[Conservative methods in the therapy of male sterility. Critical analysis].

The treatment of 126 patients with male sterility was analyzed. The low efficiency of therapy with hormonal and nonhormonal drugs in patients with testicular form of sterility was observed. The same patients clinically underwent general (intravenous) ozonotherapy. After one course (10 intravenous injections) stable positive clinicolaboratorial effect (increase of sperm density and qualitative characteristics of gametes) was detected in 28% patients. After 2-3 courses (with intervals of 3 months) positive dynamics was observed in almost 70% cases. Thus, general ozonotherapy should be considered as one of effective technologies of treatment in patients with male sterility.

A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in the treatment of musculoskeletal chronic pain.

Exposure to a specific pulsed electromagnetic field (PEMF) has been shown to produce analgesic (antinociceptive) effects in many organisms. In a randomized, double-blind, sham-controlled clinical trial, patients with either chronic generalized pain from fibromyalgia (FM) or chronic localized musculoskeletal or inflammatory pain were exposed to a PEMF (400 microT) through a portable device fitted to their head during twice-daily 40 min treatments over seven days. The effect of this PEMF on pain reduction was recorded using a visual analogue scale. A differential effect of PEMF over sham treatment was noticed in patients with FM, which approached statistical significance (P=0.06) despite low numbers (n=17); this effect was not evident in those without FM (P=0.93; n=15). PEMF may be a novel, safe and effective therapeutic tool for use in at least certain subsets of patients with chronic, nonmalignant pain. Clearly, however, a larger randomized, double-blind clinical trial with just FM patients is warranted.

In vivo alteration of Strata valve setting by vagus nerve stimulator-activating magnet.

We report the unexpected adjustment of a Strata shunt valve by a vagus nerve stimulator-activating magnet, resulting in symptomatic under-drainage of CSF. Implantable devices using magnets for calibration and activation are becoming more prevalent within neurosurgery and the present case highlights the potential for adverse interactions.

[Magnetic stimulation of the pelvic floor in older patients. Results of a prospective analysis]. / Magnetstimulation des Beckenbodens beim älteren Menschen. Ergebnisse einer prospektiven Untersuchung.

Since 2001 magnetic stimulation therapy has been available in Germany for treating urinary incontinence as an alternative to traditional electrical stimulation therapy. The results of 83 patients who underwent magnetic stimulation therapy for stress incontinence, OAB, and pelvic pain syndrome were evaluated. The results differed depending on the underlying disease. Patients with stress incontinence who could not properly contract pelvic floor muscles before could do so in 74% when clinically evaluated and patients with OAB symptoms improved in 54% as assessed by objective and subjective criteria, whereas patients with pelvic pain syndrome only benefited in 23%. Comparison of the results according to age revealed no significant difference between patients >65 years and younger patients.

Magnetic stimulation of the quadriceps femoris muscle: comparison of pain with electrical stimulation.

OBJECTIVE: The objective of this study was to compare pain induced by magnetic stimulation of the quadriceps femoris (QF) muscle with that induced by transcutaneous neuromuscular electrical stimulation (NMES). DESIGN: Magnetic stimulation and transcutaneous NMES were applied to QF muscles of 17 normal volunteers. The intensity of each mode of stimulation was increased in a stepwise manner. Peak torque values of isometric contractions of QF muscles and visual analog scale (VAS) scores were recorded at each intensity level. The VAS scores of the two stimulating modalities were compared at the intensity-generating same peak torque values. RESULTS: The median VAS scores for electrical and magnetic stimulation were 5.7 and 0.3, respectively. The median difference between the VAS scores for electrical and magnetic stimulation was 3.7 (range, 1.7-8.5). The mean of the maximum peak torque obtained from each subject was higher in magnetic stimulation than in electrical stimulation (9.5 +/- 4.8 vs. 4.4 +/- 2.9 Nm). CONCLUSIONS: Magnetic stimulation of the QF muscle produced less pain at the same level of isometric peak torque than did transcutaneous NMES. Magnetic stimulation is a potential alternative to transcutaneous NMES, especially for persons with intact or residual sensory function.

A double blind study showing that two weeks of daily repetitive TMS over the left or right temporoparietal cortex reduces symptoms in patients with schizophrenia who are having treatment-refractory auditory hallucinations.

The aim of this study was to evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on the left and right temporoparietal cortex compared with sham stimulation in schizophrenic patients with treatment-refractory auditory hallucinations (AH). Thirty-nine patients with schizophrenia with treatment-refractory AH were allocated randomly to one of three groups: daily left, right, and sham rTMS groups. rTMS was applied to the TP3 or 4 regions with the aid of the electroencephalography 10-20 international system at 1 Hz for 20 min per day for 10 treatment days. Symptoms were evaluated using the Auditory Hallucination Rating Scale (AHRS), the Positive and Negative Symptoms Scale (PANSS), the Clinical Global Impression--Severity (CGI-S), and Clinical Global Impression--Improvement (CGI-I) scale. For the time effect (within-subject comparison), there were significant changes in the frequency of AHs, positive symptoms of PANSS, and CGI-I. A between-group comparison revealed significant differences in the positive symptoms of PANSS, and CGI-I scores. Post hoc analysis revealed that both the right- and left-side rTMS treatment groups exhibited better CGI-I scores compared to the sham-stimulated group. This study suggests that 10 days of low-frequency rTMS applied daily for 20 min to either temporoparietal cortex significantly reduces the symptoms in patients with schizophrenia who are having refractory AH, but the left sided rTMS is not superior to right or sham rTMS.

Toward establishing a therapeutic window for rTMS by theta burst stimulation.

In this issue of Neuron, Huang et al. show that a version of the classic theta burst stimulation protocol used to induce LTP/LTD in brain slices can be adapted to a transcranial magnetic stimulation (TMS) protocol to rapidly produce long lasting (up to an hour), reversible effects on motor cortex physiology and behavior. These results may have important implications for the development of clinical applications of rTMS in the treatment of depression, epilepsy, Parkinson's, and other diseases.

The effects of static magnetic field on action potential propagation and excitation recovery in nerve.

Calculations using the Hodgkin-Huxley and one-dimensional cable equations have been performed to determine the expected sensitivity of conduction and refractoriness to changes in the time constant of sodium channel deactivation at negative potentials, as reported experimentally by Rosen (Bioelectromagnetics 24 (2003) 517) when voltage-gated sodium channels are exposed to a 125 mT static magnetic field. The predicted changes in speed of conduction and refractory period are very small.

Functional magnetic ventilation in dogs.

OBJECTIVE: To investigate the efficacy of the magnetic stimulation of inspiratory muscles as an alternative to mechanical ventilation and functional electric stimulation. DESIGN: A prospective before-after trial. SETTING: Functional magnetic stimulation laboratory in a Veterans Administration health care system. ANIMALS: Six male mongrel dogs, each weighing between 25 and 35 kg. INTERVENTIONS: Commercially available magnetic stimulators with a round magnetic coil were used. The center of the magnetic coil was placed posteriorly over the C5-7 vertebrae of the spinal cord transected dogs. Magnetic stimulation parameters were set at 80% intensity, 20 Hz, and a 1.2-second on and 3.8-second off pulse train. MAIN OUTCOME MEASURES: The major outcomes were changes in tidal volume (VT), tracheal pressure (Ptr), and arterial partial pressure of carbon dioxide (PaCO2) and oxygen sustained by magnetic stimulation over time. RESULTS: The average Vt and Ptr produced during functional magnetic ventilation (FMV) were.47+/-.07 L and -4.7+/-.51 cmH2O, respectively. Blood gas data showed that PaCO2 increased from a baseline of 33 to 75 mmHg, whereas pH decreased from 7.33 to 6.99 at the end of the 1-hour FMV period. CONCLUSIONS: FMV was achieved for 2 hours in dogs with C2 spinal cord transection. Additional refinements in magnetic stimulation are needed to improve ventilation in animals.

No deterioration of cognitive performance in an aggressive unilateral and bilateral antidepressant rTMS add-on trial.

BACKGROUND: Cognitive functions were assessed before and following a course of repetitive transcranial magnetic stimulation (rTMS) in patients with depression participating in a sham-controlled, randomized trial of rTMS as adjunct to antidepressant treatment. METHOD: Forty-one medicated inpatients with a DSM-IV diagnosis of a depressive episode were consecutively randomly assigned to 1 of 3 groups comparing 2 active rTMS conditions with sham stimulation. The rTMS was applied either at high frequency over the left dorsolateral-prefrontal cortex (DLPFC) (10 sessions x 10 trains x 10 seconds 20 Hz at 100% motor threshold [MT], 90-second intertrain interval) or in a combined high- and low-frequency manner to the left and right DLPFC, respectively (10 sessions x 1 train x 10 minutes at 120% MT). Thirty-eight patients completed a neuropsychological test battery at baseline and following day 14. The cognitive assessment focused on motor skills, attention, executive functions, learning, and memory. Data were collected from November 1999 to August 2002. RESULTS: Active treatment groups did not differ with respect to assessed cognitive measures and thus were pooled. A comparison of short-term changes (baseline-day 14) in neuropsychological performance revealed a more favorable time course of the actively treated patients for encoding in the verbal memory test compared with the sham-stimulated patients. CONCLUSIONS: Unilateral rTMS as well as bilateral combined rTMS revealed no detrimental effects on cognition, as compared with the sham group. Moreover, neither the add-on design nor the used aggressive parameters had a negative impact on cognitive measures in comparison with sham. Repetitive transcranial magnetic stimulation might have mild beneficial cognitive effects partly independent of its antidepressant efficacy.

[Estimation of therapeutical efficacy of weak variable magnetic fields with low value of induction in patients with depression]. / Ocena skutecznosci terapeutycznej slabych zmiennych pól magnetycznych o niskiej wartosci indukcji u chorych z zaburzeniami depresyjnymi.

AIM: Preliminary results of research on the therapeutical efficacy of weak variable magnetic fields with low value of induction used as magnetostimulation in patients with depression not reacting to two consecutive, correctly applied anti-depressant pharmacological treatment are presented in the paper. METHOD: The examined patients (24 persons aged 18-65 years) treated with anti-depressants accessible in Poland were randomly divided into 2 groups. In 1 group (11 persons--9 women and 2 men) magnetostimulation with the use of a weak variable magnetic field with a low value of induction of 15 microT generated by the VIOFOR JPS device (Poland) lasting 12 minutes daily for 15 days was added to pharmacological therapy. Patients from 2 groups (13 persons--11 women and 2 men) were exposed to exposure with the same device. The intensity of depression was estimated with Beck's, Montgomery-Asberg's and Hamilton's scales. RESULTS: As a result of a cycle of active magnetostimulation a distinct, statistically significant decrease of intensification of depression, both in the 7th and 15th day exposure was obtained, while in the sham-exposed group only slight, transient decrease of intensification of depression in the 7th day of sham-exposure was observed. CONCLUSIONS: It was concluded that adding magnetostimulation to pharmacological therapy results in a progressive, significant reduction of intensification of depression symptoms.

Phase I clinical study of a static magnetic field combined with anti-neoplastic chemotherapy in the treatment of human malignancy: initial safety and toxicity data.

We have completed the lowest level of exposure in a Phase I study, designed to establish the safety and toxicity of the combination of a static magnetic field (SMF) and antineoplastic chemotherapy in patients with advanced malignancy. The SMF application is carefully controlled by applying the magnet to the patient only in our clinic during chemotherapy administration. No increase in the severity of chemotherapy toxicity as measured by white blood cell count and platelet count was seen in the participants exposed to SMF compared to the historical control subjects. These data have permitted the next group of subjects to be treated at the next dose level.

New developments in electroconvulsive therapy and magnetic seizure therapy.

New findings regarding the mechanisms of action of electro-convulsive therapy (ECT) have led to novel developments in treatment technique to further improve this highly effective treatment for major depression. These new approaches include novel placements, optimization of electrical stimulus parameters, and new methods for inducing more targeted seizures(eg, magnetic seizure therapy [MST]). MST is the use of transcranial magnetic stimulation to induce a seizure. Magnetic fields pass through tissue unimpeded, providing more control over the site and extent of stimulation than can be achieved with ECT. This enhanced control represents a means of focusing the treatment on target cortical structures thought to be essential to antidepressant response and reducing spread to medial temporal regions implicated in the cognitive side effects of ECT. MST is at an early stage of development. Preliminary results suggest that MST may have some advantages over ECT in terms of subjective side effects and acute cognitive functioning. Studies designed to address the antidepressant efficacy of MST are underway. As with all attempts to improve convulsive therapy technique, the clinical value of MST will need to be established through controlled clinical trials. This article reviews the experience to date with MST, and places this work in the broader context of other means of optimizing convulsive therapy in the treatment of depression.

Induction of mania by rTMS: report of two cases.

There is some evidence that repetitive transcranial magnetic stimulation (rTMS) may be effective in treating depression. Using an intensive methodology of rTMS in two drug-resistant patients, we observed a good antidepressant effect, but also, induction of manic symptoms.