Magnetic Therapy
& Repetitive Transcranial Magnetic Stimulation (rTMS/TMS)
In
Stroke: A pulsed electromagnetic therapy research review
Pulsed
electromagnetic field (PEMF) research shows PEMF improved cell
survival
after ischemic (no oxygen) shock. Studies show 90% reduced
ischemic damage and subsequent disability. PEMF works so good
protecting against (and recovering from stroke disability) that
like heart defibrillators, this simple technology
should be
made
available in the home for those at risk for stroke in case
of an
adverse event with the any component of the cardiovascular
system.
ARM
YOURSELF, BECAUSE YOUR DOCTOR SURE ISN'T GOING TO TELL YOU
ABOUT
IT.
Repetitive
transcranial magnetic stimulation (rTMS / TMS) research on
human
subjects repeatedly shows statistically significantly motor and
cognitive improvement in
human stroke participants w/ no adverse side effects. rTMS and
PEMF studies
even 5-10 years post stroke show measurable improvement. Based
on available research (see below links)
PEMF used for stroke in concert with standard rehabilitative
stroke therapy should result
in significantly improved outcome over standard rehabilitative
therapy alone.
In unrelated studies PEMF have shown
clear neuroprotective and regenerative effects. Ask yourself why
you've
never known about it until now.
Frequency Specific Pulsed
Electromagnetic Field (PEMF) Research Bibliographies:
Several
hundred pulsed electromagnetic field therapy citations contained
in our research bibliographies are linked directly to PubMed
a service of the U.S. National Library of Medicine and the U.S.
National Institutes of Health. These studies are offered for your education only and are not intended as promotional material.
See also; Sandyk R, Anninos PA
, Jacobson
JI; three pioneers of electromagnetic field therapy to
treat Parkinson's, Alzheimer's and epilepsy.
PEMF Background:
PEMF Research By
Effect:
EarthPulse research:
Brain Lang. 2011 Mar;116(3):125-35.
Epub 2010 Aug 3.
Modulation
of
N400 in chronic non-fluent aphasia using low frequency
Repetitive
Transcranial Magnetic Stimulation (rTMS).
Barwood CH, Murdoch BE, Whelan BM, Lloyd D, Riek S, O'Sullivan JD,
Coulthard A, Wong A.
Centre for Neurogenic Communication Disorders Research, School of
Health and Rehabilitation Sciences, University of Queensland
Med Sci Monit. 2011
Feb
25;17(3):CR132-139.
Excitatory
repetitive transcranial magnetic stimulation induces
improvements in
chronic post-stroke aphasia.
Szaflarski JP, Vannest J, Wu SW, Difrancesco MW, Banks C, Gilbert
DL.
Department of Neurology, University of Cincinnati Academic Health
Center, Cincinnati, OH, U.S.A.and Center for Imaging Research,
University of Cincinnati Academic Health Center, Cincinnati, OH,
U.S.A.
and Pediatric Neuroimaging Research Consortium, Cincinnati
Children's
Hospital Medical Center, Cincinnati, OH, U.S.A.
Australia.NeuroRehabilitation.
2011
Jan
1;28(2):113-28.
The effects of low frequency
Repetitive
Transcranial Magnetic Stimulation (rTMS) and sham condition rTMS
on
behavioural language in chronic non-fluent aphasia: Short term
outcomes.
Barwood
CH,
Murdoch BE, Whelan BM, Lloyd D, Riek S, O'Sullivan J, Coulthard A,
Wong A, Aitken P, Hall G.
Centre
for Neurogenic Communication Disorders Research, School of Health
and
Rehabilitation Sciences, University of Queensland, Australia.
Eur J Neurol. 2010
Sep;17(9):1203-9. Epub 2010 Apr 8.
Repetitive
transcranial magnetic stimulation at 1Hz and 5Hz produces
sustained
improvement in motor function and disability after ischaemic
stroke.
Emara TH, Moustafa RR, Elnahas NM, Elganzoury AM, Abdo TA, Mohamed
SA,
Eletribi MA.
Department of Neurology and Psychiatry, Rheumatology and
Rehabilitation, Ain Shams University, Cairo, Egypt.
Eur J Neurol. 2010 Dec 7. doi: 10.1111/j.1468-1331.2010.03284.x.
[Epub
ahead of print]
Improved
language
performance subsequent to low-frequency rTMS in patients with
chronic
non-fluent aphasia post-stroke.
Barwood CH, Murdoch BE, Whelan BM, Lloyd D, Riek S, O' Sullivan
JD,
Coulthard A, Wong A.
Centre for Neurogenic Communication Disorders Research, School of
Health and Rehabilitation Sciences, University of Queensland,
Australia
School of Human Movement Studies, University of Queensland,
Australia
Department of Neurology, Royal Brisbane and Women's Hospital,
Australia
Department of Medical Imaging, Royal Brisbane and Women's
Hospital,
Australia.
J Rehabil Med. 2010 Sep;42(8):758-64.
Long-term
effects
of rTMS on motor recovery in patients after subacute stroke.
Chang WH, Kim YH, Bang OY, Kim ST, Park YH, Lee PK.
Department of Physical Medicine and Rehabilitation, Samsung
Medical
Center, Sungkyunkwan University School of Medicine, Seoul,
Republic of
Korea.
Restor Neurol Neurosci. 2010;28(4):545-59.
Short- and
long-term effect of rTMS on motor function recovery after
ischemic
stroke.
Khedr EM, Fetoh NA.
Department of Neurology, Assiut University Hospital, Assiut,
Egypt.
Eur J Nucl Med Mol
Imaging. 2010 Jan 27. [Epub ahead of print]
Protective
effects
of repetitive transcranial magnetic stimulation in a rat model
of transient cerebral ischaemia: a microPET study.
Gao
F,
Wang S, Guo Y, Wang J, Lou M, Wu J, Ding M, Tian M, Zhang H.
Department
of
Nuclear Medicine, Second Affiliated Hospital of Zhejiang
University School of Medicine, 88 Jiefang Road, Hangzhou, 310009,
Zhejiang, China.
PURPOSE:
Repetitive
transcranial magnetic stimulation (rTMS) is a
noninvasive method to excite neurons in the brain. However, the
underlying mechanism of its therapeutic effects in stroke
remains
unclear. The aim of this study was to investigate the
neuroprotective
effect of high-frequency rTMS (usually 1< up to 20 hz but not
disclosed here) in a rat model of transient cerebral ischaemia
using
positron emission tomography (PET). METHODS: Sprague-Dawley rats
(n=30)
were anaesthetized with chloral hydrate and subjected to 90 min
of
intraluminal middle cerebral artery occlusion (MCAO) with
subsequent
reperfusion in three groups: control (n=10), rTMS (n=10), or
sham-rTMS
groups (n=10). In the rTMS group, rTMS was given 1 h after
ischaemia
and every 24 h for 7 days after MCAO. In all three groups,
small-animal
PET (microPET) imaging with (18)F-FDG was used to evaluate brain
glucose metabolism. Apoptotic molecules were measured in the
infarct
margin using immunohistochemical staining. RESULTS: The neurological
scores of the rats in the rTMS group were higher than
in those
of the control group over the whole 7-day observation period.
The
total, cortical and striatal infarct volumes were significantly
less in
the rTMS group than in the control group, as measured by
2,3,5-triphenyltetrazolium chloride staining. (18)F-FDG microPET
images
showed significantly higher standardized uptake values in the
cortex
and striatum in the rTMS group than in the control group in the
affected hemisphere. The number of cells positive for caspase-3
was
significantly lower in the rTMS group than in the control group,
while
the Bcl-2/Bax ratio was significantly higher in the rTMS group
than in
the control group. CONCLUSION:
rTMS therapy increased glucose
metabolism (no doubt in tandem w/enhanced oxygen
metabolism) and inhibited apoptosis in the
ischaemic
hemisphere. (18)F-FDG PET could be used to monitor rTMS therapy
in transient cerebral ischaemia in animal studies and in future
clinical trials.
Acta Neurol Scand. 2010
Jan;121(1):30-7. Epub 2009 Aug 11.
Long-term effect of
repetitive
transcranial magnetic stimulation on motor function recovery
after
acute ischemic stroke.
Khedr EM, Etraby AE, Hemeda
M,
Nasef AM, Razek AA.
Department of Neurology,
Assiut University Hospital, Assiut, Egypt. emankhedr99@yahoo.com
OBJECTIVE: Although there
is
evidence for short term benefits of rTMS in stroke, longer term
effects
have not been reported. The aim of the study was to evaluate the
effect
of two different frequencies of rTMS on motor recovery and on
cortical
excitability up to 1 year post-treatment. METHODS: Forty-eight
patients
with acute ischemic stroke were randomly classified into three
groups.
The first two groups
received
real rTMS over motor cortex (3 and 10 Hz respectively) of
the
affected hemisphere and the third group received sham stimulation
of
the same site, daily for five consecutive days. Disability was
assessed
before, after fifth sessions, and then after 1, 2, 3 and 12
months.
Cortical excitability was assessed for both hemispheres before and
after the second and fifth sessions. RESULTS: A significant 'rTMS
x
time' interaction was obtained indicating that real and sham rTMS
had
different effects on rating scales. This was because real rTMS produced greater
improvement than
sham that was evident even at one year follow-up. These
improvements were associated with changes in cortical excitability
over
the period of treatment. CONCLUSION: These results confirm that real rTMS
over motor cortex can enhance and maintain recovery and may be a
useful
add on therapy in treatment of acute stroke patients.
J Neurol Neurosurg Psychiatry. 2009 Dec 3. [Epub ahead of print]
Therapeutic role of rTMS on
recovery of dysphagia in patients with lateral medullary
syndrome and
brain stem infarction.
Khedr E, Abo-Elfetoh N.
Department of Neurology ,
Assiut University Hospital, Assiut, Egypt.
Background and purpose:
There
is some evidence for a therapeutic effect of rTMS on dysphagia in
hemispheric stroke. Aim of the study: To compare the effect of
real or
sham rTMS applied to the motor area of both hemispheres in
patients
with acute Lateral medullay (LMI) or brain stem infarctions.
Material
and METHOD: The study included 22 patients with acute ischemic
stroke
who had severe bulbar manifestation. 11 patients had LMI and 11
had
brain stem infarction. They were randomly allocated to receive
real (n
= 11) or sham (n = 11) rTMS of the esophageal motor cortex. Each
patient received 300 rTMS pulses at 3 Hz and an intensity of 130%
resting motor threshold to each hemisphere for five consecutive
days.
Clinical ratings of dysphagia and motor disability were assessed
before
and immediately after the last session and then again after 1 and
2
months. RESULTS: There were no significant differences in baseline
clinical assessment of swallowing between real and sham groups.
Real
rTMS improved dysphagia compared with sham rTMS in both groups of
patients,(P = 0.001 for both); the LMI group also improved the
scores
in the Barthel Index. All improvements were maintained over 2
months of
follow-up (P = 0.001). CONCLUSION: These
findings
suggest
that
rTMS could be a useful adjuvant strategy in
neurorehabilitation of dysphagia due to LMI or brain stem
infarction,
although
further
assessment
is necessary in multicentre clinical trials.
Eur J Neurol. 2009
Dec;16(12):1323-30. Epub 2009 Sep 23.
Role
of
1
and
3
Hz repetitive transcranial magnetic stimulation on motor
function recovery after acute ischaemic stroke.
Khedr EM, Abdel-Fadeil MR,
Farghali A, Qaid M.
Department of Neurology,
Assiut University Hospital, Assiut, Egypt. emankhedr99@yahoo.com
BACKGROUND AND PURPOSE: The
purpose of this study was to compare the long-term effect of five
daily
sessions of 1 vs. 3 Hz repetitive transcranial magnetic
stimulation
(rTMS) on motor recovery in acute stroke. METHODS: A total of 36
patients with acute ischaemic stroke participated in the study.
The
patients were randomly assigned into one of three groups; the
first and
second groups received real rTMS; 1 and 3 Hz and third group
received
sham stimulation, daily for 5 days. Motor disability was assessed
before and after the last session, and then after first, second
and
third month. Cortical excitability was assessed before and after
the
second and fifth session. The outcome measure was clinical
disability
at 3 months post-rTMS. RESULTS: No significant differences were
found
in basal rating scales between the three groups. At the 3-month
time
point, both of the real rTMS groups had improved significantly
more in
different rating scales than the sham group; in addition, the 1 Hz
group performed better than the 3 Hz group. Measures of cortical
excitability immediately after the last session showed that the 1
Hz
group had reduced excitability of the non-stroke hemisphere and
increased excitability of the stroke hemisphere, whereas the 3 Hz
group
only showed increased excitability of the stroke hemisphere.
CONCLUSION: These results confirm that five daily sessions of rTMS
over
motor cortex using either 1 Hz over the unaffected hemisphere or 3
Hz
over the affected hemisphere can enhance recovery. At 3 months,
the
improvement was more pronounced in 1 Hz group.
J Neuroeng Rehabil. 2009 Mar
2;6:7.
Links
Transcranial
magnetic
stimulation, synaptic plasticity and network oscillations.
The basic principle of TMS is
that
most neuronal axons that fall within the volume of magnetic
stimulation
become electrically excited, trigger action potentials and
release
neurotransmitter into the postsynaptic neurons. What happens afterwards remains
elusive, especially
in the case of repeated
stimulation. Here we discuss the likelihood that
certain TMS protocols produce long-term changes in cortical
synapses akin to
long-term potentiation and
long-term depression of synaptic transmission. Beyond the
synaptic
effects, TMS might have consequences on other neuronal
processes, such as
genetic and protein regulation,
and circuit-level patterns, such as network oscillations.
Furthermore,
TMS might have non-neuronal effects such as changes in blood
flow,
which are still poorly understood.
Acta Neurol Scand. 2009
Mar;119(3):155-61. Epub 2008 Sep 3. Links
Treatment of
post-stroke dysphagia with repetitive transcranial magnetic
stimulation.
Department of Neurology,
Assiut University Hospital, Assiut, Egypt.
Chin Med J (Engl). 2008 Jul 20;121(14):1307-12.
Effects of
repetitive transcranial magnetic stimulation on adenosine
triphosphate
content and microtubule associated protein-2 expression after
cerebral
ischemia-reperfusion injury (stroke)
in rat brain.
Feng HL, Yan L, Cui LY.
Department of Neurology, First Hospital of Harbin Medical
University,
Harbin, Heilongjiang 150001, China.
RESULTS: rTMS could
significantly
increase ATP content
and MAP-2 expression in the left brain following ischemic insult
(P
< 0.01) and different rTMS parameters had different effects
on the
ATP level and the MAP-2 expression in the left striatum. A
high-frequency rTMS played an important role in MAP-2 expression
and
ATP preservation.
CONCLUSIONS: This study
revealed
that rTMS induced significant increase of ATP content and
MAP-2
expression in the injured area of the brain, suggesting that the
regulation of both ATP and MAP-2 may be involved in the
biological
mechanism of the effect of rTMS on neural recovery. Therefore,
rTMS may
become a potential adjunctive therapy for ischemic
cerebrovascular
disease.
Stroke. 2007
Apr;38(4):1286-92. Epub 2007 Feb 22.
The right inferior frontal
gyrus and poststroke aphasia: a follow-up investigation.
Winhuisen L, Thiel A,
Schumacher B, Kessler J, Rudolf J, Haupt WF, Heiss WD.
Source
Department of Neurology,
University of Cologne, Cologne, Germany
Clin
Neurophysiol. 2007 Feb;118(2):333-42. Epub 2006 Dec 12.
Links
Exploring Theta Burst
Stimulation
as an intervention to improve motor recovery in chronic stroke.
Institute
of
Neurology, University College London (UCL), UK
NeuroRx. 2006 Oct;3(4):474-81. Links
Noninvasive
brain
stimulation
in
stroke
rehabilitation.
Human Cortical Physiology Section and Stroke Neurorehabilitation
Clinic, National Institute of Neurological Disorders and Stroke,
National Institutes of Health, Bethesda, Maryland 20892, USA.
Kim YH, You SH, Ko MH, Park JW, Lee KH,
Jang SH, Yoo WK,
Hallett M.
RESULTS: rTMS resulted in significantly larger
increase in the MEP amplitude than the sham rTMS (P<0.01),
and the
change was positively associated with an enhanced motor
performance
accuracy.
Fregni F, Boggio PS, Valle AC, Rocha RR, Duarte J,
Ferreira
MJ, Wagner T, Fecteau S, Rigonatti SP, Riberto M, Freedman SD,
Pascual-Leone A. From the Harvard Center for Non-Invasive Brain
Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, Mass.
RESULTS: Active rTMS resulted in
a significant
improvement of the motor function performance in the affected
hand that
lasted for 2 weeks. These effects were not observed
in the
sham rTMS group (affected and unaffected hand). Furthermore,
this
increased dose of rTMS is not associated with cognitive adverse
effects
and/or epileptogenic activity
Neurology. 2005 Aug 9;65(3):466-8.
Therapeutic
trial
of
repetitive
transcranial
magnetic
stimulation
after acute
ischemic stroke.
Khedr EM, Ahmed MA, Fathy N, Rothwell JC.
Department of
Neurology, Assiut University Hospital, Assiut, Egypt.
Disability scales at the end of the last
rTMS session, and 10
days later showed that real rTMS improved patients' scores more
than
sham.
Improving
disability in
stroke with RTMS.
Lancet Neurol. 2005 Aug;4(8):454-5. No
abstract
available (huh?...i wonder what this showed they don't want
you to read)
PMID: 16033688 [PubMed - indexed for MEDLINE]
Semin
Speech Lang. 2004
May;25(2):181-91.
Transcranial
magnetic
stimulation
as
a
complementary
treatment
for aphasia.
Following 10 rTMS treatments,
significant
improvement in naming pictures was observed. This form of rTMS
may
provide a novel, complementary treatment for aphasia.
Clin
Neurophysiol. 2004
May;115(5):1044-51.
Induction
of
long-term
plasticity
in
human
swallowing
motor cortex following
repetitive cortical stimulation.
SIGNIFICANCE: This might be a useful
approach in the motor rehabilitation of dysphagic stroke
patients who
have damage to sensory projections to the swallowing cortex.
Biol
Psychiatry. 2004 Feb
15;55(4):398-405.
Repetitive
transcranial
magnetic
stimulation
as
treatment
of
poststroke
depression: a preliminary study.
BACKGROUND: Depression has a significant
impact on poststroke recovery and mortality. There are a
proportion of
patients with poststroke depression (PSD) who do not respond to
antidepressants. Repetitive Transcranial Magnetic Stimulation
(rTMS)
might be a safe and effective alternative in these refractory
cases.
CONCLUSIONS: Taken together, these
preliminary
findings suggest that rTMS may be an effective and safe
treatment
alternative for patients with refractory depression and stroke.
Bioelectromagnetics. 1994;15(3):205-16.
Related Articles, Links
Protection against focal cerebral
ischemia
following exposure to a
pulsed electromagnetic field.
Grant G, Cadossi R, Steinberg G.
Department of Neurosurgery, Stanford University, California
94305.
There is evidence that electromagnetic stimulation may
accelerate the
healing of tissue damage following ischemia. We undertook this
study to
investigate the effects of low frequency pulsed electromagnetic
field
(PEMF) exposure on cerebral injury in a rabbit model of
transient focal
ischemia (2 h occlusion followed by 4 h of reperfusion). PEMF
exposure
(280 V, 75 Hz, IGEA Stimulator) was initiated 10 min after the
onset of
ischemia and continued throughout reperfusion (six exposed, six
controls). Magnetic resonance imaging (MRI) and histology were
used to
measure the degree of ischemic injury. Exposure to pulsed
electromagnetic field attenuated cortical ischemia edema on MRI
at the
most anterior coronal level by 65% (P < 0.001). On histologic
examination, PEMF exposure reduced ischemic neuronal damage in
this
same cortical area by 69% (P < 0.01) and by 43% (P < 0.05)
in the
striatum. Preliminary data suggest that exposure to a PEMF of
short
duration may have implications for the treatment of acute
stroke.
J Cell Biochem. 1993 Apr;51(4):387-93.
Related
Articles, Links
Beneficial effects of electromagnetic fields.
Bassett CA.
Bioelectric Research Center, Columbia University, Riverdale, New
York
10463.
Selective control of cell function by applying specifically
configured,
weak, time-varying magnetic fields has added a new, exciting
dimension
to biology and medicine. Field parameters for therapeutic,
pulsed
electromagnetic field (PEMFs) were designed to induce voltages
similar
to those produced, normally, during dynamic mechanical
deformation of
connective tissues. As a result, a wide variety of challenging
musculoskeletal disorders have been treated successfully over
the past
two decades. More than a quarter million patients with
chronically
ununited fractures have benefitted, worldwide, from this
surgically
non-invasive method, without risk, discomfort, or the high costs
of
operative repair. Many of the athermal bioresponses, at the
cellular
and subcellular levels, have been identified and found
appropriate to
correct or modify the pathologic processes for which PEMFs have
been
used. Not only is efficacy supported by these basic studies but
by a
number of double-blind trials. As
understanding of mechanisms expands, specific requirements for
field
energetics are being defined and the range of treatable ills
broadened.
These include nerve regeneration, wound healing, graft
behavior,
diabetes, and myocardial and cerebral ischemia (heart attack
and
stroke), among other conditions. Preliminary data even suggest
possible
benefits in controlling malignancy.
Basset pre-dates R.O. Becker's
use of
electricity to heal bone.