Preprint Microtesla Magnetic Therapy for cognitive impairment in post-acute sequelae of SARS CoV-2: A randomized controlled feasibility study Canori Putrino

[Hutan]

“No. Very different. It is a continuous magnetic field rather than pulsed like TMS and it is about 1/100000th the strength of the magnet used in TMS. TMS is about stimulating neurons, MMT triggers reductions in neuroinflammation without stimulating neurons.”

@SNT Gatchaman, you might be able to give us some comparison for this magnetic therapy. I think the treatment was 15 minutes, twice a week. Is there something we know about that we can equate that to?

Here is the full thread.

That was extraordinary from Putrino. There's no real acknowledgement of the cherry picking. It's definitely not ok.

Unfortunately, every time someone challenges him on what he's done, he seems to turn the response into an opportunity to promote the product. People will be signing up for the treatment.

I don't think patients should participate in his studies. This behaviour is not an ethical way to serve a patient community.

 

[ryanc97]

Conflict of interest exposed here - I know this guy is a bit full on but what he says is correct.

The owner of the device funding a paper. It is likely there are some financial gain from Putrino to do this.

Competing Interest Statement​

At the time of submission, authors Blake Gurfein and David Maltz were employed at Fareon, Inc. The other authors have no competing interests to declare.

 

[ChronicallyOverIt]

I just feel that he is in way over his head with respect to his own research capabilities, and I don’t think he understands this fact, and the damage it causes to patients by diverting funds from more capable researchers.

I think he legitimately believes there is a device out there or treatment that’s already made, just sitting there ready to “fix us”. Similar to OMF wanting to repurpose existing drugs, except they are doing basic biological research to arrive at these drugs. He’s skipping that for “speed”. You eventually start running out of things to try and that’s how you end up here.

How do you pick a treatment for an unknown mechanism of action. You can’t. There’s too much unknown, maybe this works in physio therapy but not with something so complex it’s had top level researchers scratching their heads for decades.

 

[SNT Gatchaman]

@SNT Gatchaman, you might be able to give us some comparison for this magnetic therapy. I think the treatment was 15 minutes, twice a week. Is there something we know about that we can equate that to?

Clinical MRI machines have static fields that are orders of magnitude stronger (generally 3T, as opposed to this microTesla range). As far as I'm aware there are no known biological effects of the MRI static field, once someone is cleared for ferromagnetic risks, such as pacemakers or metal fragments around the eye etc. The gradient coils reverse rapidly (that's the "chugga-chugga" noise) to encode the signal in 3D space and that can affect eg peripheral nerve signalling; and the radio-frequency transmit/receive coils cause heating, so the operator needs to keep below SAR limits (Specific Absorption Rate).

I doubt the two can be compared. I haven't looked into this paper or the references, but on a quick look they're talking about treating neuroinflammation or "improving mitochondrial function", neither of which has been demonstrated to be relevant in ME/LC to date. Though lots of people are trying to make the case.

We did see the paper showing anti-inflammatory effects of medical ultrasound so I wouldn't dismiss the possibility of this or MRI scans having some potential benefit. But for clinical MRI, I don't think anyone's noticed any positive side-effects over 4 decades of quite enthusiastic use.

 

[EndME]

The conflict of interest is a red herring to me. If you run a trial you will often have a pharmaceutical company as sponsor, that’s how all trials work, to me that’s irrelevant if the methodology is solid.

The problem here is the methodology. A lack of outcome measures being prespecified and no assessment of blinding. I don't think the multiple corrections problem is an issue if the trial is only exploratory and outcome measures are prespecified and there are no claims of efficacy. It becomes different here because statements about efficacy are being made, in the paper and especially online by the lead author. There are questions surrounding whether this trial is actually blinded at all or whether it can be told whether you have the sham or not. There are no previous studies that have established that the sham actually works as sham by assessing blinding. But I find it very plausible as well that the producers are quite aware that the device anyways does nothing physically meaningful in the first place so never put much care into rigor to begin with.

Isn't most of BPS research done like that?

Often yes, because they run unblinded studies and don't care for controlling that variable at all, which I think would actually be not as hard as often pretended. So one group of people is told they are given a cure which the therapist is even completely convinced of and the other group is given little in return after having to live with the disappointment of not getting the treatment they originally signed up for and which the therapist is convinced of. In placebo-controlled trials this shouldn’t be a problem if there is genuine blinding and in well-run trials, for example in the past Fluge and Mella have assessed blinding and people couldn't tell active substance from placebo, we have seen often people reporting some improvements in both groups, the placebo and the active substance group equally, precisely because of things like Hawthorne effect.

I don't see questioning someone's intentions as particularly useful here when other issues are already so glaringly obvious. We've all seen that the field seems to be plagued by incompetence, I would not be surprised if it is no different here, incompetent people tend to be willing to turn a blind eye whenever it suits them. Just how BPS researchers can astutely recognize the flaws in certain biomedical research but fail to address their own glaringly obvious own ones.

 

[EndME]

But for clinical MRI, I don't think anyone's noticed any positive side-effects over 4 decades of quite enthusiastic use.

I think one can only speculate but should one not even expect the effect of one MRI of half an hour to be much larger than the effect 120 minutes of being subdued to a field that is of equal strength of household devices? Perhaps a very weak field that isn't static and is somehow meaningfully synchronised to something can still have a meaningful effect, but synchronised to what? The jump seems no different to me then claims of topolologically and clinically meaningfully influencing neuroplasticity tied to CBT.