Department of Neurology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
PLoS One. 2018 Sep 25;13(9):e0204478. doi: 10.1371/journal.pone.0204478. eCollection 2018.
Parkinson's disease is caused by dopaminergic neurodegeneration resulting in motor impairments as slow movement speed and impaired balance and coordination. Pulsed electromagnetic fields are suggested to have neuroprotective effects, and could alleviate symptoms.
To study 1) effects of 8-week daily transcranial pulsed electromagnetic field treatment on functional rate of force development and movement speed during two motor tasks with different levels of complexity, 2) if treatment effects depend on motor performance at baseline.
Ninety-seven persons with Parkinson's disease were randomized to active transcranial pulsed electromagnetic field (squared bipolar 3 ms pulses, 50 Hz) or placebo treatment with homebased treatment 30 min/day for 8 weeks. Functional rate of force development and completion time of a sit-to-stand and a dynamic postural balance task were assessed pre and post intervention. Participants were sub-grouped in high- and low-performers according to their baseline motor performance level. Repeated measure ANOVAs were used.
Active treatment tended to improve rate of force development during chair rise more than placebo (P = 0.064). High-performers receiving active treatment improved rate of force development during chair rise more than high-performers receiving placebo treatment (P = 0.049, active/placebo: 11.9±1.1 to 12.5±1.9 BW/s ≈ 5% / 12.4±1.3 to 12.2±1.3 BW/s, no change). No other between-treatment-group or between-treatment-subgroup differences were found. Data on rate of force development of the dynamic balance task and completion times of both motor tasks improved but did not allow for between-treatment differentiation.
Treatment with transcranial pulsed electromagnetic fields was superior to placebo regarding functional rate of force development during chair rise among high-performers. Active treatment tended to increase functional rate of force development while placebo did not. Our results suggest that mildly affected persons with Parkinson's disease have a larger potential for neural rehabilitation than more severely affected persons and indicate that early treatment initiation may be beneficial.
帕金森病是由多巴胺能神经元变性引起的，导致运动障碍，如运动缓慢、平衡和协调受损。脉冲电磁场具有神经保护作用，可以缓解症状。
研究 1）8 周每日经颅脉冲电磁场治疗对两种运动任务中功能力量发展速度和运动速度的影响，这两种任务的复杂性不同，2）治疗效果是否取决于基线时的运动表现。
97 名帕金森病患者随机分为经颅脉冲电磁场（双相 3 ms 脉冲，50 Hz）或安慰剂治疗，在家中每天治疗 30 分钟，共 8 周。干预前后评估功能力量发展速度和从坐姿到站姿的完成时间以及动态姿势平衡任务。根据基线运动表现水平，将参与者分为高绩效者和低绩效者亚组。采用重复测量方差分析。
与安慰剂相比，主动治疗在坐起时更倾向于提高力量发展速度（P = 0.064）。与接受安慰剂治疗的高绩效者相比，接受主动治疗的高绩效者在坐起时力量发展速度提高（P = 0.049，主动/安慰剂：11.9±1.1 至 12.5±1.9 BW/s≈5%/12.4±1.3 至 12.2±1.3 BW/s，无变化）。未发现其他治疗组间或治疗亚组间差异。动态平衡任务的力量发展速度和两个运动任务的完成时间均有改善，但不能区分治疗。
与安慰剂相比，经颅脉冲电磁场治疗在高绩效者的坐起时功能力量发展速度方面更优。主动治疗有增加功能力量发展速度的趋势，而安慰剂则没有。我们的结果表明，轻度帕金森病患者比重度患者具有更大的神经康复潜力，并表明早期治疗开始可能有益。
