Diabetes and Magnetic Bio-Stimulation

staff — Sat, 29 Jul 2006 21:29:36 -0700

Magnetic Bio-Stimulation in Painful Diabetic Peripheral Neuropathy: A Novel Intervention - A Randomized, Double-Placebo Crossover Study
by Michael I. Weintraub, MD, FACP

Volume: AJPM Vol. 9 No. 1 January 1999 pgs 8-17

Abstract:
The pathophysiology of diabetic peripheral neuropathy (DPN) is complex and poorly understood. Despite the current state of technology, dysesthetic pain in the extremities of diabetics and other patients with neuropathies remains a refractory problem. Conventional treatment is largely symptomatic, somewhat arbitrary, and often ineffective. Prior preliminary studies suggested that the application of magnetic foot pads may be a modifiable factor in intractable neuropathic pain syndromes. The primary objective of this randomized, double-placebo control, crossover trial was to test the effectiveness of magnetotherapy in neuropathic pain and also to assess the role of placebo. Secondary objectives were to quantify nerve conduction electrophysiologic changes and neurologic examination changes over a 4-month period. Of 24 initial patients, 19 completed the 4-month trial. There were 10 patients with advanced and refractory DPN (Stage II/III) and 9 non-DPN. Improvement was significantly more pronounced in the diabetic cohort, 90% versus 33%, at the end of four months (p < 0.02). During the first month, the placebo response was noted to be the same in both groups (22%) for symptoms of burning and numbness and tingling, whereas in the second month, the placebo effect was greater in the DPN cohort (38% versus 22%). This was felt to represent an overshoot phenomenon. At the end of 4 months, improvement was significantly more pronounced in the diabetic cohort for burning (p < .05) and numbness and tingling reduction (p < .05). Neuropathologic differences identified severe axonal damage principally in the diabetic cohort (absent CMAP 60%, absent SNAP 100%), whereas mild demyelinating changes were seen principally in the N-DPN group. These severe axonal changes were strongly predictive of clinical success and responsiveness. There were no significant serial changes in the neurologic examination or electrodiagnostic studies. Painful dysesthesias associated with C-fiber dysfunction in the diabetic cohort responded dramatically to exposure to static magnetic fields. The most plausible explanation of benefit and suppression of symptoms was that the K+ internal rectifying channels were stimulated producing repolarization and/or hyperpolarization. Despite the uncertainty regarding the precise mechanism of this novel approach, the results are impressive and suggest that a legitimacy exists for magnetotherapy as a safe and unique therapy in neuropathic diabetic foot pain. These preliminary data need to be validated by a larger longitudinal study.

Foundation for Magnetic Science - Dr M Weintraub MD FACP (papers)

Diabetes and Magnetic Bio-Stimulation