New hope against ALS from Italian research. A study by the Fondazione Policlinico Università Campus Bio-Medico and the Fondazione Irccs Istituto Auxologico Italiano shows that “magnetic fields can be used as real drugs to slow down the degenerative process of neurons that increasingly reduces the ability to move in patients with amyotrophic lateral sclerosis). The research, published in ‘Lancet Regional Health Europe’, shows that “after 24 months of treatment with static transcranial brain magnetic stimulation, over 70% of patients with ALS survived without the need for mechanical ventilation, compared to 35% of patients who had not received this treatment”.
The work was coordinated by Vincenzo Di Lazzaro for the Campus Bio-Medico and Vincenzo Silani for Auxologico. The method used, the two facilities explain, is a new, completely non-invasive technique capable of modulating the excitability of nerve cells through the use of magnetic fields, correcting the hyperexcitability that leads to the death of motor neurons in patients with ALS. Although the causes of this neurodegenerative disease are still unknown, recent research has in fact shown that an excessive response to excitatory impulses by nerve cells that control movement can trigger the degenerative process. Hence the idea of using non-invasive magnetic stimulation instead of drugs, a modality defined for this reason as “electroceutical”.
The approach has been studied in ALS by Di Lazzaro’s team for over 20 years. Several preliminary studies – a note explains – have suggested that it is possible to obtain a slight but significant slowing of the progression of the disease. Recently, a new form of electroceuticals has been introduced that uses a static magnetic field (emitted by a powerful magnet) and which, due to its ease of use, can be used directly by patients at home, daily and for prolonged periods. In a preliminary study in 2019, static magnetic stimulation was tested in 2 patients with a rapidly evolving form of ALS, in whom a significant slowing of the progression of the disease was observed. Based on that experience, the new study was therefore started, which involved 40 ALS patients. The primary objective was to evaluate whether the stimulation was able to reduce the progression of the disease during a 6-month treatment period, but at the end of this period no significant change in the speed of progression of the disease was observed. The researchers and patients, however, did not give up and the study continued for another 18 months, for a total of 2 years, at the end of which the results observed, unlike those that emerged in the short term, appear “extremely promising”.
“This is a significant difference that makes us optimistic, but it must be considered with caution – says Di Lazzaro, director of Neurology at the Fondazione Policlinico Università Campus Bio-Medico in Rome – In fact, when a study does not reach the primary objective, but evidence of efficacy emerges from a continuation of the same in a so-called open-label mode, further confirmation is necessary”, specifies the specialist. “Therefore – he points out – even if the results make us decidedly optimistic, we cannot conclude that we have found the cure for ALS. However, we can confidently state that further studies evaluating the efficacy of static magnetic stimulation in a greater number of patients and with a prolonged treatment period are fully justified”.
“In a difficult moment due to the recent failure of several pharmacological trials that had been given much hope for the sporadic form of ALS, this study opens up an unexpected positive perspective for patients – says Silani, director of the Department of Neuroscience of the Fondazione Irccs Istituto Auxologico Italiano – Centro ‘Dino Ferrari’, Università Statale di Milano – Electroceuticals are now proving to be an essential component for a therapeutic combination that many believe to represent the definitive solution for a disease characterized by different pathogenetic moments. Future therapeutic strategies will have to adequately take into account the data produced today with this study”.
The study – we read in the note – was made possible by the support of the Nicola Irti Foundation for charitable and cultural works and is dedicated to the memory of Nicola Irti. The authors also want to remember Vincenzo Russo, the first patient who decided to voluntarily undergo static magnetic stimulation and who continues to promote research on ALS through his friends at the Ance association in Salerno. The association has in fact funded a PhD scholarship in memory of Russo, intended for a young researcher who wants to challenge ALS at the Fondazione Policlinico Università Campus Bio-Medico.
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