Use of a PEMF to Treat Complex TBI with Brain Gauge and Rivermead Outcome Measures
The US Centers for Disease Control (CDC) claims that about 2.5 million cases of death, hospital admissions and emergency visits occurred in 2010 for traumatic brain injury (TBI), but this is expected to be a significant underestimate. It is also estimated that about 5.3 million Americans are living with post TBI disabilities. Certain populations are at higher risk for TBI with brain Gauge and Rivermead Outcome. For sports, between 1.6 and 3.8 million sports – related concussions are estimated to occur annually within the USA1. The military population is another major at-risk group, with screening indicating a prevalence rate of about 6.8%.
TBI should not be considered as an acute event but as a trigger of progressive injury which may occur over hours, days, weeks, months and even years3. TBI is not only a progressive disease in the early phase, but, may also, evolve into a chronic disease. The development and implementation of guidelines for many aspects of the care of TBI have led to uncritical adoption of a “one-size-fits-all,” standardized approach. This approach largely considers people with TBI to be “average patients.” Because of the complexity of TBI and the uniqueness of individuals sustaining these injuries, care needs to be individualized.
In most cases of mild traumatic brain injury (mTBI), also called concussion, the symptoms disappear in the first 2 to 4 weeks4. Symptoms that persist for months or years following the injury are considered persistent post-concussion syndrome (PCS). PCS symptoms include somatic symptoms (i.e., headache, blurry vision, anxiety, etc.) and cognitive (i.e., confusion, memory) deficits. In 20–40% of mTBI cases symptoms can still be present at 6 months post-injury, and in 10–20% of cases they may still be symptomatic at 1 year and beyond.
This case report and discussion provide substantial support for the use of this specific 10 mT/100 Gauss pulsed magnetic field 10 Hz signal for 2 hours daily to not only significantly improve clinical function, but also to objectively produce positive neurological functional changes. Further research is clearly needed on a larger sample of individuals with TBI, whether complex or not, with different times after onset of injury. It is still unknown whether 2 hours per day of this type of PEMF therapy is optimal. Clearly, in this patient, 2 hours/day of therapy made significant improvements in subjective and objective measures of function, and with internal validity, significant loss of benefit with cessation of therapy. This loss of benefit with stopping treatment has been seen in other transcranial PEMF research. It remains to be seen whether durable, long-term benefits can be seen with longer-term PEMF therapy, whether other signal parameters could be optimized, including PEMF frequencies and intensities, and whether more permanent structural improvements in the injured brain may be found.
William Pawluck, PEMF Training Academy, Journal of Science and Medicine, Vol 2, No. 1 (2020), DOI: 10.37714/JOSAM.V1|2.32