Biological Effects of Pulsed Electromagnetic Field (PEMF) Therapy

1. Biological Effects of Pulsed Electromagnetic Field (PEMF) Therapy Keith R. Holden, M.D. Ponte Vedra Beach, FL www.Dr-Holden.com

2. Objectives • What is PEMF therapy. • PEMF as a diagnostic & safe therapeutic tool. • Brief history of PEMF therapy. • Conditions that respond to PEMF in RDBPC trials. • Conditions cleared for PEMF therapy by the FDA.

3. Objectives • Future of PEMF therapy: • Diabetes. • Cardiovascular disease. • Antimicrobial therapy. • Antitumor therapy. • How PEMF promotes bone health & how to monitor response to therapy.

4. Pulsed Electromagnetic Field (PEMF) Therapy • Time-varying EM fields → microcurrents. • Microcurrents (information) create specific biological responses. • Specific biological responses dependent on field amplitude, frequency, wave form and condition.

5. PEMF Device Specifications • Frequency range 0.1 – 32,000 Hz • Induced current up to 400 micro Amps • Handheld applicator 55mT • Neck applicator 40mT • Matrix applicator 10mT • Wide Field applicator 0.9mT (dia. 50cm)

6. PEMF as a Diagnostic Tool • Body contains multiple electromagnetic fields. • Each organ & tissue has a unique electromagnetic signature. • CT & MRI scans take advantage of these unique EM signatures to create tissue maps.

7. History of PEMF Therapy • 1954 Japanese scientists discovered piezoelectric properties of bone. • Further research showed damaged bone responds therapeutically to PEMF. • 1995 Researchers showed that each soft tissue responds favorably to specific PEMF.

8. PEMF Therapy in RDBPC Trials • Chronic lower back pain. • Fibromyalgia. • Cervical and knee osteoarthritis. • Lateral epicondylitis. • Recovery from arthroscopic knee surgery. • Persistent rotator cuff tendinitis. • Multiple Sclerosis.

9. FDA Approved Indications for PEMF • Non-union fractures. • Failed joint fusion following arthrodesis. • Failed spinal fusion. • Congenital pseudoarthrosis. • Postoperative edema & pain in superficial soft tissue. • Refractory Major Depression (rTMS).

10. Repetitive Transcranial Magnetic Stimulation (rTMS) • Refractory Major Depression (FDA approved). • Schizophrenia. • PTSD. • OCD. • Alzheimer’s disease. • Parkinson’s disease.

11. Future of PEMF Therapy

12. Diabetes and PEMF Therapy • Streptozotocin induced diabetic neuropathy. • PEMF tx rats showed decreased BG levels. • Suggests PEMF can ameliorate painful sxs of DM by partially preventing hyperglycemia.

13. Hyperlipidemia and PEMF Therapy • Hyperlipidemia in rats tx with PEMF 8 weeks. • Lowered blood viscosity. • TC decreased 40.52%. • TG decreased 52.4%. • HDL increased 66.67%. • Fatty material deposition on lining of thoracic aorta significantly lighter in PEMF group.

14. Cerebral Ischemia & PEMF Therapy • Transient focal cerebral ischemia induced in rats. • PEMF (75 Hz) initiated 10 min after onset. • PEMF continued throughout reperfusion for a total of 6 hours. • PEMF attenuated cortical ischemic edema on MRI by 65%. • Histologic exam showed PEFM reduced ischemic neuronal damage by 69%.

15. Antimicrobial Effects of PEMF • Staph aureus in fluid medium. • Treated with low-frequency PEMF +AC. • Sig. growth reduction of CFU/ml by 36%. • Application of low-frequency PEMF could theoretically be useful in osteomyelitis.

16. Biofilms and PEMF Therapy • Applied PEMF 50 Hz to H. pylori biofilms. • PEMF sig ↓ cell viability during early biofilm formation but not mature biofilm. • Sig ↓ biofilm cell mass in both biofilms. • PEMF induces phenotypic changes of adhering bacteria & dec cell adhesion. • PEMF creates unbalanced population thus reducing H. pylori’s ability to protect itself.

17. Antitumor Effect & PEMF Therapy • PEMF in melanoma model mice sig ↓ tumor weight vs controls. • TNF-alpha was sig ↑ in PEMF group. • PEMF slowed growth of T-cell lymphoma & prolonged survival. • Synergizing antitumor effect with PEMF +suboptimal doxorubicin dose.

18. PEMF and Osteoporosis

19. PEMF Physiologic Effects • Increases bone mineral density. • Increases growth of osteoblasts. • Increases TGF-beta 1 (growth factor). • Decreases IL-6 (inflammatory cytokine). • Decreases PGE-2 (prostaglandin). • Lowers urinary deoxypyridinoline (uDPD).

20. Urinary Deoxypyridinoline (uDPD) • DPD cross-links Type I collagen. • uDPD measure of bone resorption. • ↑ levels indicate active bone loss. • Easy to measure spot AM urine. • Recheck within 30-90 days. • Covered by Medicare.

21. Osteoporosis Case Studies

22. PEMF/Osteoporosis Case Study #1 66 y.o ♀ with osteoporosis (T-score -3.1) • Baseline uDPD 9.7 nMCr (NL <6.5) • Weekly 1 hour PEMF sessions x 2 months • At 2 months, uDPD 4.5 (53.61% drop!) • Maintenance monthly 1 hour PEMF sessions • At 6 months, uDPD 5.5 • At 9 months, uDPD 4.5

23. Case Study #1 Urine DPD

24. PEMF/Osteoporosis Case Study #2 63 y.o. ♀ osteoporosis (T-score LS -4.1) • Baseline uDPD 9.7 nMCr (NL < 6.5) • Monthly 1 hour PEMF sessions x 4 months • Weekly 1 hour PEMF sessions x 6 months • 2-3 x weekly PEMF sessions x 3 weeks • At 6 months, uDPD 5.0 (48.5% drop!)

25. Case Study #2 Urine DPD

26. PEMF/Osteoporosis Case Study #3 62 y.o. ♀ with osteoporosis (T-score -2.6) • Baseline uDPD 8.9 nMCr (NL < 6.5) • Eight 30 minute PEMF session over 3 weeks • At 3 weeks, uDPD 6.6 (25.84% drop!)

27. Case Study #3 Urine DPD

28. Conclusion • Biological systems ⇔ dynamic EM entity. • PEMF beneficial effects from bone to brain. • PEMF provides intelligent information. • Before any physiologic repair response, there must be an exchange of energy (information). • PEMF promotes this exchange in ailing tissue.

29. Contact Information Keith R. Holden, M.D. 822 A1A North, Suite 310 Ponte Vedra Beach, FL 32082 (904) 473-4954 krholden@gmail.com www.Dr-Holden.com