The effect of 8 weeks of treatment with transcranial pulsed electromagnetic fields on hand tremor and inter-hand coherence in persons with Parkinson’s disease

Abstract

BackgroundParkinson’s disease (PD) tremor comprises asymmetric rest and postural tremor with unilateral onset. Tremor intensity can be amplified by stress and reduced by attention, and the medical treatment is complex. Mirror movements and unintentional synchronization of bimanual movements, possibly caused by insufficient inhibition of inter-hemispheric crosstalk, have been reported in PD, indicating a lag of lateralization.Potential neuroprotective effects of pulsed electromagnetic fields (PEMF) have been reported in-vitro and in rodents, as have influences of PEMF on human tremor.The aim was to investigate the effect of 8 weeks daily transcranial PEMF treatment (T-PEMF) of persons with PD on rest and postural hand tremor characteristics and on inter-hand coherence.MethodsHand accelerations of 50 PD participants with uni- or bilateral tremor participating in a clinical trial were analysed. A rest and postural tremor task performed during serial subtraction was assessed before and after 8 weeks of T-PEMF (30 min/day, 50 Hz, ±50 V, 3 ms squared pulses) or placebo treatment (sham stimulation 30 min/day). Forty matched healthy persons (no treatment) were included as reference. Intensity and inter-hand coherence related measures were extracted.ResultsThe T-PEMF treatment decreased the inter-hand coherence in the PD group with unilateral postural tremor. The PD group with unilateral postural tremor was less clinically affected by the disease than the PD group with bilateral postural tremor. However, no differences between T-PEMF and placebo treatment on either intensity related or coherence related measures were found when all persons with PD were included in the analyses. The peak power decreased and the tremor intensity tended to decrease in both treatment groups.ConclusionsEight weeks of T-PEMF treatment decreased inter-hand coherence in the PD group with unilateral postural tremor, while no effects of T-PEMF treatment were found for the entire PD group. The unilateral postural tremor group was less clinically affected than the bilateral postural tremor group, suggesting that early treatment initiation may be beneficial. In theory, a reduced inter-hand coherence could result from a neuronal treatment response increasing inter-hemispheric inhibition. However, this requires further studies to determine. Studies of even longer treatment periods would be of interest.Trial registrationClinicalTrials.gov, NCT02125032. Registered 29 April 2014, https://clinicaltrials.gov/ct2/show/NCT02125032?term=NCT02125032&rank=1Electronic supplementary materialThe online version of this article (10.1186/s12984-019-0491-2) contains supplementary material, which is available to authorized users.

Tratamiento a largo plazo con campos electromagnéticos en un modelo animal de la enfermedad de Parkinson

“…El tratamiento con el CEM utilizado en nuestro estudio, parece compensar esa deficiencia dopaminérgica y permitir mantener una mejoría en el equilibrio. Además, los tratamientos electromagnéticos en pacientes con la EP han mostrado una mejora en el temblor postural (Malling et al, 2019) y otros síntomas motores (Liu, Wang, He & Ye, 2008).…”

The influence of posture duration on hand tremor during tasks with attention-distraction in persons with Parkinson’s disease

“…The present study includes baseline accelerometer data sampled during a rest and a postural condition from a subsample of persons diagnosed with idiopathic PD (PD-group) participating in a double-blinded randomized clinical trial [8–11] (clinicaltrials.gov NCT02125032) along with data from an age and sex matched healthy reference group without visible tremor (REF-group) [8, 11, 12]. Inclusion criteria for the trial were an unchanged and optimal medical treatment regarding PD 6 weeks prior to participation; Mini Mental State Examination score > 22; and age > 18 years.…”

“…Exclusion criteria were any known neuromuscular or neurological disease other than PD that might interfere with motor function; psychopathological treatment of other conditions than depression; substance abuse; and active medical implants. The REF-group was included to determine pathologic tremor threshold values defined as mean tremor intensity + 2 SD of the REF-group (rest: 0.300 m/s 2 , postural: 0.783 m/s 2 ) [11] and to gain a reference pattern of time-dependency of movements in the two conditions. Fifty persons with PD had at least one tremoring hand and were included in this study.…”

“…The procedure for the tremor assessment has been reported elsewhere [11]. In short, two-dimensional cylindrical accelerometers (Catsys PD, Danish Product Development Ltd., Snekkersten, Denmark) were fixed on the hand dorsum along and between metacarpal bone II and III on each hand and hand tremor was sampled synchronously from both hands at 50 Hz.…”

Long-term treatment with transcranial pulsed electromagnetic fields improves movement speed and elevates cerebrospinal erythropoietin in Parkinson’s disease

“…This study focused on non-invasive functional effect measures and was the first to apply T-PEMF in PD. We found that 30-min daily treatment with T-PEMF over eight weeks were superior to placebo treatment to increase functional rate of force development during a cyclic chair rise task, and that inter-hand coherence was reduced in the least affected patients with PD [ 15 , 17 ]. However, structural changes in the brain take time and eight weeks of treatment is unlikely to be sufficient.…”