Weak, But Complex Pulsed Magnetic Fields May Reduce Depression Following Traumatic Brain Inpry
Weak, But Complex Pulsed Magnetic Fields May Reduce Depression Following Traumatic Brain Inpry
Weak, But Complex Pulsed Magnetic Fields May Reduce Depression Following Traumatic Brain Inpry
'Please send reprint requests and correspondence to Dr. M. A. Persinger, Clinical Neuro sy
chology Laboratory, De artment of Psychology, Laurentian University, Ramsey Lake Road, {ud:
bury, Ontario, Canada &E 2C6.
492 L. A. BAKER-PRICE & M. A. PERSINGER
ton Depression scale were 23.8 and 4.2 before the treatment and 17.5 and
8.4 after the treatment (estimated q2 would be about 70%); however, only
two (of the six) patients exhibited chical improvement.
Other researchers (Jacobson, 1994; Persinger, Richards, & Koren, 1994;
hchards, Persinger, & Koren, 1996; Sandyk, 1994a, 1994b, 1995) contend-
ed that the information content of the applied signal is more critical than the
magnitude. From this perspective the functional neural networks mediating
neurocognitive processes are more optimally described by models of neuro-
electromagnetic resonance or "narrow-band" processes within neural pat-
terns or nets that respond to information (John, 1990). Although the con-
h c t between methodologies that emphasize "meaning" of the stimulus ver-
sus the "magnitude" of the stimulus is frequent in science, the positive con-
tributions of one technology to effective treatment do not necessarily imply
the negation of the other.
Disruption of the microneuroelectrical processes that slowly escalate
into sustained subchical, complex partial conditions may require minimal
energies if the parameters of the applied field employ disruptive properties
and they are initiated before the numbers of recruited neurons achieve a
critical mass. Recently Bureau and Persinger (1995) reported that the thresh-
old for overt lunbic seizures was elevated if the rats were exposed for ap-
proximately 1 ksec. to a 50 pT (rnicroTesla) pulsed field once every two to
three days. When human beings are exposed to similar pulsed, complex
fields but at lower intensities (1 pT), they report most of the experiences
(Persinger, 1993a; Ruttan, Persinger, & Koren, 1990) associated with neuro-
surgical stimulation (Bancaud, Brunet-Bourgin, Chauvel, & Halgren, 1994).
Four weekly, 30-min, exposures to these field parameters did not produce
adverse effects in normal volunteers ( G A S & Persinger, 1993).
The purpose of the present study was to test the feasibihty of externally
applying weak, complex magnetic fields through the brain to help reduce
psychological depression in patients who s t d exhibit mild to moderate brain
impairment after a neurologically verified, acquired brain injury. We rea-
soned that, like aspirin which does not influence core body temperature if a
person is euthermic but clearly elicits an antipyretic effect if the person dis-
plays a fever, the neuroprocesses of this type of postconcussional depression
would be particularly sensitive to weak, complex applied magnetic fields. If
the effects of these weak, complex electromagnetic fields were considered to
have any potential chical utibty, it should be evident with only four sub-
jects who are exposed once per week for only five weeks. If a significant
effect was not obvious during this period, then the feasibhty of ultimately
supplementing or replacing pharmacological treatments with this technology
would be minimal.
Two male (ages 34 and 37 years) and two female (ages 40 and 45
4 94 L. A. BAKCR.PRICE & M.A. PERSINGER
all patients receive the treatment and be (indirectly) monitored by both ex-
perimenters. We assumed that the problem of placebo effects could be par-
tially accommodated by requiring an extremely large effect size that would
be evident with only four patients. An effect size of at least 50% (equivalent
to an r >.70) of the variance in change of symptoms over a 5-wk. period
should exceed the size of an effect from placebos, particularly if the change
in scores were stable. Although some researchers would prefer random allo-
cation to sham-field conditions, we concluded that treating all of the sub-
jects and then assessing the strength of the treatment upon scores for de-
pression would satisfy both experimental and humanist considerations.
All analyses involved SPSS on a VAX 4000 computer. A two-way analy-
sis of variance with one level repeated (the five sessions) and one not re-
peated (sex) were completed for the mean total scores on the Beck De-
pression Inventory, the Physical Symptoms scores, and for scores on each of
the nine scales (compulsion, phobia, hosthty, depression, anxiety, paranoia,
interpersonal sensitivity, psychasthenia, and psychoticism) from the Symp-
tom Check List-90. There were no significant differences between sexes ( F , ,
< 1.00, p > .05) or interactions between sex and sessions.
There were only two significant changes over time (all d b =4,8). There
was a significant decrease in Beck Depression scores (F=4.22, p < .04; partial
q 2 = 6 7 % ) over the five weeks. The means and standard deviations for the
Beck Depression scores were 33 (SD= 9), 27 (SD= 7), 20 (SD= lo), 21 (SD=
8), and 17 (SD=9), respectively. Poost hoc paired t tests indicated that the
effect was due to the attenuated depression between the first two sessions
and the last three sessions. There was also a decrease in the magnitude of
phobias (F= 6.43, p < .01; q 2= 76%). The means and standard deviations
were 72 (SD= l l ) , 66 (SD= 12), 64 (SD= 151, 59 (SD= 171, and 56 (SD= 16)
over the five weeks. There were neither main effects for gender
- nor interac-
tions between gender and the within-subject measures for these variables.
None of the other measures exhibited a significant decrease over time.
The results of this study indicate that four successively assigned patients
who displayed persistent depression and complex partial epileptic-Ue indi-
cators after a closed head injury (mild to moderate brain impairment) and
who were refractory to (antidepressant) medcation responded positively to a
procedure that involved the brief 30-min., weekly application of burst-firing
magnetic fields over the temporal lobes. The specificity of the effect is sug-
gested by the change primarily for scores on the Beck Depression Inventory
and the scale from which one may infer phobias (frequent symptoms, partic-
ularly after motor vehicle incidents). Although the mean scores for the de-
pression scale of the Symptom Check List-90 did not achieve statistical sig- -
nificance, the attenuation of these scores over time approached this criterion
4 96 L. A. BAKER-PRICE & M. A. PERSINGER
(F=3.01, . 1 0 > p > .05; q 2 = 6 0 % ) and also showed a mean decrease of 1.5
standard deviations (change in T score of 15 standardized units).
There are several lunitations to this study. In addition to the absence of
sham-field controls, we did not assess the continuity of the effect one week
and ten weeks after the treatment had been completed. The role of the ex-
perimenter and the effects of the posttreatment discussion concerning per-
sonal issues during the previous week cannot be quantitatively removed
from the effect. [One patient sent an unsolicited letter which stated an ap-
preciation for the treatment, a reduction of the depression and thanks to the
first author.] However, both quantitative (unpublished data, n = 11 patients)
and qualitative evaluations of this population of patients have indicated that
this magnitude of improvement does not normally occur within five weeks,
even with casual contact about once per week from health professionals. An
ABAB design, although experimentally elegant, was not considered ethically
appropriate because (1) repeated stimulations were considered to be critical
to the elicitation of the effect and ( 2 ) variabhty in the continuity of the at-
tenuation of the depressive, aversive symptoms was considered counterpro-
ductive to the maintenance of the more adaptive behaviors emerging during
the treatment.
Despite these limitations, the employment of weak, complex fields
which may interfere with the limbic electrical activity that generates depres-
sion could be a supplementary procedure to traditional techniques. Electro-
convulsive shock (ECS) has been considered an effective treatment for se-
vere depressions that are refractory to pharmacological intervention. With
this technique, current densities from highly redundant (symmetrical) wave
forms are applied to one or both temporal lobes to induce paroxysmal dis-
charges. The neuromechanism for the antidepressive consequences of mas-
sive surges of current across the temporal lobes (similar intensities of current
applied across the brain stem would be fatal) is not clear (George, et al.,
1995). If the functional consequence of this massive current induction is to
inhibit the disinhibited limbic structures, then the efficacy of this process for
some patients who exhibit depression could be rationalized.
We suspect that the large electric currents associated with electrocon-
vulsive shock are effective indirectly because they may damage the nonmy-
elinated varicosities of fibers from the locus ceruleus (noradrenaline), the
ventral tegmentum, including the substantia nigra compacta (dopamine), and
the median raphe (serotonin). When the cell bodies of these aggregates re-
spond (to the insult) by reactive synaptogenesis and reconstruction of their
processes, there is an epiphenomena1 increase in the synthesis of neurotrans-
mitters, unocclusion of the receptors inactivated by the depression process,
and reactive protrusions of the axonal varicosities. Such changes would atten-
uate the interference with postsynaptic sequestering of these transmitters
MICROT FIELDS, DEPRESSION AFTER BRAIN INJURY 497