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Sansevere KS, MacVicar JA, Samuels DR, Yang AK, Johnson SK, Brunyé TT, Ward N. Balancing Act: Acute and Contextual Vestibular Sensations of Cranial Electrotherapy Stimulation Using Survey and Sensor Outcomes in a Non-Clinical Sample. Brain Sci 2024; 14:87. [PMID: 38248302 PMCID: PMC10813998 DOI: 10.3390/brainsci14010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Cranial electrotherapy stimulation (CES) delivers low-intensity electrical currents to the brain to treat anxiety, depression, and pain. Though CES is considered safe and cost-effective, little is known about side effects emerging across different contexts. Our objective was to investigate how varying physical and cognitive demands impact the frequency and intensity of CES vestibular sensations in a sample of healthy young adults. We used a 2 (stimulation: sham, active) × 2 (physical demand: static sway, dynamic sit-to-stand) × 2 (cognitive demand: single-task remain silent, dual-task count backward) repeated measures design. Vestibular sensations were measured with surveys and wearable sensors capturing balance changes. Active stimulation did not influence reported vestibular sensations. Instead, high physical demand predicted more sensation reports. High cognitive demand, but not active stimulation, predicted postural sway unsteadiness. Significant effects of active stimulation on balance were observed only during the dynamic sit-to-stand transitions. In summary, CES induces vestibular sensations only for a specific outcome under certain circumstances. Our findings imply that consumers can safely maximize the benefits of CES while ensuring they are taking steps to minimize any potential side effects by considering their context and circumstances.
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Affiliation(s)
- Kayla S. Sansevere
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
| | - Joel A. MacVicar
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
| | - Daniel R. Samuels
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
| | - Audrey K. Yang
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
| | - Sara K. Johnson
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, 105 College Ave., Medford, MA 02145, USA
| | - Tad T. Brunyé
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
- U.S. Army Combat Capabilities Development Command Soldier Center, 15 General Greene, Natick, MA 01760, USA
- Center for Applied Brain and Cognitive Sciences, 200 Boston Ave., Suite 1800, Medford, MA 02155, USA
| | - Nathan Ward
- Department of Psychology, Tufts University, 490 Boston Ave., Medford, MA 02155, USA (N.W.)
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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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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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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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5
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Fiore M, Petrella C, Coriale G, Rosso P, Fico E, Ralli M, Greco A, De Vincentiis M, Minni A, Polimeni A, Vitali M, Messina MP, Ferraguti G, Tarani F, de Persis S, Ceccanti M, Tarani L. Markers of Neuroinflammation in the Serum of Prepubertal Children with Fetal Alcohol Spectrum Disorders. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2022; 21:854-868. [PMID: 34852752 DOI: 10.2174/1871527320666211201154839] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorders (FASD) are the manifestation of the damage caused by alcohol consumption during pregnancy. Children with Fetal Alcohol Syndrome (FAS), the extreme FASD manifestation, show both facial dysmorphology and mental retardation. Alcohol consumed during gestational age prejudices brain development by reducing, among others, the synthesis and release of neurotrophic factors and neuroinflammatory markers. Alcohol drinking also induces oxidative stress. HYPOTHESIS/OBJECTIVE The present study aimed to investigate the potential association between neurotrophins, neuroinflammation, and oxidative stress in 12 prepubertal male and female FASD children diagnosed as FAS or partial FAS (pFAS). METHODS Accordingly, we analyzed, in the serum, the level of BDNF and NGF and the oxidative stress, as Free Oxygen Radicals Test (FORT) and Free Oxygen Radicals Defense (FORD). Moreover, serum levels of inflammatory mediators (IL-1α, IL-2, IL-6, IL-10, IL-12, MCP-1, TGF-β, and TNF-α) involved in neuroinflammatory and oxidative processes have been investigated. RESULTS We demonstrated low serum levels of NGF and BDNF in pre-pubertal FASD children with respect to healthy controls. These changes were associated with higher serum presence of TNF- α and IL-1α. Quite interestingly, an elevation in the FORD was also found despite normal FORT levels. Moreover, we found a potentiation of IL-1α, IL-2, IL-10, and IL-1α1 in the analyzed female compared to male children. CONCLUSION The present investigation shows an imbalance in the peripheral neuroimmune pathways that could be used in children as early biomarkers of the deficits observed in FASD.
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Affiliation(s)
- Marco Fiore
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - Giovanna Coriale
- Centro Riferimento Alcologico Regione Lazio, ASL Roma 1, Rome, Italy
| | - Pamela Rosso
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - Elena Fico
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | | | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Antonella Polimeni
- Department of Odontostomatological and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | | | | | | | - Francesca Tarani
- Department of Pediatrics, Sapienza University Hospital of Rome, Italy
| | | | - Mauro Ceccanti
- SITAC, Societa' Italiana per il Trattamento dell'Alcolismo, Roma Italy SIFASD, Società Italiana Sindrome Feto-Alcolica, Roma, Italy
| | - Luigi Tarani
- Department of Pediatrics, Sapienza University Hospital of Rome, Italy
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Dai Y, Qin Q, Chen B, Chen L, Sun Q, Vgontzas AN, Basta M, Li Y. Effects of electrostatic therapy on nighttime sleep and daytime symptoms in patients with chronic insomnia: Evidences from an open label study. Front Neurosci 2022; 16:1047240. [PMID: 36685220 PMCID: PMC9853294 DOI: 10.3389/fnins.2022.1047240] [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: 09/17/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Transcranial electric stimulation (TES) is a neuromodulation approach that applies low-intensity electrical current to the brain and has been proposed as a treatment for insomnia. Electrostatic therapy is a kind of TES and people do not have a feeling of electrical stimuli when the voltage of static electricity is lower than 2,000 volts. However, no studies have examined the effects of electrostatic therapy on objective sleep and daytime symptoms in patients with insomnia. MATERIALS AND METHODS Thirty chronic insomnia patients were included. All patients received a 6 week electrostatic therapy and three comprehensive assessments including two consecutive polysomnography (PSG) and daytime symptoms assessments, at pre-treatment, 3 week and 6 week of treatment. Insomnia Severity Index (ISI) was used to assess the severity of insomnia. Multiple sleep latency test (MSLT), Epworth Sleepiness Scale (ESS), and Flinders Fatigue Scale (FFS) were used to assess objective and self-reported daytime sleepiness and fatigue, respectively. Attention network test (ANT) was used to assess attention levels. RESULTS Total ISI scores decreased significantly at 3 weeks (p < 0.001) and 6 weeks (p < 0.001) after initiation of treatment. Furthermore, objective total sleep time (TST, p = 0.020) and sleep efficiency (SE, p = 0.009) increased and wake time after sleep onset (p = 0.012) decreased significantly after 6 weeks electrostatic therapy. Regarding daytime symptoms, ESS and FFS scores decreased significantly at 3 weeks (ESS, p = 0.047; FFS, p = 0.017) and 6 weeks (ESS, p = 0.008; FFS, p = 0.003) after initiation of treatment. Moreover, executive control improved significantly from pre-treatment to 3 weeks (p = 0.006) and 6 weeks (p = 0.013) and altering network improved significantly at 6 weeks (p = 0.003) after initiation of treatment. Secondary analyses showed that TST and SE improved significantly after electrostatic therapy in insomnia patients who slept < 390 min (all p-value < 0.05). However, no significant changes regarding TST and SE were observed in insomnia patients who slept ≥ 390 min. CONCLUSION Electrostatic therapy improves both nighttime sleep and daytime symptoms in patients with chronic insomnia. The effect on objective sleep appears to be stronger in patient with objective short sleep duration. Electrostatic therapy might be a therapeutic choice for insomnia patients with difficulty maintaining sleep and not responding to behavioral treatments. CLINICAL TRIAL REGISTRATION [www.clinicaltrials.gov], identifier [ChiCTR2100051590].
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Affiliation(s)
- Yanyuan Dai
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Qingsong Qin
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Le Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Qimeng Sun
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Alexandros N. Vgontzas
- Department of Psychiatry, Sleep Research and Treatment Center, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Greece
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
- *Correspondence: Yun Li,
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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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Perrin AJ, Pariante CM. Endocrine and immune effects of non-convulsive neurostimulation in depression: A systematic review. Brain Behav Immun 2020; 87:910-920. [PMID: 32126288 DOI: 10.1016/j.bbi.2020.02.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-convulsive neurostimulation is a rapidly-developing alternative to traditional treatment approaches in depression. Modalities such as repetitive Transcranial Magnetic Stimulation (rTMS), transcranial Direct Current Stimulation (tDCS), Vagal Nerve Stimulation (VNS) and Deep Brain Stimulation (DBS) are now recognized as potential treatments. How non-convulsive neurostimulation interventions impact the neurohormonal and neuroimmune changes that accompany depression remains relatively unknown. If this type of intervention can drive endocrine, immune, as well symptom changes in depression, non-convulsive neurostimulation may represent a viable, multi-faceted treatment approach in depression. We were therefore interested to understand the state of the literature in this developing area. METHODS A systematic review of all studies that examined the impact of non-convulsive neurostimulation interventions on the hypothalamic-pituitary-adrenal (HPA) axis and immune function in the form of cytokine production in depression. RESULTS We identified 15 human studies, 9 that examined rTMS, 2 that examined tDCS, 2 that examined VNS and 2 that examined electroacupuncture. 11 animal studies were also identified, 3 that examined rTMS, 2 that examined DBS and 6 that examined electroacupuncture. All types of non-convulsive neurostimulation were able to revert the increases in cortisol, ACTH and other components of the HPA axis that are seen in depressed patients, as well as to modulate the levels of key cytokines known to be up-regulated in depression, such as IL-1β, IL-6 and TNF-α. Changes in the HPA axis and levels of cytokines in response to non-convulsive neurostimulation often did not correlate with change in depressive symptoms. Most studies were not controlled trials and thus, significant methodologic variability existed. Furthermore, many human studies lacked a sham stimulation comparator arm. We were unable to conduct relevant meta-analyses due to the design heterogeneities, heterogeneity in the reported outcome measures and the limited number of studies retrieved. Animal studies generally supported the findings of those in human, but again, significant variability in methodology and study design were evident. CONCLUSIONS Non-convulsive neurostimulation interventions show promise in their ability to alter the endocrine and immune disturbances that accompany depression. Further research, which includes blinded, sham-controlled comparator designs is required.
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Affiliation(s)
- Andrew J Perrin
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 9RT, United Kingdom; Clinician Investigator Program and Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver V5Z 3X7, Canada.
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 9RT, United Kingdom
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Wu WJ, Wang Y, Cai M, Chen YH, Zhou CH, Wang HN, Cui LB. A double-blind, randomized, sham-controlled study of cranial electrotherapy stimulation as an add-on treatment for tic disorders in children and adolescents. Asian J Psychiatr 2020; 51:101992. [PMID: 32145674 DOI: 10.1016/j.ajp.2020.101992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022]
Abstract
AIM The aim of this study was to determine the efficacy and safety of cranial electrotherapy stimulation (CES) as an add-on treatment for TD. METHODS A randomized, double-blind, sham-controlled trial was conducted at an outpatient, single-center academic setting. A total of 62 patients aged 6-17 years with TD and lack of clinical response to 4 weeks' pharmacotherapy were enrolled. Patients were divided randomly into 2 groups and given 4 weeks' treatment, including 30 min sessions of active CES (500 μA-2 mA) or sham CES (lower than 100 μA) per day for 40 d on weekdays. Change in Yale Global Tic Severity Scale (YGTSS), Clinical Global Impression-severity of illness-severity (CGI-S) and Hamilton Anxiety Scale-14 items (HAMA-14) were performed at baseline, week 2, week 4. Adverse events (AEs) were also evaluated. RESULTS 53 patients (34 males and 9 females) completed the trial, including 29 in the active CES group and 24 in the sham CES group. Both groups showed clinical improvement in tic severities compared to baseline respectively at week 4. Participants receiving active CES showed a reduction of 31.66 % in YGTSS score, compared with 23.96 % in participants in sham CES group, resulting in no significant difference between the two groups (t = 1.54, p = 0.13). CONCLUSION Four-week's treatment of CES for children and adolescents with TD is effective and safe, but the improvement for tic severity may be related to placebo effect.
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Affiliation(s)
- Wen-Jun Wu
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Ying Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Min Cai
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Cui-Hong Zhou
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi'an, 710032, China.
| | - Long-Biao Cui
- Department of Clinical Psychology, School of Medical Psychology, Fourth Military Medical University, 169 # West Changle Road, Xi'an, 710032, China.
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Romero-Martínez Á, Bressanutti S, Moya-Albiol L. A Systematic Review of the Effectiveness of Non-Invasive Brain Stimulation Techniques to Reduce Violence Proneness by Interfering in Anger and Irritability. J Clin Med 2020; 9:jcm9030882. [PMID: 32213818 PMCID: PMC7141522 DOI: 10.3390/jcm9030882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/06/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022] Open
Abstract
The field of neurocriminology has proposed several treatments (e.g., pharmacological, brain surgery, androgen-deprivation therapy, neurofeedback) to reduce violence proneness, but unfortunately, their effectiveness has been limited due to their side-effects. Therefore, it is necessary to explore alternative techniques to improve patients’ behavioural regulation with minimal undesirable effects. In this regard, non-invasive brain stimulation techniques, which are based on applying changing magnetic fields or electric currents to interfere with cortical excitability, have revealed their usefulness in alleviating the symptomatology of several mental disorders. However, to our knowledge, there are no reviews that assess whether these techniques are useful for reducing violence proneness. Therefore, we conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria using the following databases: PsycINFO, PubMed, Dialnet, Psicodoc, Web of Knowledge, and the Cochrane Library. We initially identified 3746 entries, and eventually included 56 publications. Most of the studies were unanimous in concluding that the application of these techniques over the prefrontal cortex (PFC) was not sufficient to promote anger and irritability reductions in euthymic individuals of both genders. Nevertheless, the application of non-invasive brain stimulation techniques, especially transcranial direct current stimulation, over the right PFC seemed to reduce violent reactions in these individuals by interfering with the interpretation of the unfavourable situations (e.g., threating signals) or inner states that evoked anger. In antisocial and pathological populations, the conclusions were provided by a few pilot studies with important methodological weaknesses. The main conclusion of these studies was that bilateral stimulation of the PFC satisfactorily reduced anger and irritability only in inmates, patients with autism spectrum disorders (ASD), people who suffered a closed-head injury, and agitated patients with Alzheimer’s disease. Moreover, combining these techniques with risperidone considerably reduced aggressiveness in these patients. Therefore, it is necessary to be cautious about the benefits of these techniques to control anger, due the methodological weaknesses of these studies. Nonetheless, they offer valuable opportunities to prevent violence by designing new treatments combining brain stimulation with current strategies, such as psychotherapy and psychopharmacology, in order to promote lasting changes.
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Marino MJ, Luong A, Yao WC, Citardi MJ. Nonpharmacological Relaxation Technology for Office-Based Rhinologic Procedures. ORL J Otorhinolaryngol Relat Spec 2019; 81:48-54. [PMID: 30836361 DOI: 10.1159/000488323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Office-based rhinologic procedures are increasingly performed to control costs and enhance patient convenience. Adequate management of pain and anxiety is essential for the technical performance of these procedures, in addition to ensuring patient comfort. Pharmacologic agents are often used to manage anxiety and pain. Nonpharmacological adjuncts may be useful for achieving these effects without oral opioids and benzodiazepines. METHODS Charts of patients who underwent office-based rhinologic procedures with the NuCalm system (Solace Lifesciences, Inc., Wilmonton, DE, USA) in combination with local anesthesia were reviewed. NuCalm is a proprietary system that combines cranial electrotherapy stimulation, neuroacoustic software, light-blocking lenses, and topical γ--aminobutyric acid. Patients rated their pain and anxiety before, during, and after the procedure. RESULTS Twenty-five patients underwent office procedures using the NuCalm system. Preoperative anxiety (2.00) was significantly higher than postoperative anxiety (1.25) according to patient reporting on a 5-point scale (p = 0.005). Preoperative pain (1.83) was not significantly different from intraoperative (2.54) and postoperative pain (2.04, p = 0.054). CONCLUSIONS A variety of office-based rhinologic procedures are technically feasible and can be performed with adequate patient comfort without the use of oral drugs. Adjuncts to pharmacologic agents may enhance pain control and anxiety management and improve patient tolerance of these procedures.
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Affiliation(s)
- Michael J Marino
- Department of Otorhinolaryngology - Head and Neck Surgery, John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA,
| | - Amber Luong
- Department of Otorhinolaryngology - Head and Neck Surgery, John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - William C Yao
- Department of Otorhinolaryngology - Head and Neck Surgery, John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Martin J Citardi
- Department of Otorhinolaryngology - Head and Neck Surgery, John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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Ross CL. Energy Medicine: Current Status and Future Perspectives. Glob Adv Health Med 2019; 8:2164956119831221. [PMID: 30834177 PMCID: PMC6396053 DOI: 10.1177/2164956119831221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 12/18/2022] Open
Abstract
Current practices in allopathic medicine measure different types of energy in the human body by using quantum field dynamics involved in nuclear medicine, radiology, and imaging diagnostics. Once diagnosed, current treatments revert to biochemistry instead of using biophysics therapies to treat the disturbances in subtle energies detected and used for diagnostics. Quantum physics teaches us there is no difference between energy and matter. All systems in the human being, from the atomic to the molecular level, are constantly in motion-creating resonance. This resonance is important to understanding how subtle energy directs and maintains health and wellness in the human being. Energy medicine (EM), whether human touch or device-based, is the use of known subtle energy fields to therapeutically assess and treat energetic imbalances, bringing the body's systems back to homeostasis (balance). The future of EM depends on the ability of allopathic medicine to merge physics with biochemistry. Biophoton emissions as well as signal transduction and cell signaling communication systems are widely accepted in today's medicine. This technology needs to be expanded to include the existence of the human biofield (or human energy field) to better understand that disturbances in the coherence of energy patterns are indications of disease and aging. Future perspectives include understanding cellular voltage potentials and how they relate to health and wellness, understanding the overlap between the endocrine and chakra systems, and understanding how EM therapeutically enhances psychoneuroimmunology (mind-body) medicine.
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Affiliation(s)
- Christina L Ross
- Wake Forest Center for Integrative Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
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