December 2002


The Crossroads Institute Newsletter

Crossroads Institute is moving!!!!! We are moving our facility from Cave Creek Arizona to a more central location in the heart of North Phoenix. For those who live locally, as of December 15th, The Crossroads Clinic can be found in the John C. Lincoln Medical Building, Suite 207 at 18404 N. Tatum. This is just off the Hwy. 101 and Tatum Exit. We are excited about our expansion and hope our new location is more convenient for our valley wide clients. For our out of town clients we are now closer to the Sky Harbor Airport and much more direct.

Dr. Martha Grout, M.D. returned from China last month and I hope you will enjoy reading a little about her facinating trip there and the additional knowlege she has brought to Crossroads Clinic.

Dr. Curtis Cripe is currently in Russia at the invitation of Dr. Juri D. Kropotov, Director of the Russian Academy of NeuroScience in St. Petersburg. Dr. Cripe is gathering the latest equipment and advancements on evoked potentials as they relate to neurodevelopment.

We will highlight his trip in the next issue of The Crossroads Institute Newletter.

-The Crossroads Staff-

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NEWS BRIEFS



Newsweek Cover: 'The Science of Alternative Medicine'-Complementary and Alternative Therapies Now Being Evaluated In Controlled Scientific Studies as Nearly Half of U.S. Adults Go Outside the Traditional Health System

NEW YORK, Nov 24, 2002 -- Although nearly half of U.S. adults are going outside the health system for at least some of their care and spending about $30 billion a year for the privilege, few complementary and alternative therapies have been evaluated in controlled scientific studies-until now. At research hospitals around the country, physicians are studying herbs and biofeedback as rigorously as they would a new antibiotic, Newsweek reports in the Dec. 2 cover story (on newsstands Monday, Nov. 25).

Complementary and alternative medicine, or CAM, is not a single, unified tradition. The term covers practices ranging from the credible (acupuncture, chiropractic) to the laughable (coffee enemas), writes Senior Editor Geoffrey Cowley. Because few of these therapies have been thoroughly evaluated in controlled studies, their effectiveness is still widely debated. But now no one disputes their significance. After dismissing CAM therapies as quackery for the better part of a century, the medical establishment now finds itself racing to evaluate them. The short-term goal is to identify the most effective and safe alternative therapies and make them part of routine clinical practice. But the larger mission is to spawn a new kind of integrative medicine, one that employs the rigor of modern science without being constrained by it.

Studies are now underway to determine whether acupuncture can ease arthritis pain, whether vitamin E and selenium help prevent prostate cancer and whether ginkgo biloba can preserve mental function in the elderly. And while these huge clinical trials plod along, researchers are also using state- of-the-art laboratory techniques to glimpse the physiological effects of different CAM remedies. By placing CAM under the microscope, scientists will no doubt gain a better sense of which therapies work, how they work, whether they're safe and who is most likely to benefit, writes Cowley.

Newsweek's cover story also looks at the effectiveness of Chinese medicine. Modern science is starting to verify that some of the age-old remedies really work and the evidence is promising enough that Western researchers have begun looking to China for potential new therapies, writes Reporter Anne Underwood. CAM therapies are also playing a bigger role in pediatric medicine. Senior Writer David Noonan reports that there now is a small but growing cadre of researchers who are subjecting pediatric CAM therapies to the rigors of traditional, randomized, controlled clinical trials to find out what will work best for kids. And in the psychiatric field, Americans are avidly pursuing alternative treatments since the effectiveness of traditional drugs vary widely from person to person and often come with an array of side effects. While the research on these therapies is still preliminary, the science is beginning to improve, reports General Editor Claudia Kalb.

HMO Lawsuit Could Jolt Health Care

The question of who makes your medical decisions - a doctor or an insurance company - lies at the heart of a landmark case before the federal appeals court in Atlanta.

The high-stakes legal feud pits hundreds of thousands of doctors against the nation's largest HMOs, with millions of Americans in the middle.

In a decision expected any day, the 11th U.S. Circuit Court of Appeals will decide whether to hear an appeal seeking to throw out a class action lawsuit against the HMOs brought by more than 600,000 doctors nationwide. If the court declines to take the case, the managed care companies must stand trial next spring against a case involving billions of claims, billions of dollars and millions of patients.

Legal experts say if the class action case is allowed to proceed, it may force the HMOs to settle the dispute and change the way health care is delivered nationwide. The HMOs say if they are forced to pay out hundreds of millions of dollars in settlements, it would further increase the escalating cost of health care.

In their lawsuit, the doctors allege the HMOs have engaged in a racketeering conspiracy by illegally delaying and denying reimbursement of health care costs. They also accuse the HMOs - including some with the largest enrollments in the country - of fraudulently rejecting expensive but necessary medical treatments.

``One of our goals is to allow medical necessity decisions to be made by doctors, rather than computers and claims adjusters,'' said Atlanta lawyer Ken Canfield, who represents the Medical Association of Georgia and four Georgia doctors who are among the lead plaintiffs in the HMO litigation.

Canfield said the doctors want a court-ordered injunction that halts the claims processing practices used by the HMOs. While the suit asks for unspecified monetary damages, it also seeks ``to change the health care delivery system to make it fairer, more rational and more responsive to the needs of patients,'' he said.

The HMOs counter that there are mechanisms in place that allow doctors to resolve their payment disputes, and they contend it is the doctors who have improperly jacked up the claims they charge for office visits and medical treatments.

The case has the potential of forcing the HMOs to abandon ``cost-containment principles that have kept health insurance affordable for many Americans over the past two decades,'' said the organizations' appeal, recently filed with the 11th Circuit. It adds that the class action case ``threatens to precipitate a major upheaval in the nation's health care system.''

Emory University law professor David Bederman said the stakes for both sides are enormous and are likely to turn on the class certification issue before the Atlanta appeals court.

``Your settlement power as a plaintiff increases greatly once you're a class,'' Bederman said. ``That's why the HMOs are fighting tooth and nail on this. Once the defendants have to fight a large, unified class, they know their liability exposure skyrockets.''

Three years ago, Georgia's physicians were among the first to sue HMOs for violating prompt pay laws. Since then, Georgia's doctors have joined medical associations in California, Florida, Louisiana and Texas in a national class action case overseen by a federal judge in Miami.

``We're hearing in deafening unison complaints that the HMOs manipulate their computer software, they lie about ever receiving legitimate claims and that they hold claims for excessive periods of time to make money on the float,'' said Archie Lamb of Birmingham, the lead attorney for the doctors. ``And that's just the tip of the iceberg.''

Paperwork vs, patients

David Cook, executive director of the Medical Association of Georgia, said doctors spend so much time disputing HMO claims that they don't have enough time to spend with their patients. These disputes involve the HMOs' denial of payments for medical procedures doctors believe to be necessary as well as the denial or downgrading of reimbursements after claims are filed, Cook said.

``We need to make things as simple and efficient as possible so that physicians who are trained to practice medicine can deliver patient care,'' he added.

The epic lawsuit, pitting one segment of the U.S. economy against another, encompasses billions of claims submitted by more than 600,000 doctors since 1990. The processing of these claims has generated paperwork and electronic data that is ``many times the volume of the entire Library of Congress,'' the HMOs' court motion said.

Defendants in the case include Aetna, Anthem, CIGNA, Coventry Health Care, Health Net, Humana, PacifiCare Health Systems, Prudential Insurance, United Health Group and WellPoint Health Networks Inc.

Judge affirms complaint

The HMOs are asking the 11th Circuit to reverse a ruling issued in September by U.S. District Judge Federico Moreno of Miami, who certified the class action case on behalf of the doctors.

In his decision, Moreno said the plaintiff doctors ``have done more than just allege a common scheme, they have demonstrated facts which support its existence.''

The judge noted that the HMOs meet together in trade groups and other industry organizations ``specifically to discuss and develop common plans regarding the processing of provider claims.''

Moreno also found that the HMOs uniformly require physicians to use the same type of forms in submitting claims and that the HMOs use the same type of computer software in processing them. All this gives the HMOs the ability to manipulate billing codes and ``delay and wrongfully deny payments,'' Moreno found.

In their appeal, the HMOs strongly criticized Moreno's findings, particularly his observation that all HMOs require doctors to use a common form when submitting their claims. The health care organizations noted that the U.S. government and some states require the forms to be used.

``Justifying class litigation on the strength of these observations is akin to commissioning a worldwide class product defect trial against all automobile manufacturers on the grounds that they all power their vehicles with a volatile, flammable substance,'' the HMOs told the 11th Circuit.

Jeffrey Klein, one of the lead defense lawyers in the case, said the HMOs are hopeful the 11th Circuit will agree that such a large-scale case is unmanageable.

``This involves virtually unlimited numbers of doctors with different claims involving different health plans and different types of employer benefit plans providing different types of coverage over a 12-year period,'' he said.

Victor Schwartz, general counsel of the American Tort Reform Association, said that if the class action case is allowed to proceed, pretrial discovery - the legal fact-finding process where defendants must disclose documents to plaintiffs - could prove ``so massive and costly that defendants may settle cases they could win on the merits.''

One of the HMO defendants in the litigation, CIGNA, has already begun settlement negotiations.

Court `anti-class action'

Atlanta lawyer Michael Terry tried unsuccessfully this year to get the 11th Circuit to approve class action status in a race discrimination case against the Southern Co. He said the 11th Circuit may be responsive to the HMOs' appeal and decide the class action issue.

``The 11th Circuit is known as one of the most anti-class action circuit courts in the country,'' Terry said. ``It's now a conservative Southern court. Its judges vote against class certification the majority of the time.''

In the meantime, Moreno, a Miami judge appointed by former President Bush, signed an order Wednesday denying a request by the HMOs to halt pretrial discovery while the 11th Circuit considers whether to hear the appeal.

``This court is confident it correctly certified the class,'' Moreno wrote.

Food Additives Ban Improves Pupils' Behavior

A SCHOOL that banned food additives from children's meals has seen a remarkable improvement in pupils' behaviour and concentration.

St Barnabas First and Middle School, in Drakes Broughton, Worcestershire, has removed 27 artificial colourings and preservatives from its menu after concerns that they were making some children hyperactive.

The school's canteen still serves a traditional menu but the ingredients of every meal have been checked to ensure that none of the blacklisted "E" numbers are present.

Yesterday, pupils had a choice of spaghetti bolognese or pizza with chips or salad, followed by fruit or a doughnut.

"You wouldn't notice any difference from just looking at the menu," said Ann Fitzgerald, the teacher behind the scheme. "There are a lot of hidden additives out there. We've just read the labels and switched brands to avoid the `E' numbers. For instance, we have checked that the jam in the doughnut doesn't contain bright red colouring."

Staff had been amazed at how many foods contained the 27 additives, Mrs Fitzgerald said. Gravy, sauces, ham and bacon were found to contain undesirable colourings and preservatives, so the school has now switched brands. Even the canteen's clear flavoured waters were found to contain sodium benzoate - E211 - a preservative that has been linked to hyperactivity and bad behaviour.

The only obvious difference in the canteen is that it now only serves white custard, having banned the colouring used to make it appear yellow.

Emma Drinkwater, who manages the canteen, said that most of the children had not noticed any change in the food. "They are not the sort of changes that would taste any different," she said. "What has surprised us all is just how many foods contain these additives. It's definitely changed the way I shop for myself - I now spend hours reading all the labels."

Charlie Lupton, the school's headteacher, said: "We are so convinced of the negative effects of food additives that we are very keen for other parents to be aware of our findings."

The school first adopted the additive ban during a two-week trial this summer. The pilot was so successful that one in three parents said their children were better behaved during the trial, while 18 per cent reported that their children were sleeping better.

The teachers also noticed that children who usually found it difficult to concentrate were much calmer and more able to get on with their work.

During the trial, the parents of 100 of the school's 355 pupils also introduced the additive ban to their homes. Mrs Fitzgerald said: "You can look around any school and find at least one child in every class who is not concentrating as well as the teacher would like. These are the children who could benefit from an additive- free diet."

Last month, a study by the Food Commission, an independent watchdog, found that food additives could lead to hyperactivity and tantrums in a quarter of children exposed to them. It analysed the effects of five different additives on 277 three-year-olds from the Isle of Wight. The children were given a drink containing the artificial colourings tartrazine (E102), sunset yellow (E110), carmoisine (E122), ponceau 4R (E124), and the preservative sodium benzoate (E211).

The school recently banned junk food during breaks. "We want the school to be an additive-free zone ... so that children will not eat anything containing these additives from the moment they walk in the gates to the minute they go home," Mrs Fitzgerald said.


RESEARCH AND ADVANCEMENTS

Quantitative EEG Evidence of Increased Alpha Peak Frequency In Children with Precocious Reading Ability
Shannon M. Suldo, MA, Lynn A. Olson, PhD, James R. Evans, PhD

Background: EEG research with specific clinical populations (e.g., Alzheimer's and mentally disabled) has confirmed that reduced alpha peak frequency often is associated with impaired cognitive functioning. However, research with high-functioning populations does not exist, and increased peak frequency in alpha has only been hypothesized to relate to advanced brain maturation.

Methods: This study compared peak frequency in the alpha band (8.0 to 12.0 Hz) of children with precocious reading ability to that of control groups. The experimental group consisted of 15 early readers (ER). One comparison sample included 15 age-level matched (ALM) children, similar to the ER group in terms of cognitive functioning and age, but reading at grade level. A second comparison group, composed of 15 reading-level matched (RLM) children, had intelligence and reading level scores equivalent to the ER group, but was 2.5 years older. Using Lexicor NeuroSearch-24 equipment and v151 software, quantitative EEG (QEEG) data on each participant were obtained from 19 scalp electrode sites.

Results: As hypothesized, peak frequency in alpha differentiated the groups. Specifically, the ER group had significantly higher alpha peak frequency than the ALM group at 16 of the 19 electrode sites examined. The differences were consistent across all brain regions, as the mean alpha peak frequency at each site was between 9.0 and 9.3 Hz for members of the ER group and between 8.6 and 8.8 Hz for members of the ALM group. Peak frequency in alpha did not differ significantly between the ER and RLM sample.

Conclusions: Peak frequency in the alpha band is associated with precocious reading ability, and may be an indicator of advanced brain maturation.

Specificity of quantitative EEG analysis in adults with attention deficit hyperactivity disorder.
Bresnahan SM, Barry RJ.
Department of Psychology, Brain and Behaviour Research Institute, University of Wollongong, Australia

Attention deficit hyperactivity disorder (ADHD) in children and adolescents is characterised by excessive restlessness and an extremely poor concentration span, resulting in impulsive and disruptive behaviour. Clinical observation of ADHD in adults suggests that the early hyperactivity is diminished in terms of its impact on social and academic function, while impulsive-type behaviours remain unchanged.

EEG studies in children and adolescents with ADHD have reported significantly more low-frequency power (predominantly theta) and less high-frequency power (predominantly beta) than in normal subjects.

In normal children and adolescents, a decrease in theta power and an increase in beta power are found with increasing age, leading some researchers to interpret the EEG anomalies in ADHD as evidence of developmental delay.

Studies of adults with ADHD compared with normal adult control subjects have found a reduction in the difference between the two groups, suggesting that the reduced beta activity apparent in ADHD children and adolescents changes with age. Adults with ADHD thus appear to have elevated low-frequency power as their predominant EEG difference from normal control subjects.

The present study examined whether this EEG profile was specific to adult ADHD patients. Quantitative EEGs were recorded at rest in an eyes-open condition and used to compare 50 adult patients diagnosed with ADHD with 50 non-ADHD subjects (who presented for ADHD assessment but failed to meet the diagnostic criteria) and 50 control subjects.

The ADHD group differed from both the non-ADHD and the control groups on the basis of elevated theta activity. The ADHD and control groups did not differ in beta activity, but relative theta was reduced and relative beta power was elevated in the non-ADHD group compared with both the ADHD and control groups.

These results suggest that quantitative EEG may be used to differentiate ADHD adults from both normal adults and adults who display some of the symptoms of ADHD.

The effects of neonatal lesions in the amygdala or ventral hippocampus on social behaviour later in life.

Daenen EW, Wolterink G, Gerrits MA, Van Ree JM.
Department of Pharmacology and Anatomy, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands

Disruption of normal social behaviour is seen in psychiatric neurodevelopmental disorders like schizophrenia or autism. In a rat model of neurodevelopmental disorders we investigated the social behavioural changes after damage of limbic brain areas, at two early stages of life.

The effects of ibotenic acid lesions made on day 7 or 21 of life in the amygdala (AM) ((baso)lateral/medical) or ventral hippocampal area on social play behaviour, social behaviour unrelated to social play behaviour early in life, and social behaviour in adulthood were assessed.

Lesions of the AM, but not lesions of the ventral hippocampal area, resulted in decreased social play behaviour, and no differences were found between lesions made on day 7 or 21 of life.

Social behaviour unrelated to social play behaviour early in life and in adulthood was decreased in animals lesioned in the AM on day 7 but not in animals lesioned on day 21 of life.

This effect was particularly present in animals with an additional lesion in the medial nuclei of the AM. Lesions in the ventral hippocampal area did not affect social behaviour. It is concluded that the AM is an important structure for social play behaviour.

The effects on social behaviour that are dependent on the day of lesioning (day 7 vs. 21) are an indication of a neurodevelopmental deficit of structures connected to the (medial part) of the AM.

NEURO-PROCESSING

Effects of neonatal dietary manganese exposure on brain dopamine levels and neurocognitive functions.

Tran TT, Chowanadisai W, Lonnerdal B, Le L, Parker M, Chicz-Demet A, Crinella FM.
Department of Nutrition, University of California, Davis, USA.

Neonatal exposure to high levels of manganese (Mn) has been indirectly implicated as a causal agent in attention deficit hyperactivity disorder (ADHD), since Mn toxicity and ADHD both involve dysfunction in brain dopamine (DA) systems.

This study was undertaken to examine this putative relationship in an animal model by determining if levels of neonatal dietary Mn exposure were related to brain DA levels and/or behavioral tests of executive function (EF) when the animals reached maturity.

We used 32 newborn male Sprague-Dawley rats and randomly assigned them to one of the four dietary Mn supplementation conditions: 0, 50, 250 and 500 microg per day, administered daily in water from postnatal days 1-21. During days 50-64, the animals were given a burrowing detour test and a passive avoidance test. At day 65, the animals were killed and brains were assayed for DA.

There was a statistically significant relationship (P = 0.003) between dietary Mn exposure and striatal DA. On the burrowing detour and passive avoidance, greater deficits were observed for animals subjected to higher Mn exposure, but these differences did not reach statistical significance.

However, tests for heterogeneity of variance between groups were statistically significant for all measures, with positive relationship between Mn exposure and degree of within-group behavioral variability.

Kendall's nonparametric test of the relationship between the three behavioral measures and striatal DA levels was also statistically significant (P = 0.02). These results lend support to the hypothesis that neonatal Mn exposure is related to brain DA levels and neurocognitive deficit in the rodent.

AUDITORY NEWS/UPDATES

Mismatched Negativity

Summary
The mismatch negativity (MMN) is a component of the auditory event related potential (ERP) which is elicited task-independently by an infrequent  change in a repetitive sound.

The MMN can be recorded in response to any discriminable change in the stimulus stream. The MMN data imply the existence of a sensory-memory trace in which the features of the frequently occurring standard stimuli are represented.

One can probe this trace by presenting deviant stimuli of different magnitudes and thus indirectly determine the accuracy of this central sound representation. Several recent studies have shown that these representations govern attentive auditory discrimination ability in humans.

Therefore the MMN is an objective, easilyquantifiable index of the quality of sensory stimulus representations from which auditory percepts are built. The most recent studies have provided evidence that even complex, temporal, linguistic stimulus features and long-term learning effects are reflected in MMN responses, thus significantly broadening the theoretical scope of the MMN research.

The MMN is consequently of great potential interest in attempts to understandcentral auditory function, its development, and various forms of its pathology.

MMN in clinical research.

The MMN has been documented in a number of studies to disclose neuropathological changes. Presently, the accumulated body of evidence suggests that while the MMN offers unique opportunities to basic research of the information processing of a healthy brain, it might be useful in tapping neurodegenerative changes as well. The clinical populations studied in CBRU include:

* Alzheimer's disease
* Parkinson's disease
* schizophrenia
* dyslexia
* aphasia
* alcoholism

MMN, which is elicited irrespective of attention, provides an objective means for evaluating possible auditory discrimination and sensory-memory anomalies in such clinical groups as dyslexics and patients with aphasia,who have a multitude of symptoms including attentional problems. Our recent results suggest that a major problem underlying the reading deficit in dyslexia might be an inability of the dyslexics' auditory cortex to adequately model complex sound patterns with fast temporal variation. According to the results of our ongoing study, MMN might also be used in the evaluation of auditory perception deficits in aphasia.

AD patients demonstrate decreased amplitude of MMN, especially with long inter-stimulus intervals; this is thought to reflect reduced span of auditory sensory memory. Parkinsonian patients do demonstrate a similar deficit pattern, whereas alcoholism would appear to enhance the MMN response. This latter, seemingly contradictory, finding could be explained by hyperexcitability of CNS neurones resulting from neuroadaptive changes taking place during a heavy drinking bout.

While the results obtained thus far seem encouraging, several steps need to be taken before the MMN can be used as a clinical tool in patient treatment. Recently, a project funded by EU, COBRAIN, has been assembledto tackle some of the key signal-analysis problems encountered in development of clinical use of MMN. Nevertheless, as it stands, clinical research employing the MMN has already produced significant knowledge on the CNS functional changes related to cognitive decline in the aforementioned clinical disorders.

Noise and auditory perception

Cognitive Brain Research Unit, Helsinki, Netherlands

(Principal investigator - Teija Kujala)   Speech, music, or other environmental sounds are normally heard in the presence of background noise. In the modern society, inconvenient or unpleasant noise is, in fact, a continuously increasing problem. In its most destructive form, long-term exposure to loud noise may cause high blood pressure, cognitive disturbances, or malfunctions of the immune system. A CBRU project supported by the Finnish Work Environment Fund for 1998-2000 (director Dr. Teija Kujala) aims at determining how the background noise, as well as long-term noise exposure, affects the central auditory system and the attentional mechanisms of the brain. The results suggest that background noise has both acute and chronic adverse effects on the neural processing underlying speech perception (e.g., Shtyrov et al., 1998, Kozou et al., in preparation, Kujala et al., in preparation).

SPEECH AND LANUGAGE

Language-specific speech representations in the brain.

Cognitive Brain Research Unit, Helsinki, Netherlands

(Principal investigator — Risto Näätänen) This work belongs to the most central of the basic research conducted in the (CBRU) Cognitive Brain Research Unit, Helsinki, Netherlands . In January 1997, we reported a study (Näätänen et al.,1997; see the figure) which showed a native-language specific enhancement of the Mismatched Negativity (MMN) amplitude for phonemes belonging to the subject´s native language while he/she was ignoring speech sounds. The result was based on a smaller MMN response of Finns than that of Estonians to a stimulus that was a phoneme in the Estonian but not in the Finnish language (MMNs being of a very similar amplitude for those phonemes that were common to the two languages). Moreover, we also found, by using the MEG, that this native-language-related MMN enhancement originates from the left auditory cortex. It was concluded that this cortex might be the locus of language-specific memory traces, too, i.e., of the phoneme recognition patterns (templates) enabling one correctly to recognize the speech stimuli belonging to one´s own language.

On the basis of the data pattern obtained, we further concluded that while the processing of the acoustic stimulus features occurs in both hemispheres, that for the phonetic features occurs only in the left hemisphere. (This does not depend on stimulus complexity: a non-phoneme which is acoustically equally complex as a phoneme does not elicit a left-hemispherically preponderant MMN but one with an equal contribution from both hemispheres; Näätänen et al., 1997). The existence of the system of speech-specific traces in the left hemisphere might explain, for the most part, the left-hemisphere preponderance of the processing of speech sounds.

In a subsequent study, we (Winkler et al.,1999a) showed that native-language phoneme boundaries affect the MMN to vowel contrasts. MMNs were recorded in Finnish and Hungarian subjects to vowel contrasts. Each pair of synthesized vowels was perceived as two different vowels in one language, but fall within the boundaries of one vowel in the other language. In both subject groups, it was found that a larger MMN was elicited by the change that crossed the vowel boundary in their native language than the one that did not cross the vowel boundary. One may conclude that the MMN can serve as a probe for native-language-specific speech sounds.

Next we will try to locate MMNm (the magnetic equivalent of the electric MMN) generators of the left auditory cortex separately for the different vowels in order to reconstruct a vowel-representation map for individual subjects. Our hypothesis is that with an increased distance between the neural traces of any two phonemes in this map, there is a larger-amplitude MMNm and the perceptual discriminability of the two phonemes is better.

Another set of interesting questions involves the formation of traces for a second language. Can the system of these later-developed traces be detected with our measures? In this study, we will compare the MMN responses of an individual in ignore conditions before and after an intensive study period of the foreign language in question. In another related study, we (Winkler et al.,1999b) found that Hungarians who did not know Finnish had a very small and late MMN when stimuli were Finnish vowels. This MMN, however, was much larger and earlier in Hungarians who had learned Finnish in their adulthood, yet later and smaller than that in native Finnish speakers. These results clearly demonstrate that MMN can be used for the testing of the memory-trace development necessary for the correct perception of the phonemes of the language studied.

The above-mentioned second-language studies will not only use phonemes but also words and, if possible, even short sentences. We expect that MMN might provide an objective index of when in the course of training or exposure, two different sounds which are initially easily confused with each other become discriminable. Previously we (Näätänen et al.,1993) have shown the emergence of such a training effect by using two almost identical spectrotemporal sound patterns: one as a standard, the other as a deviant stimulus. Such a training effect can be recorded from the brain even after a month´s break in training, or in REM sleep (Atienza & Cantero, in press), implying that the memory traces for complex stimuli caused by intense training are permanent (Kraus et al.,1996).

In a further study (Rinne et al.,1999), we wished to determine whether MMN becomes left-hemisphere predominant at the same point at which an auditory stimulus starts to be perceived as a speech sound when new stimulus elements are gradually added to a simple tone until the stimulus sounds like a phoneme. It was found that the addition of the second formant, which was shown by behavioral studies to be essential for perceiving the stimulus as a speech sound, caused the automatically-elicited MMN response suddenly to become left-hemisphere preponderant, whereas MMN to simple stimuli was larger over the right hemisphere.

Disorders of speech-sound processing.

Cognitive Brain Research Unit, Helsinki, Netherlands

(Principal investigator — Teija Kujala)

One group of persons with pronounced learning disabilities are dyslexic individuals. It has been suggested, but this far not conclusively shown, that in dyslexia the underlying deficit primarily relates to malfunctions in the phonological system and, further, that the phonological difficulties might be based on problems in the basic sensory analysis of auditory stimuli.

Mismatched Negativity (MMN), elicited irrespective of attention, is a promising tool for probing such deficits in dyslexia, as suggested by recent studies (e.g., Baldeweg et al.,1999; Kujala et al., 2000).

Our recent results (Kujala et al., 2001) in collaboration with Prof. K. Karma, the Sibelius Academy, Helsinki demonstrated that plastic changes in the brain caused by remediation of dyslexia can be detected with the MMN.

In this study, a computer-based training programme, developed by Prof. Karma, involving no phonetic stimuli was used. The results suggested improved reading abilities and an amplification of MMN to tone-order reversals in dyslexic children trained with this programme (Kujala et al., 2001). The fact that non-phonetic training had an effect on dyslexia speaks for a general deficit underlying the phonological deficit.

Another major group suffering from speech-processing disorders consists of patients with aphasia. Our studies (Ilvonen et al., in press) aim at finding ways to evaluate the deficits in the central auditory processing preventing correct speech perception in these patients.

Moreover, we currently investigate (in collaboration with Prof. M. Kaste, Department of Neurology, HUCH) whether the MMN can be used in follow-up of plastic neural changes after left temporal-lobe stroke (Ilvonen et al., in preparation). In this study, we measure MMN from stroke patients 3-5 days, 10 days, and 3 and 6 months after stroke onset.

VISION/VISUALIZATION

Cross-modal brain plasticity.

Cognitive Brain Research Unit, Helsinki, Netherlands

(Principal investigator — Teija Kujala)

In a series of studies we have found that the visual cortex of the early-blinded humans processes auditory and somatosensory information (Kujala et al.,1992, 1995a, b, 1997a; for a review, see Kujala et al. Trends in Neurosciences, 2000).

This visual-cortex activation does not relate to the early stages of sensory analysis but to later, attentional stages. Our recent results obtained with fMRI indicate that both primary and associative visual areas of the early- blinded are activated by attending to an auditory stimulus stream (Kujala et al., in preparation).

Consistently with these brain- imaging studies, our behavioral results indicate that the blind are better than the sighted in detecting targets from two simultaneously attended stimulus streams (Kujala et al.,1997b).

We also found that cross-modal plasticity may take place even in the adult brain (Kujala et al.,1997a, see also Buechel et al.,1998).

This result, contrasting with the prevailing view of the brain losing its intermodal plasticity soon after the early developmental phase, stresses the need of rehabilitation methods exploiting the brain´s plasticity in adult patients suffering from peripheral or central damage of the nervous system.

TRADITIONAL CHINESE MEDICINE

Chinese Taoist Traditional Medical Ba Gua QiGong School
Martha M. Grout, MD, MD(H)
October 30, 2002

I went to China in early October to learn something about the ancient healing art of QiGong. I came back with an understanding of how the QiGong masters use the energies of the world which surrounds them. China is a land of extraordinary contrasts – fierce mountains and exquisite gardens, huge palaces and tiny hovels, beautiful clear air and unbelievably bad air pollution.

We stayed at a School of QiGong in Beijing. The school is also an orphanage. When children are abandoned in China, they are taken to the Shao Ling Temple. There they receive education in Daoism and the martial arts. Master Wan Su Jie picks out children whom he thinks have potential to become QiGong doctors. He brings them back to the school, where he educates and cares for them for over 10 years.

Children also come from very poor villages in the North of China, often with severe congenital deformities caused by residuals of chemical warfare in the 1940s.The children are schooled by teachers who come to the school in the winter. Their deformities are healed, using a combination of QiGong, acupuncture, massage, and love. The school is supported largely by the money which is brought in by groups of visitors, who come twice a year to learn about QiGong and to see the sights of China.

We stayed mostly in Beijing, although we did take two side trips to sites in China which are especially beautiful and have especially good energy (or Qi). The food was astounding – lots of fresh vegetables and fruits, fish every day, a little meat every day, soup with every meal.

The children were clearly well cared for and well loved, and extraordinarily well disciplined. They spoke a little tiny bit of English, and all of the older ones served both as our hosts and our teachers. The oldest students came with us on trips, along with some of those who are already QiGong doctors.

We had QiGong treatments every day, and I personally witnessed the rapid healing of my roommate. She had sprained her ankle very badly on day 4 of the trip, the kind of sprain which, under ordinary circumstances, would have required walking with crutches for at least 2 weeks before thinking about putting weight on it. With the daily treatments, she was walking perfectly normally by the time we arrived back in the U.S. 10 days later.

QiGong is used in two ways. The first way, and the most important, is to help the individual practitioner clear his own body of tension or congestion, so that the body is relaxed, the energy flows freely, the organs lose their congestion, and the practitioner becomes healthy.

The second way is to use that energy to assist in the healing of others. The students practiced QiGong daily for at least an hour, in addition to the time they spend on the martial arts. We were instructed in the beginning exercises of QiGong, which are good for the health of anyone who chooses to do them.

I brought back a DVD of the Master and some of his students teaching the exercises. I also brought back new ways of healing for my own practice of medicine. I am grateful for Master Wan Su Jie for sharing his knowledge, and for helping me to feel like an honored guest in his establishment.

Irritable Bowel Syndrome (IBS)

A wide range of other therapies has been used to treat irritable bowel syndrome (IBS). Treatment methods that help improve responses to stressful situations can be helpful.

No one treatment works best for everyone.

Psychological treatment

The following psychological treatment options may help relieve symptoms of irritable bowel syndrome (IBS) in some people. Psychological treatment methods are usually more effective if they are used along with other treatment methods, such as diet changes, stress reduction and sometimes medication.

* Therapy. Psychotherapy and behavioral therapy may be effective if you have pain caused by IBS. Some people who use these treatment methods may have long-term relief.
* Hypnosis. Hypnosis may be an effective way to treat IBS that does not respond to other treatment methods.6 Hypnosis can help some people relax, which may relieve abdominal pain. Hypnosis has been especially successful in people younger than age 50.
* Relaxation or meditation. Relaxation training and meditation involves concentrating on a word, image, or phrase for a given length of time to reach a state of deep relaxation. It may be helpful in reducing generalized muscle tension and abdominal pain. Used regularly, these techniques can be helpful in dealing with stressful situations. With practice, you can learn to relax easily in almost any setting.
* Biofeedback. Biofeedback training may help relieve pain from intestinal spasms. It also may help improve bowel movement control in people who have severe diarrhea.


Complementary treatment

Complementary or alternative treatments, such as Chinese herbal medicine (CHM), have been used in the treatment of IBS symptoms. CHM involves using certain plants and other natural substances.

One clinical trial showed that taking certain Chinese herbal formulations effectively reduced symptoms of IBS in some people who took them. The effects lasted for 14 weeks after treatment stopped.7 Talk with your doctor if you are thinking about trying CHM.

Some people use beneficial bacteria, known as probiotics, to try to improve IBS symptoms. A few studies have indicated some benefit, but they have not proven that probiotics prevent or reduce IBS symptoms.

Some people have been successful at handling stressful situations and controlling their symptoms after trying psychological therapies. These techniques are not harmful and have no side effects. Some of them can be used before a stressful event to prevent or reduce symptoms.

Like conventional medicines, people who have chronic health problems should not use any herbs or natural supplements without first consulting their doctor.

Kids' Acupuncture Gaining Interest

WASHINGTON (AP) - Four-year-old Eliza Brady held very still as Dr. Yuan-Chi Lin slowly stuck hair-thin needles into her legs. After six months of these acupuncture treatments, the painful intestinal inflammation that plagued Eliza for two years was finally better.

Coincidence or the ancient Chinese therapy? No one knows for sure, because inflammatory diseases can wax and wane.

But scientists are just starting to study acupuncture in young children - unusual in U.S. kids despite its popularity among adults. And some say if tots could put aside the fear of needles, it might prove as helpful for them as it does for certain adult conditions.

``It's not easy to do for kids. You really need to spend time and effort to explain it to the patient and the family,'' says Lin, a Harvard Medical School anesthesiologist who often needles the parents first, saying children are less afraid if mom doesn't flinch from what some describe as the mosquito-bite sensation.

Lin's pain clinic at Children's Hospital in Boston just finished a study of yearlong acupuncture in 243 children, one of the largest pediatric studies yet. The children reported less pain and missed school due to headaches, abdominal pain and other common conditions than before they tried acupuncture, he told a recent meeting of the American Society of Anesthesiology.

He's preparing another, more scientifically stringent, study - giving half the children real acupuncture and half a sham version.

Adult acupuncture has gained in popularity in recent decades, particularly after the National Institutes of Health in 1997 declared it can help relieve certain conditions, such as surgical pain and the nausea and vomiting that accompanies chemotherapy.

Oriental medicine practitioners say needles placed at certain points, along with other practices such as the use of herbs, can heal by correcting flows from the body's energy channels.

While many Western scientists are skeptical that acupuncture has as many bodywide effects as Oriental medicine practitioners believe, they have found evidence that it may affect body chemicals related both to pain sensitivity and other functions. Now the NIH is funding half a dozen studies to see if acupuncture significantly helps certain non-pain disorders, such as high blood pressure.

You can't assume what works in adults will work in children - it must be tested, cautions Dr. Brian Berman, the University of Maryland's director of complementary medicine.

Yet pediatric acupuncture research is in its infancy, says Richard Nahin of the NIH's National Center for Complementary and Alternative Medicine. There have been a handful of pilot studies, on conditions including attention deficit disorder and cerebral palsy, but Nahin says the strongest evidence so far backs acupuncture to relieve chemotherapy-induced nausea and vomiting. The NIH now is studying child cancer patients.

Parents' interest is rising, says Lin, who estimates a third of pediatric pain centers have begun offering child acupuncture.

``I had nothing to lose and everything to gain,'' says Eliza's mother, Susan Luchetti.

The Weston, Mass., mother balked when her daughter's gastroenterologist said Eliza's Crohn's disease-like intestinal inflammation was worsening despite mild medication and recommended stronger steroid treatment. Instead, Eliza tried acupuncture, which is common in Asia for certain gastrointestinal problems. After years of blood tests, the much smaller acupuncture needles didn't frighten her.

Remarkably, blood and stool tests showed inflammation receding as Eliza felt better. Nobody knows if it was just a routine remission and six months later, Eliza, now 5, still takes mild medication. But Luchetti would try acupuncture again if she worsens.

Where can parents find child acupuncture?

There are 15,000 licensed acupuncturists, non-physicians who learn acupuncture and Oriental medicine techniques at nationally accredited schools. Also, a small but growing number of mainstream physicians like Lin mix acupuncture with conventional treatments.

Few specialize in children, and state laws governing who is qualified to practice acupuncture in general vary widely. People can find information on acupuncturists at the National Certification Commission for Acupuncture and Oriental Medicine - http://www.nccaom.org - or the American Academy of Medical Acupuncture - http://www.medicalacupuncture.org.

Scientific Evidence in Support of Acupuncture and Meridian Theory

Professor Julia J. Tsuei M.D., F.A.C.O.G.

National Yang-Ming University School of Medicine
Graduate Institute of Traditional Medicine
Taipei, Taiwan, Republic of China

Acupuncture is a therapeutic modality used in China as early as the late stone age. Throughout Chinese history both acupuncture theory and practice has steadily evolved into an increasingly rich and complex system, eventually offering treatments for virtually every form of medical condition. Much of the history of the development of acupuncture therapeutics can be seen in the evolution of the needles themselves, but the meridian system is of primary importance, and the conceptualization of the system has changed very little in the last 2000 years.

Acupuncture has long been considered more important then herbal pharmacology. The earliest classical books on traditional Chinese medicine discuss Acupuncture and do not discuss herbal pharmacology. These include Huangdi's Internal Classic (ca. 100 B.C.E.) and two other works that pre-date it, the Moxibustion Classic with Eleven Foot-Hand Channels and the Moxibustion Classic with Eleven Ying-yang Channels, both of which were discovered during the Mawangdui tomb excavations in 1973. There is even a traditional saying: "first you use the needle (acupuncture), then fire (moxibustion), and then herbs."

Acupuncture did not enter modern Western consciousness until the 1970's when China ended a period of isolation and resumed foreign political and cultural contacts. In 1972 the respected New York Times columnist James Reston underwent an emergency appendectomy while in China. He latter wrote about acupuncture treatment for post-operative pain that was very successful. This report attracted attention and many American physicians and researchers went to China to observe and learn acupuncture techniques.

It appeared as though Acupuncture was used to treat everything in China, but the number of accepted acupuncture applications has grown very slowly in the West. The first area of partial acceptance was in analgesia, which is still the area where its effectiveness is best documented. Acupuncture research has since become a very broad, active area both in Asia and the West. Research at the Shanghai Institute has demonstrated acupuncture's effect on various biological systems, including the digestive tract, cardiovascular system (helpful in hypotensive states), immune system (phagocytosis), and the endocrine system (the secretion of ACTH, oxytocin, vasopressin, norepinephrine, follicle stimulating hormone, prolactin, and 17-hydroxycorticosteroids). A recent issue of the bilingual, Chinese journal Acupuncture Research includes successful studies of acupuncture treatment for hemiparalysis, facial paralysis, cervical spondylosis, humeral epicondylitis, herpes zoster, and lumbago.Current research in North American and Europe includes uterine contractions, pulmonary disease, addiction, mental disorders, and as an adjunct to AIDS treatment. Research continues, but widespread acceptance and integration are still far from realized.

The primary reason for the slow acceptance of acupuncture is the lingering suspicion that there is no substantial, scientific reality behind it because a demonstrable mechanism of action has yet to be found. For the most part, early attempts to "explain" acupuncture have been either thinly disguised denials or have embraced and verified acupuncture only partially, disproving traditional acupuncture as much as validating it. The most prevalent example of the former is the argument that any effect acupuncture may have is psychogenetic, a placebo effect. This has been disproven by successful studies of acupuncture in animals, many examples of which can be found in Kuo and Kuo. [2] Two important forms of partial validation of acupuncture are the neuralphysiological and neurohormonal schools. The neuralphysiological school defines acupuncture points on "roughly dermatome basis; partially involv[ing] 'long' reflexes to distant parts of the body, which implicates a distribution by specific spinal segments or nerves; and are partially via unknown connections." [8] This could explain remote stimulation, but as the quote suggests, it is a very incomplete explanation. Neurohormonal theories center on the release of neurohormones triggered by the pain and microphysical damage caused by needle insertion. This has been used primarily to explain acupuncture-induced general analgesics, but it can explain little else.

Both of the above explanations are attempts to use structures and concepts acceptable to the mainstream medical community to explain acupuncture. But in grafting acupuncture to Western medical theory, aspects foreign to orthodox medicine are simply jettisoned. Because of the emphasis on genetics, anatomy, physiology, and bio-chemistry in modern medicine, and a near complete denial of energetic processes in the body, chi (body energy) and meridians (paths of body energy flow) are either ignored or considered fallacies with some metaphorical or pneumonic value. Emphasis is placed by most researchers on the needle and the physical effect of its insertion into the skin, but this side of acupuncture is not essential. According to our research, acupuncture is essentially manipulation of bodily energy as it flows through the meridian system. The acupuncture needle is only one of many possible tools used to accomplish this. In the remainder of this article, "meridian theory" will be understood to include acupuncture theory and practice. "Meridian" is used to stand for both the meridian itself and the acupuncture points along the meridian.

A bio-physical or bio-chemical approach to acupuncture robs it of its actual foundation, and because of this acupuncture research to date has been only partially successful. Fortunately, advances in physics, electro-magnetism, quantum-mechanics, and bio-energetic research have enabled researchers to develop a paradigm that for the first time successfully explains the majority of acupuncture related phenomena. [9] We have embraced this bio-energetic paradigm not simply because it can explain more of acupuncture phenomena, but because it is a true description of acupuncture's mechanism of action and is an important facet of all life processes. The only way to address acupuncture successfully and scientifically is through the meridian system.

This four-article series will attempt to give a fairly complete representation of meridian theory research based on the bio-energetic paradigm. This, the first article, covers traditional acupuncture, early research into the electrical properties of acupuncture points, and basic EDS Test (EDST) methodologies. The theoretical foundation for the bio-energetic paradigm is discussed in two articles by Physicist Kuo Gen CHEN. The fourth article is a review of research into an application of bio-energetic properties called the electrodermal screening system (EDSS). In that article Dr. F.M.K. Lam, Prof. Pesus Chou, and I hope to demonstrate the effectiveness of the EDSS as a screening/diagnostic method and offer evidence of the causal connection between acupuncture points, meridians, and internal organs.

Traditional Meridian Theory
According to traditional Chinese medicine, a form of bodily energy called chi is generated in internal organs and systems. This energy combines with breath and circulates throughout the body, forming paths called meridians. The meridians form a complex, multilevel network which connects the various areas of the body, including the surfaces with the internal. All of the various meridian systems work together to assure the flow and distributon of chi thoughout the body, thus controlling all bodily functions. The interwoven meridian systems and the possibilities for diagnosis and treatment they offer, are called meridian theory. When an organ or system is not balanced, related acupuncture points may become tender or red, allowing for diagnosis. For treatment, a point on the skin is stimulated through pressure, suction, heat, or needle insertion, affecting the circulation of chi, which in turn affects related internal organs and systems.

"Meridian" is the most common translation of the Chinese ching-lo (jingluo), but it is a very imperfect translation. Ching means to pass through, and lo means a net or to connect. "Meridian" was originally used by French researchers to describe all meridians, and is used in this article in that sence. The term "channel" is used increasingly for all meridians, while some prefer to maintain the original distinction between ching and lo and use the terms channels and collaterals respectively. For them, meridian theory would be reffered to as the theory of channels and collaterals. There is another sub-classification of meridians called vessels. Although it is a valid distinction, it is not important to the immediate discussion.

Meridians are classified into 6 groups according to their location and function. The best known of the meridians are the 12 regular meridians, also called the major trunks. They connect with the organ they are named for by way of collateral meridians (see bellow) and run along the surface of the body either on the chest or back and along either both of the arms or both of the legs. These are the primary conduits for the passage of chi through the body, which flows through this network in a regular, 24-hour pattern. The 12 regular meridians therefore control or take part in every facet of the daily metabolic and physiological functioning of the body.

There are three meridian groupings directly associated with the regular meridians, each with 12 meridians. 1) Each of the divergent meridians arises from one of the 12 regular meridians, passes through the thorax or abdomen to join with the named organ, and then surface at the neck or head. 2) The muscle network meridians distribute chi from the 12 regular meridians among muscles, tendons, and joints, ensuring normal body motion and flexibility. This circulation of chi is referred to as superficial because there is no direct connection with an internal organ. 3) The cutaneous network meridians run parallel to the regular meridians in the cutaneous skin layer and are therefore considered even more superficial. We believe that they are a part of the function of the sensory nervous system.

The 8 extra meridians (also referred to as vessels) are the paths by which the 12 regular meridians connect, share chi, and support each other. None of the individual extra meridians are associated with a specific organ or regular meridian, though all of them connect with a number of other meridians. Their paths are considered superficial but deep. It is through the extra meridians that imbalances in chi are regulated through storage and drainage. The most important of the extra meridians are the govorner meridian, which runs along the middle of the back, and the conception meridian, which runs along the middle of the chest and stomach.

The system of 15 collateral meridians is responsible for the thorough and complete circulation of chi. One collateral meridian arises from each of the 12 regular meridians, the governor and conception meridians, and from the spleen (which does not have a regular meridian). Each of the collateral meridians branch out, forming minute or "grandson" collateral meridians, creating both horizontal and vertical connections within the complete meridian system.

Energy Medicine
This energetic view of the body is not entirely new to Western medicine. The basic concepts were present in the work of "vitalist" scientists such as Galvani, Hahnemann, and Mesmer, who were active in the 17th through 19th centuries. Vitalism was gradually pushed out of the relm of accpeted medical science in the 19th and 20th centuries due to apparent inefficacy, but the real problem was inadequate instrumentation and a medical paradigm that made no room for energetic processes. Technology has advanced to a point where devices can successfully and consistently measure biological energy. The body's energetic processes have always been there and were always important, as the history of acupuncture suggests. It is now time to standardize and integrate energetic practices into modern health care and make energy medicine an essential part of medical science.

The basic premise of energy medicine (also called bio-energetic medicine) is that energetic processes, including electrical and magnetic processes, vibrational resonance, and bio-photon emission, are essential to life processes. Bio-energy functions as a carrier of "bio-information" and is crucial to biological self-regulation. With this in mind, there are at least three areas where medical practitioners could find useful applications: 1) gearing all treatment to preserve the well-being of the electro-magnetic energy network of the body, 2) use of beneficial, external energies in amounts similar to that already present in body in order to balance or reinforce natural energetic functions, 3) use of greater amounts of external energy to actively influence body function by way of the energy network, correcting functional imbalances. Traditional acupuncture belongs to category 2, and many modern meridian-based techniques belong to category 3.

According to what we have observed in our research, a complete, bio-energetic definition of meridians includes four facets, or "units": structure of the organ of origin, function of the organ, the electro-magnetic pathway, and emotional/vibrational interaction. All four are crucial to the creation and existence of the meridians. An organ, by its physical existence and functioning, relases energy (chi) and creates an electro-magnetic field. This energy contains information about the organ and its activity, so both the physical structure and the functioning of the organ affect the quality and strength of the energy and information that are created. This is the source of the meridians. An imbalance in one meridian often brings about imbalances in others, and other factors, including emotions, can effect individual meridians and the meridian network as a whole. Each meridian can be viewed as existing individually or as a part of the intricate meridian system and can be treated as such, though the synergistic totality of the meridian system is always of primary importance. It is precisely for this reason that diagnostic and therapeutic procedures based on meridian theory are successful at approaching the body holistically.

In electroacupuncture treatment, direct electric current is administered through the acupuncture points. This energy follows the electromagnetic tracks to the system, effecting treatment. (Electroacupuncture therapeutics is a separate area of research and will not be discussed in detail here.) On the other hand, anything that alters or interferes with a system's function or structure also changes the performance of the related meridian and acupuncture points. The electrodermal screening device (EDSD) measures the balance of systems by measuring resistance and polarization at these points. In other words, acupuncture and standard electroacupuncture are therapeutic and the EDST is used in a screening process and can be integrated into diagnostic procedures.

In the 1950's and 60's two distinct electrodermal screening methodologies were developed, one by Nakatani in Japan (Ryodoraku) and one by Voll in Germany (EAV, electroacupuncture according to Voll). The most obvious difference between the two systems were the types of points they measured. In Ryodoraku, meridian passage points on the wrists and ankles are measured. The points used in EAV are located all over the body, though the distal points on the hands and feet are used most often. EAV is the more versatile and precise of the two methods, and for this reason we were attracted to it. EAV is the basis of the EDST, and the standard device used in EAV, the Dermatron (Pitterling Electronics, Munich), is the prototype of modern EDSDs.

There are some variations in the construction and performance of EDSDs, but all share the same basic design. The core of the EDSD is an ohm meter designed to deliver approximately 10-12 microamperes of direct electrical current at 1-1.25 volts, a perfectly safe amount. (The ionization potential of hydrogen atoms is 1.36 volts; only at this level and above could any physical damage occur.) On the majority of the devices the meter is calibrated to read from 0 to 100 such that the standard skin resistance of 100 kilo-ohms reads 50. The minimum value of zero represents infinite resistance (no electrical conductivity), and the maximum value of 100 indicates zero resistance at the given voltage and amperage. Some of the devices use a range of 0 to 200, with 100 being normal skin resistance.

The EDSD testing probe consists of an insulated body with a tip of brass or silver connected to the positive side of the circuit. The examiner holds the probe by the insulated body and presses the tip against the measurement point of the patient (fig. 4). The negative side of the circuit is connected to a hand electrode made of brass tubing, which is held by the patient in one hand. If medicine testing (described below) is to be done, a metal plate or holding device, usually made of aluminum, is placed in the circuit between the device and the hand electrode. The pressure of the tip of the probe on the skin might create a temporary dimple and be slightly uncomfortable, but it should not be painful. To assure adequate electrical contact, it is usually necessary to slightly dampen the probe tip and the hand electrode with water.

A reading taken with the EDSD is usually described using two values, the initial reading (generally the highest value) and the indicator drop (ID). Many practitioners also note the length of time of the ID. An initial reading of approximately 50 followed by little or no indicator drop is considered to be balanced. Initial readings above 60 may indicate inflammation in the system being measured, and initial readings below 45 may indicate changes caused by degenerative processes. An ID indicates a probable imbalance. When an ID is present it is considered the most important part of the reading, and through a process called medicine testing the ID can be used to determine the nature and cause of an imbalance.

Voll expanded upon traditional acupuncture point classification in three directions: by discovering unknown meridians (which he referred to as "systems"), unknown points on traditional meridians, and unknown functions of existing points. Voll's understanding of the traditional meridians is in agreement with the Chinese tradition in that each meridian relates to a specific internal organ (lung, stomach, heart, etc.). Voll's new meridians go beyond this to cover tissue and structure types and categories of biological function. These meridians cover joints, skin, fibrous tissue, fatty tissue, serous membranes, the nervous system (including autonomic innervation), lymphatic drainage, capillary circulation and allergic reactions. Many of the branch points are examples of newly discovered points and point functions. Branch points help tremendously in pinpointing the exact location of abnormal function. For example, the branch points on the two heart meridians (one on each of the hands) include the aortic valve, mitral valve, pulmonary valve, tricuspid valve, conduction system, and coronary arterioles. By combining the information read from all of the different types of measurement points, it is possible to determine the exact location of a given disturbance, including the layer of tissue effected.

A typical examination with the EDSD begins with the four quadrant measurements (hand to hand, foot to foot, right hand to foot, and left hand to foot) which are measurements of whole-body energy levels. These are taken using a pair of brass tube hand electrodes and a pair of brass plate foot electrodes. Using the probe, the control measurement points (CMP, some of which are also referred to as summation measurement points) are then measured to ascert281281ain the general condition of an entire meridian. The branch points along the same meridian are checked if there is a positive reading at the CMP or if symptoms suggest that a complete check of a meridian is warranted regardless of the CMP reading.

When a point exhibiting an ID is located, various reagents can be tested against the point in a process referred to as medicine testing. It is the goal of the physician to find one or a combination of reagents that will balance the point, i.e. cause the point tested to have a reading near 50 and not have an ID. Reagent samples in sealed glass containers are placed within the circuit of the measurement by placing them on the metal plate designed for this purpose. The physician tests various reagents, basing his selection on medical knowledge and experience, until an appropriate reagent or combination of reagents is found. A reagent that balances the reading may have a positive effect on the system being measured and therefore be an appropriate medication or dietary supplement. No response implies that the reagent would have no effect on the system, and a worsening response implies a negative effect. For example, pancreas CMP readings of a person with diabetes will become balanced when the proper dose of insulin is placed within the circuit and will show a larger ID if refined sugar is put there.

Medicine testing is perhaps the most controversial aspect of the EDSS, though many also consider it the most promising. It was discovered and used by Voll in connection with homeopathy, and the effectiveness of the EDSD in testing homeopathic remedies has been demonstrated in clinical studies. Homeopathic remedies serve as particularly useful reagents for medicine testing because they are prepared at various dilutions, which increases the likelihood of finding an appropriate "resonance," a phenomenon which Kuo-Gen Chen describes in the third article of this series as "bio-informational quantum interference." Medicine testing has also been shown effective in the testing of herbal and allopathic medicines and has been used very successfully to test for allergies and for the presence of environmental pathogens such as insecticides. Virtually any sort of biological reagent can be tested in this fashion.

Conclusion
Acupuncture has been used for thousands of years and is effective in a wide range of situations. It has not been integrated into modern health care primarily because of lingering suspicions that it is not scientific. A bio-energetic model has been developed to explain nearly all aspects of acupuncture and meridian theory, but there remains a definite prejudice against human energetic theories in the medical-scientific community, which must be overcome before integration can take place.

The EDST and EDSD are outgrowths of the scientific, electro-magnetic understanding of meridian theory. The EDST may appear similar to other ultra-modern techniques such as MRI, but there are important differences. Both are relatively new techniques based on modern technology, but the EDST is also based on ancient practices and is safer and more holistic, versatile, and cost effective. The device is elegantly simple and not extremely expensive. Hopefully, it will help free medical progress from its dependence on ever more expensive and specialized medical instrumentation. This alone would have a profound effect on health care cost and accessibility. The quality of health care will also improve with integration of the EDST into modern medical practice. Because the EDST makes use of the body's meridian system, it can map out and help analyze the body's own signals, making it particularly useful in early diagnosis. With its solid theoretical foundation in modern physics and quantum mechanics, it is perhaps the most "modern" medical methodologies available today.

NEUROFEEDBACK UPDATE

Sources of EEG activity in learning disabled children.

Fernandez T, Harmony T, Fernandez-Bouzas A, Silva J, Herrera W, Santiago-Rodriguez E, Sanchez L.
Institute of Neurobiology, National Autonomous University of Mexico,

The sources of different EEG frequencies were studied in 25 normal children and 46 learning disabled (not otherwise specified) children between 7 and 11 years old.

The EEG sources were computed using Frequency-domain Variable Resolution Electromagnetic Tomography which produces a three dimensional picture of the currents at each EEG frequency.

Significant differences between groups were observed. LD children showed more theta activity (3.5 to 7.02 Hz) in the frontal lobes and control children more alpha (9.75 to 12.87 Hz) in occipital areas.

These results may support the maturational lag hypothesis, as the neurobiological cause of learning deficiencies not otherwise specified.

Orbitofrontal cortex and memory formation.

Frey S, Petrides M.
Montreal Neurological Institute, McGill University, Quebec, Canada.

Which one of the many regions of the anatomically heterogeneous prefrontal cortex is part of the critical core of the neural circuit for encoding?

This positron emission tomography (PET) experiment measured changes in cerebral blood flow (CBF) in normal human participants during the presentation of abstract visual information in four conditions that varied in their encoding demands.

As encoding increased across the different conditions, there was an increase in activity in the right orbitofrontal cortex and the right parahippocampal region. No significant activation peaks were present in any other region of the frontal or temporal lobe.

These findings indicate that the orbitofrontal cortex, which is massively connected to the medial temporal cortex, is a critical frontal region for memory formation.


NUTRITION NEWS

Harvard Questions Nutrition Pyramid

A long-term study of more than 100,000 men and women has found that the U.S. Department of Agriculture's dietary guidelines and food pyramid may not be the best prescription for warding off chronic diseases.

The Harvard School of Public Health study, released Thursday and published in the December issue of the American Journal of Clinical Nutrition, found that those who ate a modified version of the USDA diet and took a multivitamin reduced their risk of chronic disease significantly more than those who followed the USDA's recommendations.

The food pyramid emphasizes carbohydrates as the basis of a healthy diet and restricts all types of oils and fats, advising that they be used sparingly. The Harvard study identified an ideal diet as one rich in whole grains, fruits and vegetables, with moderate amounts of fat and alcohol and a preference for poultry and fish rather than red meat.

"These results suggest that simple improvements in our diet may have a strong impact on reducing the risk of chronic disease in U.S. adults," said Marji McCullough, the study's lead author.

USDA nutrition officials could not be reached for comment.

Men who followed the alternative diet lowered their risk of cardiovascular disease by 39 percent, compared with a 28 percent reduction for those following USDA guidelines. For women, the alternative diet reduced the risk of heart disease by 28 percent, compared with 14 percent for the USDA diet. The Harvard diet didn't appear to affect cancer risk.

The study followed participants in the Health Professionals Follow-Up Study and the Nurses' Health Study over 10 to 15 years.

"The current federal guidelines as displayed in the government food-guide pyramid emphasize large amounts of carbohydrates, don't make a distinction between types of fat or protein and lump red meat, chicken, nuts and legumes together," said Walter Willett, one of the study's authors and chairman of the Department of Nutrition at the Harvard School of Public Health.

Willett, a critic of the USDA pyramid, proposed an alternative pyramid last year in his book "Eat, Drink and Be Healthy." The study's ideal diet incorporates many of the features of Willett's pyramid.

The USDA pyramid has attracted criticism since its unveiling. Recent dietary research that examines some of its most basic underpinnings --- addressing issues such as whether a high-carbohydrate diet is suitable for everyone and whether all types of dietary fats should be viewed equally --- has given more ammunition to detractors.

Federal nutritional policy is changing to incorporate some of the recent research. The "Dietary Guidelines for Americans" were updated in 2000 to place more emphasis on whole grains and to distinguish between unsaturated fats and saturated ones that can lead to cardiovascular disease. The Institute of Medicine, which advises Congress, in September issued nutritional guidelines that said a healthy diet could include up to 35 percent of daily calories from fat, with consumption of saturated fats and trans-fatty acids kept as low as possible. The pyramid itself may be altered.

The Harvard study established an alternative diet based on consuming four times as much fish and poultry as red meats; five servings of vegetables daily; four servings of fruit daily; one daily serving of nuts or vegetable protein such as soy; at least as much polyunsaturated fat as saturated fat; one-half to 1.5 alcoholic drinks daily for women and 1.5 to 2.5 alcoholic drinks daily for men. It also called for 15 grams of fiber a day from grain sources such as cereals and whole-wheat bread.

The study did not establish daily amounts for all food groups, as federal nutritional guidelines do. Dairy products, for example, were not evaluated as part of the study. Weight control and physical exercise, although considered important by researchers, were also not evaluated for their impact on chronic disease.

"There's a lot of debate about what the best diet is, but this study showed that following several healthy behaviors really does reduce the risk of developing several major diseases," said McCullough, now a nutritional epidemiologist for the American Cancer Society in Atlanta.

The Harvard study is valuable because it tracked eating patterns and disease outcomes over a long period, said Alice Lichtenstein, a Tufts University nutrition professor who specializes in cardiovascular disease. But more study is needed, she said.

"This is one part of the puzzle," Lichtenstein said. "It's a good, big piece, but it's not the whole thing."

Some moods trigger food cravings -- and vice versa. The challenge is to keep both in check.

By  Star Lawrence

Think of your body as an insanely complex, gooey car. Put in gas and oil (a balanced diet), and you're good to go. Put in nicotine, alcohol, caffeine, weird, manufactured fats, gummy, washed-out flour, and sugar, and it's like pouring sugar into the gas tank. You'll sputter, run on, stop and start, or stall.

Put Food In, See a Difference

Senior New York University clinical nutritionist Samantha Heller, MS, RD, would probably prefer an analogy to a chemistry set. "If you are chemically balanced," Heller contends, "your moods will be balanced."

A lot of factors can throw the body out of balance. "A lot of women are anemic," she says. "This leads to depression and fatigue. Older people are often deficient in the B vitamins. People who don't eat regularly often have big shifts in blood sugar." People also have chemical sensitivities to certain foods that can govern mood.

In a study of 200 people done in England for the mental health group known as Mind, subjects were told to cut down on mood "stressors" they consumed, while increasing the amount of mood "supporters." Stressors included sugar, caffeine, alcohol, and chocolate (more of that coming up). Supporters were water, vegetables, fruit, and oil-rich fish.

Eighty-eight percent of the people who tried this reported improved mental health. Specifically, 26% said they had fewer mood swings, 26% had fewer panic attacks and anxiety, and 24% said they experienced less depression.

How Moods Are Fed or Starved

One big set of chemicals that control mood are the neurotransmitters in the brain led by the pleasure "drug" serotonin. These substances determine whether you feel good and energetic or tired, irritable, and spacey. They run on sugar, preferably the form that comes from low glycemic carbohydrates (not doughnut sprinkles), according to Molly Kimball, RD, sports and lifestyle nutritionist at the Ochsner Clinic Foundation and Hospital in New Orleans.

The idea, she says, is to maintain a stable blood sugar level through the day, slowly feeding these substances into the brain. Low glycemic carbs include whole grain bread, beans, whole grain crackers, soy, apples, pears, peaches, and other fruits.

What Kimball calls "crappy carbs" -- commercial granola bars, animal crackers, graham crackers, potato chips, and of course, cakes and pies -- flood into the system too fast and cause your body to order up a big shot of insulin, which then tips the balance you've tried to maintain. "You can see it when you've had a white flour pancake and syrup for breakfast," Kimball says. "By mid-afternoon, you're ready for a nap." This sugar alert/insulin cycle can gradually become less efficient and lead to diabetes and other problems.

Comfort Foods Really Work

If you have let your neurotransmitters get off balance or if external forces have conspired to put you in a bad mood, don't fret, it happens. That's when your body will start to think "comfort food."

According to Joy Short, MS, RD, assistant professor and head of undergraduate nutrition and dietetics at St. Louis University, you should fulfill that craving -- but in moderation. "You might take time to think, 'Am I really hungry or just feel like eating because I am stressed,'" she says. However, if you can't think of a healthier response, eat your comfort item and enjoy it! If you must eat a deep-fried Twinkie, eat one and lighten up on (but don't skip) the rest of the meals in the day, she says.

You could make comfort foods more nutritional, she says. Interestingly, both men and women choose ice cream as their preferred comfort food, but coming in second is chocolate for women and pizza for men. "If you want a cookie, make it oatmeal raisin or vanilla wafers. Buy low-fat ice cream. Make your hot chocolate with skim milk. And forget the chips, in favor of popcorn or pretzels," Short says. Or after Domino's arrives, throw some artichoke pieces, anchovies, or frozen veggies on top and heat.

What about that universal comfort food, chocolate? Much has been written about chocolate's rich complement of mood-altering chemicals, some of which trip the serotonin receptors and cause a "falling in love" feeling, according to millions of chocoholics.

Chocolate is also supposedly loaded with antioxidants that keep the brain and other organs from being bashed by rogue cells called free radicals. Kimball says chocolate can act almost as a cannabinoid -- the mood-altering chemical found in marijuana. But Heller and Short say the touchy-feely chemicals are not in sufficient strength to make a difference in the body.

Recommendations for Managing Moods

* Maintain a stable blood sugar, no big swings. This means frequent small meals and snacks, every four hours or so.
* Be sure to drink a lot of water and juice.
* Exercise 20 minutes a day for mood -- and an hour for fat-burning.
* Do not follow an extremely low-fat diet (quick weight loss is also bad for mood, Heller says). Fat is needed for anti-depression. Stick with polyunsaturated and monounstaurated fats and fatty fish or flaxseeds, which are full of healthy omega-3 fats.
* Take in tryptophan, an amino acid that makes blood sugar accessible to the neurotransmitters. This means milk or turkey. Eat a carb alongside your tryptophan source for better absorption.
* Have breakfast.
* Spend time in the produce department when you shop (try to eat a lot of bright colors, which means fruits and veggies).
* Pass on food items that come wrapped in crackly cellophane.
* Limit coffee (even nutritionist Kimball drinks some).
* Don't eliminate any one food group, such as carbs.

RECIPE OF THE MONTH (and other good things to eat)

Fabulous Apple-Rhubarb-Pie with Oats

Chef Oscar Umahro Cadogan

The following recipe addresses the special diet considerations for: dairy-free, vegan, vegetarian, low-fat, cancer, cardiovascular disease.

Serves 6-8.
Succulent and savory apple-rhubarb-pie made with rolled oats and honey without any added fat. The pie contains plenty of fiber and tastes absolutely heavenly. But be warned: It is addictive and very filling. Try substituting the apple slices with pears or ripe mango.

Use a small electric coffee mill for grinding the rolled oats into flour. The dough is rather tough to mix at first, so a foodprocessor might come in handy. Use a 10 inch (26 cm) springform pan with a 3 inch (7.5 cm) high edge for baking the pie.

* 2 vanilla pods
* 1 1/3 cup (3 dl) honey
* 1 1/3 cup (3 dl) water
* 10 large rhubarb stalks (approx. 1 lb/ 500 gr), cut into 6 inch (15 cm) pieces
* 8 cups (18 dl) rolled oats, ground into fine flour
* 1 stick of cinnamon, roasted and ground finely
* 4 green cardamom pods, roasted and ground finely
* 1/4 cup (1/2 dl) honey
* 3 cooking apples, such as Baldwin, Cortland or Winesap

Cooking Instructions
1) Slice the vanilla pods open longitudinally and scrape out the seeds inside. Save both for later.
2) To make thin honey-vanilla-rhubarb syrup, combine honey and water in a saucepan together with vanilla pods, bring to a simmer, and leave for 15 minutes with a lid on before removing the vanilla pods.
3) Add rhubarb pieces and simmer for another 15 minutes or so until they are very tender (almost falling apart). Stir at first, to cover all the rhubarb slices in the honey-vanilla syrup. This helps them to cook evenly.
4) Mix oat flour and vanilla seeds thoroughly in a large bowl.
5) Take the saucepan off the heat once all the rhubarb pieces are tender. Scoop the tender rhubarb pieces out of the syrup and strain them over the saucepan. Leave them for 10 minutes or so until all the liquid has dripped back into the saucepan.
6) Pour 2 2/3 cups (6 dl) of the honey-vanilla-rhubarb syrup from the saucepan into the oat flour little by little while constantly stirring; mix any remaining syrup with the tender rhubarb pieces. Mix the dough thoroughly, divide into 4 smaller portions, and place these in the refrigerator for an hour or so, until the dough has cooled thoroughly and become firm.
7) Recombine the dough and knead for a few minutes.
8) Grease the pie mold with a bit of butter or extra virgin olive oil and cover the bottom of the pie mold with half of the dough.
9) Combine cinnamon, cardamom, and 1/4 cup (1/2 dl) honey in a bowl and mix thoroughly. Remove stems and seeds from apples, cut into thin slices, add to the bowl containing the honey mixture, and toss gently to cover thoroughly.
10) Place half of the honey-covered apple slices in the center of the dough, and place the other half of the dough on top. Press gently to flatten the surface and join the two halves along the outer edges.
11) Pre-bake the pie for about 15 minutes in the center of a 350° F (180° C) hot oven until the crust turns a creamy white with a few golden brown spots.
12) Spread the tender rhubarb pieces on top of the pie in an even layer, arrange the other half of the apple slices on top, and drizzle the leftover honey on top of these.
13) Bake the pie for another 20 minutes in a 430° F (220° C) hot oven until the apples turn soft and golden brown.

BOOK NOTES

"Brains That Work a Little Bit Differently"
by Allen D. Bradgon, David Gamon Ph.D.

Explores the causes and consequences of common neurological conditions, both positive and negative, such as ADHD, dyslexia, left-handedness, eidetic or photographic memory, and deja vu, among others.



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