Working Group 2 (WG2) – Non-cancer EMF interactions and applications
Leader: Lluis M. Mir, CNRS, France
concerting the research on non-cancer applications and procedures: based on applying EMFs to tissues and cells to produce direct effects of such stimulation; essentially and functionally based on EMFs.
– establish the scientific rationale of applications and procedures based on EM stimulation of excitable and non-excitable tissues and cells
– optimize the administration and control of EM stimulation
– develop and/or improve biomedical applications and procedures essentially and functionally based on EMFs
– develop associated technology for clinical use
This topic includes applications and procedures based on applying EMFs to tissues and cells, causing interactions that produce direct effects of such stimulation. These can be both short-term and long-term in nature. Health promoting effects can be produced in both excitable and non-excitable tissues and cells, by applying EMFs having specific controlled parameters. Envisaged applications and procedures include: electrical and magnetic stimulation of central and peripheral nervous system; minimally invasive stimulation for promoting pain treatment, treatment of chronic (non-healing) wounds, treatment of neurological disorders (dystonia, Parkinson, Alzheimer, depression, etc.); EMF-induced/promoted bone healing, healing or growing tissue, tissue regeneration, etc. Large amount of concerted research efforts is needed in this area. Many observed interactions have not yet been fully understood, and there are still more to be discovered. The parameters of the applied EMFs and the associated effects have yet to be determined or optimized to maximize the benefits of such procedures. Ultimately, the accumulated knowledge will help in developing or optimizing the associated biomedical applications.
EMF interactions with excitable tissues can interfere with signalling activity. While some interactions are unintended (e.g., nerve stimulation by gradient field in MRI), EMF may be applied specifically to achieve beneficial effects, e.g., to induce, suppress, or synchronize (across neurons) spiking and signal propagation. Examples include deep brain stimulation with implanted electrodes, e.g., to manage chronic pain, tremor, dystonia, or Parkinson’s disease; magnetic stimulation; and neuroprosthetics. The latter uses external or implanted electrodes to replace lost sensory functionality – e.g., retinal, vestibular, cochlear prostheses for blindness, balance loss, and hearing deficiencies, respectively – or motor action, e.g., to overcome paralysis. Simulating such applications – to develop and optimize devices, improve mechanistic understanding, or assess risk – requires the integration of dynamic neuron models in anatomical models, and coupling of EM and neuron simulations.
Transcranial magnetic stimulation (TMS) and transcranial electric stimulation (such as transcranial direct current stimulation tDCS, or transcranial alternating current stimulation tACS) are techniques for non-invasive application of magnetic and electrical stimuli to induce electrical currents in brain tissue, modulating neuronal activity in the brain. The two principal stimulation techniques induce changes in cortical excitability that outlast the duration of the stimulation itself, thus underscoring the potential of the techniques for therapeutic treatment of neurological and psychiatric diseases (e.g. depression, epilepsy). This has opened up new opportunities for therapy and rehabilitation following stroke and other brain injuries, for producing analgesic effects in pain syndromes and for curbing the progression of psychiatric and neurodegenerative disorders (e.g. Alzheimer’s, Parkinson’s disease), thus reducing personal, economic, and social burden. Notwithstanding these practical benefits, these stimulation techniques remain under-investigated in many clinical conditions, mainly because disease-specific best-practice protocols are still lacking and technical limitations restrict the focality, depth and predictability of the site of activation. Insights on mechanisms between exogenous stimuli and neural tissues mediating its therapeutic benefits, and the neurodegenerative diseases that are its targets, will offer exciting new vistas for neuroscience. Progress in these techniques requires modelling of brain electromagnetic and neurological properties, development of technology and applications, and close cooperation between research, clinical and technological partners.
With respect to non-excitable tissues, the biological effects of low-intensity and low-frequency EMFs for therapeutic purposes (healing applications, fractures and non-union consolidation, osteonecrosis) present a significant socio-economic interest. However, the selection of electrical or electromagnetic stimulation patterns is empirical, and the electrical parameters acting on the cellular mechanism and the metabolic pathways involved in reception, transcription and response to pulsed EMF are still unknown. The scientific knowledge and the techniques in molecular biology evolved significantly over the past ten years and a better understanding of the cellular mechanism involved in the electric and/or magnetic stimulation will give a scientific base to the treatment. The better knowledge of the cellular mechanism and the identification of effective electric characteristics will allow improving the existing electric patterns often established empirically in the early indication. The better correlation between specific electrical characteristics and the cellular response will improve both the efficacy and the specificity of the effects, thus providing to the surgeons a more obvious positive relation between the treatment and its result.
In addition to the direct effects of EMFs on tissues and cells, this topic also refers to the biomedical procedures, applications, and technologies that are essentially and functionally based on EMFs. Use of EMFs, as the common feature of such applications, implicates the use of the same methodology of research, especially in terms of EMF dosimetry that is a common feature for all topics in this Action. The non-exhaustive list includes: wearable/implantable/ingestible radio-sensors for body-centric applications, autonomous body sensors, room temperature magnetic sensors for medical uses, RFID/Short-Range-Device/other wireless EMF-based technologies related to medical telemetry and other medical uses, radar systems for remote monitoring of human physiologic parameters, magnetic drug targeting, diagnosis through magnetic beads, etc.