Extremely low-frequency pulsed magnetic fields and multiple sclerosis: effects on neurotransmission alone or also on immunomodulation? Building a working hypothesis.

This paper outlines the current state of knowledge on the pathology and treatment of multiple sclerosis (MS) and critically analyses the vast clinical experience of Sandyk in the use of pulsed magnetic fields of 5 Hz at 7.5 pT to treat many symptoms of MS. A complete regression of symptoms, or at least a major improvement, is sometimes so rapid as to suggest that ELF fields exert a greater effect on axonal and synaptic neurotransmission than on the processes leading to demyelination. Pulsed magnetic fields of 50-100 Hz and a few mT (whose flux intensity is 10(9) times greater than that of the fields used by Sandyk) have been seen to induce profound morphological changes (the Marinozzi effect) in the plasma membrane of several cell types, including Raji human lymphoblastoid cells. These observations underlie the author's hypothesis on the possible use of such fields in the treatment of MS. Indeed, these fields should induce the functional arrest of the cells (B- and T-lymphocytes, macrophages, microglia, dendritic cells) of the MS plaque, thereby providing an "electromagnetic immunomodulatory boost" to the effects of drug therapy. To test this working hypothesis, it is suggested that preliminary experimental research be carried out to ascertain: 1) the Marinozzi effect in vivo; 2) the Marinozzi effect on microglia and dendritic cells; and 3) the duration of the membrane changes and their relaxation rate. ELF magnetic fields in the picotesla and millitesla ranges are aimed at improving neurotransmission and correcting local immune pathology, respectively. Both types of field might find application in the treatment of MS patients who no longer respond to or tolerate currently used drugs.