Sandyk R
Department of Neuroscience, Institute for Biomedical Engineering and Rehabilitation Services, Touro College, Dix Hills, NY 11746, USA.
Int J Neurosci. 1998 May;94(1-2):41-54. doi: 10.3109/00207459808986437.
Freezing is a common and disabling symptom in patients with Parkinsonism. It affects most commonly the gait in the form of start hesitation and sudden immobility often resulting in falling. A higher incidence of freezing occurs in patients with progressive supranuclear palsy (PSP) which is characterized clinically by a constellation of symptoms including supranuclear ophthalmoplegia, postural instability, axial rigidity, dysarthria, Parkinsonism, and pseudobulbar palsy. Pharmacologic therapy of PSP is currently disappointing and the disease progresses relentlessly to a fatal outcome within the first decade after onset. This report concerns a 67 year old woman with a diagnosis of PSP in whom freezing and frequent falling were the most disabling symptoms of the disease at the time of presentation. Both symptoms, which were rated 4 on the Unified Parkinson Rating Scale (UPRS) which grades Parkinsonian symptoms and signs from 0 to 4, with 0 being normal and 4 being severe symptoms, were resistant to treatment with dopaminergic drugs such as levodopa, amantadine, selegiline and pergolide mesylate as well as with the potent and highly selective noradrenergic reuptake inhibitor nortriptyline. Weekly transcranial applications of AC pulsed electromagnetic fields (EMFs) of picotesla flux density was associated with approximately 50% reduction in the frequency of freezing and about 80-90% reduction in frequency of falling after a 6 months follow-up period. At this point freezing was rated 2 while falling received a score of 1 on the UPRS. In addition, this treatment was associated with an improvement in Parkinsonian and pseudobulbar symptoms with the difference between the pre-and post EMF treatment across 13 measures being highly significant (p < .005; Sign test). These results suggest that transcranial administration AC pulsed EMFs in the picotesla flux density is efficacious in the treatment of PSP.
冻结现象是帕金森综合征患者常见且致残的症状。它最常影响步态，表现为起步犹豫和突然静止不动，常导致跌倒。进行性核上性麻痹（PSP）患者中冻结现象的发生率更高，该病临床上的特征是一系列症状，包括核上性眼肌麻痹、姿势不稳、轴性强直、构音障碍、帕金森综合征和假性球麻痹。目前PSP的药物治疗效果令人失望，疾病在发病后的头十年内无情地进展至致命结局。本报告涉及一名67岁诊断为PSP的女性，在就诊时，冻结现象和频繁跌倒为该病最致残的症状。这两种症状在统一帕金森评定量表（UPRS）上的评分为4分，该量表将帕金森症状和体征从0到4进行分级，0为正常，4为严重症状，它们对左旋多巴、金刚烷胺、司来吉兰和甲磺酸培高利特等多巴胺能药物以及强效且高度选择性的去甲肾上腺素再摄取抑制剂去甲替林的治疗均有抵抗。在6个月的随访期后，每周经颅施加皮特斯拉磁通密度的交流脉冲电磁场（EMF）与冻结频率降低约50%以及跌倒频率降低约80 - 90%相关。此时，冻结现象在UPRS上的评分为2分，跌倒评分为1分。此外，这种治疗与帕金森综合征和假性球麻痹症状的改善相关，在13项测量指标中，EMF治疗前后的差异具有高度显著性（p < .005；符号检验）。这些结果表明，经颅施加皮特斯拉磁通密度的交流脉冲EMF对PSP的治疗有效。
