Department of Neurology, Odense University Hospital, University of Southern Denmark, Odense.
The Danish Rehabilitation Centre for Neuromuscular Diseases, Taastrup.
Eur J Neurol. 2018 Jul;25(7):963-e74. doi: 10.1111/ene.13637. Epub 2018 Apr 17.
Pulsed electromagnetic fields induce a protective and anti-inflammatory effect in the nervous system primarily due to growth factor upregulation that possibly abates neurodegeneration in Parkinson's disease (PD). This study investigated treatment effects of transcranial pulsed electromagnetic fields (T-PEMFs) on quality of life in PD and the feasibility and safety of this treatment.
In this double-blinded clinical study, 97 participants with idiopathic PD (Hoehn & Yahr stage I-IV), on optimal medical anti-parkinsonian treatment, were block randomized (3:3) to either active (n = 49) or placebo treatment (n = 48). Treatment with T-PEMFs entailed one daily 30-min home treatment for eight consecutive weeks. The 39-item Parkinson's Disease Questionnaire (PDQ-39) was assessed at baseline and endpoint. A special questionnaire was used to profile adverse events by interviewing the participants over the full treatment period. Treatment compliance was accounted for by daily treatment registration.
The active group improved with respect to clinical effect size for the two dimensions, i.e. mobility and activities of daily living, compared with the placebo group. No between-group differences were found for the remaining PDQ-39 dimensions. There were no between-group difference in adverse events. Treatment compliance was 97.9%.
Treatment with T-PEMFs improved mobility and activities of daily living scores for clinical effect size only in the active group, indicating a positive treatment response for motor symptoms. No difference was found between the two groups for the remaining PDQ-39 dimensions. The treatment had no or only mild adverse events and was performed with high compliance.
脉冲电磁场主要通过上调生长因子在神经系统中诱导出保护和抗炎作用,从而可能减轻帕金森病(PD)中的神经退行性变。本研究调查了经颅脉冲电磁场(T-PEMFs)治疗对 PD 患者生活质量的影响,以及这种治疗的可行性和安全性。
在这项双盲临床试验中,97 名特发性 PD 患者(Hoehn & Yahr 分期 I-IV)接受最佳药物抗帕金森病治疗,按 3:3 比例随机分为活性(n = 49)或安慰剂治疗(n = 48)组。T-PEMFs 治疗包括每天在家中进行一次 30 分钟的治疗,连续 8 周。在基线和终点时使用 39 项帕金森病问卷(PDQ-39)进行评估。通过对参与者进行全程访谈,使用专门的问卷来描述不良事件。通过每日治疗登记来记录治疗依从性。
与安慰剂组相比,活性组在移动性和日常生活活动这两个维度上的临床效果大小均有改善。在其余 PDQ-39 维度上,两组之间没有差异。不良事件无组间差异。治疗依从率为 97.9%。
T-PEMFs 治疗仅在活性组中改善了移动性和日常生活活动评分的临床效果大小,表明对运动症状有积极的治疗反应。在其余 PDQ-39 维度上,两组之间没有差异。治疗无或仅有轻微的不良事件,且治疗依从性高。