The technique of transcranial magnetic stimulation (TMS) of the brain provides promising results in neurologic and psychiatric disorders due to its investigational, diagnostic, and therapeutic prospective (Hameed:2017). (Anninos:1995) invented an electronic device that emits pico-Tesla (pT) TMS (1 pT = 10$^{-12}$ Tesla) and increases the frequencies of (2-7 Hz) toward the alpha frequency (8-13 Hz) of each patient (Anninos:2016a, Anninos:2016b, Anninos:2016c, Anninos:2008, Anninos:2007, Anninos:2003, Anninos:2000, Anninos:1986). One probable electrophysiological explanation for the effectiveness of pT-TMS has been provided by the “Neural Net Model” (Anninos:1986). This model suggests that magnetic stimulation induces a temporally modulated neuronal inhibition in regions that exhibit abnormal activity in the frequency range of 2-7 Hz. This hypothesis is agreement with information reported by other researchers (John:1967).

This paper aims to identify any change in the brain state of cerebral palsy (CP) patients with the use of a pT helmet electronic device (Hameed:2017). Only (Pihko:2014) have previously investigated and reported the reactivity of sensorimotor oscillations in children with hemiplegic CP to the use of magnetoencephalography (MEG) and TMS. Their results were in agreement with extensive alterations found in information processing in the sensorimotor system.

Fig. 1A shows a MEG record of nine seconds duration obtained from a CP subject. The x-axis gives the time whereas the y-axis gives MEG amplitude in femtoTesla (fT, 10$^{-15}$ Tesla). The actual signal length for analysis is two minutes but the FFT was applied to only nine seconds because this temporal duration was sufficient to identify the primary dominant frequency within the target 2-7 Hz frequency range. The application of FFT to the MEG record that gives that the primary dominant frequency as 2.8 Hz, is shown in Fig. 1B.

Figure 1.

A) Nine second MEG record obtained from a CP patient. B) The application of FFT to the MEG record gives the primary dominant frequency as 2.8 Hz.

Fig. 2-Fig. 6 gives the maps of the application of FFT to MEG data before and after the pT-TMS stimulus applied to each patient. The numbers in the maps correspond to the 122 channels of the MEG system according to Table. 1. Different colors represent different frequencies (red = 2 Hz, orange = 3 Hz, yellow = 4 Hz, green = 5 Hz, blue $\geq$ 6 Hz).

Figure 2.

Power spectra map for subject one. A) Before pT-TMS, and B) After pT-TMS.

Figure 3.

Power spectra map for subject two. A) Before pT-TMS, and B) After pT-TMS.

Figure 4.

Power spectra for subject three. A) Before pT-TMS, and B) After pT-TMS.

Figure 5.

Power spectra map for subject four. A) Before pT-TMS, and B) After pT-TMS.

Figure 6.

Power spectra map for patient five. A) Before pT-TMS, and B) After pT-TMS.

Fig. 2A and Fig. 2B: Map of the primary dominant frequencies over the scalp for subject one. Fig. 2A: one channel 6 Hz and 4 channels 4 Hz (blue and yellow, respectively), remainder are 2 Hz and 3 Hz (red and orange, respectively). Fig. 2B: Following pT-TMS stimulation, one channel 4 Hz (yellow), remainder 2 Hz and 3 Hz (red and orange, respectively).

Fig. fig3A and Fig. 3B: Map of the primary dominant frequencies over the scalp for subject two. Fig. 3A: All channels 2 Hz and 3 Hz (red and orange respectively). Fig. fig3B: Following pT-TMS stimulation, two channels 4 Hz, remainder 2 Hz (yellow and orange respectively).

Fig. 4A and Fig. 4B: Map of the primary dominant frequencies over the scalp for subject three. Fig. 4A: One channel 5 Hz and two channels 4 Hz (green and yellow, respectively), remainder 4 Hz and 3 Hz (red and orange, respectively). Fig. 4B: After pT-TMS stimulation 2-7 Hz channels indicated in different colors.

Fig. 5A and Fig. 5B: Map of the primary dominant frequencies over the scalp for subject four. Fig. 5A: Two channels 4 Hz (yellow), remainder 2 Hz and 3 Hz, (red and orange, respectively). Fig. 5B: After pT-TMS stimulation 2-7 Hz channels indicated in different colors.

Fig. 6A and Fig. 6B: Map of the primary dominant frequencies over the scalp for patient five. Fig. 6A: One channel 4 Hz (yellow), remainder are 2 Hz and 3 Hz (red and orange, respectively). Fig. 6B: After pT-TMS stimulation 2-7 Hz channels indicated in different colors.

In this study, preliminary effects of pT-TMS stimulation of CP subjects included increased amplitudes across the 2-7 Hz range and a substantial improvement and normalization of their MEG as shown in Table. 2 and Table. 3, which show that in four out of five patients. This result was statistically significant at the 0.05 level (80%). Table. 1 shows the corresponding channels for each brain region. Table. 2 shows the true effect of the pT-TMS. In this table BS and AS represent the effect before and after stimulation, respectively, for each of the five CP subjects in each of the seven brain regions indicated in Table. 1. Table. 3 shows the statistical analysis for the five CP subjects using an unpaired t-test. The results were statistically significant for four out of five subjects (80%). The mechanisms by which the pT-TMS stimulus resolved the abnormal frequencies observed in the subjects are unknown. One possible explanation is that the application of magnetic fields has been shown to influence the activity of the pineal gland which regulates endogenous opioid functions (Lissoni:1986) and dopaminergic modulation (Brandbury:1985).

The treatment of CP patients with pT-TMS has the potential to be an significant non-invasive, secure, and efficacious modality. Although the results were positive with only a small number of patients, it encourages more studies using this method so as to evaluate its beneficial contribution to the management of the symptoms of CP patients.

Financial support for this research was provided by our collaboration with General Secretariat of Research and Technology, GR and the ERGO AEBE, INC, GR research program (Grant Number: 80623).

The authors declare that they have no conflict of interest.