Psychosomatic disorders: influence of white noise on disease in patients with cervicalgia (Message 1)

Introduction. Psychosomatic disorders (PSR) develop as a result of somatization of psychogenic factors. In osteopathy, PSRs are reflected in the so-called psychoviscerosomatic disorder which is a variant of a global neurodynamic functional disorder characterized by poly-regional disorders of tissue mobility that are associated with psychoemotional overloads. In most cases of PSR, neurotization of patients is obligate due to the involvement of a number of nervous structures in the pathological process and the subsequent general decrease in the body's adaptive reserves. According to the polyvagal theory of S. Porges (1995), the vagus nerve is divided into two functionally different branches: nucl. dorsalis n. vagi and n. ambigius. Third core nucl. tractussolitarii is the endpoint of many afferent pathways through n. vagus from peripheral organs, which forms the central regulator of the vagal system. In the process of phylogenesis, the vagus nerve system became more complex due to the inclusion of the pathways of the trigeminal, facial, accessory and glossopharyngeal nerves. S. Porges distinguishes the autonomic vagus nerve associated with passive regulation of visceral functions and the social or intellectual vagus, which is responsible for the processes of attention, movement and communication. The auditory sensory system provides encoding and evaluation of acoustic stimuli that determine the ability to adapt. We suggested that by affecting the auditory system, it is possible to affect the autonomic nervous system and reduce the severity of individual symptoms of PSR.

The goal of research — is to study the effect of white noise (WN) stimulation of the auditory sensory system on the manifestations of the disease in patients with cervicalgia (CA).

Materials and methods. In the period from 03.2020 to 07.2020 on the basis of the «Professor Novikov'sFamily Osteopathy Clinics», an analytical one-stage (cross-sectional) study was conducted, which involved 109 patients with an established clinical diagnosis of CA, who were divided into two groups: an experimental group (76 people) exposed to WN, and a control group (33 people), in which there was no such exposure. To irritate the auditory sensory system, a WN with a frequency of 1-22,05 kHz was used. Patients of the experimental group were divided into 3 groups depending on the level of neuroticism: low (13 people), medium (49 people), high (14 people). The examination included an assessment of the level of neuroticism, biomechanical indicators that characterize the volume of movements in the cervical region, and the level of pain. The L. I. Wasserman questionnaire was used to assess the level of personal neuroticism. The volume of movements in the cervical spine in degrees was determined using an original device for determining the mobility of the cervical spine. Subjective assessment of pain was performed using the VAS scale. To obtain a quantitative assessment of the achieved result, a «B-A-analysis» method is proposed, based on the evaluation of the modules of 6-timer (by the number of analyzed indicators) vectors A (after the study) and B (before the study) and pairwise analysis of the corresponding components of these vectors.

Results. Patients of the main group in subgroups with high, medium and low levels of neuroticism irritation auditory system has led to increased range of motion in the cervical spine that best identified patients with low levels of neuroticism, and minimally high. No significant changes were registered in the control group. There was no convincing difference in the dynamics of VAS indicators.

Conclusion. The study showed the possibility of influencing biomechanical parameters when the auditory sensory system is irritated by WN in patients with CA, and the result differed depending on the level of neuroticism — high, medium, low. The subjective assessment of the pain syndrome in VAS case is significantly influenced by the emotional component. Thus, if the nervous system is exposed, the biomechanical parameters changes take place, and it indirectly confirms the integrity and interdependence of the neurodynamic and biomechanical components of functional disorders. The results suggest further study of the possibilities of using WN in patients with various somatic dysfunctions accompanying PSR.

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