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Chu CS, Chang CH, Pan CC, Chiang YC, Kuo HY, Hsu TW, Chen SL, Chen CS. Effect of cranial electrotherapy stimulation as an add-on therapy on late-life generalized anxiety disorder: An open-label study. J Formos Med Assoc 2024; 123:781-787. [PMID: 38485555 DOI: 10.1016/j.jfma.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/19/2023] [Accepted: 12/04/2023] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Cranial electrotherapy stimulation (CES) is beneficial in reducing anxiety in psychiatric patients. However, no studies have reported on elderly patients with generalized anxiety disorders (GAD). This study aimed to determine the efficacy and safety of a 6-week CES intervention for late-life GAD. MATERIALS AND METHODS This single-arm pilot study assessed 6-week CES treatment (Alpha-Stim AID) for late-life GAD and 4-week follow-up post intervention. The Hamilton Rating Scale for Anxiety (HAMA) and Beck Anxiety Inventory (BAI) were used as baseline and outcome measures at weeks 4, 6, and 10, respectively. Treatment response was defined as 50 % or more reduction of the HAMA score and remission was defined as a of score ≤7 on the HAMA. Other measures included depression, sleep quality, and quality of life assessment. RESULTS We included participants (n = 27) aged 68.0 ± 5.0 years, 81.5 % of whom were female. Fifteen (55.6 %), 18 (66.7 %), and 15 (55.6 %) patients were concurrently treated with antidepressants, BZDs, and antipsychotics, respectively. Intention-to-treat (ITT) analysis revealed a significant decrease in HAMA scores from baseline (20.96 ± 3.30) to week 6 (12.26 ± 7.09) and one-month (12.85 ± 7.08) follow-up at W10 (all p < 0.001). The response and remission rates were 33.3 %, 40.7 %, and 48.1 % and 25.9 %, 29.6 %, and 25.9 % at W4, W6, and W10, respectively. The CES improved depression and sleep conditions as measured by the Beck Depression Inventory-II and Pittsburgh Sleep Quality Index. CONCLUSION CES clinically reduces symptoms of anxiety and depression and may improve sleep quality in late-life GAD. Future randomized controlled study is needed.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Non-invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan
| | - Cheng-Ho Chang
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Chuan Pan
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yung-Chih Chiang
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsin-Ya Kuo
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Tien-Wei Hsu
- Department of Psychiatry, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Shiou-Lan Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Drug Development and Value Creation Research Center and MSc Program in Tropical Medicine, Department of Medicine Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University, Pingtung, Taiwan
| | - Cheng-Sheng Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Xu W, Zhao N, Li W, Qiu L, Luo X, Lin Y, Wang W, Garg S, Sun H, Yang Y. Effects of repetitive transcranial magnetic stimulation on fear of cancer recurrence and its underlying neuromechanism. Contemp Clin Trials Commun 2024; 39:101299. [PMID: 38720913 PMCID: PMC11076408 DOI: 10.1016/j.conctc.2024.101299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/07/2024] [Accepted: 04/21/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Many breast cancer patients suffer from fear of cancer recurrence (FCR). However, effective physical intervention for FCR has been scarce. Previous studies have confirmed that repetitive transcranial magnetic stimulation (rTMS) can help improve patients' anxiety, depression, fear, and stress level. Therefore, this study aims to assess the efficacy of rTMS in the treatment of FCR in breast cancer patients and explore its underlying neural mechanism. Methods and analysis and analysis: Fifty breast cancer patients with high FCR (FCR total score >27), and fifty age- and gender-matched patients with low FCR (FCR total score <7) will be recruited to participate in this study. Patients in the high FCR group will be randomly assigned to receive 4-week low-frequency rTMS targeting the right dorsolateral prefrontal cortex (rDLPFC) + treatment as usual (TAU) (n = 25), or to receive sham stimulation + TAU (n = 25). Patients in the low FCR group will only receive TAU. All participants will take a baseline fMRI scan to examine the local activities and interactions of brain activity between the prefrontal cortex (DLPFC), amygdala and hippocampus. Fear of Cancer Recurrence Questionnaire (FCRQ7), Patient Health Questionnaire (PHQ9), Generalize Anxiety Disorder (GAD7), Numeric Rating Scale (NRS), and Insomnia Severity Index (ISI7) will be used to measure an individual's FCR, depression, anxiety, pain, and insomnia symptoms at week 0 (baseline), week 4 (the end of intervention), week 5 (1 week post-treatment), week 8 (1 month post-treatment), and week 16 (3 months post-treatment). Participants in the high FCR group will receive a post-treatment fMRI scan within 24 h after intervention to explore the neural mechanisms of rTMS treatment. The primary outcome of the study, whether the rTMS intervention is sufficient in relieving FCR in breast cancer patients, is measured by FCRQ7. Additionally, task activation, local activity and functional connectivity of the DLPFC, amygdala and hippocampus will be compared, between high and low FCR group, and before and after treatment. Discussion Studies have shown that low-frequency rTMS can be used to treat patient's FCR. However, there is a lack of relevant evidence to support the efficacy of rTMS on FCR in cancer patients, and the neural mechanisms underlying the effects of rTMS on FCR need to be further investigated. Ethics and dissemination Ethical approval for the study has been obtained from the Ethics Committee of Guangdong Provincial People's Hospital (reference number: KY-N-2022-136-01). The results of the investigation will be published in scientific papers. The data from the investigation will be made available online if necessary. Trial registration NCT05881889 (ClinicalTrials.gov). Date of registration: May 31, 2023.
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Affiliation(s)
- Wenjing Xu
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Na Zhao
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 311121, China
| | - Wengao Li
- Department of Psychiatry, General Hospital of Southern Theatre Command, Guangzhou, 510515, China
| | - Lirong Qiu
- Mental Health Education Center, University of Electronic Science and Technology of China, Chengdu, 611701, China
| | - Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China
| | - Yuanyuan Lin
- Department of Medical Treatment, Mental Hospital of Guangzhou Civil Affairs Bureau, Guangzhou, 510000, China
| | - Wenjing Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9BL, UK
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
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Hong JK, Yoon IY. Efficacy of cranial electrotherapy stimulation on mood and sense of well-being in people with subclinical insomnia. J Sleep Res 2024; 33:e13978. [PMID: 37366366 DOI: 10.1111/jsr.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
Cranial electrotherapy stimulation is a non-invasive brain stimulation method characterised by using a microcurrent. The objective of the study was to investigate whether a novel device with a stable supplement of electronic stimulation would improve sleep and the accompanying mood symptoms in people with subclinical insomnia. People who had insomnia symptoms without meeting the criteria for chronic insomnia disorder were recruited and randomly assigned to an active or a sham device group. They were required to use the provided device for 30 min each time, twice a day for 2 weeks. Outcome measures included questionnaires for sleep, depression, anxiety, and quality of life, 4 day actigraphy, and 64-channel electroencephalography. Fifty-nine participants (male 35.6%) with a mean age of 41.1 ± 12.0 years were randomised. Improvement of depression (p = 0.032) and physical well-being (p = 0.041) were significant in the active device group compared with the sham device group. Anxiety was also improved in the active device group, although the improvement was not statistically significant (p = 0.090). Regarding sleep, both groups showed a significant improvement in subjective rating, showing no significant group difference. The change in electroencephalography after the 2 week intervention was significantly different between the two groups, especially for occipital delta (p = 0.008) and beta power (p = 0.012), and temporo-parieto-occipital theta (p = 0.022). In conclusion, cranial electrotherapy stimulation can serve as an adjunctive therapy to ameliorate psychological symptoms and to alter brain activity. The effects of the device in a clinical population and an optimal set of parameters of stimulation should be further investigated.
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Affiliation(s)
- Jung Kyung Hong
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - In-Young Yoon
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
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Kim EH, Lee WS, Lee JH, Kwon DR. Microcurrent therapy as the nonpharmacological new protocol against Alzheimer's disease. Front Aging Neurosci 2024; 16:1344072. [PMID: 38304741 PMCID: PMC10833500 DOI: 10.3389/fnagi.2024.1344072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Introduction Alzheimer's disease (AD) poses an increasing global health challenge and is marked by gradual cognitive deterioration, memory impairment, and neuroinflammation. Innovative therapeutic approaches as non-pharmacological protocol are urgently needed with side effect risk of drugs. Microcurrent therapy, a non-invasive modality involving low-level electrical currents, has emerged as a potential solution to address AD's complex pathogenesis. This study investigates the optimal application of microcurrent therapy as a clinical protocol for AD, utilizing a comprehensive approach that integrates behavioral assessments and neuroinflammation evaluation in a mouse model of dementia. Methods and results The results reveal that microcurrent therapy holds promise in ameliorating memory impairment and reducing neuroinflammation in AD. Behavioral assessments, including the Novel Object Recognition Test (NOR) and Radial Arm Maze Test (RAM), demonstrated improved cognitive function following microcurrent therapy. Furthermore, microcurrent therapy inhibited expression of neuroinflammatory proteins, including ionized calcium binding adaptor molecule 1 (Iba1), and glial fibrillary acidic protein (GFAP) in current-treated group. Mechanistic insights suggest that microcurrent therapy may modulate neuroinflammation through the regulation of MAPK signaling pathways. Conclusion This study emphasizes the prospect of microcurrent therapy as a safe and efficacious non-pharmacological strategy for Alzheimer's disease (AD), providing optimism to the countless individuals impacted by this debilitating ailment. These results contribute to the developments of an innovative clinical protocol for AD and recovery from neurological injury, underscoring the significance of investigating unconventional therapeutic approaches for addressing this complex condition.
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Affiliation(s)
- Eun Ho Kim
- Department of Biochemistry, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Won Seok Lee
- Department of Biochemistry, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Jae Hee Lee
- Department of Rehabilitation Medicine, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Dong Rak Kwon
- Department of Rehabilitation Medicine, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
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Chiriac VF, Ciurescu D, Moșoiu DV. Cancer Pain and Non-Invasive Brain Stimulation-A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1957. [PMID: 38004006 PMCID: PMC10673188 DOI: 10.3390/medicina59111957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Pain is the most prevalent symptom in cancer patients. There is a paucity of data regarding non-invasive brain stimulation (NIBS) for the treatment of chronic pain in patients with cancer. The purpose of this article is to review the techniques of NIBS and present the published experiences of the oncological population. Materials and Methods: Databases including MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched for articles on cancer patients with pain that was managed with non-invasive brain stimulation techniques. We included articles in English that were published from inception to January 2023. As studies were limited in number and had different designs and methodologies, a narrative review was considered as the best option to integrate data. Results: Four studies focusing on transcranial magnetic stimulation, six articles on transcranial direct current stimulation, and three articles regarding cranial electric stimulation were found and reviewed. Conclusions: Data are limited and not robust. Further studies in this field are required. Guidelines on NIBS for non-malignant chronic pain conditions provide good premises for cancer-related chronic pain.
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Affiliation(s)
- Valentina-Fineta Chiriac
- Departament of Medical Oncology, “Dr Pompei Samarian” County Emergency Hospital, 910071 Călărași, Romania
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
| | - Daniel Ciurescu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
| | - Daniela-Viorica Moșoiu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania
- HOSPICE Casa Sperantei, 500074 Brașov, Romania
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Lee M, Kim Y, Yoon IY, Hong JK. Effects of cranial electrotherapy stimulation on improving depressive symptoms in people with stress: A randomized, double-blind controlled study. J Affect Disord 2023; 340:835-842. [PMID: 37598716 DOI: 10.1016/j.jad.2023.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/18/2023] [Accepted: 08/11/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Cranial electrotherapy stimulation (CES) is a form of neurostimulation that delivers alternating microcurrent via electrodes on the head. We investigated the effectiveness of CES in reducing stress. METHODS Participants who experienced subjective stress combined with subclinical depression or insomnia were recruited based on interviews and questionnaires. The subjects were randomly assigned to the active CES or sham groups and asked to use the device for 30 min twice a day for three weeks. Psychological rating scales, quantitative electroencephalography (QEEG), and serial salivary cortisol levels were measured before and after the intervention. RESULTS Sixty-two participants (58 females, mean age = 47.3 ± 8.2 years) completed the trial. After intervention, the depression scores improved significantly to a nearly normal level (Beck depression inventory-II, 31.3 ± 11.6 to 10.8 ± 7.2, p < 0.001) in the CES group, which were greater improvement compared to the sham group (p = 0.020). There were significant group-by-visit interactions in absolute delta power in the temporal area (p = 0.033), and theta (p = 0.038), beta (p = 0.048), and high beta power (p = 0.048) in the parietal area. CES led to a flattening of the cortisol slope (p = 0.011) and an increase in bedtime cortisol (p = 0.036) compared to the sham group. LIMITATIONS Bias may have been introduced during the process because device use and sample collection were self-conducted by participants at home. CONCLUSIONS CES can alleviate depressive symptoms and stress response, showing a potential as an adjunctive therapy for stress.
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Affiliation(s)
- Minji Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Yuna Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - In-Young Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jung Kyung Hong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
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Gikaro JM, Bigambo FM, Minde VM, Swai EA. Efficacy of electrophysical agents in fibromyalgia: A systematic review and network meta-analysis. Clin Rehabil 2023; 37:1295-1310. [PMID: 37082791 DOI: 10.1177/02692155231170450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To examine the effectiveness of electrophysical agents in fibromyalgia. DATA SOURCES CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. METHODS This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. RESULTS Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms (P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status (P = 0.018); and microcurrent (P = 0.001), repetitive transcranial magnetic stimulation (P = 0.022), and no treatment (P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). CONCLUSION This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.
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Affiliation(s)
- John Marwa Gikaro
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Francis Manyori Bigambo
- Department of Orthopedics and Neurosurgery, Muhimbili Orthopaedic Institute, Dar Es Salaam, Tanzania
| | - Victor Mark Minde
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Elia Asanterabi Swai
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Shaygan M, Hosseini FA, Shemiran M, Hedayati A. The effect of mobile-based logotherapy on depression, suicidal ideation, and hopelessness in patients with major depressive disorder: a mixed-methods study. Sci Rep 2023; 13:15828. [PMID: 37740006 PMCID: PMC10516998 DOI: 10.1038/s41598-023-43051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023] Open
Abstract
Major depressive disorder is one of the most common psychiatric disorders in the world. It is essential to study and use effective, available, and affordable psychotherapy methods along with drug therapy to manage the symptoms of this disease. Therefore, the current study aimed to determine the effect of mobile phone-based logotherapy on depression, suicidal ideation, and hopelessness in patients with major depressive disorder by using a mixed-methods approach. In the first phase of this mixed-methods study, 70 patients completed the quantitative phase (control group = 35, intervention group = 35). The intervention group received an 8-week mobile-based logotherapy program via WhatsApp (one 180-min module per week) combined with sertraline, while the control group received just sertraline plus education about pharmacotherapy. Data was collected before, immediately after the intervention, and 3 months later using the Beck depression inventory short form items (BDI-13), the Beck hopelessness scale (BHS), and the Beck scale for suicide ideation (BSSI). Then, a qualitative study on the intervention group was conducted to explain the findings of the quantitative phase. The repeated measure MANOVA revealed a significant interaction effect of time and group on the set of dependent variables (F(6,63) = 25.218, P < 0.001). Qualitative analysis confirmed the efficacy of sertraline plus mobile-based logotherapy on depression, suicidal ideation, and hopelessness in the intervention group. Three key themes extracted from the participants' experiences of mobile-based logotherapy were "efficient instruction", "user-friendly intervention" and "constructive change". Mobile-based logotherapy through WhatsApp was an effective psychotherapy method for decreasing depression, hopelessness, and suicidal ideation in patients with major depressive disorder. It is suggested that educational, institutional, and technological infrastructure for providing and using mobile-based logotheapy for patients with major depressive disorder be considered in the mental health care system.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fahimeh Alsadat Hosseini
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Shemiran
- Student Research Committee, Department of Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arvin Hedayati
- Research Center for Psychiatry and Behavior Science, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Ellis JD, Rabinowitz JA, Strickland JC, Skandan N, Hobelmann JG, Finan PH, Huhn AS. Latent patterns of sleep disturbance, pain impact, and depressive symptoms in residential substance use treatment. Drug Alcohol Depend 2023; 248:109903. [PMID: 37182354 PMCID: PMC10330676 DOI: 10.1016/j.drugalcdep.2023.109903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
AIM Sleep disturbance, clinically significant pain, and depressive symptoms commonly occur together among individuals with substance use disorders. The purposes of the present study were to 1) identify subgroups of individuals with heterogenous patterns of pain, sleep disturbance, and depressive symptoms, and 2) identify demographic and clinical correlates of profile membership. MATERIAL AND METHODS The present study assessed a sample (N = 8621) of individuals seeking residential substance use treatment in 2020 and 2021 in the United States. We examined whether unique sub-groups could be identified based on patterns of sleep disturbance, pain impact, and depressive symptoms during the first four weeks of treatment, using longitudinal latent profile analysis. Next, we explored demographic, substance use, and clinical correlates (i.e., distress intolerance) of profile membership, as well as whether profile membership was associated with treatment attrition. RESULTS The identified classes were: 1) Low sleep disturbance, pain impact, and depressive symptoms, 2) High pain, remitting depressive symptoms, and mild sleep disturbance, 3) High depressive symptoms, low pain, and remitting sleep disturbance, and 4) High sleep disturbance, pain impact, and depressive symptoms. Individuals with high pain, depressive symptoms, and sleep disturbance were more likely to be older, use opioids as their primary substance, have high distress intolerance, and discontinue treatment. CONCLUSION Results highlight the importance of comprehensive care and management of physical health conditions, particularly among older adults. Further, results highlight that distress intolerance may be a modifiable risk factor for co-occurring sleep disturbance, pain impact, and depressive symptoms.
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Affiliation(s)
- Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Neha Skandan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - J Gregory Hobelmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Ashley Addiction Treatment, Havre de Grace, MD, United States
| | - Patrick H Finan
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Ashley Addiction Treatment, Havre de Grace, MD, United States.
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Szymoniuk M, Chin JH, Domagalski Ł, Biszewski M, Jóźwik K, Kamieniak P. Brain stimulation for chronic pain management: a narrative review of analgesic mechanisms and clinical evidence. Neurosurg Rev 2023; 46:127. [PMID: 37247036 PMCID: PMC10227133 DOI: 10.1007/s10143-023-02032-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/30/2023]
Abstract
Chronic pain constitutes one of the most common chronic complaints that people experience. According to the International Association for the Study of Pain, chronic pain is defined as pain that persists or recurs longer than 3 months. Chronic pain has a significant impact on individuals' well-being and psychosocial health and the economy of healthcare systems as well. Despite the availability of numerous therapeutic modalities, treatment of chronic pain can be challenging. Only about 30% of individuals with non-cancer chronic pain achieve improvement from standard pharmacological treatment. Therefore, numerous therapeutic approaches were proposed as a potential treatment for chronic pain including non-opioid pharmacological agents, nerve blocks, acupuncture, cannabidiol, stem cells, exosomes, and neurostimulation techniques. Although some neurostimulation methods such as spinal cord stimulation were successfully introduced into clinical practice as a therapy for chronic pain, the current evidence for brain stimulation efficacy in the treatment of chronic pain remains unclear. Hence, this narrative literature review aimed to give an up-to-date overview of brain stimulation methods, including deep brain stimulation, motor cortex stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, cranial electrotherapy stimulation, and reduced impedance non-invasive cortical electrostimulation as a potential treatment for chronic pain.
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Affiliation(s)
- Michał Szymoniuk
- Student Scientific Association at the Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Jia-Hsuan Chin
- Student Scientific Association at the Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Łukasz Domagalski
- Student Scientific Association at the Department of Neurosurgery, Medical University of Lublin, Lublin, Poland.
| | - Mateusz Biszewski
- Student Scientific Association at the Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Jóźwik
- Student Scientific Association at the Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Piotr Kamieniak
- Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
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Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis. Eur J Cancer Care (Engl) 2023. [DOI: 10.1155/2023/5612061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Purpose. Noninvasive brain stimulation (NIBS) has been reported to have analgesic effects on fibromyalgia and chronic neuropathic pain; however, its effects on cancer pain have yet to be determined. The present study aimed to evaluate the effects of NIBS on patients with pain secondary to nonbrain malignancy. Methods. Electronic databases including PubMed, Embase, Cochrane Library, and Web of Science were searched from inception through June 5th, 2022. Parallel, randomized, placebo-controlled studies were included that enrolled adult patients with cancer pain, except for that caused by brain tumors, compared NIBS with placebo stimulation, and reported sufficient data for performing meta-analysis. Results. Four parallel, randomized, sham-controlled studies were included: two of repetitive transcranial magnetic stimulation (rTMS), one of transcranial direct current stimulation (tDCS), and one of cranial electrical stimulation (CES). rTMS significantly improved pain in the subgroup analysis (standardized mean difference (SMD): −1.148, 95% confidence interval (CI): −1.660 to −0.637, (
)), while NIBS was not benefited in reducing pain intensity (SMD: −0.632, 95% CI: −1.356 to 0.092, p = 0.087). Also, NIBS significantly improved depressive symptoms (SMD: −0.665, 95% CI: −1.178 to −0.153, p = 0.011), especially in the form of rTMS (SMD: −0.875, 95% CI: −1.356 to −0.395,
) and tDCS (SMD: −1.082, 95% CI: −1.746 to −0.418, p = 0.001). Conclusion. rTMS significantly improved pain secondary to nonbrain malignancy apart from other forms of NIBS without major adverse events.
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Cranial electrotherapy stimulation alleviates depression-like behavior of post-stroke depression rats by upregulating GPX4-mediated BDNF expression. Behav Brain Res 2023; 437:114117. [PMID: 36116735 DOI: 10.1016/j.bbr.2022.114117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022]
Abstract
To elucidate whether cranial electrotherapy stimulation (CES) improves depression-like behavior of post-stroke depression (PSD) via regulation of glutathione peroxidase 4 (GPX4)-mediated brain-derived neurotrophic factor (BDNF) expression. Middle cerebral artery occlusion (MCAO) and chronic unpredictable mild stress (CUMS) were used to develop a rat PSD model. CES was applied, and RAS-selective lethal 3 (RSL3) was injected into the hippocampus to inhibit GPX4 in PSD rats. The depression behavior was detected by sucrose preference and forced swimming tests. The structure and morphology of the hippocampus were observed and analyzed by histopathological hematoxylin-eosin (HE) staining. The mRNA and protein expressions of GPX4 and BDNF in the hippocampus were detected by qRT-PCR, western blot and immunohistochemical analysis.The degeneration and necrosis of hippocampal neurons, the depression-like behavior were severer and the expression of BDNF in the hippocampus were decreased in PSD rats than those in MCAO and control groups. CES promoted the hippocampal neuron repair, alleviated the depression-like behavior and increased the expression of BDNF in PSD rats. The inhibition of GPX4 by RSL3 exacerbated the depression-like behavior and decreased the expression of BDNF in PSD rats. In addition, we found that RSL3 disrupted the positive effects of CES on the PSD rats. Conclusion: CES improves depression-like behavior of PSD rats through upregulation of GPX4-mediated BDNF expression in the hippocampus.
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Lo YJ, Mishra VK, Lo HY, Dubey NK, Lo WC. Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective. Aging Dis 2022:AD.2022.1203. [PMID: 37163444 PMCID: PMC10389812 DOI: 10.14336/ad.2022.1203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/03/2022] [Indexed: 05/12/2023] Open
Abstract
Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may be associated with neurocognitive, musculoskeletal, cardiovascular, gastrointestinal, renal, hepatic, and metabolic disorders. Epidemiological evidence also revealed the association of insomnia with oncologic and asthmatic complications, which has been indicated as bidirectional. Two therapeutic approaches including cognitive behavioral therapy (CBT) and drugs-based therapies are being practiced for a long time. However, the adverse events associated with drugs limit their wide and long-term application. Further, Traditional Chinese medicine, acupressure, and pulsed magnetic field therapy may also provide therapeutic relief. Notably, the recently introduced cryotherapy has been demonstrated as a potential candidate for insomnia which could reduce pain, by suppressing oxidative stress and inflammation. It seems that the synergistic therapeutic approach of cryotherapy and the above-mentioned approaches might offer promising prospects to further improve efficacy and safety. Considering these facts, this perspective presents a comprehensive summary of recent advances in pathological aetiologies of insomnia including COVID-19, and its therapeutic management with a greater emphasis on cryotherapy.
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Affiliation(s)
| | | | | | - Navneet Kumar Dubey
- Victory Biotechnology Co., Ltd., Taipei 114757, Taiwan
- ShiNeo Technology Co., Ltd., New Taipei City 24262, Taiwan
| | - Wen-Cheng Lo
- Department of Surgery, Division of Neurosurgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 11031, Taiwan
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14
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Integrative Pain Solutions, Part 3: Chronic Pain and Evidence-Based Nonpharmacologic Strategies. Holist Nurs Pract 2022; 36:327-329. [PMID: 35981116 DOI: 10.1097/hnp.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Cranial Electrotherapy Stimulation (CES) Does Not Reliably Influence Emotional, Physiological, Biochemical, or Behavioral Responses to Acute Stress. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00248-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Surin W, Chatiketu P, Hutachok N, Srichairatanakool S, Chatupos V. Pain intensity and salivary α‐amylase activity in patients following mandibular third molar surgery. Clin Exp Dent Res 2022; 8:1082-1091. [PMID: 35801257 PMCID: PMC9562728 DOI: 10.1002/cre2.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Objective We aimed to compare the levels of pain and salivary α‐amylase (SAA) in patients before and after mandibular third molar surgery. Materials and Methods Patients were divided into asymptomatic and symptomatic groups and were then identified by the analgesic drug taken throughout the 2‐week study. The visual analog scale (VAS) was employed to evaluate the severity of pain experienced by a given subject before treatment, when the anesthetic wore off, in the morning, and at night for a period of 1 week. Saliva was collected from the mouth floor of the subjects and the levels of SAA activity were measured at indicated times. Results The levels of postoperative pain were higher than those of pretreatment pain (p < 0.05), but were not necessarily different between the two groups. The pain levels were positively correlated with SAA activities in both groups (p < 0.05). There was no difference between the number of analgesics taken by the two groups and the postoperative complications observed during the study. A significant correlation was observed between the VAS pain scale and SAA activities. Conclusion SAA would be a simple effective biomarker for the objective assessment of pain intensity in patients who have undergone mandibular third molar surgery.
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Affiliation(s)
- Wanvipa Surin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
| | - Piyanart Chatiketu
- Department of Family and Community Dentistry, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
| | - Nuntouchaporn Hutachok
- Department of Biochemistry, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | | | - Vuttinun Chatupos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand
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Gbadamosi IT, Henneh IT, Aluko OM, Yawson EO, Fokoua AR, Koomson A, Torbi J, Olorunnado SE, Lewu FS, Yusha'u Y, Keji-Taofik ST, Biney RP, Tagoe TA. Depression in Sub-Saharan Africa. IBRO Neurosci Rep 2022; 12:309-322. [PMID: 35746974 PMCID: PMC9210463 DOI: 10.1016/j.ibneur.2022.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Mood disorders can be considered among the most common and debilitating mental disorders. Major depression, as an example of mood disorders, is known to severely reduce the quality of life as well as psychosocial functioning of those affected. Its impact on the burden of disease worldwide has been enormous, with the World Health Organisation projecting depression to be the leading cause of mental illness by 2030. Despite several studies on the subject, little has been done to contextualise the condition in Africa, coupled with the fact that there is still much to be understood on the subject. This review attempts to shed more light on the prevalence of depression in Sub-Saharan Africa (SSA), its pathophysiology, risk factors, diagnosis and the experimental models available to study depression within the sub-region. It also evaluates the contribution of the sub-region to the global research output of depression as well as bottlenecks associated with full exploitation of the sub region's resources to manage the disorder.
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Affiliation(s)
- Ismail Temitayo Gbadamosi
- Department of Anatomy, University of Ilorin, Nigeria
- Laboratory for Translational Research in Neuropsychiatric Disorders, BRAINCITY Nencki-EMBL Center of Excellence for Neural Plasticty and Brain Disorders, Warsaw, Poland
| | - Isaac Tabiri Henneh
- Department of Pharmacotherapeutics and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of Cape Coast, Ghana
| | - Oritoke Modupe Aluko
- Department of Physiology, School of Basic Medical Sciences, Federal University of Technology, Akure, Nigeria
| | | | | | - Awo Koomson
- Department of Pharmacology and Toxicology University of Ghana, Ghana
| | - Joseph Torbi
- Department of Pharmacology and Toxicology University of Ghana, Ghana
| | | | | | - Yusuf Yusha'u
- Department of Human Physiology Ahmadu Bello University, Zaria, Nigeria
| | | | - Robert Peter Biney
- Department of Pharmacotherapeutics and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of Cape Coast, Ghana
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Cheng YC, Kuo PH, Su MI, Huang WL. The efficacy of non-invasive, non-convulsive electrical neuromodulation on depression, anxiety and sleep disturbance: a systematic review and meta-analysis. Psychol Med 2022; 52:801-812. [PMID: 35105413 DOI: 10.1017/s0033291721005560] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The effects of non-invasive, non-convulsive electrical neuromodulation (NINCEN) on depression, anxiety and sleep disturbance are inconsistent in different studies. Previous meta-analyses on transcranial direct current stimulation (tDCS) and cerebral electrotherapy stimulation (CES) suggested that these methods are effective on depression. However, not all types of NINECN were included; results on anxiety and sleep disturbance were lacking and the influence of different populations and treatment parameters was not completely analyzed. We searched PubMed, Embase, PsycInfo, PsycArticles and CINAHL before March 2021 and included published randomized clinical trials of all types of NINCEN for symptoms of depression, anxiety and sleep in clinical and non-clinical populations. Data were pooled using a random-effects model. The main outcome was change in the severity of depressive symptoms after NINCEN treatment. A total of 58 studies on NINCEN were included in the meta-analysis. Active tDCS showed a significant effect on depressive symptoms (Hedges' g = 0.544), anxiety (Hedges' g = 0.667) and response rate (odds ratio = 1.9594) compared to sham control. CES also had a significant effect on depression (Hedges' g = 0.654) and anxiety (Hedges' g = 0.711). For all types of NINCEN, active stimulation was significantly effective on depression, anxiety, sleep efficiency, sleep latency, total sleep time, etc. Our results showed that tDCS has significant effects on both depression and anxiety and that these effects are robust for different populations and treatment parameters. The rational expectation of the tDCS effect is 'response' rather than 'remission'. CES also is effective for depression and anxiety, especially in patients with disorders of low severity.
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Affiliation(s)
- Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Min-I Su
- Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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19
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Wang JH, Wang LW, Liang SY, Rosenberg J, Wang TJ, Wu SF, Liu CY. Relationship between prescribed opioids, pain management satisfaction, and pain intensity in oncology outpatients. Support Care Cancer 2022; 30:3233-3240. [PMID: 34977980 DOI: 10.1007/s00520-021-06722-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pain is the most severe and commonest symptom for patients with cancer. Patients' pain management satisfaction is an essential indicator of quality care and further affects their willingness to seek care. PURPOSE This study aimed to examine the correlations between patients' prescribed opioids, pain management satisfaction, and pain intensity. METHODS This study adopted a cross-sectional correlation design, recruited a total of 123 patients with cancer pain through convenience sampling, and used two research scales, namely the Chinese version of the Pain Treatment Satisfaction Scale and the Brief Pain Inventory-Short Form. RESULTS The findings indicated that the correlations of prescribed opioid dosage with pain management satisfaction (r = - .10, p > .05) and pain intensity (worst pain, least pain, average pain, and pain right now; r = - .05 to .01, p > .05) were nonsignificant. The correlations of pain management satisfaction with pain intensity (r = .24 to .32, p < .01), pain interference (r = .32, p < .01), and pain relief (r = - .25, p < .01) were all significant, but that with the worst pain (r = .06, p > .05) was nonsignificant. CONCLUSIONS Medical professionals providing cancer pain management should focus on medicines strategies and individuals' pain relief requirements. In particular, patients with the worst pain require extra investigations into their needs, and their satisfaction with their level of pain should be further evaluated.
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Affiliation(s)
- Jia-Hua Wang
- Changhua Nursing Home, Ministry of Health and Welfare, No 1, Hugang Rd, Changhua City, Changhua Country, 500040, Taiwan
| | - Ling-Wei Wang
- Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Beitou, Taipei, 112, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan.
| | - John Rosenberg
- School of Nursing, University of the Sunshine Coast, 80-106 Tallon Street, Caboolture, QLD, 4059, Australia
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Chieh-Yu Liu
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Peitou, Taipei, 112, Taiwan
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Biomarcadores salivares na avaliação da dor: revisão integrativa. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar03203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Chang WD, Tsou YA, Chen YY, Hung BL. Cranial Electrotherapy Stimulation to Improve the Physiology and Psychology Response, Response-Ability, and Sleep Efficiency in Athletes with Poor Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041946. [PMID: 35206134 PMCID: PMC8871707 DOI: 10.3390/ijerph19041946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
Athletes often have poor sleep quality before a competition. Sleep quality can stabilize mood and improve sports performance. The randomized controlled study explored the effects of cranial electrotherapy stimulation (CES) on the physiology, psychology, response-ability, and sleep quality of athletes who had poor sleep quality before a competition. Athletes who had poor sleep quality (Pittsburgh Sleep Quality Scale score > 5) and had a competition in less than 2 months were recruited. The athletes were grouped into the CES group, which received a 2-week CES treatment (n = 20, age = 21.55 ± 2.26 years), and a placebo group (n = 20, age = 21.05 ± 1.46 years), which received a 2-week sham CES treatment. We performed biochemical analysis, a simple reaction time test, choice reaction time tests, the Profile of Mood States, heart rate variability (HRV), and an Actigraphy activity recorder to measure outcomes before and after the interventions. Our results revealed no significant differences in blood urea nitrogen, creatine phosphate, testosterone, cortisol, and saliva pH between and within groups (p > 0.05). Significant decreases in negative mood states (i.e., anger, tension, and depression) and choice reaction time in the CES group were noted (p < 0.05), moreover, the anger, tension, and depression mood decreased from 0.36 ± 0.45 (95% CI = 0.16–0.55), 1.62 ± 0.97 (95% CI = 1.19–2.04), and 1.67 ± 1.06 (95% CI = 1.20–2.13) to 0.11 ± 0.20 (95% CI = 0.02–0.19, p = 0.03), 1.12 ± 0.74 (95% CI = 0.79–1.44, p = 0.04), and 0.81 ± 0.75 (95% CI = 0.48–1.13, p = 0.001), respectively. Additionally, choice reaction time was decreased from 420.85 ± 41.22 ms (95% CI = 402.78–438.91) to 399.90 ± 36.71 ms (95% CI = 383.81–415.98, p = 0.04) and was also noted in the CES group. For HRV, and Actigraphy activity for sleep measure, the low-frequency (LF)/high-frequency (HF) ratios changed from 1.80 ± 1.39 (95% CI = 1.19–2.40) to 1.21 ± 0.73 (95% CI = 0.89–1.53, p = 0.10), and sleep efficiency decreased from 87.94 ± 6.76% (95% CI = 84.97–90.90) to 81.75 ± 9.62% (95% CI = 77.53–85.96, p = 0.02) in the CES group. The change in LF/HF after the trial were found between CES and placebo groups (p < 0.05). Yet, the decrease in sleep efficiency in the placebo group were noted (p < 0.05). However, we found that the regression line for sleep efficiency was decreased less during the study while using CES. The CES intervention could reduce negative emotions, improve choice reaction times, enhance the parasympathetic and sympathetic nerve activity imbalances, and slow sleep efficiency deterioration. Regardless, small effect sizes of the application of CES on psychology response, response-ability, and sleep efficiency were concluded in athletes with poor sleep quality before a competition.
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Affiliation(s)
- Wen-Dien Chang
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan;
- Correspondence:
| | - Yung-An Tsou
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 40402, Taiwan;
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung 41354, Taiwan
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Yi-Ying Chen
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Bao-Lien Hung
- Department of Sports Medicine, China Medical University, Taichung 406040, Taiwan;
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22
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Shaygan M, Jaberi A. The effect of a smartphone-based pain management application on pain intensity and quality of life in adolescents with chronic pain. Sci Rep 2021; 11:6588. [PMID: 33758322 PMCID: PMC7988051 DOI: 10.1038/s41598-021-86156-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/11/2021] [Indexed: 11/09/2022] Open
Abstract
The development, implementation, and qualitative evaluation of smartphone-based pain management applications may provide an opportunity for more optimal management of pediatric pain in the homesetting. The present mixed-method study was conducted to assess a smartphone-based pain management application regarding the feasibility, adherence, participant satisfaction, and effectiveness on pain intensity and quality of life in adolescents with chronic pain. The study was carried out in the quantitative and qualitative stages using a mixed-method approach. The quantitative stage included 128 adolescents who met the ICD-11 criteria of chronic pain. After random allocation, adolescents allocated to the intervention group received a pain management program through a smartphone-based application. No education was given to the adolescents in the control group. The adolescents were assessed regarding pain intensity and different dimensions of quality of life at pre-intervention, post-intervention, and three-month follow-up. The findings in the quantitative stage were explained by qualitative interviews. The findings of the quantitative stage showed significant improvements in the pain intensity, emotional, social, and school functioning but not in the physical functioning of the adolescents. A high level of adherence (78.12%) and satisfaction (Mean = 26.45, SD = 6.45) with thes martphone-based pain management program was found. Based on the qualitative interviews, adolescents' pain management strategies can be classified in three main categories: physical management, psychological management, and interpersonal resources. The results confirm the positive effect of a smartphone-based pain management program on the pain intensity and different dimensions of quality of life of adolescents with chronic pain. Within the context of chronic pain management, a mobile application incorporating both the psychological and physical management of pain may help adolescents with chronic pain to reduce the negative impacts of pain on their life.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Jaberi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Konopka LM, Glowacki A, Konopka CJ, Wuest R. Objective Assessments in Diagnoses and Treatment: A Proposed Change in Paradigm. Clin EEG Neurosci 2021; 52:90-97. [PMID: 33370217 DOI: 10.1177/1550059420983998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For patients with psychiatric disorders, current diagnostic and treatment approaches are far from optimal. The clinical interview drives the standard approach-matching symptoms to diagnostic criteria-and results in standardized pharmacological and behavioral treatments, often, with inadequate outcome; but now, recent imaging advances can correlate behavioral assessments with brain function and measure them against normative databases to provide data critical for the reevaluation of patient diagnosis and treatment. This article addresses the data that support a redefinition of our current paradigm. We believe a neurobehavioral approach provides for more personalized treatment approaches unbound from classically defined diagnostic biases.
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Affiliation(s)
| | | | - Christian J Konopka
- Department of Bioengineering, 14589University of Illinois at Urbana-Champaign, Urbana, IL, USA.,97472Beckman Institute for Advanced Science and Technology, Urbana, IL, USA.,43988University of Illinois College of Medicine, Urbana, IL, USA
| | - Ronald Wuest
- Institute for Personal Development, Romeiville, IL, USA
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Price L, Briley J, Haltiwanger S, Hitching R. A meta-analysis of cranial electrotherapy stimulation in the treatment of depression. J Psychiatr Res 2021; 135:119-134. [PMID: 33477056 DOI: 10.1016/j.jpsychires.2020.12.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression rates have reached historic highs, with 49% of Americans reporting unabating symptoms and signs of depression, representing a 12% increase compared to the same time in 2019. With depression as a moderating factor for suicide, the need for efficacious treatments for depression has never been more pronounced. Although the armamentarium of the psychiatrist seems impressive having multiple medications and psychotherapy options, with guidelines for combination and augmentation treatments; many patients do not improve or are not suitable candidates for the usual, customary and reasonable (UCR) depression treatments. The use of various forms of brain stimulation technology as a complementary or alternative treatment for depression is growing and is expected to be part of the armamentarium of most psychiatrists by 2030. One form of brain stimulation, available in a phone sized prescription device, is cranial electrical stimulation (CES) which has been used as a treatment for depression since the 1970s. We have conducted two meta-analyses of CES research for depression separating randomized controlled trials (N = 5) from non-randomized studies on interventions (N = 12). For the double-blind RCTs 100 μA was used for 1 hour per day as 100 μA is a subsensory level of current so identical sham treatment devices could be used. METHODS Our literature review followed Cooper's Taxonomy of Literature Reviews that is appropriate for the behavioral and physical sciences and the PRISMA reporting guidelines. The evaluation of strengths and limitations of the research studies included in this report adheres to recommended published guidelines in the Cochrane Handbook for Systematic Reviews of Interventions, and in the Handbook of Research Synthesis and Meta-Analysis. We used the Cohen's d effect size summary metric in all analyses. Homogeneity of effect sizes within the fixed and random effects models are reported. Meta-analyses were performed using the Compressive Meta-Analysis, version 3 program. RESULTS The 5 RCTs represent a combined N of 242 and the 12 NRSIs represent 16 data sets with a combined N of 1173 for total of 1415 subjects across 17 studies. There were male and female subjects, from adolescents to 60 years old. The average effect for the 5 RCTs was calculated as d = -0.69 (i.e., the mean depression level at posttest for the active group was -0.69 standard deviations lower than the mean depression level for the sham group), a medium effect. The additional 12 NRSI studies analyzed show a small effect of d = -0.43 in favor of the active treatment group. CONCLUSION We conclude that CES has a small to medium significant effect in symptoms of depression across moderate to severe patients in civilian, military, veterans, advanced cancer and pediatric populations.
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Affiliation(s)
- Larry Price
- Methodology, Measurement & Statistical Analysis, Office of Research and Sponsored Programs, San Marcos, TX, USA; Psychometrics & Statistics, Texas State University, USA
| | - Josh Briley
- Electromedical Products International, Inc., Mineral Wells, TX, USA.
| | | | - Rita Hitching
- Electromedical Products International, Inc., Mineral Wells, TX, USA
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25
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Shaygan M, Yazdani Z, Valibeygi A. The effect of online multimedia psychoeducational interventions on the resilience and perceived stress of hospitalized patients with COVID-19: a pilot cluster randomized parallel-controlled trial. BMC Psychiatry 2021; 21:93. [PMID: 33573631 PMCID: PMC7877318 DOI: 10.1186/s12888-021-03085-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/01/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is evidence suggesting that quarantine might have undesirable psychological impacts on the patients. Therefore, it is important to seek for ways to increase the resilience and alleviate the psychological pressure of the patients who are quarantined due to infection with COVID-19. The present study was conducted to assess an online multimedia psychoeducational intervention regarding the feasibility, adherence, patient satisfaction and effectiveness on resilience and perceived stress of patients hospitalized with confirmed COVID-19. METHOD This was a pilot cluster randomized parallel-controlled trial with hospital wards as the units of randomization. Participants in this fully online trial were 50 consecutive patients who were hospitalized in 2 hospitals in Shiraz, after being diagnosed with COVID-19. Before the beginning of the intervention, four inpatient wards inside two of the hospitals were randomly assigned to either intervention or control conditions. All eligible participants in the wards allocated to the intervention condition received online multimedia psychoeducational interventions during the 2 weeks, whilst the patients in the wards allocated to the control condition were offered the opportunity to receive telephone-based psychological counseling if needed. Psychoeducational interventions mainly included cognitive-behavioural techniques, stress management techniques, mindfulness-based stress reduction and positive psychotherapy. The patients were assessed regarding resilience and perceived stress at baseline and after two weeks. RESULTS Of 27 patients starting multimedia psychoeducational interventions, 26 (96.29%) completed post-assessments. A high level of adherence (80.76%) and satisfaction (Mean = 29.42; SD = 4.18) with the online multimedia psychoeducational interventions was found. Compared with the control group, the patients who used online multimedia psychoeducational interventions reported greater resilience (Meanintervention = 81.74; Meancontrol = 72.86; adjusted t (46) = 2.10; p = 0.04; CI: 0.39 to 17.38; dppc2 = 0.83) and fewer perceived stress (Meanintervention = 22.15; Meancontrol = 29.45; adjusted t (46) = 2.66; p = 0.01; CI: - 12.81 to - 1.78; dppc2 = - 0.77) after 2 weeks. DISCUSSION The findings of the present study provided a successful first attempt at implementing feasible online multimedia psychoeducational interventions to promote resilience and mitigate stress among the patients who were hospitalized due to infection with COVID-19. The present results could help mental health professionals to determine which psychological techniques should be emphasized to promote patients' resilience in the context of COVID-19 disease. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT20201001048893N1 . Retrospectively registered, 29 Jan 2021.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, P.O. Box 713451359, Shiraz, Iran.
| | - Zahra Yazdani
- Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adib Valibeygi
- Fasa Neuroscience Circle (FNC), Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
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Ibáñez-del Valle V, Navarro-Martínez R, Ballestar-Tarín ML, Cauli O. Salivary Inflammatory Molecules as Biomarkers of Sleep Alterations: A Scoping Review. Diagnostics (Basel) 2021; 11:diagnostics11020278. [PMID: 33579032 PMCID: PMC7916754 DOI: 10.3390/diagnostics11020278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
Poor sleep quality and sleep disorders are the most common problems in people, affecting health-related quality of life. Various studies show an association between sleep disorders and altered levels of stress hormones and inflammatory cytokines measured in saliva. The main objective of this article is to provide an analysis of the current evidence related to changes in inflammatory markers in the saliva and their associations with sleep quality measurement (both objective and subjective methods) in healthy subjects and in sleep-related disorders. To that end, a scoping review was carried out, following the PRISMA criteria in the bibliographic search in several databases: PubMed, EBSCO, and SCOPUS. Eleven of the articles are from the adult population and two from the child-youth population. They mainly measure the relationship between sleep and interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα) alpha, as well as other inflammatory markers such as myeloperoxidase (MPO) and prostaglandin-endoperoxide synthase 2. An analysis shows the relationship between these salivary biomarkers and sleep quality, especially in the case of IL-6 in both healthy subjects and several pathologies associated with sleep-disorders. The results for TNFα and IL-1β measurements are still inconclusive and the difference with IL-6 was assessed. Two studies reported interventions that result in sleep improvement and are accompanied by the normalization of inflammatory changes detected in the saliva. As it is an easy-to-apply and non-invasive method, the measurement of salivary cytokines can be very useful in chronobiology studies. Further studies are required to determine the sensitivity of salivary inflammatory markers in monitoring biological rhythms and acting as biomarkers in the detection of sleep disorders and sleep interventions.
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Affiliation(s)
- Vanessa Ibáñez-del Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
| | - Rut Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
| | - Maria Luisa Ballestar-Tarín
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/Jaume Roig s/n, 46010 Valencia, Spain; (V.I.-d.V.); (R.N.-M.); (M.L.B.-T.)
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
- Correspondence:
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Brunyé TT, Patterson JE, Wooten T, Hussey EK. A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples. Front Hum Neurosci 2021; 15:625321. [PMID: 33597854 PMCID: PMC7882621 DOI: 10.3389/fnhum.2021.625321] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/07/2021] [Indexed: 01/27/2023] Open
Abstract
Cranial electrotherapy stimulation (CES) is a neuromodulation tool used for treating several clinical disorders, including insomnia, anxiety, and depression. More recently, a limited number of studies have examined CES for altering affect, physiology, and behavior in healthy, non-clinical samples. The physiological, neurochemical, and metabolic mechanisms underlying CES effects are currently unknown. Computational modeling suggests that electrical current administered with CES at the earlobes can reach cortical and subcortical regions at very low intensities associated with subthreshold neuromodulatory effects, and studies using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) show some effects on alpha band EEG activity, and modulation of the default mode network during CES administration. One theory suggests that CES modulates brain stem (e.g., medulla), limbic (e.g., thalamus, amygdala), and cortical (e.g., prefrontal cortex) regions and increases relative parasympathetic to sympathetic drive in the autonomic nervous system. There is no direct evidence supporting this theory, but one of its assumptions is that CES may induce its effects by stimulating afferent projections of the vagus nerve, which provides parasympathetic signals to the cardiorespiratory and digestive systems. In our critical review of studies using CES in clinical and non-clinical populations, we found severe methodological concerns, including potential conflicts of interest, risk of methodological and analytic biases, issues with sham credibility, lack of blinding, and a severe heterogeneity of CES parameters selected and employed across scientists, laboratories, institutions, and studies. These limitations make it difficult to derive consistent or compelling insights from the extant literature, tempering enthusiasm for CES and its potential to alter nervous system activity or behavior in meaningful or reliable ways. The lack of compelling evidence also motivates well-designed and relatively high-powered experiments to assess how CES might modulate the physiological, affective, and cognitive responses to stress. Establishing reliable empirical links between CES administration and human performance is critical for supporting its prospective use during occupational training, operations, or recovery, ensuring reliability and robustness of effects, characterizing if, when, and in whom such effects might arise, and ensuring that any benefits of CES outweigh the risks of adverse events.
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Affiliation(s)
- Tad T. Brunyé
- U. S. Army Combat Capabilities Development Command Soldier Center, Cognitive Science Team, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Joseph E. Patterson
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Thomas Wooten
- Department of Psychology, Tufts University, Medford, MA, United States
| | - Erika K. Hussey
- U. S. Army Combat Capabilities Development Command Soldier Center, Cognitive Science Team, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
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28
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Jeon MS, Agar MR, Koh ES, Nowak AK, Hovey EJ, Dhillon HM. Barriers to managing sleep disturbance in people with malignant brain tumours and their caregivers: a qualitative analysis of healthcare professionals' perception. Support Care Cancer 2021; 29:3865-3876. [PMID: 33386987 DOI: 10.1007/s00520-020-05970-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE This study explores healthcare professionals (HCPs)' perception and current management of sleep disturbance (SD) in people with malignant brain tumours and their caregivers. We aimed to identify barriers to effective management of SD in neuro-oncology care. METHODS We conducted semi-structured interviews with 11 HCPs involved in neuro-oncology care. The study was underpinned by the Capability Opportunity Motivation-Behaviour (COM-B) model within the Behavioural Change Wheel (BCW) guiding topic selection for the exploration of underlying processes of HCPs' behaviours and care decisions for SD management. Data were analysed thematically using a framework synthesis, and subsequently mapped onto the BCW to identify barriers for effective management and recommend potential interventions. RESULTS We identified four themes: HCPs' clinical opinions about SD, the current practice of SD management in neuro-oncology clinics, gaps in the current practice, and suggested areas for improvements. HCPs perceived SD as a prevalent yet secondary issue of low priority in neuro-oncology care. SD was unrecognised, and inadequately managed in usual clinical settings. Interventional options included modifying the use of corticosteroids or prescribing sedatives. When mapped onto the BCW, themes identified main barriers as a lack of awareness among HCPs about SD warranting care, due to the absence of screening tools and limited knowledge and resources for therapeutic interventions. CONCLUSIONS Multidisciplinary HCPs need training in the routine use of appropriate sleep assessment tools, and access to clear management pathways. More professional resources are needed to educate staff in implementing appropriate interventions for people with malignant brain tumours who are experiencing SD.
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Affiliation(s)
- Megan S Jeon
- South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia.
| | - Meera R Agar
- South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Eng-Siew Koh
- South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - Anna K Nowak
- Medical School, QEII Medical Centre Unit, University of Western Australia, Crawley, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA, Australia
| | - Elizabeth J Hovey
- University of New South Wales, Sydney, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
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Kang HW, Kim HJ, Kim WY, Min WK, Min TJ, Lee YS, Kim JH. Effects of cranial electrotherapy stimulation on preoperative anxiety and blood pressure during anesthetic induction in patients with essential hypertension. J Int Med Res 2020; 48:300060520939370. [PMID: 32865096 PMCID: PMC7469723 DOI: 10.1177/0300060520939370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Cranial electrotherapy stimulation (CES) is a non-invasive treatment that improves symptoms such as anxiety and pain. The purpose of this study was to analyze the effect of CES pretreatment on levels of preoperative anxiety, pain, and hemodynamic responses—especially changes in blood pressure—during anesthetic induction in patients with essential hypertension. Methods Eighty patients undergoing general anesthesia were randomly assigned to receive either no pretreatment (control group, n = 40) or CES pretreatment (CES group, n = 40). Anxiety scores, systolic and diastolic blood pressures, mean arterial pressure, and heart rate were measured in the general ward the evening before surgery, as well as in the preoperative holding area, operating room, and after intubation. Withdrawal responses to rocuronium injection were also measured. Results Anxiety scores in the operating room were significantly lower in the CES group. Withdrawal responses to rocuronium injection were also significantly lower in the CES group. There were no significant differences in hemodynamic values between the two groups. Conclusions CES pretreatment reduces both preoperative anxiety levels and withdrawal responses to rocuronium injection. However, it does not have a significant effect on hemodynamic responses.
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Affiliation(s)
- Hee Won Kang
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Hyun Joong Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Woon Young Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Too Jae Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Yoon Sook Lee
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jae Hwan Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
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Ahn H, Galle K, Mathis KB, Miao H, Montero-Hernandez S, Jackson N, Ju HH, McCrackin H, Goodwin C, Hargraves A, Jain B, Dinh H, Abdul-Mooti S, Park L, Pollonini L. Feasibility and efficacy of remotely supervised cranial electrical stimulation for pain in older adults with knee osteoarthritis: A randomized controlled pilot study. J Clin Neurosci 2020; 77:128-133. [PMID: 32402609 DOI: 10.1016/j.jocn.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
Cranial electrical stimulation (CES) is a noninvasive brain stimulation technique that has been shown to improve pain. However, few studies have investigated the potential benefits associated with remotely supervised CES in older adults with knee osteoarthritis (OA). The aim of this study was to examine the feasibility and preliminary efficacy of remotely supervised CES via secure videoconferencing software on clinical pain severity, experimental pain sensitivity, and pain-related cortical response in older adults with knee OA. Thirty participants with symptomatic knee OA pain were randomly assigned to receive 10 daily sessions (60 min each) of remotely supervised CES (n = 15) or sham CES (n = 15) over two weeks. We measured clinical pain severity via a Numeric Rating Scale, experimental pain sensitivity (e.g., heat pain sensitivity, pressure pain sensitivity, and conditioned pain modulation) using quantitative sensory testing, and pain-related cortical response via functional near-infrared spectroscopy imaging. We also measured participant satisfaction with treatment using the Client Satisfaction Questionnaire. Active CES significantly reduced scores on the Numeric Rating Scale and increased heat pain threshold, pressure pain thresholds, and conditioned pain modulation. We also found significant changes in pain-related cortical hemodynamic activity after CES. Participants tolerated CES well without serious adverse effects and were satisfied with the treatment. Our findings demonstrate promising clinical efficacy of remotely supervised CES for older adults with knee OA.
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Affiliation(s)
- Hyochol Ahn
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Kelli Galle
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kenneth B Mathis
- Department of Orthopedic Surgery, School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hongyu Miao
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Natalie Jackson
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hsiao-Hui Ju
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Heather McCrackin
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Catherine Goodwin
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Allison Hargraves
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bhawna Jain
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Helen Dinh
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sarah Abdul-Mooti
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lindsey Park
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Luca Pollonini
- Department of Engineering Technology, University of Houston, Houston, TX, USA
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31
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Kwon DR, Park JA, Lee YS, Kwak JH, Do JK, Kim JE. Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia. ACTA ACUST UNITED AC 2019. [DOI: 10.13078/jsm.19029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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32
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Salinas-Asensio MM, Ríos-Arrabal S, Artacho-Cordón F, Olivares-Urbano MA, Calvente I, León J, Núñez MI. Exploring the radiosensitizing potential of magnetotherapy: a pilot study in breast cancer cells. Int J Radiat Biol 2019; 95:1337-1345. [PMID: 31140889 DOI: 10.1080/09553002.2019.1619951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: To explore the influence of electromagnetic fields (EMFs) on the cell cycle progression of MDA-MB-231 and MCF-7 breast cancer cell lines and to evaluate the radiosensitizing effect of magnetotherapy during therapeutic co-exposure to EMFs and radiotherapy. Material and methods: Cells were exposed to EMFs (25, 50 and 100 Hz; 8 and 10 mT). In the co-treatment, cells were first exposed to EMFs (50 Hz/10 mT) for 30 min and then to ionizing radiation (IR) (2 Gy) 4 h later. Cell cycle progression and free radical production were evaluated by flow cytometry, while radiosensitivity was explored by colony formation assay. Results: Generalized G1-phase arrest was found in both cell lines several hours after EMF exposure. Interestingly, a marked G1-phase delay was observed at 4 h after exposure to 50 Hz/10 mT EMFs. No cell cycle perturbation was observed after repeated exposure to EMFs. IR-derived ROS production was enhanced in EMF-exposed MCF-7 cells at 24 h post-exposure. EMF-exposed cells were more radiosensitive in comparison to sham-exposed cells. Conclusions: These results highlight the potential benefits of concomitant treatment with magnetotherapy before radiotherapy sessions to enhance the effectiveness of breast cancer therapy. Further studies are warranted to identify the subset(s) of patients who would benefit from this multimodal treatment.
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Affiliation(s)
| | - S Ríos-Arrabal
- Radiology and Physical Medicine Department, University of Granada , Granada , Spain.,Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain
| | - F Artacho-Cordón
- Radiology and Physical Medicine Department, University of Granada , Granada , Spain.,Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain
| | - M A Olivares-Urbano
- Radiology and Physical Medicine Department, University of Granada , Granada , Spain.,Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain
| | - I Calvente
- Radiology and Physical Medicine Department, University of Granada , Granada , Spain.,Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain
| | - J León
- Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain.,Digestive Unit, San Cecilio University Hospital , Granada , Spain.,CIBER of Hepatic and Digestive Diseases (CIBEREHD) , Madrid , Spain
| | - M I Núñez
- Radiology and Physical Medicine Department, University of Granada , Granada , Spain.,Biosanitary Research Institute of Granada ibs.GRANADA , Granada , Spain.,CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,Biopathology and Regenerative Medicine Institute (IBIMER) , University of Granada, Granada , Spain
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Pan-Weisz TM, Kryza-Lacombe M, Burkeen J, Hattangadi-Gluth J, Malcarne VL, McDonald CR. Patient-reported health-related quality of life outcomes in supportive-care interventions for adults with brain tumors: A systematic review. Psychooncology 2018; 28:11-21. [DOI: 10.1002/pon.4906] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/26/2018] [Accepted: 08/30/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Tonya M. Pan-Weisz
- San Diego State University/University of California; San Diego Joint Doctoral Program in Clinical Psychology; San Diego California
- University of California, San Diego Moores Cancer Center; San Diego California
| | - Maria Kryza-Lacombe
- San Diego State University/University of California; San Diego Joint Doctoral Program in Clinical Psychology; San Diego California
| | - Jeffrey Burkeen
- University of California, San Diego Moores Cancer Center; San Diego California
- Department of Radiation Medicine and Applied Sciences; University of California, San Diego; San Diego California
| | - Jona Hattangadi-Gluth
- University of California, San Diego Moores Cancer Center; San Diego California
- Department of Radiation Medicine and Applied Sciences; University of California, San Diego; San Diego California
| | - Vanessa L. Malcarne
- San Diego State University/University of California; San Diego Joint Doctoral Program in Clinical Psychology; San Diego California
- University of California, San Diego Moores Cancer Center; San Diego California
- Department of Psychology; San Diego State University; San Diego California
| | - Carrie R. McDonald
- San Diego State University/University of California; San Diego Joint Doctoral Program in Clinical Psychology; San Diego California
- University of California, San Diego Moores Cancer Center; San Diego California
- Department of Radiation Medicine and Applied Sciences; University of California, San Diego; San Diego California
- Department of Psychiatry; University of California, San Diego; San Diego California
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34
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Marksberry J. Benefits and Harms of Cranial Electrical Stimulation. Ann Intern Med 2018; 169:268-269. [PMID: 30128521 DOI: 10.7326/l18-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jeff Marksberry
- Electromedical Products International, Mineral Wells, Texas (J.M.)
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