Short-term exposure to a 1.5 tesla static magnetic field does not affect somato-sensory-evoked potentials in man

No modulatory effects by transcranial static magnetic field stimulation of human motor and somatosensory cortex

BACKGROUND

Recently, it was reported that the application of a static magnetic field by placing a strong permanent magnet over the scalp for 10 min led to an inhibition of motor cortex excitability for at least 6 min after removing the magnet. When placing the magnet over the somatosensory cortex, a similar inhibitory after effect could be observed as well.

OBJECTIVE

Our aim was to replicate the inhibitory effects of transcranial static magnetic field stimulation in the motor and somatosensory system.

METHODS

The modulatory effect of static magnetic field stimulation was investigated in three experiments. In two experiments motor cortex excitability was measured before and after 10 or 15 min of magnet application, respectively. The second experiment included a sham condition and was designed in a double-blinded manner. In a third experiment, paired-pulse SSEPs were measured pre and four times post positioning the magnet over the somatosensory cortex for 10 min on both hemispheres, respectively. The SSEPs of the non stimulated hemisphere served as control condition.

RESULTS

We did not observe any systematic effect of the static magnetic field neither on motor cortex excitability nor on SSEPs. Moreover, no SSEP paired-pulse suppression was found.

CONCLUSION

We provide a detailed analysis of possible confounding factors and differences to previous studies on tSMS. After all, our results could not confirm the static magnetic field effect.

Magnetic resonance safety

Magnetic resonance imaging (MRI) has a superior soft-tissue contrast compared to other radiological imaging modalities and its physiological and functional applications have led to a significant increase in MRI scans worldwide. A comprehensive MRI safety training to protect patients and other healthcare workers from potential bio-effects and risks of the magnetic fields in an MRI suite is therefore essential. The knowledge of the purpose of safety zones in an MRI suite as well as MRI appropriateness criteria is important for all healthcare professionals who will work in the MRI environment or refer patients for MRI scans. The purpose of this article is to give an overview of current magnetic resonance safety guidelines and discuss the safety risks of magnetic fields in an MRI suite including forces and torque of ferromagnetic objects, tissue heating, peripheral nerve stimulation, and hearing damages. MRI safety and compatibility of implanted devices, MRI scans during pregnancy, and the potential risks of MRI contrast agents will also be discussed, and a comprehensive MRI safety training to avoid fatal accidents in an MRI suite will be presented.

MRI evaluation and safety in the developing brain

Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences, such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility-weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5-T and 3-T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges, and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, and sedation considerations, and a discussion of current technologies such as MRI conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners.

Exposure to high-field MRI does not affect cognitive function

PURPOSE

To assess potential cognitive deficits under the influence of static magnetic fields at various field strengths some studies already exist. These studies were not focused on attention as the most vulnerable cognitive function. Additionally, mostly no magnetic resonance imaging (MRI) sequences were performed.

MATERIALS AND METHODS

In all, 25 right-handed men were enrolled in this study. All subjects underwent one MRI examination of 63 minutes at 1.5 T and one at 7 T within an interval of 10 to 30 days. The order of the examinations was randomized. Subjects were referred to six standardized neuropsychological tests strictly focused on attention immediately before and after each MRI examination. Differences in neuropsychological variables between the timepoints before and after each MRI examination were assessed and P-values were calculated

RESULTS

Only six subtests revealed significant differences between pre- and post-MRI. In these tests the subjects achieved better results in post-MRI testing than in pre-MRI testing (P = 0.013-0.032). The other tests revealed no significant results.

CONCLUSION

The improvement in post-MRI testing is only explicable as a result of learning effects. MRI examinations, even in ultrahigh-field scanners, do not seem to have any persisting influence on the attention networks of human cognition immediately after exposure.

Short term effects of magnetic resonance imaging on excitability of the motor cortex at 1.5T and 7T

RATIONALE AND OBJECTIVES

The increasing spread of high-field and ultra-high-field magnetic resonance imaging (MRI) scanners has encouraged new discussion of the safety aspects of MRI. Few studies have been published on possible cognitive effects of MRI examinations. The aim of this study was to examine whether changes are measurable after MRI examinations at 1.5 and 7 T by means of transcranial magnetic stimulation (TMS).

MATERIALS AND METHODS

TMS was performed in 12 healthy, right-handed male volunteers. First the individual motor threshold was specified, and then the cortical silent period (SP) was measured. Subsequently, the volunteers were exposed to the 1.5-T MRI scanner for 63 minutes using standard sequences. The MRI examination was immediately followed by another TMS session. Fifteen minutes later, TMS was repeated. Four weeks later, the complete setting was repeated using a 7-T scanner. Control conditions included lying in the 1.5-T scanner for 63 minutes without scanning and lying in a separate room for 63 minutes. TMS was performed in the same way in each case. For statistical analysis, Wilcoxon's rank test was performed.

RESULTS

Immediately after MRI exposure, the SP was highly significantly prolonged in all 12 subjects at 1.5 and 7 T. The motor threshold was significantly increased. Fifteen minutes after the examination, the measured value tended toward normal again. Control conditions revealed no significant differences.

CONCLUSION

MRI examinations lead to a transient and highly significant alteration in cortical excitability. This effect does not seem to depend on the strength of the static magnetic field.

Current status of 3-T cardiovascular magnetic resonance imaging

Continued advances in radiofrequency hardware and tailored software have, in recent times, greatly increased the power and performance of magnetic resonance imaging for noninvasive evaluation of cardiovascular diseases. Magnetic resonance imaging can uniquely be manipulated to trade temporal resolution and spatial resolution against each other, depending on whether detailed structural or functional information is required. However, to date, a number of cardiovascular magnetic resonance applications have been somewhat limited due to signal-to-noise ratio constraints, reflecting the narrow imaging window imposed by physiological cardiac motion. By increasing the operating field strength from 1.5 to 3 T, it is possible (in principle) to double the signal-to-noise ratio, which in turn may be "traded" for improvements in spatial resolution, coverage, or imaging speed. In this context, the development of parallel imaging has set the stage for impressive performance improvements in contrast-enhanced magnetic resonance angiography at 3 T. Indeed, one could argue that without parallel acquisition, the bang for the buck in going from 1.5 to 3 T would be limited. In this paper, we discuss the current status of 3-T magnetic resonance imaging for cardiovascular imaging, considering the relative gains and limitations relative to 1.5 T.

Static magnetic field-induced anti-nociceptive effect and the involvement of capsaicin-sensitive sensory nerves in this mechanism

Data concerning the effect of static magnetic field (SMF) on nociceptive processes are contradictory in the literature probably due to differences in species, characteristics of the magnetic fields, and duration of the exposure. The aim of the present series of experiments was to elucidate the action of acute full-body exposure of mice to a special SMF developed and validated by us on acute visceral and somatic chemonociception and inflammatory mechanical hyperalgesia. SMF exposure significantly diminished the number of acetic acid- or MgSO4-induced abdominal contractions (acute visceral nociception), formalin-evoked paw lickings and liftings in both phase I (acute somatic nociception) and phase II (acute inflammatory nociception) and mechanical hyperalgesia evoked by i.pl. injection of carrageenan as well as the TRPV1 capsaicin receptor agonist resiniferatoxin. Selective inactivation of capsaicin-sensitive sensory fibres by high dose resiniferatoxin pretreatment decreased nocifensive behaviours in phase II of the formalin test to a similar extent suggesting that pro-inflammatory neuropeptides such as substance P and calcitonin gene-related peptide released from these fibres are involved in this inflammatory reaction. Significant inhibitory effects of SMF on formalin-induced nociception and carrageenan-evoked hyperalgesia were absent in resiniferatoxin-pretreated mice, which also points out that capsaicin-sensitive nerves are involved in the SMF-induced anti-nociceptive action.

Effects of a time-varying strong magnetic field on transient increase in Ca2+ release induced by cytosolic Ca2+ in cultured pheochromocytoma cells

Exposure of pheochromocytoma (PC 12) cells to a time-varying 1.51 T magnetic field inhibited an increase in the intracellular Ca2+ concentration ([Ca2+]i) induced by addition of caffeine to Ca(2+)-free medium. This inhibition occurred after a 15-min exposure and was maintained for at least 2 h. [Ca2+]i sharply increased in cells loaded with cyclic ADP-ribose, and 2-h exposure significantly suppressed the increase. Addition of ATP induced a transient increase in intracellular Ca2+ release mediated by IP3 receptor, and this increase was strongly inhibited by the exposure. Results indicated that the magnetic field exposure strongly inhibited Ca2+ release mediated by both IP3 and ryanodine receptors in PC 12 cells. However, thapsigargin-induced Ca2+ influx (capacitative Ca2+ entry) across the cell membrane was unaffected. The ATP content was maintained at the normal level during the 2-h exposure, suggesting that ATP hydrolysis was unchanged. Therefore, Mg2+ which is known to be released by ATP hydrolysis and inhibit intracellular Ca2+ release may not relate the exposure-caused inhibition. Eddy currents induced in culture medium appear to change cell membrane properties and indirectly inhibit Ca2+ release from endoplasmic reticulum and other Ca2+ stores in PC 12 cells.

Static magnetic fields: animal studies

Various experimental studies carried out over the last 30-40 years have examined the effects of the chronic or acute exposure of laboratory animals to static magnetic fields. Many of the earlier studies have been adequately reviewed elsewhere; few adverse effects were identified. This review focuses on studies carried out more recently, mostly those using vertebrates, particularly mammals. Four main areas of investigation have been covered, viz., nervous system and behavioural studies, cardiovascular system responses, reproduction and development, and genotoxicity and cancer. Work on the role of the natural geomagnetic field in animal orientation and migration has been omitted. Generally, the acute responses found during exposure to static fields above about 4 T are consistent with those found in volunteer studies, namely the induction of flow potentials around the heart and the development of aversive/avoidance behaviour resulting from body movement in such fields. No consistently demonstrable effects of exposure to fields of approximately 1T and above have been seen on other behavioural or cardiovascular endpoints. In addition, no adverse effects of such fields on reproduction and development or on the growth and development of tumours have been firmly established. Overall, however, far too few animal studies have been carried out to reach any firm conclusions.

MR procedures: biologic effects, safety, and patient care

The technology used for magnetic resonance (MR) procedures has evolved continuously during the past 20 years, yielding MR systems with stronger static magnetic fields, faster and stronger gradient magnetic fields, and more powerful radiofrequency transmission coils. Most reported cases of MR-related injuries and the few fatalities that have occurred have apparently been the result of failure to follow safety guidelines or of use of inappropriate or outdated information related to the safety aspects of biomedical implants and devices. To prevent accidents in the MR environment, therefore, it is necessary to revise information on biologic effects and safety according to changes that have occurred in MR technology and with regard to current guidelines for biomedical implants and devices. This review provides an overview of and update on MR biologic effects, discusses new or controversial MR safety topics and issues, presents evidence-based guidelines to ensure safety for patients and staff, and describes safety information for various implants and devices that have recently undergone evaluation.

Biological effects of exposure to magnetic resonance imaging: an overview

The literature on biological effects of magnetic and electromagnetic fields commonly utilized in magnetic resonance imaging systems is surveyed here. After an introduction on the basic principles of magnetic resonance imaging and the electric and magnetic properties of biological tissues, the basic phenomena to understand the bio-effects are described in classical terms. Values of field strengths and frequencies commonly utilized in these diagnostic systems are reported in order to allow the integration of the specific literature on the bio-effects produced by magnetic resonance systems with the vast literature concerning the bio-effects produced by electromagnetic fields. This work gives an overview of the findings about the safety concerns of exposure to static magnetic fields, radio-frequency fields, and time varying magnetic field gradients, focusing primarily on the physics of the interactions between these electromagnetic fields and biological matter. The scientific literature is summarized, integrated, and critically analyzed with the help of authoritative reviews by recognized experts, international safety guidelines are also cited.

Safety of strong, static magnetic fields

Issues associated with the exposure of patients to strong, static magnetic fields during magnetic resonance imaging (MRI) are reviewed and discussed. The history of human exposure to magnetic fields is reviewed, and the contradictory nature of the literature regarding effects on human health is described. In the absence of ferromagnetic foreign bodies, there is no replicated scientific study showing a health hazard associated with magnetic field exposure and no evidence for hazards associated with cumulative exposure to these fields. The very high degree of patient safety in strong magnetic fields is attributed to the small value of the magnetic susceptibility of human tissues and to the lack of ferromagnetic components in these tissues. The wide range of susceptibility values between magnetic materials and human tissues is shown to lead to qualitatively differing behaviors of these materials when they are exposed to magnetic fields. Mathematical expressions are provided for the calculation of forces and torques.

Histological changes during development of the cerebellum in the chick embryo exposed to a static magnetic field

Few studies have been performed to evaluate the ultrastructural changes that exposure to static magnetic fields (SMF) can cause to the processes of cell migration and differentiation in the cerebellum during development. Thus, we have studied the development of the cerebellum in the chick embryo (n = 144) under a uniform SMF (20 mT). All of our observations were done on folium VIc of Larsell's classification. The cerebella of chick embryos, which were exposed solely on day 6 of incubation and sacrificed at day 13 of incubation [short exposure (S)1; n = 24], showed an external granular layer (EGL) that was less dense than the EGL in the control group (n = 24). The molecular layer (ML) exhibited a low number of migratory neuroblastic elements. Moreover, the internal granular layer (IGL) was immature, with the cellular elements less abundant and more dispersed than in controls. In chick embryos exposed on day 6 of incubation and sacrificed at day 17 (S2; n = 24), the outstanding feature was the regeneration of the different layers of the cerebellar cortex. The cerebellar cortex of chick embryos exposed continuously to an identical field from the beginning of the incubation up to day 13 [long exposure (L)1; n = 24] or day 17 (L2; n = 24) of incubation showed a higher number of alterations than that of group S1. Electron microscopy confirmed the findings from light microscopy and, at the same time, showed clear signs of cell degeneration and delay in the process of neuronal differentiation. This was more apparent in groups L1 (100%) and L2 (100%) than in groups S1 (95.4%) and S2 (65.2%). In conclusion, the present study showed that SMF can induce irreversible developmental effects on the processes of cell migration and differentiation of the chick cerebellar cortex.

Effects on Rb(+)(K+) uptake of HeLa cells in a high K(+) medium of exposure to a switched 1.7 Tesla magnetic field

Effects of a switched, time-varying 1.7 T magnetic field on Rb(+)(K+) uptake by HeLa S3 cells incubated in an isosmotic high K(+) medium were examined. The magnetic flux density was varied intermittently from 0.07-1.7 T at an interval of 3 s. K(+) uptake was activated by replacement of normal medium by high K(+) medium. A membrane-permeable Ca(2+) chelating agent (BAPTA-AM) and Ca(2+)-dependent K(+) channel inhibitors (quinine, charibdotoxin, and iberiotoxin) were found to reduce the Rb(+)(K+) uptake by about 30-40%. Uptake of K(+) that is sensitive to these drugs is possibly mediated by Ca(2+)-dependent K(+) channels. The intermittent magnetic field partly suppress ed the drug-sensitive K(+) uptake by about 30-40% (P < 0.05). To test the mechanism of inhibition by the magnetic fields, intracellular Ca(2+) concentration ([Ca(2+)]c) was measured using Fura 2-AM. When cells were placed in the high K(&plus;) medium, [Ca(2+)]c increased to about 1.4 times the original level, but exposure to the magnetic fields completely suppressed the increase (P < 0.01). Addition of a Ca(2+) ionophore (ionomycin) to the high K(+) medium increased [Ca(2+)]c to the level of control cells, regardless of exposure to the magnetic field. But the inhibition of K(+) uptake by the magnetic fields was not restored by addition of ionomycin. Based on our previous results on magnetic field-induced changes in properties of the cell membrane, these results indicate that exposure to the magnetic fields partly suppresses K(+) influx, which may be mediated by Ca(2+)-dependent K(+) channels. The suppress ion of K(+) fluxes could relate to a change in electric properties of cell surface and an inhibition of Ca(2+) influx mediated by Ca(2+) channels of either the cell plasma membrane or the inner vesicular membrane of intracellular Ca(2+) stores.

Differentiation of human prostate cancer from benign hypertrophy by in vitro 1H NMR

In vitro 1H NMR spectra were acquired for perchloric acid extracts of tissue samples of human prostate. Seven patients were diagnosed with prostate cancer, 13 with benign prostatic hypertrophy, and 3 with both conditions. Statistically significant differences between the cancer and benign groups were seen for the metabolite peak area ratios of citrate, creatine, and phosphorylcholine to alanine, and citrate to glutamate. There was no correlation of Gleason grade with any of the ratios measured for the cancer samples. Spectra from different sections of large tumors often yielded substantially different area ratios, confirming the heterogeneous nature of these prostate tumors.

Phantom limb pain induced in amputee by strong magnetic fields

An amputee (traumatic) experienced increased phantom limb pain when exposed to the magnetic fields of two magnetic resonance imagers. With a visual analog scale used to measure pain, electric stimulation studies demonstrated that the residual limb was unusually sensitive to subthreshold (for muscle twitch) levels of current. The painful symptoms produced mimicked those experienced in the presence of the imagers.