Functional brain MRI in patients complaining of electrohypersensitivity after long term exposure to electromagnetic fields

Abstract Introduction: Ten adult patients with electromagnetic hypersensitivity underwent functional magnetic resonance imaging (fMRI) brain scans. All scans were abnormal with abnormalities which were consistent and similar. It is proposed that fMRI brain scans be used as a diagnostic aid for determining whether or not a patient has electromagnetic hypersensitivity. Over the years we have seen an increasing number of patients who had developed multi system complaints after long term repeated exposure to electromagnetic fields (EMFs). These complaints included headaches, intermittent cognitive and memory problems, intermittent disorientation, and also sensitivity to EMF exposure. Regular laboratory tests were within normal limits in these patients. The patients refused to be exposed to radioactivity. This of course ruled out positron emission tomography (PET) and single-photon emission computed tomography (SPECT) brain scanning. This is why we ordered fMRI brain scans on these patients. We hoped that we could document objective abnormalities in these patients who had often been labeled as psychiatric cases. Materials and methods: Ten patients first underwent a regular magnetic resonance imaging (MRI) brain scan, using a 3 Tesla Siemens Verio MRI open system. A functional MRI study was then performed in the resting state using the following sequences: A three-dimensional, T1-weighted, gradient-echo (MPRAGE) Resting state network. The echo-planar imaging (EPI) sequences for this resting state blood oxygenation level dependent (BOLD) scan were then post processed on a 3D workstation and the independent component analysis was performed separating out the various networks. Arterial spin labeling. Tractography and fractional anisotropy. Results: All ten patients had abnormal functional MRI brain scans. The abnormality was often described as hyper connectivity of the anterior component of the default mode in the medial orbitofrontal area. Other abnormalities were usually found. Regular MRI studies of the brain were mostly unremarkable in these patients. Conclusion: We propose that functional MRI studies should become a diagnostic aid when evaluating a patient who claims electrohypersensitivity (EHS) and has otherwise normal studies. Interestingly, the differential diagnosis for the abnormalities seen on the fMRI includes head injury. It turns out that many of our patients indeed had a history of head injury which was then followed sometime later by the development of EHS. Many of our patients also had a history of exposure to potentially neurotoxic chemicals, especially mold. Head injury and neurotoxic chemical exposure may make a patient more vulnerable to develop EHS.

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