptive, Jacques Postel,LarousseDicionar de psihiatrie i de psihopatologie clinic, Editura Univers

enciclopedic, Bucureti, 1998, p.284.7Valeriu Rusu,Dicionar medical, Ediia a-IV-a revizuit i adugit, Editura medical, Bucureti, 2010,p.480.
http://www.amazon.com/s/ref=ntt_athr_dp_sr_1?_encoding=UTF8&sort=relevancerank&search-alias=books&ie=UTF8&field-author=Jean%20Du%20Chazaudhttp://www.amazon.com/s/ref=ntt_athr_dp_sr_1?_encoding=UTF8&sort=relevancerank&search-alias=books&ie=UTF8&field-author=Jean%20Du%20Chazaud


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From a therapeutic standpoint, in terms of building a particularised approach, we are just quoting

the main categories of CNS deficiencies that can cause changes in the functioning of the body

which, at his turn, adversely affects the psychological balance of the individual, one of the elements

being represented by the causal relationship established between marrow Vegetative Nervous

System/VNSmarrowcerebral Cortex: (1) organogenetic troubles, (2) endogenetic troubles, (3)psycho-genetic troubles and (4) socio-genetic troubles (Aurel Romila)8. In this context, the

therapist must consider the concept of sociogenetic disorder representing a key notion in the

initialization and development of the psycho-neuro-vegetative and psycho-neuro-somatic disorders

e.g. the effects of social conflicts of the historical period in which the patient lives, conflicts that

are come from its surrounding environment (unemployment, divorce, disorganized family,

immorality, conflicts in family and society) and tend to invade the individual psyche. There are a

number of manifestations such as anxiety and somatoform disorders, dissociative disorders,factitious disorders, sexual dysfunctions, paraphilias, gender identity disorders, eating and sleeping

disorders, the impulse-control troubles (including the sexual one), adaptation and personality

disorders9.

It is essential to remember that therapeutic success in these situations is strictly related to the

empathy that is established between the therapist and the patient, empathy that is designed to

determine a decoupling of the peripheral nervous system from the upper and central part

(voluntary semi-automated structures), procedure aimed to stop the negative influence of thepersons thoughts (manifested in the cortex), emotional feelings (manifested in the limbic system)

on the sensory and motor control centers from the brainstem and to orient his/her thought flow

toward self-regulating and balancing activities. All the regulating process is carried out with internal

resources and with the active participation of the patient but is guided from outside by the therapist.

By the way of massage, of stimulating reflexology, by improving blood flow to internal organs and

bone marrow, we will get a resetting ofthe automatic controls by a simultaneous and interactive

regulating of the endocrine system, autonomic nervous system and lymphatic system. Starting from

the clinical and practical observation that ultimately all forms of psychic aggression and self-

harming have as result the imbalance of the autonomic nervous system imbalance which also

provoques poor vascular nutrition followed by a decrease of the vital signs power, we draw the

conclusion that the restoring of the blood flow pressure (on arterial, capillary, metacapillary levels)

is a necessity and a priority. When the fundamental functions such as cellular respiration, cellular

8For an extensive approach see Aurel Romila,Psihiatrie/Psychiatry, Ediia a-2-a revizuit, Asociaia Psihiatrilor Liberidin Romnia, ISBN 973-0-03617-9, pp.256-376.9ibidem, p.376.


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nutrition, both as anabolic and catabolic parts, are significantly improved, the human body tends to

recover from stress. Starting from this moment we can talk about a solid foundation for gaining a

positive psychiatric, psychological and neurological involution of the pathological trouble.

Individuals ability to manage his existential problems can be improved only by means of a

psychosomatic self-knowledge in which the therapist plays a major role.

In conclusion, the complex causal chains involved in the activity of the central nervous system and

in its troubles require the presence of a pluri-disciplinary team able to offer a trans-disciplinary

approach to the patient taking into consideration what he really is a complex coherent living of

system.

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