Magnetic Field Therapy: A Review

Triggerable Patches for Medical Applications

Medical patches have garnered increasing attention in recent decades for several diagnostic and therapeutic applications. Advancements in material science, manufacturing technologies, and bioengineering have significantly widened their functionalities, rendering them highly versatile platforms for wearable and implantable applications. Of particular interest are triggerable patches designed for drug delivery and tissue regeneration purposes, whose action can be controlled by an external signal. Stimuli-responsive patches are particularly appealing as they may enable a high level of temporal and spatial control over the therapy, allowing high therapeutic precision and the possibility to adjust the treatment according to specific clinical and personal needs. This review aims to provide a comprehensive overview of the existing extensive literature on triggerable patches, emphasizing their potential for diverse applications and highlighting the strengths and weaknesses of different triggering stimuli. Additionally, the current open challenges related to the design and use of efficient triggerable patches, such as tuning their mechanical and adhesive properties, ensuring an acceptable trade-off between smartness and biocompatibility, endowing them with portability and autonomy, accurately controlling their responsiveness to the triggering stimulus and maximizing their therapeutic efficacy, are reviewed.

Efficacy of one-hour negative pressure wound therapy and magnetic field energy in wound healing

OBJECTIVE

Wound healing is an important aspect of health but needs further research to identify the effects and interactions of different treatment approaches on healing. The aims of this study were to investigate the effectiveness of one-hour negative pressure wound therapy (NPWT) and compare histological differences between one-hour NPWT and magnetic field energy (MFE) in rats on early-stage wound healing, wound size and angiogenesis.

METHOD

Standardised wounds were created on Wistar rats that were allocated and divided into NPWT, MFE and control groups. Both treatments were applied for 1 hour/day for 10 days. Wound size, histological changes and wound area blood flow were assessed.

RESULTS

The wound size of all groups was similar on days 0, 2 and 10. The MFE group's wound size was smaller than the NPWT group on days 4, 6 and 8 (p<0.05). Development of the granulation tissue in both the one-hour NPWT and MFE groups was greater than in the control group. Additionally, the inflammatory phase was shorter, and wounds entered the proliferative stage faster in the MFE group than both of the other groups.

CONCLUSION

Treatment with MFE may be more effective in terms of early stage wound closure and angiogenesis. On the other hand, the NPWT group's wound area blood flow was significantly greater than the other two groups. MFE is superior to one-hour NPWT in terms of wound area and angiogenesis. Furthermore, it is worthwhile to note that one-hour NPWT increases bloodflow in the wound area, which stimulates healing.

Using Magnetic Fields to Enhance the Seed Germination, Growth, and Yield of Plants

Geomagnetic field (GMF) protects living organisms on the Earth from the radiation coming from space along with other environmental factors during evolution, and it has affected the growth and development of plants. Many researchers have always been interested in investigating these effects in different aspects. In this chapter, we focus on the methods of using different types of magnetic fields (MFs) to investigate the dimensions of their biological effects on plants. The aim is to increase seed germination, growth characters, and yield of plants using the following methods: (1) Using MFs lower than GMF to study effects of GMF on the growth and yield of plants. (2) Using reversed magnetic fields (RMFs) lower than GMF to study its effects on the growth and development of plants during evolution. (3) Using static magnetic fields (SMFs) higher than GMF and reversed SMFs to study effects of the south (S) and north (N) magnetic pole on plants. (4) Using electromagnetic fields (EMFs) to increase and accelerate seed germination, growth, and yield of plants, and establish the status of plants against other environmental stresses. (5) Using magnetized water (MW) to improve plant seed germination, growth, and yield. (6) Using high gradient magnetic field (HGMF) to study magneto-tropism in plants. In this chapter, we recommend application of various types of MFs to study their biological effects on plants to improve crop production.

Clinical efficacy of electroacupuncture-like magnetic therapy compared to conventional transcutaneous electrical nerve stimulation in individuals with carpal tunnel syndrome

This study aimed to evaluate the clinical efficacy of an electroacupuncture-like magnetic therapy (ELMT) and conventional transcutaneous electrical nerve stimulation (TENS) in patients with carpal tunnel syndrome (CTS). A prospective randomized controlled trial in single-centre was conducted. Thirty-four CTS patients confirmed by electrodiagnostic study were randomized into TENS or ELMT group and completed a six-week treatment program. TENS or ELMT treatment was applied on acupuncture point PC-6 (Neiguan) and one selected hand acupoint. Therapeutic exercises were also included after the electrophysical modality. Their physical signs, motor and sensory performances, Boston Carpal Tunnel Questionnaire (BCTQ) scores, and results of electrodiagnostic study were evaluated. After treatments, both groups demonstrated significantly decreased BCTQ scores and positive rate of Tinel's sign in the major symptomatic side, which indicated improvements in the symptom severity and physical functions. Significant increases in distal sensory amplitude and nerve conduction velocity of the median nerve were only found in the ELMT group. Our study found either conventional TENS or ELMT plus therapeutic exercises could improve the symptomatology and physical provocation sign of CTS. The ELMT has additional improvement in the nerve conduction in patients with CTS.

The Effects of Antioxidants and Pulsed Magnetic Fields on Slow and Fast Skeletal Muscle Atrophy Induced by Streptozotocin: A Preclinical Study

Results

Our findings suggest that antioxidants and PMF may alleviate impaired protein synthesis and degradation pathways in skeletal muscle atrophy. PTS showed a positive effect on the anabolic pathway, while RSV and PMF demonstrated potential for ameliorating the catabolic pathway. Notably, the combination therapy of antioxidants and PMF exhibited a stronger ameliorative effect on skeletal muscle atrophy than either intervention alone.

Conclusion

The present results highlight the benefits of employing a multimodal approach, involving both antioxidant and PMF therapy, for the management of muscle-wasting conditions. These treatments may have potential therapeutic implications for skeletal muscle atrophy.

Pulsed Electromagnetic Fields (PEMF)-Physiological Response and Its Potential in Trauma Treatment

Environmental biophysical interactions are recognized to play an essential part in the human biological processes associated with trauma recovery. Many studies over several decades have furthered our understanding of the effects that Pulsed Electromagnetic Fields (PEMF) have on the human body, as well as on cellular and biophysical systems. These investigations have been driven by the observed positive clinical effects of this non-invasive treatment on patients, mainly in orthopedics. Unfortunately, the diversity of the various study setups, with regard to physical parameters, molecular and cellular response, and clinical outcomes, has made it difficult to interpret and evaluate commonalities, which could, in turn, lead to finding an underlying mechanistic understanding of this treatment modality. In this review, we give a birds-eye view of the vast landscape of studies that have been published on PEMF, presenting the reader with a scaffolded summary of relevant literature starting from categorical literature reviews down to individual studies for future research studies and clinical use. We also highlight discrepancies within the many diverse study setups to find common reporting parameters that can lead to a better universal understanding of PEMF effects.

Effect of Peripheral Magnetic Stimulation on Acute and Chronic Pain After Surgery: A Systematic Review and Meta-Analysis

Peripheral magnetic stimulation (PMS) is a potentially promising modality to help manage postoperative pain. We systematically reviewed the effect of PMS on acute and chronic postoperative pain. MEDLINE, Cochrane CENTRAL, EMBASE, ProQuest Dissertations, and clinical trials.gov were searched from inception until May 2021. We included studies of any study design that included patients ≥18 years of age undergoing any type of surgery that administered PMS within the perioperative period and evaluated postoperative pain. Seventeen randomized controlled trials and 1 nonrandomized clinical trial were included into the review. Thirteen out of the 18 studies found a positive effect with PMS on postoperative pain scores. In our meta-analysis, peripheral magnetic stimulation was more efficacious than sham or no intervention within the first 7 postoperative days (mean difference [MD] -1.64 on a 0 to 10 numerical rating score, 95% confidence interval [CI] -2.08 to -1.20, I2 = 77%, 6 studies, 231 patients). This was also true at 1 and 2 months after surgery (MD -1.82, 95% CI -2.48 to -1.17, I2 = 0%, 3 studies, 104 patients; and MD -1.96, 95% CI -3.67 to -.26, I2 = 84%, 3 studies, 104 patients, respectively). A difference was not seen with persistent pain at 6 and 12-months after surgery, acute postoperative opioid consumption, or adverse events between groups. Results are limited by heterogeneity and generally low-quality studies, as well as low or very low quality of evidence. High-quality and adequately blinded trials are needed to definitively confirm the benefits of peripheral magnetic stimulation administered in the perioperative period. PERSPECTIVE: This review evaluates the efficacy and safety of PMS on postoperative pain. The results help elucidate PMS' role in postoperative pain management and identify gaps where more research is required.

External magnetic field non-invasively stimulates spinal cord regeneration in rat via a magnetic-responsive aligned fibrin hydrogel

Magnetic stimulation is becoming an attractive approach to promote neuroprotection, neurogenesis, axonal regeneration, and functional recovery in both the central nervous system and peripheral nervous system disorders owing to its painless, non-invasive, and deep penetration characteristics. Here, a magnetic-responsive aligned fibrin hydrogel (MAFG) was developed to import and amplify the extrinsic magnetic field (MF) locally to stimulate spinal cord regeneration in combination with the beneficial topographical and biochemical cues of aligned fibrin hydrogel (AFG). Magnetic nanoparticles (MNPs) were embedded uniformly in AFG during electrospinning to endow it magnetic-responsive feature, with saturation magnetization of 21.79 emu g-1. It is found that the MNPs under the MF could enhance cell proliferation and neurotrophin secretion of PC12 cellsin vitro. The MAFG that was implanted into a rat with 2 mm complete transected spinal cord injury (SCI) effectively enhanced neural regeneration and angiogenesis in the lesion area, thus leading to significant recovery of motor function under the MF (MAFG@MF). This study suggests a new multimodal tissue engineering strategy based on multifunctional biomaterials that deliver multimodal regulatory signals with the integration of aligned topography, biochemical cues, and extrinsic MF stimulation for spinal cord regeneration following severe SCI.

Combined Rehabilitation Protocol in the Treatment of Osteoarthritis of the Knee: Comparative Study of Extremely Low-Frequency Magnetic Fields and Soft Elastic Knee Brace Effect

The investigation of this observational case-control study aimed at determining the effectiveness of a combined treatment of extremely low-frequency electromagnetic fields (ELF) with a soft elastic knee brace versus ELF alone in knee osteoarthritis (KOA) with respect to a reduction in pain and functional recovery. We hypothesized that the combined use of ELF and a soft elastic knee brace may provide better results. Thirty-five patients (N = 35, divided into Group 1 = ELF and Group 2 = ELF with the soft elastic knee brace) were analyzed. The rehabilitative protocol consisted of 10 sessions of antiphlogistic and antiedema programs (first cycle) for 2 weeks, followed by twelve sessions of bone repair and connective tissue repair programs (second cycle) in patients with knee osteoarthritis (KOA) for 4 weeks. Patient evaluations were conducted at baseline (T0) and after 2 (T1) and 4 (T2) weeks of treatment. A follow-up evaluation was conducted 6 weeks after treatment (T3). The LIMFA© Therapy System was used to create multifrequency magnetoelectric fields with an intensity of 100 µT and a low-frequency field. The Incrediwear Cred 40 knee sleeve (Incred) was used for alleviating knee pain. The Visual Analogue Scale (VAS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Lysholm score (Ls) were used as outcome measures. The results showed that pain at rest (Vr), pain in motion (Vm), KOOS, and Ls were significantly affected by ELF over time. In conclusion, Group 2 had a better response in terms of pain resolution at rest (p < 0.05) and a concurrent better response at T3 in terms of functional recovery (p < 0.05).

Rotating Magnetic Field Mitigates Ankylosing Spondylitis Targeting Osteocytes and Chondrocytes via Ameliorating Immune Dysfunctions

Ankylosing spondylitis (AS) is clinically characterized by bone fusion that is induced by the pathological formation of extra bone. Unfortunately, the fundamental mechanism and related therapies remain unclear. The loss of SHP-2 (encoded by Ptpn11) in CD4-Cre;Ptpn11^f/f mice resulted in the induction of AS-like pathological characteristics, including spontaneous cartilage and bone lesions, kyphosis, and arthritis. Hence, this mouse was utilized as an AS model in this study. As one of the basic physical fields, the magnetic field (MF) has been proven to be an effective treatment method for articular cartilage degeneration. In this study, the effects of a rotating magnetic field (RMF; 0.2 T, 4 Hz) on an AS-like mouse model were investigated. The RMF treatment (2 h/d, 0.2 T, 4 Hz) was performed on AS mice from two months after birth until the day before sampling. The murine specimens were subjected to transcriptomics, immunomics, and metabolomics analyses, combined with molecular and pathological experiments. The results demonstrated that the mitigation of inflammatory deterioration resulted in an increase in functional osteogenesis and a decrease in dysfunctional osteolysis due to the maintenance of bone homeostasis via the RANKL/RANK/OPG signaling pathway. Additionally, by regulating the ratio of CD4+ and CD8+ T-cells, RMF treatment rebalanced the immune microenvironment in skeletal tissue. It has been observed that RMF interventions have the potential to alleviate AS, including by decreasing pathogenicity and preventing disease initiation. Consequently, RMF, as a moderately physical therapeutic strategy, could be considered to alleviate the degradation of cartilage and bone tissue in AS and as a potential option to halt the progression of AS.

Multidisciplinary and Nonpharmacological Management of Pain in Temporomandibular Disorders (TMDs)

Temporomandibular joint dysfunction (TMD) is not a single diagnosis, but a term covering a group of conditions that involve pain and dysfunction of the masticatory muscles within the temporomandibular joint (TMJ) and associated structures. It is a set of disease entities comprising various ailments and clinical symptoms. One of the most distressing symptoms for TMD patients is pain. Pain is subjective and always unpleasant. The VAS (visual analogue scale) was used in this research. The aim of this study was to assess the influence of physical stimuli, namely extremely low frequency magnetic field (ELF-MF) and LED light, on the experience of pain caused by increased tension in the masticatory muscles in adults. Out of 150 people examined, 104 were enrolled in the study after meeting the eligibility criteria. The study group was divided into 4 subgroups. Each subgroup received physical therapy treatment using a different physical stimulus. The effects of four therapeutic modalities were compared. In terms of VAS scores, pain attenuation was observed in all subgroups. The study confirmed the analgesic effect of the selected physical therapy methods. The authors focused on the analysis of the results obtained for each subgroup, comparing the effects of individual modalities on pain intensity (according to VAS scores). After the treatment, pain relief was observed in each of the studied subgroups. Treatment using ELF-MF and ELF-MF in combination with LED light in the course of TMD brings about a significant improvement in the subjective pain experience expressed in VAS pain scores. The use of selected physical stimuli and their beneficial effect on pain symptoms during mandibular movements has important implications for patients' daily life and work. Incorporation of therapeutic methods can help enhance patient satisfaction and comfort during manual TMJ therapy and lengthy dental procedures.

FT-IR Analysis of Structural Changes in Ketoprofen Lysine Salt and KiOil Caused by a Pulsed Magnetic Field

High-intensity, low-frequency magnetic fields (MFs) have been widely used in the treatment of diseases and in drug delivery, even though they could induce structural changes in pharmacological molecules. Morphological changes in ketoprofen and KiOil were investigated through Fourier-transform infrared spectroscopy (FT-IR). Unsupervised principal component analysis was carried out for data clustering. Clinical validation on 22 patients with lower back pain was managed using diamagnetic therapy plus topical ketoprofen or KiOil. The Numerical Rating Scale (NRS) and Short-Form Health Survey 36 (SF-36) were used to evaluate clinical and functional response. Ketoprofen showed clear clustering among samples exposed to MF (4000−650 cm−1), and in the narrow frequency band (1675−1475 cm−1), results evidenced structural changes which involved other excipients than ketoprofen. KiOil has evidenced structural modifications in the subcomponents of the formulation. Clinical treatment with ketoprofen showed an average NRS of 7.77 ± 2.25 before and an average NRS of 2.45 ± 2.38 after MF treatment. There was a statistically significant reduction in NRS (p = 0.003) and in SF-36 (p < 0.005). Patients treated with KiOil showed an average NRS of 7.59 ± 2.49 before treatment and an average NRS of 1.90 ± 2.26 after treatment (p < 0.005). SF-36 showed statistical significance for all items except limitations due to emotional problems. A high-intensity pulsed magnetic field is an adjunct to topical treatment in patients with localized pain, and the effect of MF does not evidence significant effects on the molecules.

The Influence of Magnetic Composite Capsule Structure and Size on Their Trapping Efficiency in the Flow

A promising approach to targeted drug delivery is the remote control of magnetically sensitive objects using an external magnetic field source. This method can assist in the accumulation of magnetic carriers in the affected area for local drug delivery, thus providing magnetic nanoparticles for MRI contrast and magnetic hyperthermia, as well as the magnetic separation of objects of interest from the bloodstream and liquid biopsy samples. The possibility of magnetic objects' capture in the flow is determined by the ratio of the magnetic field strength and the force of viscous resistance. Thus, the capturing ability is limited by the objects' magnetic properties, size, and flow rate. Despite the importance of a thorough investigation of this process to prove the concept of magnetically controlled drug delivery, it has not been sufficiently investigated. Here, we studied the efficiency of polyelectrolyte capsules' capture by the external magnetic field source depending on their size, the magnetic nanoparticle payload, and the suspension's flow rate. Additionally, we estimated the possibility of magnetically trapping cells containing magnetic capsules in flow and evaluated cells' membrane integrity after that. These results are required to prove the possibility of the magnetically controlled delivery of the encapsulated medicine to the affected area with its subsequent retention, as well as the capability to capture magnetically labeled cells in flow.

Magnetic field effects in biology from the perspective of the radical pair mechanism

Hundreds of studies have found that weak magnetic fields can significantly influence various biological systems. However, the underlying mechanisms behind these phenomena remain elusive. Remarkably, the magnetic energies implicated in these effects are much smaller than thermal energies. Here, we review these observations, and we suggest an explanation based on the radical pair mechanism, which involves the quantum dynamics of the electron and nuclear spins of transient radical molecules. While the radical pair mechanism has been studied in detail in the context of avian magnetoreception, the studies reviewed here show that magnetosensitivity is widespread throughout biology. We review magnetic field effects on various physiological functions, discussing static, hypomagnetic and oscillating magnetic fields, as well as isotope effects. We then review the radical pair mechanism as a potential unifying model for the described magnetic field effects, and we discuss plausible candidate molecules for the radical pairs. We review recent studies proposing that the radical pair mechanism provides explanations for isotope effects in xenon anaesthesia and lithium treatment of hyperactivity, magnetic field effects on the circadian clock, and hypomagnetic field effects on neurogenesis and microtubule assembly. We conclude by discussing future lines of investigation in this exciting new area of quantum biology.

SPION based magnetic PLGA nanofibers for neural differentiation of mesenchymal stem cells

Recently, magnetic platforms have been widely investigated in diagnostic, therapeutic and research applications due to certain properties, such as cell and tissue tracking and imaging, thermal therapy and being dirigible. In this study, the incorporation of magnetic nanoparticles (MNPs) in nanofibers has been proposed to combine the advantages of both nanofibers and MNPs to induce neural differentiation of mesenchymal stem cells. Magnetic poly (lactic-co-glycolic acid) nanofibers (containing 0%, 5% and 10% SPION) were fabricated and utilized as the matrix for the differentiation of mesenchymal stem cells (MSCs). Morphological, magnetic and mechanical properties were analyzed using FESEM, VSM and tensile test, respectively. The expression of neural markers (TUJ-1, NSE, MAP-2) was assessed quantitative and qualitatively utilizing RT-PCR and immunocytochemistry. Results confirmed the incorporation of MNPs in nanofibrous scaffold, presenting a saturation magnetization of 9.73 emu g^-1. Also, with increase in magnetic particle concentration (0%-10%), tensile strength increased from 4.08 to 5.85 MPa, whereas the percentage of elongation decreased. TUJ-1 expression was 3.8 and 1.8 fold for 10% and 5% magnetic scaffold (versus non-magnetic scaffold) respectively, and the expression of NSE was 6.3 and 1.2-fold for 10% and 5%, respectively. Consequently, it seems that incorporation of magnetic biomaterial can promote the neural differentiation of MSCs, during which the augmentation of super paramagnetic iron oxide concentration from 0% to 10% accelerates the neural differentiation process.

Diamagnetic Therapy in a Patient with Complex Regional Pain Syndrome Type I and Multiple Drug Intolerance: A Case Report

Complex regional pain syndrome (CRPS) is a neurologic chronic pain condition hard to diagnose and treat, and able to significantly impact the quality of life. Currently, the available multimodal, individualized treatments (i.e., pharmacological and non-pharmacological therapies including invasive procedures) are aimed only at symptom control. Herein, we report a 69-year-old Caucasian female who came to our attention due to a 3-year history of severe (10/10) burning pain in her right ankle, along with oedema and local changes in skin color and temperature, which occurred after the ankle sprain. Previous pharmacological attempts failed due to multiple drug intolerance. Clinical examination confirmed the CRPS type I diagnosis, and a weekly diamagnetic therapy protocol was started since the patient refused further medications and interventional procedures. After 10 weeks of treatment, a significant (p < 0.01) reduction in pain severity and absence of oedema (difference in ankles’ circumference: from 3 cm to 0) were observed, with consequent improvements in quality of life and no adverse events. Although high-quality clinical evidence is still lacking, our case report suggests further investigating the potential use of diamagnetic therapy as a non-invasive and safe adjunctive treatment for CRPS, and as an alternative when patients did not benefit from drugs and/or refuse invasive procedures.

Effect of an Extremely Low-Frequency Electromagnetic Field on the Concentration of Salivary Immunoglobulin A

Extremely Low-Frequency Electromagnetic Field (ELF MF) therapy is effective in the treatment of injury, inflammation and postoperative complications. Its clinical applications relate to bone unification, pain reduction, soft tissue oedema and the decrease of electric potentials in the oral cavity. It enhances regeneration of periapical bone lesions. It is obvious that cells (leukocytes, platelets, keratinocytes, osteoblasts) and proteins (fibrin, collagen, elastin and growth factors) exhibit alterations when exposed to an Extremely Low-Frequency Electromagnetic Field. The aim of the study was to evaluate the effect of an Extremely Low-Frequency Electromagnetic Field (ELF MF) on the parotid gland on the concentration of salivary immunoglobulin A. The study group consisted of 24 patients, aged 14–16, who underwent ELF MF on the parotid gland region. The control group comprised 25 matching persons. The IgA concentration in saliva samples was established using radial immunodiffusion. Following ELF MF, a statistically significant increase in the concentration of secretory immunoglobulin A was found in the study group, whereas in the control group, no statistically significant differences were noted. It can be concluded that an Extremely Low-Frequency Electromagnetic Field increases the activity of the immune system of the parotid gland.

Efficacy of Magnetic Therapy in Pain Reduction in Patients with Chronic Pelvic Pain: A Systematic Review

Chronic pelvic pain (CPP), also known as chronic pelvic pain syndrome (CPPS), is a common and painful condition. However, its treatment is still a challenge. The findings about the beneficial effects of electromagnetic therapy provide a new, potentially valid, therapeutic alternative for the management of patients with CPP. Objectives: to analyze the efficacy of magnetic field therapy in pain reduction in patients with CPP and for other variables, such as urinary symptoms and quality of life, as well as to review the evidence, in order to establish an action protocol. A qualitative systematic review was carried out, based on the PRISMA protocol and registered in PROSPERO (CRD42022285428). A search was performed in the PubMed, Medline, Scopus, Cochrane, PEDro, BVS, and WOS databases, including those articles in which the patients suffered from CPP; the study variable was pain, and the intervention was based on the application of magnetic fields. Results: Among the 81 articles found, five clinical trials were considered (with an average score of 7.2 in the PEDro scale), with a total of 278 participants, most of whom presented improvements in perceived pain (p ≤ 0.05), as well as in quality of life (p < 0.05) and urinary symptoms (p = 0.05), evaluated through the NIH-CPSI and VAS scales. The therapy was conducted as a monotherapy or in combination with a pharmacological treatment. There was no common protocol among the different articles. Conclusions: Intervention programs through electromagnetic therapy, on their own or with other therapies, can be effective in patients with CPP.

Method for Prolonging the Shelf Life of Apples after Storage

This study investigated the effects of the use of low magnetic fields as a potential method for improving the quality of apples after storage. The fruit were exposed to 100 μT magnetic fields for 8 h per day and kept for a period of two weeks in room conditions. The results showed that the samples that were treated with a magnetic field generally had a higher value ratio of total soluble solid and titratable acidity compared to the untreated samples, which indicated their higher quality. Continuous treatment with a magnetic field influenced the mechanical properties of apples, as demonstrated by the greater firmness, lower weight loss and suppressed CO2 production of the apples that were stored in room conditions. After the treatment of the apples, a new product was produced with greater firmness, higher quality potential (the ratio of total soluble solid and titratable acidity) and an extended shelf life/lower respiration rate. Therefore, treatment with a magnetic field can be used to extend the shelf life of apples and needs to be demonstrated by further investigations.

Searching for the Mechanism of Action of Extremely Low Frequency Electromagnetic Field-The Pilot fNIRS Research

There is an ongoing debate on the benefits of magnetic stimulation in neurological disorders. Objectives: We aimed to evaluate the influence of magnetic stimulation on blood oxygenation of the motor cortex using functional near-infrared spectroscopy (fNIRS). Methods: A total of 16 healthy volunteer participants were subjected to four protocols. In the first two protocols, the participants remained at rest without (and then with) magnetic stimulation. In the next two protocols, motor cortex stimulation was achieved using a finger-tapping task, with and without magnetic stimulation. Changes in blood oxygenation levels within the motor cortex were recorded and analysed. Results: No characteristic changes in the blood oxygenation level-dependent responses were observed in resting participants after magnetic stimulation. No statistically significant difference was observed in the amplitude of the fNIRS signal before and after magnetic stimulation. We observed characteristic blood oxygenation level-dependent responses after the finger-tapping task in the second protocol, but not after magnetic stimulation. Conclusions: Although we did not observe any measurable effect of the magnetic field on the haemodynamic response of the motor cortex, understanding the mechanism(s) of magnetic stimulation may be important. Additional, detailed studies are needed to prove or negate the potential of this medical procedure.

Compassionate use of Quantum Magnetic Resonance Therapy for treatment of children with Diffuse Brainstem Glioma in Mexico City: a single institutional experience

PURPOSE

Diffuse Brainstem Glioma (DBG) is a catastrophic brain tumor with a survival rate of less than 10% two years after diagnosis despite the existence of different treatment protocols. Among the devices that use magnetic fields generated by Magnetic Resonance Imaging is Quantum Magnetic Resonance Therapy (QMRT).

METHODS

Five children diagnosed with DBG in our institution in Mexico City underwent treatment of compassionate use with QMRT between December 2018 and July 2019. A survival analysis was performed with previously reported historical data (n = 15).

RESULTS

Two patients (40%) survived after three years of follow-up; the log-rank test showed a statistically significant difference in overall survival between both groups (p = 0.032). All patients tolerated the treatment adequately without reporting any severe clinical or neuroradiological adverse effects. Of the patients included, all showed a decrease in the tumor one month after the end of the treatment, although there was great variability in the response and the difference was not statistically significant (p = 0.06).

CONCLUSIONS

Although future investigations are needed to confirm the findings reported in the present study, the improvement in survival is promising for a group of patients whose prognosis has been catastrophic over the years. Trial registration NCT03577600.

Stimuli-responsive cyclodextrin-based supramolecular assemblies as drug carriers

Cyclodextrins (CDs) are widely employed in biomedical applications because of their unique structures. Various biomedical applications can be achieved in a spatiotemporally controlled manner by integrating the host-guest chemistry of CDs with stimuli-responsive functions. In this review, we summarize the recent advances in stimuli-responsive supramolecular assemblies based on the host-guest chemistry of CDs. The stimuli considered in this review include endogenous (pH, redox, and enzymes) and exogenous stimuli (light, temperature, and magnetic field). We mainly discuss the mechanisms of the stimuli-responsive ability and present typical designs of the corresponding supramolecular assemblies for drug delivery and other potential biomedical applications. The limitations and perspectives of CD-based stimuli-responsive supramolecular assemblies are discussed to further promote the translation of laboratory products into clinical applications.

Static Magnetic Field Inhibits Growth of Escherichia coli Colonies via Restriction of Carbon Source Utilization

Magnetobiological effects on growth and virulence have been widely reported in Escherichia coli (E. coli). However, published results are quite varied and sometimes conflicting because the underlying mechanism remains unknown. Here, we reported that the application of 250 mT static magnetic field (SMF) significantly reduces the diameter of E. coli colony-forming units (CFUs) but has no impact on the number of CFUs. Transcriptomic analysis revealed that the inhibitory effect of SMF is attributed to differentially expressed genes (DEGs) primarily involved in carbon source utilization. Consistently, the addition of glycolate or glyoxylate to the culture media successfully restores the bacterial phenotype in SMF, and knockout mutants lacking glycolate oxidase are no longer sensitive to SMF. These results suggest that SMF treatment results in a decrease in glycolate oxidase activity. In addition, metabolomic assay showed that long-chain fatty acids (LCFA) accumulate while phosphatidylglycerol and middle-chain fatty acids decrease in the SMF-treated bacteria, suggesting that SMF inhibits LCFA degradation. Based on the published evidence together with ours derived from this study, we propose a model showing that free radicals generated by LCFA degradation are the primary target of SMF action, which triggers the bacterial oxidative stress response and ultimately leads to growth inhibition.

High-Intensity, Low-Frequency Pulsed Electromagnetic Field as an Odd Treatment in a Patient with Mixed Foot Ulcer: A Case Report

Lower-extremity ulcers are associated with an increasing prevalence and significant economic and social costs. To date, there is no high-quality evidence related to an optimal treatment algorithm. A multimodal approach is needed particularly in patients with comorbidity and polytherapy. Herein, we report the case of a 94-year-old Caucasian female with comorbidity and polytherapy who was admitted to our observation for a history (1 year) of chronic painful malleolar mixed ulcer. After clinical evaluation, she was treated with a twice daily pain relief therapy and with a weekly diamagnetic therapy protocol plus a local treatment. During the clinical examination, we documented a statistically significant improvement in both pain (VAS score from 8 to 2 p < 0.01) and foot ulcer (surface reduction from 6 cm × 4 cm to 2 cm × 2 cm, p < 0.01) at the sixth week of combined treatment. The ulcer completely healed at the ninth week. This is the first study to document the effect of diamagnetic therapy as an add-on therapy in the management of wound healing. In conclusion, even if high-quality evidence is still lacking, diamagnetic therapy might represent an interesting option as an add-on treatment for ulcer.

Effect of weak alternating magnetic fields on planarian regeneration

We investigated the effect of weak combined magnetic field (CMF) on stem cell proliferation and regeneration of the planarian Schmidtea mediterranea. CMF parameters were set in accordance with Valery Lednev's theory of magnetic parametric resonance. It was shown that CMF with an amplitude of 74 μT and a frequency of 30 Hz accelerated the growth of the planarian head blastema by 25%. Alterations of the frequency in range from 27 to 33 Hz led to a complete disappearance of the effect. A further decrease in the CMF frequency inhibited regeneration. The maximum inhibition (24%) was observed at a frequency of 16 Hz. A further decrease in the CMF frequency (down to 13 Hz) led to disappearance of the described effect. Regeneration rate changes under the CMF are influenced by alterations in stem cell mitotic activity, which in turn depends on the wound-induced gene expression level. Thus, the CMF, preset in accordance to the Lednev's theory, can specifically influence the expression of regeneration-related genes and regeneration itself, what can find biomedical applications.

Effect of Size on Magnetic Polyelectrolyte Microcapsules Behavior: Biodistribution, Circulation Time, Interactions with Blood Cells and Immune System

Drug carriers based on polyelectrolyte microcapsules remotely controlled with an external magnetic field are a promising drug delivery system. However, the influence of capsule parameters on microcapsules’ behavior in vivo is still ambiguous and requires additional study. Here, we discuss how the processes occurring in the blood flow influence the circulation time of magnetic polyelectrolyte microcapsules in mouse blood after injection into the blood circulatory system and their interaction with different blood components, such as WBCs and RBCs. The investigation of microcapsules ranging in diameter 1–5.5 μm allowed us to reveal the dynamics of their filtration by vital organs, cytotoxicity, and hemotoxicity, which is dependent on their size, alongside the efficiency of their interaction with the magnetic field. Our results show that small capsules have a long circulation time and do not affect blood cells. In contrast, the injection of large 5.5 μm microcapsules leads to fast filtration from the blood flow, induces the inhibition of macrophage cell line proliferation after 48 h, and causes an increase in hemolysis, depending on the carrier concentration. The obtained results reveal the possible directions of fine-tuning microcapsule parameters, maximizing capsule payload without the side effects for the blood flow or the blood cells.

Correlation between ELF-PEMF exposure and Human RPE Cell Proliferation, Apoptosis and Gene Expression

Purpose

Emerging evidence implies that electromagnetic fields (EMFs) can negatively affect angiogenesis. In this regard, the effects of extremely low frequency pulsed electromagnetic field (ELF-PEMF) exposure on the relative expression level of angiogenic factors involved in the pathogenesis of ocular disorders were evaluated in human retinal pigment epithelial (hRPE) cells in order to investigate a noninvasive therapeutic method for patients with several ocular diseases associated with neovascularization.

Methods

After separating hRPE cells from globes, hRPE cells were exposed to 15 mT of ELF-PEMF (120 Hz) at 5, 10, and 15 min for seven days. Cell proliferation and apoptosis of treated cells were evaluated via ELISA assay. Moreover, relative expression changes of HIF-1α, CTGF, VEGFA, MMP-2, cathepsin D, and E2F3 were performed using real-time RT-PCR.

Results

ELF-PEMF exposure had no significant effects on the apoptosis and proliferation rate of hRPE cells. Expression level of HIF-1α, CTGF, VEGFA, MMP-2, cathepsin D, and E2F3 was downregulated following 5 min of ELF-PEMF exposure.

Conclusion

As ELF-PEMF showed inhibitory effects on the expression of angiogenic genes in hRPE cells with no cytotoxic or proliferative side effects, it can be introduced as a useful procedure for managing angiogenesis induced by retinal pathogenesis, although more studies with adequate follow-up in animal models are needed.

The effects of pulsed electromagnetic field on experimentally induced sciatic nerve injury in rats

Some experimental research indicates that low-frequency pulsed electromagnetic field (PEMF) stimulation may accelerate regeneration in sciatic nerve injury. However, little research has examined the electrophysiological and functional properties of regenerating peripheral nerves under PEMF. The main aim of the present study is to investigate the effects of PEMF on sciatic nerve regeneration in short- and long-term processes with electrophysiologically and functionally after crushing damage. Crush lesions were performed using jewelery forceps for 30 s. After crush injury of the sciatic nerves, 24 female Wistar-Albino rats were divided into 3 groups with 8 rats in each group: SH(Sham), SNI (Sciatic Nerve Injury), SNI+PEMF(Sciatic Nerve Injury+Pulsed Electromagnetic Field). SNI+PEMF group was exposed to PEMF (4 h/day, intensity; 0.3mT, low-frequency; 2 Hz) for 40-days. Electrophysiological records (at the beginning and 1st, 2nd, 4th and 6th weeks post-crush) and functional footprints (at 1st, 2nd, 3rd, 4th, 5th and 6th weeks post crush) were measured from all groups during the experiment. The results were compared to SNI and SNI+PEMF groups, it was found that amplitude and area parameters in the first-week were significantly higher and latency was lower in the SNI+PEMF group than in the SNI group (p < 0,05). However, the effect of PEMF was not significant in the 2nd, 4th, 6th weeks. In addition, in the 1st and 2nd weeks, the SSI parameters were significantly higher in SNI+PMF group than SNI group (p < .05). These results indicate that low-frequency PEMF is not effective for long-periods of application time while PEMF may be useful during the short-term recovery period.

Substantiation of the additional prescription of magnetotherapy in the complex of rehabilitation of children with concomitant diseases of the nervous system during remission of cancer

Introduction. The increase in the number of children with oncological diseases requires development of effective methods of medical rehabilitation. Purpose: To determine the effectiveness of the use of low-frequency magnetotherapy (LFMT) in children with diseases of the nervous system, manifested in the period of remission of oncological diseases (OD) in the complex of sanatorium rehabilitation (SRR). Methods: Children with OD at the stage of rehabilitation in a sanatorium underwent a clinical examination: medical history, concomitant pathology, complaints, clinical examination, assessment of neurological status; instrumental studies: electroencephalography (EEG) - assessment of the bioelectrical activity of the brain; echoencephalography (EchoEG) - assessment of CSF dynamics; Doppler ultrasound (USDG) - assessment of cerebral circulation. For 25 children with concomitant diseases of the nervous system during the period of OD remission (17 people) and solid tumors (8 people), in addition to the general complex of SRR, magnetotherapy was prescribed for the cervical-collar zone according to the following method: magnetic induction 20 - 30 mT, exposure 10 - 15 minutes, every other day, for a course of 5 procedures. Results: The use of the therapeutic complex TFR with the additional prescription of magnetotherapy can reliably reduce childrenʹs complaints in remission of the OD for the impaired activity of the nervous system. According to the USDG indicators, statistically significant positive changes in cerebral hemodynamics were established. The results of ultrasound echoEG indicate the improvement of CSF dynamics. According to the EEG data, positive changes in the state of brain electrogenesis were established. Conclusion: The effectiveness of LFMT in children in the period of remission of oncohematological diseases with concomitant diseases of the nervous system has been substantiated. Keywords: children, oncological diseases, sanatorium rehabilitation, low-frequency magnetic therapy,

Effects Induced by a Weak Static Magnetic Field of Different Intensities on HT-1080 Fibrosarcoma Cells

In this study, we investigated the effects of weak static magnetic fields (SMFs) on HT-1080 human fibrosarcoma cells. Exposures to SMFs for four consecutive days were varied from 0.5 to 600 µT for treated units, while exposures to control units were held at 45 µT. Growth rates were measured by comparing cell counts, whereas membrane potentials, mitochondrial calcium, mitochondrial superoxide (O₂ ^- ), nitric oxide (NO), hydrogen peroxide (H₂ O₂ ), intercellular pH, and oxidative stress were measured by using fluorescent dyes. The relative cell growth rates vary with the angle of the SMFs. Increases in the magnitude of the SMFs increased concentrations of mitochondrial calcium and membrane potential and decreased intracellular pH. H₂ O₂ , an important reactive oxygen species (ROS), increases at 100 and 200 µT, decreases at 300 and 400 µT and increases again at 500 and 600 µT. Overall, oxidative stress increases slightly with increasing SMFs, while superoxide and NO concentrations decrease. These results indicate that weak SMFs can accelerate and inhibit cell growth rates and induce alterations in ROS. Changes in ROS and oxidative stress are important for various cell functions. Calcium influx into mitochondria was one of the initial steps into the corresponding changes. Bioelectromagnetics. 2021. © 2021 Bioelectromagnetics Society.

A Prospective Comparative Study of Pulsed High-Intensity Laser Therapy and Pulsed Electromagnetic Field on Chronic Nonspecific Low Back Pain

Objective: This study explored the different effects of pulsed high-intensity laser therapy (HILT) versus pulsed electromagnetic field (EMF) in the treatment of chronic nonspecific low back pain (ChNsLBP). Methods: Between August and December 2019, 51 ChNsLBP participants with a mean age of 35.2 ± 8.6 years were enrolled in this prospective comparative study. At random, they were divided into three groups, 17 in each; HILT, EMF, and controls. HILT group was recruited for Nd:YAG laser using the following parameters: a wavelength of 1064 nm, fluency of 610-810 mJ, frequency of 10-40 Hz, average power of 10.5 W, and 120 μs short pulse duration in scanning mode. All groups received the treatment twice a week for 8 consecutive weeks. They were assessed for the modified Oswestry disability index (MODI), pain disability index (PDI), visual analog scale (VAS), and lumbar flexion range of motion (flex ROM) before and after 8 weeks of study program. Results: The results showed greater improvement in the HILT group (VAS, PDI, MODI, and lumbar flex ROM, p = 0.001) than the EMF group (VAS, p = 0.002, PDI, p = 0.045, MODI, p = 0.002, and lumbar flex ROM, p = 0.042), with significant difference between the two groups in favor of the HILT group (p ˂ 0.05). Conclusions: Depending on the results of the study, both HILT and EMF are useful physiotherapy modalities in the treatment of ChNsLBP with HILT exhibiting better outcomes than EMF. Clinical recommendations should be highlighted to instigate the use of HILT in the management of musculoskeletal disorders, distinctively ChNsLBP.

Magnetic fields as a potential therapy for diabetic wounds based on animal experiments and clinical trials

Diabetes mellitus (DM) is a chronic metabolic disorder with various complications that poses a huge worldwide healthcare burden. Wounds in diabetes, especially diabetic foot ulcers (DFUs), are difficult to manage, often leading to prolonged wound repair and even amputation. Wound management in people with diabetes is an extremely clinical and social concern. Nowadays, physical interventions gain much attention and have been widely developed in the fields of tissue regeneration and wound healing. Magnetic fields (MFs)-based devices are translated into clinical practice for the treatment of bone diseases and neurodegenerative disorder. This review attempts to give insight into the mechanisms and applications of MFs in wound care, especially in improving the healing outcomes of diabetic wounds. First, we discuss the pathological conditions associated with chronic diabetic wounds. Next, the mechanisms involved in MFs' effects on wounds are explored. At last, studies and reports regarding the effects of MFs on diabetic wounds from both animal experiments and clinical trials are reviewed. MFs exhibit great potential in promoting wound healing and have been practised in the management of diabetic wounds. Further studies on the exact mechanism of MFs on diabetic wounds and the development of suitable MF-based devices could lead to their increased applications into clinical practice.

Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review

Complex regional pain syndrome type I (CRPS-I) is a rare condition with huge variability in triggering factors and clinical scenarios. The complexity of the pathophysiology of this condition fosters the proposal of several therapeutic options with different mechanisms of action in both research and clinical practice. An interdisciplinary and multimodal approach, including pharmacological and non-pharmacological interventions, particularly physical therapy, is recommended by international guidelines, but the benefits and harms of available interventions are poorly known. In this scoping review, the clinical rationale for use of physical agent modalities for patients with CRPS-I will be presented. We found 10 studies addressing the role of electromagnetic field therapy, electrotherapy, and laser therapy. Our findings suggest that physical therapy modalities, in particular transcutaneous electrical nerve stimulation (TENS) and pulsed electromagnetic field therapy (PEMF), may contribute to reduce pain and improve function in patients with CRPS-1.

Finger skin blood perfusion during exposure of ulnar and median nerves to the static magnetic field of a rare-earth magnet: A randomized pilot study

This pilot study's goal was to investigate the impacts of static magnetic fields (SMF) on finger skin blood perfusion (SBP) when exposing the ulnar artery and ulnar and medial nerves to a rare earth concentric magnet for 30 minutes. Control SBP was measured in 4th fingers of adults (n = 12, age 26.0 ± 1.4 years) for 15 minutes using laser-Doppler. Then, active-magnets were placed over one arm's ulnar and median nerves at the wrist and sham-magnets placed at corresponding sites on the other arm. Devices were randomly assigned and placed by an investigator "blinded" to device type. The maximum SMF perpendicular to skin was 0.28 T measured 2 mm from magnet surface. The tangential field at this distance was 0.20 T. SBP was analyzed and tested for differential effects attributable to magnets compared to shams in each of the 5-minute intervals over the full 45-minute experiment. Results showed no statistically significant difference between SBP measured on the magnet-treated side compared to the sham side. Magnet and sham side SBP values (mean ± SEM, arbitrary units) prior to device placement were 0.568 ± 0.128 vs. 0.644 ± 0.115, p = .859 and during device placement were 0.627 ± 0.135 vs. 0.645 ± 0.117, p = .857. In conclusion, these findings have failed to uncover any significant effects of the static magnetic field on skin blood perfusion in the young healthy adult population evaluated. Its potential for altering SBP in more mature persons or those with underlying conditions affecting blood flow has not been evaluated but represents the next target of research inquiry. ClinicalTrials.gov registration number is NCT04539704.

Moderate SMFs attenuate bone loss in mice by promoting directional osteogenic differentiation of BMSCs

Background

Osteoporosis is a common metabolic bone disease without effective treatment. Bone marrow-derived mesenchymal stem cells (BMSCs) have the potential to differentiate into multiple cell types. Increased adipogenic differentiation or reduced osteogenic differentiation of BMSCs might lead to osteoporosis. Whether static magnetic fields (SMFs) might influence the adipo-osteogenic differentiation balance of BMSCs remains unknown.

Methods

The effects of SMFs on lineage differentiation of BMSCs and development of osteoporosis were determined by various biochemical (RT-PCR and Western blot), morphological (staining and optical microscopy), and micro-CT assays. Bioinformatics analysis was also used to explore the signaling pathways.

Results

In this study, we found that SMFs (0.2–0.6 T) inhibited the adipogenic differentiation of BMSCs but promoted their osteoblastic differentiation in an intensity-dependent manner. Whole genomic RNA-seq and bioinformatics analysis revealed that SMF (0.6 T) decreased the PPARγ-mediated gene expression but increased the RUNX2-mediated gene transcription in BMSCs. Moreover, SMFs markedly alleviated bone mass loss induced by either dexamethasone or all-trans retinoic acid in mice.

Conclusions

Taken together, our results suggested that SMF-based magnetotherapy might serve as an adjunctive therapeutic option for patients with osteoporosis.

Supplementary information

Supplementary information accompanies this paper at 10.1186/s13287-020-02004-y.

Characterizing the Binding of Angiotensin Converting Enzyme I Inhibitory Peptide to Human Hemoglobin: Influence of Electromagnetic Fields

Background:

Drug-protein complexes is one of the crucial factors when analyzing the pharmacokinetics and pharmacodynamics of a drug because they can affect the excretion, distribution, metabolism and interaction with target tissues.

Objectives:

The aim of this study was to investigate the interaction of human hemoglobin (Hb) and angiotensin I converting enzyme inhibitory peptide (ACEIP) in the absence and presence of different- frequency electromagnetic fields (EMF).

Methods:

Various spectroscopic methods like fluorescence spectroscopy, ultraviolet, circular dichroism and conductometry techniques were applied to investigate Hb-ACEIP interaction in the absence and presence of EMF.

Result:

The presented spectroscopic studies indicated that EMF changed the interaction between Hb and ACEIP. The a-helix content of Hb decreased upon binding to ACEIP and conductivity of the solution enhanced upon binding. Based on Stern-Volmer equations, it could be stated that the Hb-ACEIP affinity was higher in the presence of EMF.

Conclusion:

It can be concluded that for patients who use the drug to control blood pressure, a low-frequency electromagnetic field would have a positive effect on the uptake of the drug.

Electromagnetic Field Therapy: A Rehabilitative Perspective in the Management of Musculoskeletal Pain - A Systematic Review

Electromagnetic fields (EMFs) provide a non-invasive, safe, and easy method to treat pain with respect to musculoskeletal diseases. The purpose of this systematic review was to describe the use of electromagnetic therapy in the rehabilitation field by investigating the efficacy in acute and chronic pain in the musculoskeletal disorders. A database search was conducted using the following resources: PubMed, Cochrane, PEDro, SCOPUS, and WoS. The following MESH terms were used: [Electromagnetic field AND/OR Rehabilitation], [Electromagnetic field AND/OR Pain], [Pulsed Magnetic field AND/OR Rehabilitation] and [Pulsed Magnetic field AND/OR Pain], [Pulsed Electromagnetic field AND/OR Rehabilitation] and [Pulsed Electromagnetic field AND/OR Pain], per the guidelines of the PRISMA statement. Articles published between January 1, 2009 and December 31, 2018 were included as assessment of musculoskeletal pain conditions, randomized clinical trial including crossover and prospective design studies, full English text available, population age > 18 years; instead were excluded neurological randomized clinical trials, transcranial magnetic stimulation application, neuropathic pain, animal/in vitro studies, and articles without English abstract or English full text. Three independent investigators (AMC, NG, and LP) retrieved all the information. Twenty-one RTC (N=21) were considered for the inclusion and exclusion criteria. The results showed as pulsed magnetic fields at low intensity and frequency (from 1 Hz up to 100 Hz) are commonly used with efficacy in resolving musculoskeletal pain. EMFs therapy is a well tolerated, effective with no negative side effects, which can be integrated with rehabilitation for the treatment of chronic and acute pain in musculoskeletal diseases, but further studies are needed to examine the use of more standardized protocols.

Effectiveness of pulsed electromagnetic field therapy on pain, functional status, and quality of life in patients with chronic non-specific neck pain: A prospective, randomized-controlled study

Objectives

The aim of this study was to evaluate whether pulsed electromagnetic field (PEMF) therapy when applied in addition to a conventional physical therapy program would provide any further benefits in reducing pain and functional limitation in patients with chronic non-specific neck pain.

Patients and methods

This double-blind, prospective, randomized, placebo-controlled study included a total of 63 patients (15 males, 48 females; mean age 45.1; range, 25 to 59 years) with a complaint of mechanical neck pain between January 2016 and September 2016. The patients were divided into two groups as PEMF therapy group (n=33) and control group (n=30). A total of 15 sessions of conventional physical therapy program were applied to both groups for a total of three weeks. In addition, the active group received 20-min PEMF and the control group received 20-min sham PEMF. The patients were evaluated at baseline and after treatment. The therapeutic effect was evaluated using the visual analog scale (VAS), Neck Pain Disability Scale (NPDS), Short Form-36 (SF-36), and Physician Global Assessment (PGA).

Results

At baseline, two groups were similar in terms of the demographic and clinical characteristics (p>0.05). There were significant improvements in the VAS, NPDS, SF-36, and physician global assessment after treatment in both groups. However, the PEMF group was not found to be superior to the sham group in terms of improvements in the outcome parameters.

Conclusion

Our study findings indicate that PEMF therapy is safe in patients with chronic non-specific neck pain. However, it does not provide further improvement in pain and functionality when applied in addition to a conventional physical therapy.

Rotating magnetic field ameliorates experimental autoimmune encephalomyelitis by promoting T cell peripheral accumulation and regulating the balance of Treg and Th1/Th17

Multiple sclerosis (MS) is an autoimmune disease characterized by T cell infiltration and demyelination of the central nervous system (CNS). Experimental autoimmune encephalomyelitis (EAE) is a classical preclinical animal model of MS. In this study, we found that rotating magnetic field (RMF) treatment exerts potential preventive effects on the discovery of EAE, including reducing the severity of the disease and delaying the onset of the disease. The results indicated that RMF (0.2 T, 4 Hz) treatment increases the accumulation of CD4⁺ cells in the spleen and lymph nodes by downregulating the expression of CCL-2, CCL-3 and CCL-5, but has no significant effect on myelin oligodendrocyte glycoprotein (MOG) specific T cell responses. Simultaneously, RMF treatment adjusted the imbalance between regulatory T (Treg) cell and T helper 1 (Th1) cells or T helper 17 (Th17) cells by increasing the proportion of Treg cells and inhibiting the ratio of Th1 and Th17 cell subsets. These findings suggest that exposure to RMF may improve EAE disease by promoting CD4+ cell accumulation into peripheral lymphoid tissue, improving the imbalance between Treg and Th1/Th17 cells. Therefore, as a mild physical therapy approach, RMF, is likely to be a potential way to alter the development of EAE.

A Case of Nervus Laryngeus Superior Paresis Treated With Novafon Local Vibration Voice Therapy

OBJECTIVE

The aim of the study is to present a case of chronic idiopathic superior laryngeal nerve paresis (SLNp) treated with a novel voice therapy approach called Novafon Local Vibration Voice Therapy (NLVVT).

METHODS

Outcome measurements including acoustics, aerodynamics, and self-perception of voice handicap were acquired before intervention (i.e., NLVVT) and after intervention (i.e.,follow-up). The use of NLVVT was modified from previous reports of use in functional voice disorders for application to a neurological voice disorder (SLNp).

RESULTS

The results showed that NLVVT had meaningful improvements in Voice Range Profile boundaries, an increase in speaking fundamental frequency, and improved acoustic indices of voice quality in a case of SLNp. The follow-up after NLVVT intervention revealed maintenance of the post-treatment improvements at a 1-month measurement interval.

CONCLUSION

The NLVVT program may have potential to improve voice quality and vocal function in a case of SLNp. Further research is necessary to test a potential effectiveness for NLVVT applied to vocal fold immobility due to paresis in both larger numbers of patients and more well-designed, controlled experiments.

Application of a static magnetic field as a complementary aid to healing in an in vitro wound model

OBJECTIVE

Static magnetic field (SMF) has long been used as a therapeutic means, though its effects on the activity of cells and the mechanism(s) involved remain unknown. The purpose of this study is to determine the effect of a moderate-intensity SMF on the activity, growth and migration of mouse embryonic fibroblast (NIH 3T3), aiming to mimic wound healing and to study it in real time.

METHOD

A cell-free area (a scratch with a 200-500µm width) was formed in NIH 3T3 cultured cells and used as a wound model. The effects of a SMF (10, 50, 80 and 100mT) on the survival rate (MTT assay), integrity of cell membranes (lactate dehydrogenase (LDH) assay), the morphology of the cell (circularity, number and length of filopodia), cell orientation, and migration (speed, direction, rate) were studied as a function of the incubation time in a time-lapse manner.

RESULTS

The exposure of cells to SMF at all intensities had no cytotoxic effect, as revealed by the MTT assay. The integrity of the membranes of the SMF-treated cells studied by the LDH assay test showed no effects. The structure of the membrane at the leading edge of the cells changed and showed several filopodia extended parallel to the field direction. The exposure to the SMF elongated the cells and decreased their circularity at SMF 10mT. The migration of the cells from one edge of the gap towards the other was affected by the applied SMF. The maximum and minimum effects were monitored at 80mT and 10mT, respectively. Analysis of cell migration revealed an average directness of 0.73, 0.66, 0.78, 0.78 and 0.69 under SMF 10, 50, 80, 100mT and control, respectively.

CONCLUSION

The morphological and functional changes of the cells in the presence of SMF revealed particular effects on the membrane and cytoskeleton. Cells were affected by physicochemical changes caused by the applied SMF, though the extent of the incurred effects was not a linear function of the field intensity. This low cost, non-invasive approach can be used as a magneto-manipulative means to tailor a practical, independent or complementary means of manipulating the activities of cells and tissues for clinical purposes.

Emerging medical applications based on non-ionizing electromagnetic fields from 0 Hz to 10 THz

The potential for using non-ionizing electromagnetic fields (EMF; at frequencies from 0 Hz up to the THz range) for medical purposes has been of interest since many decades. A number of established and familiar methods are in use all over the world. This review, however, provides an overview of applications that already play some clinical role or are in earlier stages of development. The covered methods include modalities used for bone healing, cancer treatment, neurological conditions, and diathermy. In addition, certain other potential clinical areas are touched upon. Most of the reviewed technologies deal with therapy, whereas just a few diagnostic approaches are mentioned. None of the discussed methods are having such a strong impact in their field of use that they would be expected to replace conventional methods. Partly this is due to a knowledge base that lacks mechanistic explanations for EMF effects at low-intensity levels, which often are used in the applications. Thus, the possible optimal use of EMF approaches is restricted. Other reasons for the limited impact include a scarcity of well-performed randomized clinical trials that convincingly show the efficacy of the methods and that standardized user protocols are mostly lacking. Presently, it seems that some EMF-based methods can have a niche role in treatment and diagnostics of certain conditions, mostly as a complement to or in combination with other, more established, methods. Further development and a stronger impact of these technologies need a better understanding of the interaction mechanisms between EMF and biological systems at lower intensity levels. The importance of the different physical parameters of the EMF exposure needs also further investigations.

The Response of Osteoblasts and Bone to Sinusoidal Electromagnetic Fields: Insights from the Literature

Electromagnetic fields (EMFs) have been proposed as a tool to ameliorate bone formation and healing. Despite their promising results, however, they have failed to enter routine clinical protocols to treat bone conditions where higher bone mass has to be achieved. This is no doubt also due to a fundamental lack of knowledge and understanding on their effects and the optimal settings for attaining the desired therapeutic effects. This review analysed the available in vitro and in vivo studies that assessed the effects of sinusoidal EMFs (SEMFs) on bone and bone cells, comparing the results and investigating possible mechanisms of action by which SEMFs interact with tissues and cells. The effects of SEMFs on bone have not been as thoroughly investigated as pulsed EMFs; however, abundant evidence shows that SEMFs affect the proliferation and differentiation of osteoblastic cells, acting on multiple cellular mechanisms. SEMFs have also proven to increase bone mass in rodents under normal conditions and in osteoporotic animals.

Sinusoidal Electromagnetic Fields Increase Peak Bone Mass in Rats by Activating Wnt10b/β-Catenin in Primary Cilia of Osteoblasts

Extremely low-frequency electromagnetic fields have been considered a potential candidate for the prevention and treatment of osteoporosis; however, their action mechanism and optimal magnetic flux density (intensity) parameter are still elusive. The present study found that 50-Hz sinusoidal electromagnetic fields (SEMFs) at 1.8 mT increased the peak bone mass of young rats by increasing bone formation. Gene array expression studies with femoral bone samples showed that SEMFs increased the expression levels of collagen-1α1 and Wnt10b, a critical ligand of the osteogenic Wnt/β-catenin pathway. Consistently, SEMFs promoted osteogenic differentiation and maturation of rat calvarial osteoblasts (ROBs) in vitro through activating the Wnt10b/β-catenin pathway. This osteogenesis-promoting effect of SEMFs via Wnt10b/β-catenin signaling was found to depend on the functional integrity of primary cilia in osteoblasts. When the primary cilia were abrogated by small interfering RNA (siRNA) targeting IFT88, the ability of SEMFs to promote the osteogenic differentiation of ROBs through activating Wnt10b/β-catenin signaling was blocked. Although the knockdown of Wnt10b expression with RNA interference had no effect on primary cilia, it significantly suppressed the promoting effect of SEMFs on osteoblastic differentiation/maturation. Wnt10b was normally localized at the bases of primary cilia, but it disappeared (or was released) from the cilia upon SEMF treatment. Interestingly, primary cilia were elongated to different degrees by different intensities of 50-Hz SEMFs, with the window effect observed at 1.8 mT, and the expression level of Wnt10b increased in accord with the lengths of primary cilia. These results indicate that 50-Hz 1.8-mT SEMFs increase the peak bone mass of growing rats by promoting osteogenic differentiation/maturation of osteoblasts, which is mediated, at least in part, by Wnt10b at the primary cilia and the subsequent activation of Wnt/β-catenin signaling. © 2019 American Society for Bone and Mineral Research.

Exploring the radiosensitizing potential of magnetotherapy: a pilot study in breast cancer cells

Aim: To explore the influence of electromagnetic fields (EMFs) on the cell cycle progression of MDA-MB-231 and MCF-7 breast cancer cell lines and to evaluate the radiosensitizing effect of magnetotherapy during therapeutic co-exposure to EMFs and radiotherapy. Material and methods: Cells were exposed to EMFs (25, 50 and 100 Hz; 8 and 10 mT). In the co-treatment, cells were first exposed to EMFs (50 Hz/10 mT) for 30 min and then to ionizing radiation (IR) (2 Gy) 4 h later. Cell cycle progression and free radical production were evaluated by flow cytometry, while radiosensitivity was explored by colony formation assay. Results: Generalized G1-phase arrest was found in both cell lines several hours after EMF exposure. Interestingly, a marked G1-phase delay was observed at 4 h after exposure to 50 Hz/10 mT EMFs. No cell cycle perturbation was observed after repeated exposure to EMFs. IR-derived ROS production was enhanced in EMF-exposed MCF-7 cells at 24 h post-exposure. EMF-exposed cells were more radiosensitive in comparison to sham-exposed cells. Conclusions: These results highlight the potential benefits of concomitant treatment with magnetotherapy before radiotherapy sessions to enhance the effectiveness of breast cancer therapy. Further studies are warranted to identify the subset(s) of patients who would benefit from this multimodal treatment.

The cellular effects of Pulsed Electromagnetic Fields on osteoblasts: A review

Electromagnetic fields (EMFs) have long been known to interact with living organisms and their cells and to bear the potential for therapeutic use. Among the most extensively investigated applications, the use of Pulsed EMFs (PEMFs) has proven effective to ameliorate bone healing in several studies, although the evidence is still inconclusive. This is due in part to our still-poor understanding of the mechanisms by which PEMFs act on cells and affect their functions and to an ongoing lack of consensus on the most effective parameters for specific clinical applications. The present review has compared in vitro studies on PEMFs on different osteoblast models, which elucidate potential mechanisms of action for PEMFs, up to the most recent insights into the role of primary cilia, and highlight the critical issues underlying at least some of the inconsistent results in the available literature. Bioelectromagnetics. 2019;9999:XX-XX. © 2019 Bioelectromagnetics Society.

Pulsed electromagnetic fields promote bone formation by activating the sAC-cAMP-PKA-CREB signaling pathway

The application of pulsed electromagnetic fields (PEMFs) in the prevention and treatment of osteoporosis has long been an area of interest. However, the clinical application of PEMFs remains limited because of the poor understanding of the PEMF action mechanism. Here, we report that PEMFs promote bone formation by activating soluble adenylyl cyclase (sAC), cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), and cAMP response element-binding protein (CREB) signaling pathways. First, it was found that 50 Hz 0.6 millitesla (mT) PEMFs promoted osteogenic differentiation of rat calvarial osteoblasts (ROBs), and that PEMFs activated cAMP-PKA-CREB signaling by increasing intracellular cAMP levels, facilitating phosphorylation of PKA and CREB, and inducing nuclear translocation of phosphorylated (p)-CREB. Blocking the signaling by adenylate cyclase (AC) and PKA inhibitors both abolished the osteogenic effect of PEMFs. Second, expression of sAC isoform was found to be increased significantly by PEMF treatment. Blocking sAC using sAC-specific inhibitor KH7 dramatically inhibited the osteogenic differentiation of ROBs. Finally, the peak bone mass of growing rats was significantly increased after 2 months of PEMF treatment with 90 min/day. The serum cAMP content, p-PKA, and p-CREB as well as the sAC protein expression levels were all increased significantly in femurs of treated rats. The current study indicated that PEMFs promote bone formation in vitro and in vivo by activating sAC-cAMP-PKA-CREB signaling pathway of osteoblasts directly or indirectly.

A high throughput screening system of coils for ELF magnetic fields experiments: proof of concept on the proliferation of cancer cell lines

Background

It has been demonstrated that relatively small variations of the parameters of exposure to extremely low frequency magnetic fields (ELF-MF) can change significantly the outcome of experiments. Hence, either in trying to elucidate if these fields are carcinogenic, or in exploring their possible therapeutic use, it is desirable to screen through as many different exposures as possible. The purpose of this work is to provide a proof of concept of how a recently reported system of coils allows testing different field exposures, in a single experiment.

Methods

Using a novel exposure system, we subjected a glioblastoma cancer cell line (U251) to three different time modulations of an ELF-MF at 60 different combinations of the alternated current (AC) and direct current (DC) components of the field. One of those three time modulations was also tested on another cell line, MDA-MB-231 (breast cancer). After exposure, proliferation was assessed by colorimetric assays.

Results

For the U251 cells, a total of 180 different exposures were tested in three different experiments. Depending on exposure modulation and AC field intensity (but, remarkably, not on DC intensity), we found the three possible outcomes: increase (14.3% above control, p < 0.01), decrease (16.6% below control, p < 0.001), and also no-effect on proliferation with respect to control. Only the time modulation that inhibited proliferation of U251 was also tested on MDA-MB-231 cells which, in contrast, showed no alteration of their proliferation on any of the 60 AC/DC field combinations tested.

Conclusions

We demonstrated, for the first time, the use of a novel system of coils for magnetobiology research, which allowed us to find that differences of only a few μT resulted in statistically different results. Not only does our study demonstrate the relevance of the time modulation and the importance of finely sweeping through the AC and DC amplitudes, but also, and most importantly, provides a proof of concept of a system that sensibly reduces the time and costs of screening.

Electronic supplementary material

The online version of this article (10.1186/s12885-019-5376-z) contains supplementary material, which is available to authorized users.

The Use of Pulsed Electromagnetic Fields to Promote Bone Responses to Biomaterials In Vitro and In Vivo

Implantable biomaterials are extensively used to promote bone regeneration or support endosseous prosthesis in orthopedics and dentistry. Their use, however, would benefit from additional strategies to improve bone responses. Pulsed Electromagnetic Fields (PEMFs) have long been known to act on osteoblasts and bone, affecting their metabolism, in spite of our poor understanding of the underlying mechanisms. Hence, we have the hypothesis that PEMFs may also ameliorate cell responses to biomaterials, improving their growth, differentiation, and the expression of a mature phenotype and therefore increasing the tissue integration of the implanted devices and their clinical success. A broad range of settings used for PEMFs stimulation still represents a hurdle to better define treatment protocols and extensive research is needed to overcome this issue. The present review includes studies that investigated the effects of PEMFs on the response of bone cells to different classes of biomaterials and the reports that focused on in vivo investigations of biomaterials implanted in bone.