A Swine Model of Traumatic Brain Injury: Effects of Neuronally Generated Electromagnetic Fields and Electromagnetic Field Stimulation on Traumatic Brain Injury-Related Changes

Localization of Brain Injuries Using Cranial Electromagnetic Fields

BACKGROUND

Atraumatic brain injury and traumatic brain injury (TBI) have been demonstrated to be associated with changes in brain electromagnetic field (EMF) activity due to alterations in the structure and function of neural circuitry. Modulation of abnormal EMF activity through EMF stimulation may promote neural regeneration and may be more beneficial when the specific change in EMF frequency that is correlated with either computed tomography (CT) imaging changes, neurological changes, or both can be precisely localized. The authors investigate the efficacy and feasibility of a noninvasive portable helmet with sensors and built-in signal generators to measure and localize specific changes with frequency and amplitude from brain EMF for both atraumatic and TBI patients.

METHODS

This prospective clinical study was conducted from January 2025 to February 2025 and enrolled patients greater than 18 years old diagnosed with atraumatic and TBI, including negative image concussion. Baseline EMF activity was recorded using a helmet equipped with 20 sensor stimulators. Localization of EMF activity was determined based on sensor activity corresponding to the patient's neurological deficits on exam and/or structural lesion(s) on CT. EMF data were collected using the DAQami software (Dataq Instruments, Akron, OH) and analyzed using fast Fourier transformation with the Igor Pro 8 software (Wavemetrics Inc., Lake Oswego, OR) to localize normal and abnormal brain EMF signals by comparing opposing and adjacent sensors.

RESULTS

Ten patients were enrolled in this study with a mean age of 47.1 years. Mechanisms of injury included spontaneous hypertensive intracranial hemorrhage (one patient) and head trauma after motor vehicle collision (auto vs. auto; auto vs. motorcycle; and auto vs. pedestrian), dirt bike accident, and ground-level fall (nine patients). Radiographic findings included spontaneous basal ganglia hemorrhage (one patient), isolated traumatic subdural hematoma (one patient), traumatic subarachnoid hemorrhage (one patient), and no intracranial abnormalities (seven patients). Abnormal EMF activity was recorded and correlated with neurological deficits on exam, CT findings, or both, demonstrating the usefulness of EMF in localizing brain injuries.

CONCLUSIONS

These results demonstrate the efficacy and feasibility of utilizing a noninvasive portable helmet for real-time EMF recording and localization of brain abnormalities in atraumatic and TBI patients, including image-negative concussions. EMF measurements may aid in monitoring recovery after atraumatic brain injury and TBI and enable the clinician to tailor treatment plans based on the patient's unique brain EMF patterns.

Effect of Electromagnetic Field on Proliferation and Migration of Fibroblasts and Keratinocytes: Implications in Wound Healing and Regeneration

Proliferation and migration of fibroblasts, keratinocytes, and endothelial cells are key events in the physiological process of wound healing. This process includes different but overlapping stages: hemostasis, inflammatory phase, the proliferative phase, and the remodeling phase. Traumatic brain injury (TBI) is defined as a mechanical insult to the brain from external mechanical force (primary injury), usually followed by the secondary injury including edema, inflammation, excitotoxicity, oxidative stress, or mitochondrial dysfunction. The process of tissue repair following TBI is based on the neuronal-glial interactions, where phagocytosis by microglia plays a crucial role. Low-frequency electromagnetic field (LF-EMF) has been shown to enhance tissue repair after TBI, however, there are limited studies investigating the effects of LF-EMF on the proliferation and migration of keratinocytes, fibroblasts, VSMCs, and endothelial cells in the context of wound healing and on neuronal cells and microglia in relation to healing after TBI. Better understanding of the effects of LF-EMF on the proliferation, migration, and differentiation of these cells is important to enhance tissue healing after injury. This review article comprehensively discussed the effect of EMF/LF-EMF on these cells. Results published by different authors are hardly comparable due to different methodological approach and experimental settings. EMF promotes migration and proliferation of fibroblasts, keratinocytes and endothelial cells (EC), and thus could improve wound healing. The pilot study preformed on a large animal model of TBI suggests anti-inflammatory effects of EMF stimulation following TBI. Therefore, EMF is recognized as a potential therapeutic option to accelerate the wound healing and improve cellular recovery and function after TBI. Nonetheless, future studies are needed to define the optimal parameters of EMF stimulation in terms of frequency or duration of exposure.

Epidemiology, Pathophysiology, and Treatment Strategies of Concussions: A Comprehensive Review

A concussion is a particular manifestation of a traumatic brain injury, which is the leading cause of mortality and disabilities across the globe. The global prevalence of traumatic brain injury is estimated to be 939 instances per 100,000 individuals, with approximately 5.48 million people per year experiencing severe traumatic brain injury. Epidemiology varies amongst different countries by socioeconomic status with diverse clinical manifestations. Additionally, classifying concussions is an ambiguous process as clinical diagnoses are the only current classification method, and morbidity rates differ by demographic location as well as populations examined. In this article, we critically reviewed the pathophysiology of concussions, classification methods, treatment options available including both pharmacologic and nonpharmacologic intervention methods, etiologies as well as global etiologic differences associated with them, and clinical manifestations along with their associated morbidities. Furthermore, analysis of the current research regarding the incidence of concussion based traumatic brain injuries and future directions are discussed. Investigation on the efficacy of new therapeutic-related interventions such as exosome therapy and electromagnetic field stimulation are warranted to properly manage and treat concussion-induced traumatic brain injury.

Transcriptional and Translational Regulation of Differentially Expressed Genes in Yucatan Miniswine Brain Tissues following Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of morbidity, disability, and mortality worldwide. Motor and cognitive deficits and emotional disturbances are long-term consequences of TBI. A lack of effective treatment for TBI-induced neural damage, functional impairments, and cognitive deficits makes it challenging in the recovery following TBI. One of the reasons may be the lack of knowledge underlying the complex pathophysiology of TBI and the regulatory factors involved in the cellular and molecular mechanisms of inflammation, neural regeneration, and injury repair. These mechanisms involve a change in the expression of various proteins encoded by genes whose expression is regulated by transcription factors (TFs) at the transcriptional level and microRNA (miRs) at the mRNA level. In this pilot study, we performed the RNA sequencing of injured tissues and non-injured tissues from the brain of Yucatan miniswine and analyzed the sequencing data for differentially expressed genes (DEGs) and the TFs and miRs regulating the expression of DEGs using in-silico analysis. We also compared the effect of the electromagnetic field (EMF) applied to the injured miniswine on the expression profile of various DEGs. The results of this pilot study revealed a few DEGs that were significantly upregulated in the injured brain tissue and the EMF stimulation showed effect on their expression profile.

Modulation of Inflammatory Response by Electromagnetic Field Stimulation in Traumatic Brain Injury in Yucatan Swine

Traumatic brain injury is a leading cause of disability and death worldwide and represents a high economic burden for families and national health systems. After mechanical impact to the head, the first stage of the damage comprising edema, physical damage, and cell loss gives rise to a second phase characterized by glial activation, increased oxidative stress and excitotoxicity, mitochondrial damage, and exacerbated neuroinflammatory state, among other molecular calamities. Inflammation strongly influences the molecular events involved in the pathogenesis of TBI. Therefore, several components of the inflammatory cascade have been targeted in experimental therapies. Application of Electromagnetic Field (EMF) stimulation has been found to be effective in some inflammatory conditions. However, its effect in the neuronal recovery after TBI is not known. In this pilot study, Yucatan miniswine were subjected to TBI using controlled cortical impact approach. EMF stimulation via a helmet was applied immediately or two days after mechanical impact. Three weeks later, inflammatory markers were assessed in the brain tissues of injured and contralateral non-injured areas of control and EMF-treated animals by histomorphometry, immunohistochemistry, RT-qPCR, Western blot, and ELISA. Our results revealed that EMF stimulation induced beneficial effect with the preservation of neuronal tissue morphology as well as the reduction of inflammatory markers at the transcriptional and translational levels. Immediate EMF application showed better resolution of inflammation. Although further studies are warranted, our findings contribute to the notion that EMF stimulation could be an effective therapeutic approach in TBI patients.

The Use of Induction Sensors and Helmet-Based Shielding Technology to Identify Differences in Electromagnetic Fields in Patients With Cranial Neurological Disease Versus Healthy Controls

Background and objective Electromagnetic fields (EMFs) stemming from neural circuits have been evaluated in healthy human subjects by using non-invasive induction sensor technologies with adjunctive shielding constrained to a helmet constructed of Mu-metal and copper mesh. These EMF measurements have been analyzed and discerned to alter physiological states of movement, thoughts of movement, emotional thoughts, and planned activities. However, these technologies have not yet been investigated as a diagnostic tool in patients with cranial neurological pathology to evaluate differences in patterns in the pathologic state compared to healthy controls. In light of this, we conducted this study to address this scarcity of data. Methods An observational study was conducted in which patients at a single center with cranial neurological disease of all causes were eligible to enroll; they had real-time non-invasive continuous EMF measurements obtained using induction sensors and a shielded helmet. These measurements were obtained in the resting state and then compared to previously obtained measurements in healthy volunteers. Post-processing analysis was conducted to evaluate the derivatives of these EMFs to identify changes in patterns. Results Fourteen patients with traumatic injury, stroke, and neoplasm with ages ranging from 14 to 81 years underwent successful analysis and post-processing of their cortically generated EMF waves. Patterns of EMF waves were compared to previously obtained data from four healthy controls. It was identified that there was less variation in the EMF measurements in patients with neurological disease compared to healthy controls. This was identified based on differences in derivatives of the EMF waves and decreased numbers of peaks and valleys in the EMF waves. Conclusions Novel induction sensors with an engineered, layered Mu-metal and copper mesh helmet for shielding with Mu-metal EMF channels appear to be efficient in measuring neural circuit-driven EMF non-invasively, in real-time, and continuously and can discern differences in EMF patterns between healthy volunteers and patients with neural circuit pathology. The decreased variability in EMF measurements in patients with neural pathology and greater decreases in slope within low-frequency measurements may be correlated with disrupted neural signaling from dysfunctional neurons and abnormalities in spatial and temporal summation. Some EMF changes in ill individuals correspond to changes in the experimentally induced lesions in the animal model. Further studies are warranted to devise models of disease and healthy states to improve these technologies as a diagnostic modality.

A Swine Model of Neural Circuit Electromagnetic Fields: Effects of Immediate Electromagnetic Field Stimulation on Cortical Injury

Background Neurologic diseases have profound disability, mortality, and socioeconomic effects worldwide. Treatment of these disorders varies but is largely limited to unique factors associated with neural physiology. Early studies have evaluated alterations in electromagnetic fields (EMF) due to neural disorders with subsequent modulation of EMF as a potential treatment modality. Swine models have begun to be evaluated as translational models in this effect. Methods EMF measurements of a Yucatan miniswine were recorded using proprietary non-contact, non-invasive induction sensors with a dual layer Mu-metal and interlaced copper mesh helmet. The swine then underwent controlled cortical impact (CCI) to simulate traumatic brain injury (TBI). Twenty minutes post-injury after surgical wound closure, the swine underwent targeted EMF signal modulation using a signal generator to stimulate the swine's injured cortical circuit using a sinusoidal wave individualized at 2.5 Hz with a 500mV positive offset at 1V. After 10 days of stimulation, settings were modified to another individualized frequency of 5.5 Hz, 500mV positive offset and 1V for stimulation. Behavioral patterns in swine were evaluated, and EMF measurements were recorded daily prior to, during, and after stimulation. Artificial intelligence (AI) models evaluated patterns in EMF signals. Histology of the stimulated swine cortex was evaluated using hematoxylin and eosin staining and pentachrome staining and compared to a control swine without stimulation and a swine that had received stimulation two days post-injury in a delayed fashion. Serial serum specimens and tissue at the time of euthanasia were obtained for assessment of neuron-specific enolase (NSE) concentration. Results Pre-operative and post-stimulation measurements demonstrated differences in patterns and activity early on. There was an identified peak at 1.6Hz, not frequently seen pre-operatively. There were convergent frequencies in both data sets at 10.5 Hz and 3.9 Hz. Plateaus and decreased variability of changes in slope were identified early in the post-injury phase. AI modeling identified early similarities in pre-operative and post-stimulation measurements through the patterns of peaks with similarities on postoperative day 10 and similarities in the valleys on postoperative day 17. Histologic specimens identified increased degrees of apoptosis and cellular death in the non-stimulated control compared to the stimulated swine. Similarly, the immediately stimulated swine had less apoptosis and increased histologic viability at the site of injury compared to the two-day delayed stimulation swine. There were increased levels of NSE noted in the stimulated swine at the site of injury compared to non-injured sites and the control swine. Conclusions Cortical function was appropriately measured through induction sensors and shielding in the form of a helmet and electromagnetic field channels. Early stimulation resulted in the early and durable recovery of neuronal circuit-driven electromagnetic field patterns. Histology identified increased viability of neurons with fewer apoptotic neurons and glial cells in stimulated swine with early stimulation identifying the best effect compared to a non-stimulated subject. This recovery identifies change and recovery at the circuit, cellular, and subcellular levels that potentiate the need for further study of EMF modulation as a treatment modality in neurological disorders.