Role of Magnetic Field in Parkinsons Disease

Role of Magnetic Field in Parkinsons Disease Role of Magnetic Field in Diagnosis and Treatment of Parkinson’s Disease Jehan Zaib Ali Khan, M.Phil. Abstract: Parkinson’s disease (PD) is a neurological disease. It is due to less production of Dopamine in brain. There is no permanent treatment of this disease. But with the passage of time some useful techniques and medicines are developed for diagnosis and treatment, to overcome its signs. MRI and TMS are also included in these techniques. Magnetic Field is basic thing in these techniques. Role of magnetic field is very useful to diagnose and to cure this disease but there is need of further research and work to make these techniques more effective and safe. I have studied and reviewed different researches about these techniques and try to summarize the role of magnetic field in this article. Keywords: magnetic field (MF), magnetic resonance imaging (MRI), transcranial magnetic simulation (TMS), parkinson’s disease (PD), deep brain simulation (DBS), repeated transcranial magnetic simulation (rTMS) Introduction: Parkinson’s disease is a neurological disorder. It is very chronic disease. Patients with this disease have great difficulty in movement. They also face non-motor complications like loss of appetite, sleep deprivation and pain. There is no permanent solution of this disorder. But with the passage of time some techniques and medicines are developed for proper diagnosis and treatment to overcome its symptoms. Levodopa is a basic medicine to fulfill the requirement of dopamine because lack of dopamine in brain is the basic cause of this disease. But there are some side effects of Levodopa. Levodopa-induced dyskinesias are a common complication of chronic dopaminergic therapy in patients with Parkinsons 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.[1] In that case another method is necessary to cure PD and overcome d yskinesias. For this purpose artificial week magnetic fields can be used that have dramatic effect.[1] For diagnosis purpose magnetic resonance imaging (MRI) is very useful. Another step in this direction is functional MRI which describes the neural mechanism of movement automaticity in PD patient.[2] Magnetic Field and Diagnosis of PD: MRI uses strong magnetic field, radio waves and computers to produce detailed images of interior of body. It gives 3-D image representation of internal parts of body. In this way, it is very useful for diagnosis of PD. MRI scanner contains powerful magnets. A strong magnetic field is created by passing an electric current through the wire loops. During this process, other coils in the magnet send and receive radio waves. This triggers protons in the body to align themselves. Once aligned, radio waves are absorbed by the protons, which stimulate spinning. Energy is released after exciting the molecules, which in turn emits energy signals that are picked up by the coil. This information is then sent to a computer which processes all the signals and generates it into an image.[3] Functional MRI is advance form of MRI. It can be used to investigate the underlying neural mechanisms of movement automaticity in Parkinson’s disease patients.[2] Deep brain stimulation (DBS) has become an efficient instrument in the symptomatic therapy of PD. Functional MRI can be used safely for this purpose. Positron emission tomography (PET) is used quite widely in studies dealing with DBS and with PD. fMRI has never used for this purpose but safety of fMRI during thalamic DBS has been proven by a study with a heterogeneous group of patients suffering from neurological disorders.[4] Single pulse transcranial magnetic simulation (TMS) can be used for investigation and diagnosis.[5] Magnetic Field and Treatment of PD: In 1992, it was reported that reported that extracranial treatment with picotesla range magnetic fields is an effective, safe, and revolutionary modality in the management of Parkinsonism. Also for those patients, whom are facing levodopa-induced motor complications. [6][7] It also produces improvements in non-motor aspects like sleep, appetite, pain, mood and sexual behavior. A comprehensive study on a PD patient shows that magnetic field in the range of picotesla is very useful as antiparkinsonian. In this way it reduces the requirement of antiparkinsonian medicines like levodopa.[7] In 2008, Therapeutic effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) were investigated by Toshiaki FURUKAWA and others in PD with cognitive dysfunction known as impaired set switching. They apply rTMS on six patients and monitor these patients by using different tests. They applied 0.2-Hz rTMS over the frontal region at an intensity of 1.2 x. They concluded that when combined with drug therapy and rehabilitation, rTMS appears to be useful for maintaining and improving function.[8] TMS basis on principle of inductance to get electrical energy across the scalp and skull without the pain of direct percutaneous electrical stimulation. It involves placing a small coil of wire on the scalp and passing a powerful and rapidly changing current through it. This produces a magnetic field that passes unimpeded and relatively painlessly through the tissues of the head. Magnetic field induces week electrical current and to produce enough current to excite neurons in the brain, the current passed through the coil must change within a few hundred microseconds.[5] Transcranial magnetic simulation is very useful for treatment of this neurological disease but it is not permanent solution. A patient suffering from PD needs this therapy on regular basis. Sometimes medicines are also required besides of this therapy. Therefore there is need of further research and investigation to improve that treatment of PD.[8] Although single pulse TMS is very useful for investigation purposes and rTMS is very useful for treatment but rTMS may be harmful for by kindling effects as well as the past history of possible misuse of electroconvulsive therapy. It can produce adverse effects on human body like headache, effects on hearing, kindling and effects on hormones. Metallic hardware near the coil can be moved or heated by TMS, presence of metal may be harmful.[5][9] Therefore it needs to take some safety measures to control harmful effects of magnetic field. There should use simulation parameters in safe range like duration of rTMS, frequencies and intensities.[5] Future of MF in Diagnosis and Treatment of PD: Magnetic field is very useful for treatment of diagnosis and treatment of PD. But there is need of further improvement of techniques based on the use of magnetic field. These techniques can become most suitable for patients of PD reducing harmful effects of MF. In the future, the long-term therapeutic effects of rTMS, particularly with regard to the frequency, stimulation intensity and rTMS coil-type, need to be investigated Further developments related to the application of rTMS in Parkinson’s disease are expected.[8] Conclusion: Parkinson’s disease is chronic disorder. There are different medicines and techniques for its diagnosis and treatment. For this purpose use of magnetic field and its effects are very valuable. By using appropriate amount of MF one can overcome the symptoms of PD. There are some side effects of its use for diagnosis and treatment. But these side effects can be controlled by taking some necessary steps. It will not be wrong, if I say that by further research and investigation MF can become a good replacement of antiparkinson medicines. References: [1]D. K. Sandyk R , Anninos PA, Tsagas N, â€Å"Magnetic fields in the treatment of Parkinson ’ s disease . PubMed Commons,† vol. 63, p. 1342026. [2]T. Wu and M. Hallett, â€Å"A functional MRI study of automatic movements in patients with Parkinson’s disease,† Brain, vol. 128, pp. 2250–2259, 2005. [3]T. M. Deserno, Biological and Medical Physics, Biomedical Engineering. Springer, 2010. [4]R. Jech, D. Urgosà ­k, J. Tintera, a Nebuzelskà ½, J. Krà ¡senskà ½, R. Liscà ¡k, J. Roth, and E. RÃ…Â ¯zicka, â€Å"Functional magnetic resonance imaging during deep brain stimulation: a pilot study in four patients with Parkinson’s disease.,† Mov. Disord., vol. 16, no. 4, pp. 1126–32, 2001. [5]E. M. Wassermann and E. M. Wassermann, â€Å"Risk and safety of repetitive transcranial magnetic stimulation,† Electroencephalogr. Clin. Neurophysiol., vol. 108, pp. 1–16, 1998. [6]â€Å"Pulsed electromagnetic fields potentiate neurite outgrowth in the dopaminergic MN9D cell line . PubMed Commons,† vol. 92, no. 6, p. 24523147. [7]R. Sandyk, â€Å"Treatment of Parkinson’s disease with magnetic fields reduces the requirement for antiparkinsonian medications.,† Int. J. Neurosci., vol. 74, pp. 191–201. [8]T. Furukawa, S. Izumi, M. Toyokura, and Y. Masakado, â€Å"Effects of Low-frequency Repetitive Transcranial Magnetic Stimulation in Parkinson ’ s Disease,† vol. 34, no. 3, pp. 63–71, 2009. [9]P. M. Rossini, P. M. Rossini, S. Rossi, and S. Rossi, â€Å"Transcranial magnetic stimulation: diagnostic, therapeutic, and research potential,† Neurology, vol. 68, p. 484, 2007.