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Diapulse[R] electromagnetic therapy for SCI. (Healing Options).

Past articles (March & April 2000) in this Healing Options series discussed how electromagnetic energy can treat ailments relevant to spinal-cord injury/dysfunction (SCI/D). This article specifically discusses the use of Diapulse, a device that directs a pulsed-electromagnetic field (PEMF) to an area of injury. Animal and human studies indicate this treatment soon after SCI protects neurons, promotes regeneration, and minimizes lost function.

Modern medicine focuses on the anatomical and biochemical (i.e., the physical), ignoring, until recently, the body's less-understood electromagnetic nature. As underscored by Albert Einstein's famous E= [mc.sup.2] equation, however, the physical never exists without energy, and each influences the other. Every molecule in the body emits an electromagnetic field, and because each cell--and, in turn, each organ--is an aggregation of such molecules, they too are electromagnetic.

There is no tissue in which this is more evident than the nervous system, which functions by routing electromagnetic impulses throughout the body via the spinal cord. Hence, attempts to fix an injured cord through physical means will be enhanced by working with--not against--its electromagnetic nature.

DESCRIPTION

Diapulse directs electromagnetic energy to a specific body area, even through clothing, casts, or bandages, via a cylindrical treatment head-mounted on an adjustable bracket. The technology does not cause side effects or require patient involvement.

Because the device pulses its electromagnetic output, it emits energy for only a fraction of time, allowing any heat associated with the transferred energy to dissipate. Diapulse's electromagnetic output is often pulsed at 600 per second with each lasting 65 microseconds (1 second = 1 million microseconds). Hence, this pulse rate corresponds to the device's being off 25 times longer than it is on.

HISTORY

The Diapulse prototype was developed in the early 1930s by physician Abraham Ginsberg and physicist Arthur Milinowski, who reported their initial clinical experience and animal research with the device to the 1934 and 1940 New York Academy of Medicine. Because the technology behind the device was used to develop radar, the device's emergence as a healing modality was delayed due to World War II security concerns.

Research was resumed in the 1950s by the military's Tri-Service Research Program, which after extensive studies concluded the device was safe and effective

About this time, the driving force behind Diapulse shifted from Ginsberg to Dr. Jesse Ross, a biophysicist whose impressive background includes professional associations with Einstein and being one of the founders of the prestigious Bioelectromagnetic Society and a NASA consultant. Ross created the Diapulse Corporation of America (Great Neck, N.Y.), developing a collaboration with Remington Rand to produce the device. To further assess the product's healing potential, Ross then launched ambitious research with universities and clinicians around the world.

Over time, Diapulse was adopted as a treatment in various areas of medicine throughout the world; in this country, it is approved by the Food and Drug Administration (FDA) for treatment of post-operative swelling and pain.

DIAPULSE STUDIES

Numerous studies support Diapulse's potential to treat neurologically associated problems and exert neuroprotective and -regenerative influences. After nervous-system injury, Diapulse helps restore the membrane potential (concentration difference of charged solutes between the cell inside and outside) necessary to ensure cell survival and to enhance recovery-promoting blood flow.

Blood Flow

Dr. W. Erdman (Philadelphia, 1960) demonstrated that Diapulse increases systemic blood flow without elevating pulse rate or blood pressure. This effect is most likely due to the ability of Diapulse-generated fields to induce cells to align in a pearl-chain fashion. When the device was turned off, the cells reassumed a random distribution. With such a pearl-chain alignment, blood cells can more efficiently pass through a given vascular space, like cars traveling in the same direction on parallel lanes instead of "bumper" cars.

As in all injuries, the rate of blood flow affects recovery after SCI. Specifically, the injury to the cord compromises blood flow, which, as a consequence, aggravates neurological damage. This issue's importance was emphasized in a recent SCI conference where Dr. H. Crock (London, United Kingdom), probably the world's foremost expert on spinal-cord circulation, stressed that blood flow is the primary factor that needs to be addressed after SCI (PN, August 2002). Given Diapulse's ability to enhance blood flow, it is not surprising that studies indicate it promotes healing after SCI.

Animal Studies

The first scientists to focus on Diapulse's neuronal regeneration properties were Drs. D. Wilson and P. Jagadeesh (Leeds, UK, 1975). After demonstrating that the device stimulates regeneration in rats with peripheral nerve injuries (i.e., those outside the brain and spinal cord), they examined its effects on cats whose spinal cords were half cut (hemicordotomy). Three months after hemicordotomy, compared to controls, Diapulse improved functional recovery, reduced scar formation and adhesions, increased the number of axons transversing the injury site, and promoted the integration of peripheral nerve grafts that had been inserted to bridge the lesion.

Drs. A. Raji and R. Bowden (London, UK, 1983) also demonstrated that Diapulse enhances regeneration and remyelination of rat peripheral nerves after transection.

Because surgeons are beginning to use peripheral-nerve tissue to bridge spinal-cord lesions in humans, Diapulse's ability to accelerate regeneration in peripheral tissue also has important therapeutic implications for SCI.

Dr. Wise Young (New York, 1984) showed that Diapulse reduces calcium at the injury site in cats injured through impact (an injury that resembles most human SCI). Because calcium causes secondary neuronal-cell death, this Diapulse-induced reduction lessened neurological damage and, in turn, preserved function.

Specifically, Dr. Young reported that (1) the majority of Diapulse-treated cats were walking four months after surgery compared to none in the control group and (2) the device was superior to treatment with the steroid methylprednisolone, now considered a postinjury treatment standard.

SCI Human Studies

Dr. M. Weiss et al. (Warsaw, Poland) carried out a promising SCI study in 1980. Dr. Weiss, who interestingly was funded by the U.S. Department of Veterans Affairs for developing another innovative SCI approach, arranged for acutely injured patients to be picked up by helicopter and brought to Warsaw, where they were treated with Diapulse. Of the 97 treated patients, 38 had pronounced neurological improvement; of these, 28 had substantial functional gains, and 18 were discharged with only slight impairment of the extremities. Although this preliminary study lacked controls, these are impressive statistics, which, at minimum, warrant study replication. Unfortunately, because Dr. Weiss died soon after publishing these initial results, combined with post-communism social upheaval, this promising research was not continued.

Dr. W. Ellis (1987) anecdotally noted that PEMF given for pain in patients with chronic SCI resulted in sensory or motor improvement in 7 of 13 individuals. He hypothesized that these fields can normalize viable but dysfunctional neuronal structures.

In the May 2003 PN, "Within the Realm (Part 2)" discussed a surgical procedure in which olfactory tissue was transplanted into the injury site of people with chronic SCI to restore function. Working with lead surgeon Dr. C. Lima (Portugal), Dr. Ross treated two Americans with quadriplegia (see photo) with Diapulse several days before and after surgery to promote neuronal regeneration.

Head Injury

In a large clinical trial, Dr. M. Sambasivan (India, 1993) showed that Diapulse therapy reduces cerebral edema and mortality after traumatic brain injury.

SCI Pressure Ulcers

In 1991, the Eastern Paralyzed Veterans Association (EPVA) gave several Diapulse devices to a nearby VA hospital to treat SCI-associated pressure ulcers, and, in turn, funded a double-blind study by Dr. C. A. Salzberg et al. (Valhalla, N.Y., 1995) that showed that Diapulse-treated patients with such sores healed on average in 13 days compared to 31.5 for controls.

CONCLUSION

Compelling evidence indicates that Diapulse-generated pulsed electromagnetic fields exert neuroprotective and -regenerative influences when administered soon after SCI. Although its true SCI therapeutic potential must still be determined, if Diapulse represented a more familiar pharmaceutical approach, the biomedical research community would be elated given this amount of positive preliminary evidence and pushing it to the forefront for further scrutiny instead of letting it languish on the sidelines. For the sake of all those who sustain SCI/D in the future, let's once and for all objectively evaluate its healing potential.

Laurance Johnston is an associate member of the Mountain States PVA Chapter and a PVA grantee. James Kelly is an SCI research writer and "procures" advocate from Granbury, Tex. Literature references and more in-depth summaries of key studies will be posted on www.healingtherapies.info.

Information for this column is provided by S. Laurance Johnston, Ph.D., laurancejohnsto @aol.com.
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Title Annotation:spinal cord injury
Author:Johnston, Laurance; Kelly, James
Publication:PN - Paraplegia News
Geographic Code:1USA
Date:Jul 1, 2003
Words:1407
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