Parkinson's Disease Magnetic Therapy and Parkinson's Disease; a pulsed magnetic therapy research
bibliography. Effects of successive repetitive transcranial magnetic stimulation on motor performances and brain perfusion in idiopathic Parkinson's disease. Ikeguchi M, Touge T, Nishiyama Y, Takeuchi H, Kuriyama S, Ohkawa M. Third Department of Internal Medicine, Kagawa Medical University, 1750-1, Ikenobe, Miki-cho Kita-gun, Kagawa, 761-0793, Japan. mag@kms.ac.jp We studied the effects of 0.2 Hz repetitive transcranial magnetic stimulation (rTMS) successively performed 6 times for 2 weeks in 12 patients with idiopathic Parkinson's disease (PD). Ten patients received rTMS to the bilateral frontal cortex (frontal rTMS) and six patients received rTMS to the bilateral occipital cortex (occipital rTMS). Before and after rTMS, we evaluated regional cerebral blood flow (rCBF) using 99m-Tc-ECD single photon emission computed tomography (SPECT) and clinical tests.In an analysis with statistic parametric mapping, both frontal and occipital rTMS reduced rCBF in the cortical areas around the stimulated site. The activities of daily living (ADL) and motor scores of Unified Parkinson's Disease Rating Scale (UPDRS), pronation-supination movements, and buttoning up significantly improved after frontal rTMS than before it, while occipital rTMS had no significant effects in clinical tests.The findings of the present study suggest that successive 0.2 Hz rTMS has outlasting inhibitory effects on neuronal activity around the stimulated cortical areas. Because there were no significant relations between improved clinical tests and reduced rCBF, we speculate that the indirect effects of 0.2 Hz rTMS on subcortical structures are related to improved parkinsonian symptoms. Further studies recruiting large numbers of subjects are required to confirm the efficacy of 0.2 Hz rTMS on PD. Publication Types: Int J Neurosci. 1992 Oct;66(3-4):209-35. Related Articles, Links
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811. In a recent Editorial published in this Journal, I presented a new and revolutionary method for the treatment of Parkinson's disease (PD). I reported that extracranial treatment with picoTesla magnetic fields (MF) is a highly effective, safe, and revolutionary modality in the symptomatic management of PD. My conclusion was based on experience gained following the successful treatment of over 20 Parkinsonian patients, two of whom had levodopa-induced dyskinesias. None of the patients developed side effects during a several month period of follow-up. In the present communication, I present two reports. The first concerns four Parkinsonian patients in whom picoTesla MF produced a remarkable and sustained improvement in disability. Three of the patients had idiopathic PD and the fourth patient developed a Parkinsonian syndrome following an anoxic episode. In all patients, treatment with MF was applied as an adjunct to antiParkinsonian medication. The improvement noted in these patients attests to the efficacy of picoTesla MF as an additional, noninvasive modality in the therapy of the disease. The second report concerns two demented Parkinsonian patients in whom treatment with picoTesla MF rapidly reversed visuospatial impairment as demonstrated by the Clock Drawing Test. These findings demonstrate, for the first time, the efficacy of these MF in the amelioration of cognitive deficits in Parkinson's disease. Since Alzheimer's pathology frequently coexists with the dementia of Parkinsonism, these observations underscore the potential efficacy of picoTesla MF in the treatment of dementias of various etiologies. Publication Types: Int J Neurosci. 1992 Mar;63(1-2):141-50. Related Articles, Links
Sandyk R, Anninos PA, Tsagas N, Derpapas K. Democrition University of Thrace, Department of Medical Physics and Polytechnic School, Alexandroupolis and Xanthi, Greece. Levodopa-induced dyskinesias are a common complication of chronic dopaminergic therapy in patients with Parkinson's disease (PD). The overall prevalence of levodopa-induced dyskinesias ranges from 40%-90% and is related to the underlying disease process, pharmacologic factors, and to the duration of high dose levodopa therapy. The mechanisms underlying the emergence of levodopa-induced dyskinesias are unknown, although most investigators favor the theory that striatal dopamine receptor supersensitivity is directly responsible for the development of these abnormal movements. In laboratory animals, the pineal hormone melatonin has been shown to regulate striatal dopaminergic activity and block levodopa-induced dyskinesias (Cotzias et al., 1971). Since the pineal gland is known to be a magnetosensitive organ and as application of external magnetic fields has been shown to alter melatonin secretion, we studied the effects of application of external artificial weak magnetic fields in a Parkinsonian patient with severe levodopa-induced dyskinesias ("on-off"). Application of weak magnetic fields with a frequency of 2 Hz and intensity of 7.5 picotesla (pT) for a 6 minute period resulted in a rapid and dramatic attenuation of Parkinsonian disability and an almost complete resolution of the dyskinesias. This effect persisted for about 72 hours after which the patient regressed to his pretreatment state. To ascertain if the responses elicited in the laboratory were reproducible, the patient was instructed to apply magnetic fields of the same characteristics daily at home. These subsequent treatments paralleled the initial response with a sustained improvement being maintained during an observation period lasting at least one month. This case demonstrates the efficacy of weak magnetic fields in the treatment of Parkinsonism and motor complications of chronic levodopa therapy. Publication Types:
Int J Neurosci. 1995 Jun;82(3-4):255-68. Related Articles, Links
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Visuospatial deficits are among the most frequently encountered abnormalities in neuropsychological testing of patients with Parkinson's disease, being present in up to 90% of cases. Clinically, impairment of visuospatial functions may not be noted by Parkinsonian patients but may contribute to various functional disabilities including frequent falls, difficulties operating a vehicle, ambulating, and dressing. I have reported recently that treatment with external electromagnetic fields (EMFs) in the picotesla (pT) range intensity is an effective nonpharmacological modality in the management of the motor and various cognitive deficits of Parkinsonism including visuoperceptive and visuospatial functions. The present communication concerns four fully medicated Parkinsonian patients who, in response to treatment with EMFs, exhibited reversal of visuospatial impairments as demonstrated on the Clock Drawing Test. Specifically, prior to treatment with EMFs these patients demonstrated a visuospatial deficit which was evident by the placement of the numbers on the clock distant from the periphery. Following a series of treatments with EMFs this visuospatial deficit was corrected. The report supports prior observations demonstrating that externally applied pT range intensity EMFs may bring about reversal of visuospatial deficits in Parkinsonian patients which usually are not improved by treatment with dopaminergic or anticholinergic drugs. Publication Types: PMID: 12686400 [PubMed - indexed for MEDLINE] Transcranial magnetic stimulation [Article in Portuguese] Conforto AB, Marie SK, Cohen LG, Scaff M. Divisao de Clinica Neurologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil. abcong@yahoo.com Transcranial magnetic stimulation (TMS) allows non-invasive study and modulation of cortical excitability in humans. Changes in cortical excitability in physiological and pathological conditions can be tracked by measurements such as motor threshold, motor evoked potentials, recruitment curves, intracortical facilitation and inhibition. The central motor conduction time can estimate neural transmission in central motor pathways. Changes in areas of representation in sensorimotor cortex can be studied with cortical mapping. Modulation of cortical processing can be used to evaluate different brain functions. Therapeutic use in depression, Parkinson's disease and epilepsy has raised great interest over the past decade. Non-invasive cortical mapping may be achieved by combining TMS to other neurophysiological/ neuroimaging techniques. TMS has great potential both as an investigational and as a therapeutical tool in Neurology and Psychiatry. Publication Types: PMID: 12715042 [PubMed - indexed for MEDLINE]
Sandyk R, Derpapas K. NeuroCommunication Research Laboratories, Danbury, CT 06811. External application of picoTesla range magnetic fields (MF) has been reported recently to be efficacious in the treatment of patients with Parkinson's disease (PD) including those who manifest levodopa-related dyskinesias. In the present communication, we present four additional Parkinsonian patients who showed, within a brief period of time, marked improvement in motor symptoms after therapy with MF. Three of the patients had been maintained on antiParkinsonian medication during treatment with MF while the fourth patient had never received pharmacotherapy. Improvement with magnetic therapy was noted not only in the motor sphere (resting tremor, gait apraxia, postural instability), but also in nonmotor aspects of the disease including mood, sleep, pain, anorexia, autonomic, and cognitive functions attesting to the unique efficacy of external picoTesla range MF in the treatment of Parkinsonism. Poverty of facial expression (hypomimia, "masked facies"), which correlates with the degree of striatal dopaminergic deficiency, is one of the clinical hallmarks of PD reflecting the severity of hypokinesia and rigidity in the orofacial musculature. In this report, we emphasize the effects of MF on the hypomimia of PD and provide visual documentation illustrating the changes in the patients' facial expression which follow treatment with MF. Int J Neurosci. 1993 Mar-Apr;69(1-4):167-83.
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Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811. Recently, I reported that extracranial treatment with picoTesla range magnetic fields (MF) is an effective, safe, and revolutionary modality in the management of Parkinsonism including those patients manifesting levodopa-induced motor complications. This treatment, which has emerged as a potentially more advantageous modality than pharmacologic therapy, also produces improvements in nonmotor aspects of the disease including mood, cognitive functions, sleep, pain, appetite, autonomic functions, and sexual behavior, which are usually minimally, if at all, ameliorated by long term therapy with levodopa or anticholinergic agents. The present communication concerns a 69 year old Parkinsonian patient who, following a series of two treatments with extracranial picoTesla range MF on two separate days, improved to the point where he was able to discontinue most of his antiparkinsonian medications for a period of two weeks without experiencing deterioration in symptoms. On the third week he began to develop recurrence of symptoms and resumed taking his regular medications. At the end of the fourth week the patient received a series of four magnetic treatments on four successive days after he completely discontinued his antiparkinsonian medications. During this period he experienced a remarkable improvement in motor disability as well as in cognitive functions (i.e., visuospatial performance), mood, sleep, appetite, bowel functions and resolution of pain in the lower extremity. This report attests to the antiparkinsonian efficacy of picoTesla range MF and suggests that this treatment, when applied on a regular basis, may reduce the requirement for antiparkinsonian medications. This observation, when confirmed in a larger cohort of patients, may carry important implications for the therapy of Parkinsonism as it may offer an alternative treatment for patients who develop levodopa failure or experience intolerable side effects from dopaminergic medication. The observation that magnetic treatment improved the patient's symptoms while being off dopaminergic therapy supports the role of nondopaminergic mechanisms in the pathophysiology of Parkinsonism. Int J Neurosci. 1994 Jan-Feb;74(1-4):191-201.
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Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Brief cerebral application of picotesla (pT) electromagnetic fields (EMF) has been demonstrated an efficacious, revolutionary treatment modality for the therapy of Parkinson's disease (PD) with clinical benefits being evident in all motor aspects of the disease as well as in nonmotor symptoms such as mood, sleep, pain, sexual dysfunction, autonomic regulation and cognitive functions. Since treatment with pT EMF has involved PD patients who were treated with dopaminergic agents at the time they received EMF there may have been a synergistic interaction between dopaminergic drugs and EMF. The present communication concerns a 49-year-old male Parkinsonian patient with stage 3 disability on the Hoehn and Yahr scale (1967) who, in response to brief extracranial applications of pT EMF, demonstrated a marked improvement in motor, depressive symptomatology and cognitive functions and was classified as stage 1 several weeks later. This case is remarkable in that the patient did not receive treatment with dopaminergic drugs prior to or during the course of EMF therapy. It suggests that (a) pT range EMF may be efficacious as a monotherapy for PD and should be considered also as a treatment modality for de novo diagnosed patients, and (b) application of these EMF improves Parkinsonism by a mechanism which involves, among others, augmentation of dopaminergic and serotonergic neurotransmission. Int J Neurosci. 1994 Nov;79(1-2):99-110.
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Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Visual evoked potential (VEP) studies are widely used for the diagnosis of multiple sclerosis (MS) and are also useful in monitoring the effects of various therapeutic modalities in the disease. Prolongation of the VEP latencies has been demonstrated in patients with MS and in other neurodegenerative disorders including Parkinson's disease (PD), a disorder characterized by deficient cerebral dopamine (DA) functions. Pharmacological and biochemical studies have demonstrated a positive correlation between the amplitude of the VEP response and cerebral DA levels. Since brief, extracerebral applications of picotesla (pT) range flux intensity electromagnetic fields (EMFs) of low frequency have been shown to produce rapid improvement in motor and cognitive symptoms in PD, it is expected that application these EMFs would lead also to an increase in the amplitude of VEP response. This report documents three randomly selected PD patients who, following two successive brief extracerebral applications of pT range EMFs, showed an almost 3-fold increase of the mean pretreatment amplitude of the pattern reversal VEP in response to monocular stimulation. One patient underwent also a placebo EMF treatment which did not result in a significant change in the posttreatment amplitude. The study demonstrates that in Parkinsonian patients extracerebral application of these EMFs rapidly increases in amplitude of the VEP response and, by inference, cerebral DA levels presumably by increasing DA release. Int J Neurosci. 1996 Feb;84(1-4):165-75. --------------------------------------------------------------------------------
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. The occurrence of movement disorders and particularly Parkinsonian symptoms is uncommon in patients with multiple sclerosis (MS) despite the rather frequent presence of demyelinating plaques in the basal ganglia. This disparity between the occurrence of clinical symptoms in MS and the distribution of demyelinating plaques suggests that impairment of neurotransmitter functions rather than demyelination may be critical to the clinical manifestations of the disease. A 48 year old woman with remitting-progressive MS developed a bilateral Parkinsonian syndrome in association with acute emotional stress which resolved after she received two brief successive extracerebral applications of low frequency picotesla flux density electromagnetic fields (EMFs). It is believed that in this patient Parkinsonism may have existed in a subclinical form and that acute stress, which previously has been shown to precipitate symptoms of Parkinson's disease, triggered the onset of Parkinsonism by further reducing dopaminergic and serotonergic neurotransmission in the basal ganglia. The rapid reversal of the Parkinsonian syndrome by EMFs was related to a presumed augmentation of dopaminergic and serotonergic neurotransmission which, on the basis of CSF studies, is reduced in chronic MS patients. The efficacy of EMFs in the treatment of Parkinson's disease had been documented previously but this report demonstrates that this treatment modality is beneficial also for the treatment of Parkinsonism developing in the setting of other neurodegenerative disorders. Int J Neurosci. 1996 Jul;86(1-2):33-45.
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Sandyk R. Department of Neuroscience, Institute for Biomedical Engineering and Rehabilitation Services, Touro College, Dix Hills, NY 11746, USA. Absent or markedly reduced REM sleep with cessation of dream recall has been documented in numerous neurological disorders associated with subcortical dementia including Parkinson's disease, progressive supranuclear palsy and Huntington's chorea. This report concerns a 69 year old Parkinsonian patient who experienced complete cessation of dreaming since the onset of motor disability 13 years ago. Long term treatment with levodopa and dopamine (DA) receptor agonists (bromocriptine and pergolide mesylate) did not affect dream recall. However, dreaming was restored after the patient received three treatment sessions with AC pulsed picotesla range electromagnetic fields (EMFs) applied extracranially over three successive days. Six months later, during which time the patient received 3 additional treatment sessions with EMFs, he reported dreaming vividly with intense colored visual imagery almost every night with some of the dreams having sexual content. In addition, he began to experience hypnagogic imagery prior to the onset of sleep. Cessation of dream recall has been associated with right hemispheric dysfunction and its restoration by treatment with EMFs points to right hemispheric activation, which is supported by improvement in this patient's visual memory known to be subserved by the right temporal lobe. Moreover, since DA neurons activate REM sleep mechanisms and facilitate dream recall, it appears that application of EMFs enhanced DA activity in the mesolimbic system which has been implicated in dream recall. Also, since administration of pineal melatonin has been reported to induce vivid dreams with intense colored visual imagery in normal subjects and narcoleptic patients, it is suggested that enhanced nocturnal melatonin secretion was associated with restoration of dream recall in this patient. These findings demonstrate that unlike chronic levodopa therapy, intermittent pulsed applications of AC picotesla EMFs may induce in Parkinsonism reactivation of reticular-limbic-pineal systems involved in the generation of dreaming. Int J Neurosci. 1997 Jun;90(1-2):75-86.
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Sandyk R. Department of Neuroscience, Institute for Biomedical Engineering and Rehabilitation Services of Touro College, Dix Hills, NY 11746, USA. Macrosomatognosia refers to a disorder of the body image in which the patient perceives a part or parts of his body as disproportionately large. Macrosomatognosia has been associated with lesions in the parietal lobe, particularly the right parietal lobe, which integrates perceptual-sensorimotor functions concerned with the body image. It has been observed most commonly in patients with paroxysmal cerebral disorders such as epilepsy and migraine. The Draw-a-Person-Test has been employed in neuropsychological testing to identify disorders of the body image. Three fully medicated elderly Parkinsonian patients who exhibited, on the Draw-a-Person Test, macrosomatognosia involving the upper limbs are presented. In these patients spontaneous drawing of the figure of a man demonstrated disproportionately large arms. Furthermore, it was observed that the arm affected by tremor or, in the case of bilateral tremor, the arm showing the most severe tremor showed the greatest abnormality. This association implies that dopaminergic mechanisms influence neuronal systems in the nondominant right parietal lobe which construct the body image. After receiving a course of treatments with AC pulsed electromagnetic fields (EMFs) in the picotesla flux density applied transcranially, these patients' drawings showed reversal of the macrosomatognosia. These findings demonstrate that transcranial applications of AC pulsed EMFs affect the neuronal systems involved in the construction of the human body image and additionally reverse disorders of the body image in Parkinsonism which are related to right parietal lobe dysfunction. Int J Neurosci. 1998 Feb;93(1-2):43-54. Parkinson's Disease A 73-year-old male Parkinson's patient suffering from disabling resting and postural tremors in the right hand, as well as other symptoms. Two successive 20-minute treatments with AC pulsed electromagnetic fields of 7.5-picotesla intensity and 5-Hz frequency sinusoidal wave led to improvements in visuospatial performance and a legible signature. Significant improvements in Parkinsonian motor symptoms were also seen following additional treatments. The case of a medicated 61-year-old Parkinson's patient who experienced rapid reversal of symptoms following a single external application of picotesla-range magnetic fields. The application of ELF magnetic fields via a plastic helmet device housing a set of coils (generating fields of 8 Hz and 7.5 pT) produced beneficial clinical effects after 30 minutes in patients suffering Parkinson's disease and multiple sclerosis. R. Sandyk, Brief Communication: Electromagnetic Fields Improve Visuospatial
Performance and Reverse Agraphia in a Parkinsonian Patient, International Journal
of Neurosci, 87(3-4), and Reversal of Visual Neglect in Parkinson's Disease
Treatment with picoTesla Range Magnetic Fields J. Bardasano, Extracranial Device
for Noninvasive Neurological Treatments with Pulsating ELF Magnetic Fields. Bardasano et al.: 'Extracranial Device for Noninvasive Neurological Treatments
with PEMF, 'Second World Congress for Electricity and Magnetism in Biology
and Medicine, 1997, Bologna, Italy. -This study shows that the use of pulsed
electromagnetic fields in the Pikotesla range yielded a definite clinical improvement
in patients suffering from Parkinson's disease and multiple sclerosis. Applications of transcranial magnetic stimulation in movement disorders. Cantello R. Department of Medical Sciences, Section of Neurology, School of Medicine, Amedeo Avogadro University, Novara, Italy. cantello@med.unipmn.it The author reviews the applications of transcranial magnetic stimulation (TMS) in a series of movement disorders--namely, Parkinson's disease, corticobasal degeneration, multiple system atrophy, progressive supranuclear palsy, essential tremor, dystonia, Huntington's chorea, myoclonus, the ataxias, Tourette's syndrome, restless legs syndrome, Wilson's disease, Rett syndrome, and stiff-person syndrome. Single- and paired-pulse TMS studies have been done mainly for pathophysiologic purposes. Repetitive TMS has been used largely for therapy. Many TMS abnormalities are seen in the different diseases. They concur to show that motor cortical areas and their projections are the main target of the basal ganglia dysfunction typical of movement disorders. Interpretation has not always been clear, and sometimes there were discrepancies and contradictions. Largely, this may be the result of the extreme heterogeneity of the methods used and of the patients studied. It is premature to give repetitive TMS a role in treatment. Overall, however, TMS gives rise to a new, outstanding enthusiasm in the neurophysiology of movement disorders. There is reason to predict that TMS, with its continuous technical refinement, will prove even more helpful in the near future. Then, research achievements are reasonably expected to spill over into clinical practice. Publication Types: PMID: 12436085 [PubMed - indexed for MEDLINE] Improved executive functioning following repetitive transcranial magnetic stimulation. Moser DJ, Jorge RE, Manes F, Paradiso S, Benjamin ML, Robinson RG. Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52240, USA. David.Moser@uiowa.edu The cognitive effects of active and sham repetitive transcranial magnetic stimulation (rTMS) were examined in 19 middle-aged and elderly patients with refractory depression. Patients received either active (n = 9) or sham (n = 10) rTMS targeted at the anterior portion of the left middle frontal gyrus. Patients in the active rTMS group improved significantly on a test of cognitive flexibility and conceptual tracking (Trail Making Test-B). Publication Types: Transcranial magnetic stimulation of the cerebellum in essential tremor: a controlled study. Gironell A, Kulisevsky J, Lorenzo J, Barbanoj M, Pascual-Sedano B, Otermin P. Servei de Neurologia, Hospital de Sant Pau, Av Sant Antoni Ma Claret 167, 08025 Barcelona, Catalonia, Spain. agironell@cataloniamail.com BACKGROUND: Growing evidence implicates an overactivity of the cerebellum in the pathophysiology of essential tremor. In a small series of patients, we explored the acute effects and therapeutic possibilities of low-frequency repetitive transcranial magnetic stimulation (rTMS) of the cerebellum in patients with essential tremor in a double-blind, crossover, placebo-controlled design. METHODS: Ten patients with essential tremor underwent an active and a sham rTMS session, at a 1-week interval. The rTMS was performed with a focal double 70-mm butterfly coil (maximum peak field of 2.2 T) applied 2 cm below the inion. Each session consisted of 30 trains of 10-second duration separated by 30-second pauses, at 100% of the maximum output intensity and at 1-Hz frequency. Major evaluation outcomes were the score on the Tremor Clinical Rating Scale and accelerometric recordings obtained before (-5 minutes), immediately after (+5 minutes), and 1 hour after (+60 minutes) each rTMS session. Both clinical and accelerometric measurements were obtained by a blinded neurologist. RESULTS: On the +5-minute assessment, active rTMS produced a notable tremor improvement compared with sham rTMS, as evidenced by a significant reduction in scores on the clinical rating scale and accelerometric values. At +60 minutes, no clinical or accelerometric benefit was evidenced. No adverse effects of rTMS were observed. CONCLUSIONS: This exploratory study of the potential therapeutic properties of rTMS on essential tremor showed an acute antitremor effect. Further investigation in search of a more lasting benefit is warranted. Publication Types: PMID: 11890845 [PubMed - indexed for MEDLINE] Contralateral and ipsilateral repetitive transcranial magnetic stimulation in Parkinson patients] [Article in German] de Groot M, Hermann W, Steffen J, Wagner A, Grahmann F. Klinik und Poliklinik fur Neurologie, Universitatsklinikum Leipzig, Liebigstrasse 22a, 04103 Leipzig. In seven women and two men with Parkinson's disease, Hoehn and Yahr stage 1 or 2, the effect of repetitive transcranial magnetic stimulation (rTMS) was evaluated. Primary endpoint outcome measure was the changing of the motor items of the Unified Parkinson's Disease Rating Scale (subscale III of UP-DRS) 24 h after stimulation. Kinesiologic tests and writing samples were secondary outcome measures. After discontinuing all medication, stimulation was performed with 5 Hz at 90% of the motor threshold over the primary motor cortex of the more affected. There were 2250 stimuli applied, divided into 15 trains at intervals of 10 s. The identical treatment of the opposite side served as control treatment. Only treatment of the more affected side resulted in a significant improvement of the clinical symptoms of 46% as assessed by the UPDRS (p < 0.02). This effectiveness differed significantly from the control treatment (21%, p < 0.02). The kinesiological testing did not show any significant speeding of movements (p > 0.05). Some patients showed a normalisation of the previously disturbed handwriting specimen. These data confirm the previous observation that rTMS of primary motor regions leads to at least temporary clinical improvement of symptoms in patients with Parkinson's disease. PMID: 11789438 [PubMed - indexed for MEDLINE]
Shimamoto H, Takasaki K, Shigemori M, Imaizumi T, Ayabe M, Shoji H. Shimamoto Neurosurgical Clinic, Kurume University School of Medicine, Ohnojo-city, Fukuoka, Japan. The therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on clinical performance was assessed by a double-blind study in 9 patients with Parkinson's disease (PD). Nine other patients underwent sham stimulation as controls. The modified Hoehn and Yahr (H&Y) staging scale, the Schwab and England Activities of Daily Living (ADL) scale, and the Unified Parkinson's disease rating scale (UPDRS) were used to assess changes of clinical performance. Patients were assessed prior to and following 2 months of rTMS. In addition, the mechanism of rTMS was investigated by dopamine and homovanillic acid (HVA) in the lumbar cerebrospinal fluid (CSF) of 17 patients before and after therapeutic rTMS for three or four months. rTMS was applied manually to the frontal areas 60 times per session, i. e., 30 times per side using a large circular coil, a pulse intensity of 700 V, and a frequency of 0.2 Hz. Sessions were continued once a week for 2 months. The 9 control patients showed no changes of symptoms between the initial evaluation and that after 2 months of sham rTMS. In contrast, all 9 patients receiving rTMS showed a significant decrease of the modified H&Y and UPDRS scores after 2 months, while the Schwab and England ADL Scale scores increased significantly. In the second CSF sample from patients receiving rTMS, HVA showed a significant decrease These results suggest that rTMS is beneficial for the symptoms of Parkinson's disease and that it may act via inhibition of dopaminergic systems. Publication Types: PMID: 11697688 Brain Topogr. 2000 Winter;13(2):135-44. Related Articles, Links
Anninos PA, Adamopoulos AV, Kotini A, Tsagas N. Dept. of Medicine, Demokrition University of Thrace, Alexandroupolis, Greece. anninos@med.duth.gr Magnetoencephalogram (MEG) recordings were obtained from the brain of patients
suffering from Parkinson's disease (PD) using the Superconductive Quantum Interference
Device (SQUID). For each patient the magnetic activity was recorded from a
total of 64 points of the skull (32 points from each temporal lobe) as defined
by a recording reference system, which is based on the 10-20 Electrode Placement
System. Some of the recorded points were observed to exhibit abnormal rhythmic
activity, characterized by high amplitudes and low frequencies. External magnetic
stimulation (EMS) with intensity 1-7.5pT, and frequency the alpha-rhythm of
the patient (8-13 Hz) was applied in the left-right temporal, frontal-occipital
and vertex (2 minutes over each of the above regions) and the brain magnetic
activity was recorded again. The application of the EMS resulted in rapid attenuation
of the MEG activity of PD patients. Furthermore, chaotic dynamic methods were
used, in order to estimate the correlation dimension D of the reconstructed
phase spaces. The estimated values of D, in conjunction with the results derived
from the other data analysis methods, strongly support the existence of low
dimension chaotic structures in the dynamics of cortical activity of PD patients.
In addition, the increased values of D of the MEG after the application of
EMS when compared with the corresponding ones obtained from the MEGs prior
to the EMS, suggest that the neural dynamics are strongly influenced by the
application of EMS. Nippon Rinsho. 2000 Oct;58(10):2120-4. Int J Neurosci. 1998 Sep;95(3-4):255-69. Related Articles, Links
Sandyk R. Department of Neuroscience, Touro College, Dix Hills, NY 11746, USA. The Draw-a-Bicycle Test is employed in neuropsychological testing of cognitive skills since the bicycle design is widely known and also because of its complex structure. The Draw-a-Bicycle Test has been administered routinely to patients with Parkinson's disease (PD) and other neurodegenerative disorders to evaluate the effect of transcranial applications of AC pulsed electromagnetic fields (EMFs) in the picotesla flux density on visuoconstructional skills. A seminal observation is reported in 5 medicated PD patients who demonstrated reversal of spontaneous drawing direction of the bicycle after they received a series of transcranial treatments with AC pulsed EMFs. In 3 patients reversal of the bicycle drawing direction was observed shortly after the administration of pulsed EMFs while in 2 patients these changes were observed within a time lag ranging from several weeks to months. All patients also demonstrated a dramatic clinical response to the administration of EMFs. These findings are intriguing because changes in drawing direction do not occur spontaneously in normal individuals as a result of relateralization of cognitive functions. This report suggests that administration of AC pulsed EMFs may induce in some PD patients changes in hemispheric dominance during processing of a visuoconstructional task and that these changes may be predictive of a particularly favourable response to AC pulsed EMFs therapy. Publication Types: Int J Neurosci. 1997 Nov;92(1-2):63-72. Related Articles, Links
Sandyk R. Department of Neuroscience, Touro College, Dix Hills, NY 11746, USA. A 52 year old fully medicated physician with juvenile onset Parkinsonism experienced 4 years ago severe "on-off" fluctuations in motor disability and debilitating speech impairment with severe stuttering which occurred predominantly during "on-off" periods. His speech impairment improved 20%-30% when sertraline (75 mg/day), a serotonin reuptake inhibitor, was added to his dopaminergic medications which included levodopa, amantadine, selegiline and pergolide mesylate. A more dramatic and consistent improvement in his speech occurred over the past 4 years during which time the patient received, on a fairly regular basis, weekly transcranial treatments with AC pulsed electromagnetic fields (EMFs) of picotesla flux density. Recurrence of speech impairment was observed on several occasions when regular treatments with EMFs were temporarily discontinued. These findings demonstrate that AC pulsed applications of picotesla flux density EMFs may offer a nonpharmacologic approach to the management of speech disturbances in Parkinsonism. Furthermore, this case implicates cerebral serotonergic deficiency in the pathogenesis of Parkinsonian speech impairment which affects more than 50% of patients. It is believed that pulsed applications of EMFs improved this patient's speech impairment through the facilitation of serotonergic transmission which may have occurred in part through a synergistic interaction with sertraline. Publication Types: Int J Neurosci. 1997 Oct;91(3-4):189-97. Related Articles, Links
Sandyk R. Department of Neuroscience, Touro College, Dix Hills, NY 11746, USA. A 52 year old fully medicated Parkinsonian patient with severe disability (stage 4 on the Hoehn & Yahr disability scale) became asymptomatic 10 weeks after he received twice weekly transcranial treatments with AC pulsed electromagnetic fields (EMFs) of picotesla flux density. Prior to treatment with EMFs, his medication (Sinemet CR) was about 50% effective and he experienced end-of-dose deterioration and diurnal-related decline in the drug's efficacy. For instance, while his morning medication was 90% effective, his afternoon medication was only 50% effective and his evening dose was only 30% effective. Ten weeks after introduction of treatment with EMFs, there was 40% improvement in his response to standard Sinemet medication with minimal change in its efficacy during the course of the day or evening. These findings demonstrate that intermittent, AC pulsed applications of picotesla flux density EMFs improve Parkinsonian symptoms in part by enhancing the patient's response to levodopa. This effect may be related to an increase in the capacity of striatal DA neurons to synthesize, store and release DA derived from exogenously supplied levodopa as well as to increased serotonin (5-HT) transmission which has been shown to enhance the response of PD patients to levodopa. Since decline in the response to levodopa is a phenomenon associated with progression of the disease, this case suggests that intermittent applications of AC pulsed EMFs of picotesla flux density reverse the course of chronic progressive PD. Publication Types: PMID: 9394226
Sandyk R. Department of Neuroscience, Touro College, Dix Hills, NY 11746, USA. A 74 year old retired building inspector with a 15 year history of Parkinson's disease (PD) presented with severe resting tremor in the right hand, generalized bradykinesia, difficulties with the initiation of gait with freezing, mental depression and generalized cognitive impairment despite being fully medicated. Testing of constructional abilities employing various drawing tasks demonstrated drawing impairment compatible with severe left hemispheric dysfunction. After receiving two successive transcranial applications, each of 20 minutes duration, with AC pulsed electromagnetic fields (EMFs) of 7.5 picotesla flux density and frequencies of 5Hz and 7Hz respectively, his tremor remitted and there was dramatic improvement in his drawing performance. Additional striking improvements in his drawing performance occurred over the following two days after he continued to receive daily treatments with EMFs. The patient's drawings were subjected to a Reliability Test in which 10 raters reported 100% correct assessment of pre- and post drawings with all possible comparisons (mean 2 = 5.0; p < .05). This case demonstrates in PD rapid reversal of drawing impairment related to left hemispheric dysfunction by brief transcranial applications of AC pulsed picotesla flux density EMFs and suggests that cognitive deficits associated with Parkinsonism, which usually are progressive and unaffected by dopamine replacement therapy, may be partly reversed by administration of these EMFs. Treatment with picotesla EMFs reflects a "cutting edge" approach to the management of cognitive impairment in Parkinsonism. Publication Types: Int J Neurosci. 1996 Mar;85(1-2):111-24. Related Articles, Links
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Freezing, a symptom characterized by difficulty in the initiation and smooth pursuit of repetitive movements, is a unique and well known clinical feature of Parkinson's disease (PD). It usually occurs in patients with long duration and advanced stage of the disease and is a major cause of disability often resulting in falling. In PD patients freezing manifests most commonly as a sudden attack of immobility usually experienced during walking, attempts to turn while walking, or while approaching a destination. Less commonly it is expressed as arrest of speech or handwriting. The pathophysiology of Parkinsonian freezing, which is considered a distinct clinical feature independent of akinesia, is poorly understood and is believed to involve abnormalities in dopamine and norepinephrine neurotransmission in critical motor control areas including the frontal lobe, basal ganglia, locus coeruleus and spinal cord. In general, freezing is resistant to pharmacological therapy although in some patients reduction or increase in levodopa dose may improve this symptom. Three medicated PD patients exhibiting disabling episodes of freezing of gait are presented in whom brief, extracerebral applications of pulsed electromagnetic fields (EMFs) in the picotesla range improved freezing. Two patients had freezing both during "on" and "off" periods while the third patient experienced random episodes of freezing throughout the course of the day. The effect of each EMFs treatment lasted several days after which time freezing gradually reappeared, initially in association with "off" periods. These findings suggest that the neurochemical mechanisms underlying the development of freezing are sensitive to the effects of EMFs, which are believed to improve freezing primarily through the facilitation of serotonin (5-HT) neurotransmission at both junctional (synaptic) and nonjunctional neuronal target sites. Publication Types:
Int J Neurosci. 1995 Mar;81(1-2):67-82. Related Articles, Links
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Neuropsychological studies have demonstrated that Parkinson's disease (PD) is associated with various cognitive deficits ultimately leading in about 30% of patients to the development of dementia. These studies have demonstrated also a greater decrement of right hemispheric functions with visuospatial deficits occurring in up to 90% of PD patients. The Rey-Osterrieth Complex Figure (ROCF) Test has been employed in the assessment of right hemispheric functions and particularly for the evaluation of visuoconstructive abilities and short-term visual memory. I have demonstrated recently that external application of electromagnetic fields (EMFs) in the picotesla (pT) range intensity is an effective nonpharmacological modality in the management of the motor and cognitive deficits of Parkinsonism. In the present communication I present 3 fully medicated nondemented PD patients (mean age: 68 +/- 8.1 yrs; mean duration of illness: 9.0 +/- 4.0 yrs; mean disability on the Hoehn and Yahr scale: 3) who were tested on the ROCF Test before and after a series of treatments with EMFs. In response to the administration of EMFs the group demonstrated a mean of 23.1 +/- 13.6% improved performance on copy of the ROCF and a 39.3 +/- 13.4% improvement of short-term recall of the ROCF. These findings demonstrate that treatment with pT EMFs improves deficits in visuospatial functions and visual memory in Parkinsonism which usually remain unaffected during standard treatment with dopaminergic pharmacotherapy. Publication Types: Int J Neurosci. 1995 Mar;81(1-2):47-65. Related Articles, Links
Sandyk R. NeuroCommunication Research Laboratories, Danbury, CT 06811, USA. Drawing tasks, both free and copied, have achieved a central position in neuropsychological testing of patients with unilateral cerebral dysfunction by virtue of their sensitivity to different kinds of organic brain disorders and their ability to provide information on lateralized brain damage. In the drawings of patients with right hemispheric damage, visuospatial neglect is revealed by the omission of details on the side of the drawing contralateral to the hemispheric lesion. Patients with unilateral cerebral damage, particularly those with left hemispheric damage, also demonstrate a tendency to place their drawings on the side of the page ipsilateral to the cerebral lesion, a phenomenon which has been termed visuospatial hemi-inattention. It has been reported previously that brief external application of alternating pulsed electromagnetic fields (EMFs) in the picotesla (pT) range intensity improved visuoperceptive and visuospatial functions and reversed neglect in Parkinsonian patients. The present communication concerns four fully medicated elderly nondemented Parkinsonian patients (mean age: 74.7 +/- 4.6 yrs; mean duration of illness: 7.7 +/- 5.2 yrs) in whom application of these EMFs produced reversal of visuospatial hemi-inattention related to left hemispheric dysfunction. These findings support prior observations demonstrating that pT EMFs may bring about reversal of certain cognitive deficits in Parkinsonian patients. Publication Types: Int J Neurosci. 1994 Jul;77(1-2):23-46. Related Articles, Links
Sandyk R. Neuro Communication Research Laboratories, Danbury, CT 06811. The association between degeneration of the nigrostriatal dopamine (DA) system and the motor manifestations of Parkinson's disease (PD) provided the impetus for the development of DA replacement therapy. However, clinical experience has demonstrated that DA-ergic drugs, while attenuating the motor symptoms of PD, have little or no consistent effect on the mental and cognitive symptoms of the disease which are thought to be related partly to degeneration of the meso-cortico-limbic DA system. Thus, failure of DA-ergic drugs to improve the mental and cognitive deficits of PD indicates that these agents cannot fully restore DA functions in the meso-cortico-limbic circuits. The present communication concerns five fully medicated Parkinsonian patients in whom application of a series of treatments with electromagnetic fields (EMF) of extremely low intensity (in the picotesla range) and frequency (5-8Hz) produced a dramatic improvement in performance on Thurstone's World-Fluency Test, a sensitive marker of frontal lobe functions. These findings suggest that in contrast to DA replacement therapy application of low intensity EMF may improve frontal lobe functions in patients with PD presumably by augmenting DA activity in the mesocortical system. As deficiency of the frontal DA system has been implicated also in the development of akinesia and freezing in PD these observations may explain the beneficial effects of EMF on the motor manifestations of the disease. Publication Types: Int J Neurosci. 1993 May;70(1-2):85-96. Related Articles, Links
Sandyk R, Derpapas K. NeuroCommunication Research Laboratories, Danbury, CT 06811. We report a 68 year old man with a 7 year history of Parkinson's disease (PD) who obtained little benefit from treatment by dopaminergic and anticholinergic agents. During the six months prior to presentation, he experienced more rapid deterioration in symptoms including memory functions, increasing depression, and dystonia of the foot. External application of picoTesla range magnetic fields (MF) resulted in rapid attenuation of tremor and foot dystonia with improvements in gait, postural reflexes, mood, anxiety, cognitive, and autonomic functions. Plasma prolactin and luteinizing hormone (LH) levels rose three days after initiation of treatment. In addition, distinct electroencephalographic (EEG) changes were recorded nine days after two treatments with MF and included enhancement of alpha and beta activities as well as resolution of the theta activity. These findings demonstrate, for the first time, objective EEG changes in response to picoTesla range MF in PD. Since the pineal gland is a magnetosensor and as some of the clinical effects produced by MF such as relaxation, sleepiness, mood elevation, increased dreaming, and enhancement of alpha and beta activities in the EEG have also been noted in healthy subjects administered melatonin, we propose that the clinical effects as well as the EEG changes noted after treatment with MF were mediated by the pineal gland which previously has been implicated in the pathophysiology of PD. Publication Types:
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