Electroencephalography Registration of Laser Acupuncture Action

on Children with Autism Disorder

Anastasia I. Knyazkova

1,2 a

, Polina V. Shulmina

, Alice A. Samarinova

, Yury V. Kistenev

1,3 b

and Alexey V. Borisov

1,3 c

National Research Tomsk State University, Lenin Ave. 36, Tomsk, Russia

Institute of Strength Physics and Materials Science SB RAS, Academichesky Ave., 2/4, Tomsk, Russia

Siberian State Medical University, Moskovskiy trakt, 2, Tomsk, Russia

Keywords: EEG, Brain Activity, Laser Acupuncture, Autism Spectrum Disorders.

Abstract: Laser action on acupuncture points is an alternative to traditional acupuncture. We used red semiconductor

laser diodes with a wavelength of 650 nm. Three acupuncture points (GV20, LI4, P6) were selected to relieve

headaches and reduce anxiety in the study. EEG data had been obtained from two siblings, one of whom is

without pathologies of the nervous system (8 years), and the second has a diagnosis of autism (10 years). A

significant increase in the total activity of the brain for ASD patients up to a value close to the brain activity

of healthy patients was registered.

1 INTRODUCTION

Electroencephalography (EEG) is one of the most

informative methods of studying the human brain

from the standpoint of its holistic systemic activity.

This method is based on recording the total electrical

activity of brain neurons from the surface of the scalp.

EEG makes it possible to analyze qualitatively and

quantitatively the functional state of the brain and its

reactions under the influence of stimuli. EEG

recording is used widely in medical diagnostics and

treatment, in anesthesiology, as well as in the study of

brain activity related to the implementation of

functions such as perception, memory, and adaptation

(Louis et al. 2016).

Functional tests are of great importance in the

diagnosis of brain lesions: intermittent light irritation

(photostimulation), enhanced deep breathing for 2-3

minutes (hyperventilation), sound irritation, research

after a sleepless night (sleep deprivation), and others.

It is possible to identify changes in the EEG in

90% of patients with epilepsy using functional tests

(Dziadkowiak and Podemski 2019). The EEG allows

registering neoplasm transformation when the tumor

is located close to the surface of the brain and affects

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mainly the cortex and subcortical structures. Local

pathological changes in the area of the projection of

the tumor are noted, such as inhibition of the alpha

rhythm, an increase in the amplitude of delta waves

(Roohi-Azizi et al. 2017). Intracerebral tumors cause

significant general changes in the EEG, masking

focal disorders of biopotentials.

Autism spectrum disorders (ASD) are a group of

lifelong disorders of the nervous system, and it is

believed to be the result of atypical neural

connections in the brain (Belmonte et al. 2004),

(Wang et al. 2013), (Assaf et al. 2010). Studies show

that ASD can be described as a dynamic disorder and

analyzed in terms of complex dynamic systems (Bosl

et al. 2011), (Megremi 2014). Changes in cortical

excitability may contribute to or be a manifestation of

disorders of connectivity (Boutros et al. 2015).

In (Duffy and Als 2019) showed that in patients

(N = 430 children) with a diagnosis of autism aged 2

to 12 years, the connections between different parts

of the brain are disrupted partially, which is reflected

in the EEG shape. To estimate the level of these

interactions, the authors have used the degree of

coordination (coherence) of the waves of electrical

activity in various areas of the brain. As a result of a

Knyazkova, A., Shulmina, P., Samarinova, A., Kistenev, Y. and Borisov, A.

Electroencephalography Registration of Laser Acupuncture Action on Children with Autism Disorder.

DOI: 10.5220/0009370503870394

In Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2020) - Volume 1: BIODEVICES, pages 387-394

ISBN: 978-989-758-398-8; ISSN: 2184-4305

387

computer analysis of EEG signals, the authors

managed to identify 33 areas of wave combinations

characteristic only for autists, statistically different

from the EEG signals of children from the control

group, and this applies to all age categories.

Studies show that individual rehabilitation of a

person with autism has the most positive effect on his

abilities. There are various ways of influencing the

brain to rehabilitate the patient, including transcranial

magnetic stimulation (TMS), transcranial micro

polarisation (TCMP) and reflexotherapy.

The TMS, as a method for treating ASD, is based

on the stimulation of brain neurons with an

alternating magnetic field and recording responses to

stimulation using electromyography (Eldaief et al.

2013). The essence of this approach is the occurrence

of depolarization of the membranes of nerve cells

under the influence of a strong magnetic field. TMS

helps to regenerate neural connections in the cerebral

cortex, allowing purposeful stimulation non-

invasively individual structures of the cerebral cortex.

Depending on the regimen chosen by the specialist,

the effect on the central nervous system can be either

exciting or inhibitory. Regardless of the type of

influence, in the tissues of the cerebral cortex, there is

an improvement in the intercellular interaction and all

types of metabolism, and the blood microcirculation

is normalized. Some of the clinical trials of the

effectiveness of the TMS method suggested that its

use can help alleviate symptoms such as irritability

and stereotyped behavior, as well as reduce the

manifestation of autism symptoms associated with

deficiencies in areas of functioning and connections

such as coordination of vision and arm movement,

development of social skills (Oberman et al. 2016).

The TCMP of the brain consists of exposure to

certain parts of the brain with an electric current of

low intensity and is used in the comprehensive

rehabilitation of children with various forms of

cerebral palsy and other central nervous system

disorders, speech disorders, hearing loss, stuttering,

and so on. With the appointment of TCMP, the EEG

is recorded, based on the data of which the areas for

applying electrodes of the micro polarisation circuit

are determined. Thus, selective stimulation by

microcurrents of the weakened areas of the brain

responsible for the formation of speech, motor

activity, and mental development, allows achieving a

significant restoration of their functionality.

Reflexotherapy, as a method of rehabilitation in

autism, is based on exposure on biologically active

points located on the skin. As a result of exposure, a

local, regional or general reaction of the body is

caused, which leads to a restoration of balance in the

nervous, immune, endocrine systems, the production

of biologically active substances that block nerve

impulses and lead to pain relief, muscle relaxation,

stress relief, normalization of motor, autonomic and

emotional reactions in the body, regulation of blood

pressure.

One of the classic methods of reflexotherapy is

acupuncture, and one of the most innovative methods

is laser exposure to bioactive points. The main

objective of reflexotherapy in children with autism is

to strengthen the neuroendocrine links in the

regulation of autonomic tone and activation of the

subcortical formations of the brain. As a result of the

treatment, a decrease in stereotyped hyperkinesis and

phobias is observed, which helps to compensate for

the condition of children and their adaptation in the

family and children's team (Cheuk et al. 2011).

Laser action on acupuncture points is an

alternative to traditional acupuncture. Low-level laser

stimulation causes biological and physiological

changes. Using various frequencies of laser

stimulation was showed to cause activation of

different areas of the brain (Hsieh et al. 2011).

In the previous study (Knyazkova et al. 2019), we

showed that laser stimulation at the Hegu (LI4)

acupuncture point with low-level laser exposure (λ =

532 nm) entails a redistribution of brain activity

between its regions, without changing the average

total brain activity.

The aim of this work is to test the laser

reflexotherapy as a way of individual rehabilitation of

a patient with autism.

2 MATERIALS AND METHODS

Acupoint Selection and Application

Protocol in Our Study

Three acupuncture points were selected to relieve

headaches and reduce anxiety in the study.

BaiHui (GV20) is one of the most important

points of the Du (the government vessel) meridian

and is commonly used in neurology and psychiatry. It

is located on the crown, at the intersection of the line

connecting the tops of the two auricles and the

midline of the head, behind the front line of hair

growth (see Figure 1a). The main therapeutic effects

of the GV20 are usually relief from headache, stroke,

dizziness, tinnitus, and anxiety (Satoh et al. 2009),

(Zhao et al. 2007). In addition, this point is used to

activate the area of association (associated with

emotions, memory, and behavior).

NDNSNT 2020 - Special Session on Non-invasive Diagnosis and Neuro-stimulation in Neurorehabilitation Tasks

388

The Hegu point (LI4), also known as large

intestine 4, is located in the meridian of the colon in

the middle of the 2nd metacarpal bone on the radial

side (see Figure 1b). LI4 is considered one of the most

effective acupuncture points for general pain control,

especially headaches (Luong et al. 2018).

Nei Guan (P6) is commonly used to relieve

nausea, motion sickness, and headaches (Ezzo et al.

2006), (Lee and Fan 2009). P6 is located three fingers

below the wrist on the inner forearm between the two

tendons (see Figure 1c).

Figure 1: a - BaiHui (GV20), b - Hegu (LI4), and c - Nei

Guan (P6) acupoint.

EEG data had been obtained from two siblings,

one of whom is without pathologies of the nervous

system (8 years), and the second one has a diagnosis

of autism (10 years). Participation in the study of one

child with autism and the selection of the necessary

individual parameters is explained as an approach to

personalized medicine and individual rehabilitation.

The study protocol was approved by the local ethics

committee of TSU. Adult participants and official

representatives of the minors signed "the informed

consent" to the manipulation.

The subject was supposed to take a comfortable

position in the chair, which allowed him to relax the

muscles of the head, neck, and belt of the upper

extremities as much as possible, the left hand and

forearm of the right hand were released to attach the

lasers. It was forbidden to talk, chew anything,

completely close my eyes, remove the mounts for

lasers. In the case of a child with autism, hand

movements and slight head movements were allowed.

A helmet was put on a participant's head with

electrodes located according to the standard

international scheme 10-20 (Figure 2). The electrodes

were pre-lubricated with a special conductive gel for

EEG studies.

Figure 2: Scheme electrode overlay 10-20.

Data were recorded in a state of calm wakefulness

with open eyes when watching a video clip (cartoon).

Note that to avoid the occurrence of random artifacts

during EEG recording, all objects that could distract

children from the cartoon were out of sight.

We used a CONTEC KT88-1016 digital 16-

channel EEG analyzer (China) with the

EEG18V5.0.3 software. The recording time was

reduced to 5 minutes because there was no purpose to

track the temporal dynamics of any pathology, it was

only necessary to capture the moment when the laser

was turned on and to determine whether there was a

laser effect on the functioning of the brain in a state

of calm wakefulness with open eyes.

Figure 3: Holders for points GV20, P6 (top), and for point

LI4 (bottom).

We used red semiconductor laser diodes with a

wavelength of 650 nm. Special holders have been

developed to fix the lasers at selected acupuncture

points (see Figure 3). Holders printed on a 3D printer

made of PLA plastic.

Laser diodes were fixed in the holders and

connected to a YIHUA 305D power supply with an

adjustable output voltage in the range from 0 to 30V,

Electroencephalography Registration of Laser Acupuncture Action on Children with Autism Disorder

389

an output power of 150W and an adjustable output

current from 0 to 5A. The measurements were carried

out at the following power values: 3 mW, 4 mW, and

5 mW. Table 1 shows the output voltage values and

the corresponding current power value.

Table 1: The output voltage values for the corresponding

current power value.

Powe

Volta

3mW 2V

4mW 2.5V

5mW 3V

Figure 4: Disposition of lasers in selected acupuncture

points for a healthy child (top) and a child with autism

(bottom).

Lasers were placed on the hands and head of a

subject at the selected acupuncture points and were

fixed (see Figure 4). The diodes were mounted at a

distance of approximately 30 mm from the skin (spot

area 0.31 cm

) and perpendicular to the selected

point. Each of the selected points was stimulated by

the laser for 2.5 minutes.

We used power spectral density (PSD) to describe

the EEG signal. The PSD describes a signal spectral

power distribution as a function of frequency. To

calculate PSD, the truncated Fourier transform 𝑈



(𝜔)

in a finite interval [ t



, t



] of a raw signal 𝑈

(

𝑡

)

was calculated:

𝑈



(

𝜔

)

√

𝑇

𝑈

(

𝑡

)

𝑒



𝑑𝑡.









We used T=t



−t



= 20s.

Then the power spectral density (Rieke and

Warland 1999), (Millers and Childers 2012) can be

calculated



(

𝜔

)

=lim

→

𝐄𝑈



(

𝜔

)





,

where 𝐄 denotes an expected value.

The PSD used to compute a variance of a process

(net power) by integrating over frequency (Storch and

Zwiers 2001)

Var=









(

𝜔

)

𝑑𝜔





3 RESULTS

A preliminary study had been conducted with a group

of healthy adults. Low-level laser stimulation was

shown to be able to change the power of rhythms in

the head region, which corresponds to the stimulation

of various brain regions (Knyazkova et al. 2019).

Similarly (Knyazkova et al. 2019), an EEG signal

in a 300 s interval was divided into two parts, where

the first 150 seconds are the signal without any laser

action, and the second 150 seconds are the signal

when exposed to lasers. To minimize the factors

associated with the beginning and end of signal

acquisition and the inclusion of lasers, a time interval

of 90 s was cut from each part of the interval center.

Significant noise in the form of emissions was

observed in this area (Figure 5) associated with

patient movements.

Note that patients diagnosed with ASD have much

more such noise. Noise removal (filtering) in the form

of emissions was carried out by means of a

combination of gradient methods (Kistenev et al.

2019), taking into account the threshold value of the

absolute value of 80 μV. The limitation of 80 μV

obtained by us in preliminary studies characterizes

the maximum value of the signal generated on the

surface of the head during negligible movements of

patients. Figure 5 bottom shows the result of the

filtering of the signal depicted in Figure 5 top.

The minimum time interval of the signal after

filtering during the study in all cases was more than

50 s, therefore, when analyzing the data, intervals of

50 s were used (the rest of the signal was discarded).

NDNSNT 2020 - Special Session on Non-invasive Diagnosis and Neuro-stimulation in Neurorehabilitation Tasks

390

Figure 5: Example of an EEG signal from a healthy child

(top image) and a patient with ASD (bottom image) in

which there are noise components in the form of ejections.

A discrete window Fourier transform (Sherlock

1999) was applied to the filtered signal (Figure 5,

bottom), and many different spectrograms were

constructed with the Hamming weight function

(Harris 1978), the length of which was varied so that

it was possible to analyze time intervals from 0.1 s to

50 s in duration. When constructing spectrograms, the

overlap of adjacent signal segments varied from 0 to

50%.

Figure 6 shows an example of the dependence of

the PSD (Maral 2003)of the EEG signals averaged

over the window of the spectrograms for a healthy

child and a patient with ASD. It can be concluded that

the energy density signal from all electrodes for the

patient with ASD is significantly lower than for the

healthy child

Figure 7 shows an example of a dependence of

PSD averaged over the spectrogram window of EEG

signal signals for a healthy child and a patient with

ASD when exposed to laser radiation with a

wavelength of 650 nm at various power levels.

It is obvious that when exposed to lasers, the

energy density in a patient with ASD significantly

increases at all leads with increasing radiation power.

Figure 6: The dependence of the PSD on the frequency (Hz)

averaged over the windows of the spectrograms for a

healthy child (top) and a patient with ASD (bottom).

Electroencephalography Registration of Laser Acupuncture Action on Children with Autism Disorder

391

Figure 7: Dependence of the PSD on the frequency (Hz)

averaged over the window of the spectrograms for a healthy

child (top) and a patient with ASD (bottom) when exposed

to laser radiation with a wavelength of 650 nm at a power:

3mW - solid line, 4mW - dash - point line, 5mW - dotted

line.

The energy density in a healthy child does not change

significantly.

It was shown, that when exposed to Hego's point,

the total brain activity does not change on average for

healthy participants, but a redistribution of brain

activity between its spatial regions takes place

(Knyazkova et al. 2019). A significant increase in the

total activity of the brain for ASD patients up to a

value close to the brain activity of healthy child was

registered.

Figure 8:

The total value of PSD for all temporal

windows

inside 90s interval for the healthy child (top) and

the patient with ASD (bottom) before and after laser action.

Note that visual observation of the behavior of

patients with ASD showed that when exposed to laser

radiation, there were changes in the patient's

behavior, expressed in a decrease in anxiety. For

example, the patient with ASD was obsessively

played with a laser mount mounted on his arm

without laser exposure. When the laser was turned on

at a power of 5 mW, the patient with ASD practically

stopped paying attention to this mount.

Figure 8 shows the total value of PSD for all

temporal windows inside 90s interval for the healthy

child (top) and the child with ASD (bottom) before

and after laser action. The latter presented averaged

results for three levels of laser power: 3, 4, and 5 mW.

NDNSNT 2020 - Special Session on Non-invasive Diagnosis and Neuro-stimulation in Neurorehabilitation Tasks

392

4 CONCLUSIONS

Reflexotherapy, as a method of rehabilitation in

autism, is based on the exposure of biologically active

points located on the skin. Laser action on

acupuncture points is an alternative to traditional

acupuncture. We used red semiconductor laser diodes

with a wavelength of 650 nm. Three acupuncture

points (GV20, LI4, P6) were selected to relieve

headaches and reduce anxiety in the study. The

measurements were carried out at the following

power values: 3, 4, and 5 mW. EEG data had been

obtained from two siblings, one of whom is without

pathologies of the nervous system (8 years), and the

second one has a diagnosis of autism (10 years). In

the previous study (Knyazkova et al. 2019), we

investigate a group of healthy volunteers (N = 10),

adult men (the average age was 25 years old). It was

shown, that when exposed to Hego's point, the total

brain activity does not change on average for healthy

participants, but a redistribution of brain activity

between its regions takes place. In this study, it was

confirmed for a healthy child of 8 years old, and the

ASD child. A significant increase in the total activity

of the brain of the ASD child up to a value close to

the brain activity of healthy participants was

registered after the laser action.

Note that visual observation of the behavior of

patients with ASD showed that when exposed to laser

radiation, there were changes in the patient's

behavior, expressed in a decrease in anxiety.

ACKNOWLEDGEMENTS

This work was performed within the frame of the

Fundamental Research Program of the Russian

Academy of Sciences for 2013-2020, line of research

III.23.

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