Long-term treatment with transcranial pulsed electromagnetic fields improves movement speed and elevates cerebrospinal erythropoietin in Parkinson's disease Author: Bente Rona Jensen1,2, Anne Sofie Bøgh Malling1,2, Sissel Ida Schmidt3, Morten Meyer1,2,3, Bo Mohr Morberg1, Lene Wermuth1,2 Affiliation: <sup>1</sup> Department of Neurology, Odense University Hospital, University of Southern Denmark, Odense, Denmark. <sup>2</sup> Department of Clinical Research/BRIDGE, University of Southern Denmark, Odense, Denmark. <sup>3</sup> Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark. Conference/Journal: PLoS One Date published: 2021 Apr 28 Other: Volume ID: 16 , Issue ID: 4 , Pages: e0248800 , Special Notes: doi: 10.1371/journal.pone.0248800. , Word Count: 271 Background: Parkinson's disease is characterized by motor dysfunctions including bradykinesia. In a recent study, eight weeks of daily transcranial stimulation with bipolar pulsed electromagnetic fields improved functional rate of force development and decreased inter-hand tremor coherence in patients with mild Parkinson's disease. Objective: To investigate the effect of long-term treatment with transcranial bipolar pulsed electromagnetic fields on motor performance in terms of movement speed and on neurotrophic and angiogenic factors. Methods: Patients diagnosed with idiopathic Parkinson's disease had either daily 30-min treatment with bipolar (±50 V) transcranial pulsed electromagnetic stimulation (squared pulses, 3ms duration) for three eight-week periods separated by one-week pauses (T-PEMF group) (n = 16) or were included in a PD-control group (n = 8). Movement speed was assessed in a six-cycle sit-to-stand task performed on a force plate. Cerebrospinal fluid and venous blood were collected and analyzed for erythropoietin and vascular endothelial growth factor. Results: Major significant improvement of movement speed compared to the natural development of the disease was found (p = 0.001). Thus, task completion time decreased gradually during the treatment period from 10.10s to 8.23s (p<0.001). The untreated PD-control group did not change (p = 0.458). The treated group did not differ statistically from that of a healthy age matched reference group at completion of treatment. Erythropoietin concentration in the cerebrospinal fluid also increased significantly in the treated group (p = 0.012). Conclusion: Long-term treatment with transcranial bipolar pulsed electromagnetic fields increased movement speed markedly and elevated erythropoietin levels. We hypothesize that treatment with transcranial bipolar pulsed electromagnetic fields improved functional performance by increasing dopamine levels in the brain, possibly through erythropoietin induced neural repair and/or protection of dopaminergic neurons. PMID: 33909634 DOI: 10.1371/journal.pone.0248800