Effects Of Cranial Electrotherapy Stimulation Research Articles

Effects of cranial electrotherapy stimulation on improving depressive symptoms in people with stress: A randomized, double-blind controlled study

BackgroundCranial 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. MethodsParticipants 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. ResultsSixty-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. LimitationsBias may have been introduced during the process because device use and sample collection were self-conducted by participants at home. ConclusionsCES can alleviate depressive symptoms and stress response, showing a potential as an adjunctive therapy for stress.

Comparison of the effects of cranial electrotherapy stimulation and midazolam as preoperative treatment in geriatric patients: A CONSORT-compliant randomized controlled trial.

Background:Although midazolam is widely administered as an anxiolytic premedication, it may cause over-sedation and hypoxia in geriatric patients. Cranial electrotherapy stimulation (CES) is a nonpharmacological device with anxiolytic effect. This study compared the effects of CES and midazolam as a preoperative treatment in geriatric patients.Methods:Eighty patients, under the age of 65 to 79 years, undergoing general anesthesia were randomly assigned into midazolam premedication group (M group, n = 40) or CES pretreatment group (CES group, n = 40). The patients in the M group were intramuscularly injected with midazolam (0.07 mg/kg) 30 minutes before receiving general anesthesia. The patients in the CES group received 20 minutes of CES pretreatment on the day before and on the morning of the surgery.Results:In the preoperative holding area, the anxiety score (P = .02) and the sedation score (P < .001) were significantly lower in the CES group compared with those in the M group. The oxygen saturations at the preoperative holding area and the operating room were significantly higher in the CES group than those in the M group (P < .001).Conclusion:CES pretreatment relieved preoperative anxiety with less risk of over-sedation and respiratory depression than midazolam premedication in geriatric patients.

Cranial Electrotherapy Stimulation to Improve the Physiology and Psychology Response, Response-Ability, and Sleep Efficiency in Athletes with Poor Sleep Quality.

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.

Effects of cranial electrotherapy stimulation with novel in-ear electrodes on anxiety and resting-state brain activity: A randomized double-blind placebo-controlled trial

BackgroundCranial Electrotherapy Stimulation (CES) is a promising non-invasive brain stimulation technique with the potential to alleviate anxiety. We examined the effectiveness of home-based CES with novel, headphone-like, in-ear electrodes on anxiety-related symptoms and resting-state brain activity. MethodsThis study spanned 3-weeks, with randomized, double blind, and active-controlled design. Nonclinical volunteers experiencing daily anxiety were randomly assigned to either the active or the sham groups. CES provides an alternating current (10 Hz frequency, 500 μA intensity), connected to smartphone recording treatment logs. Participants treated themselves with 20 trials of CES at home. We evaluated the effectiveness using State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Wisconsin Card Sort Test (WCST), and resting-state electroencephalography (EEG). ResultsThe active group showed a significant improvement in state-anxiety compared to sham, while there was a statistical trend in the WCST-Category Completed (p = .061) and no change in depression. In EEG analysis, the active group showed significantly increased relative power for theta in the left frontal region compared with the sham, and this significantly correlated with the changes in state-anxiety. The active group exhibited significantly increased high-beta source activity in cuneus and middle occipital gyrus after intervention compared with the baseline. LimitationsThis study had a relatively short treatment period and small sample size. ConclusionsOur findings provide the first electrophysiological evidence for CES for novel in-ear electrodes to improve anxiety. The modulatory effects of CES on resting-state oscillations of EEG imply that CES could beneficially affect functional brain activity.

Differential effects of cranial electrotherapy stimulation on changes in anxiety and depression symptoms over time in patients with generalized anxiety disorder

BackgroundCranial electrotherapy stimulation (CES) is a safe and well-tolerated 6-12 week treatment that is clinically and cost effective on both anxiety and depression symptoms resulting in sustained remission of these symptoms at 12 and 24 weeks in generalized anxiety disorder (GAD) patients. The aim of the current report was to explore whether the effectiveness of CES was related to its effects on depression or anxiety over time MethodsA consecutive sample of 161 eligible patients with GAD was recruited from two publicly funded services in England while they waited for individual cognitive behaviour therapy (CBT) after failing to achieve remission on the GAD-7 with computerised CBT. They received 60 minutes per day Alpha-Stim CES for 6-12 weeks. Outcomes were changes in PHQ-9, GAD-7 score from baseline to 4, 6, 8, 12 and 24 weeks. Latent variable cross-lagged panel analysis permitted an analysis of the differential effects of anxiety and depression with CES treatment over time. ResultsAnxiety at baseline significantly predicted depression at week 4 (standardized regression weight = .40, p<0.001). Depression at week 12 significantly predicted anxiety at week 24 (standardized regression weight = .28, p<0.05). LimitationsNot a randomized controlled trial but further analysis of a prospective observational cohort. High rates of loss to follow up by 24 weeks. ConclusionSustained effectiveness required a CES response to anxiety symptoms in first 4 weeks and improvement in depression symptoms by 12 weeks.

Effects of cranial electrotherapy stimulation on preoperative anxiety and blood pressure during anesthetic induction in patients with essential hypertension.

ObjectiveCranial 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.MethodsEighty 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.ResultsAnxiety 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.ConclusionsCES pretreatment reduces both preoperative anxiety levels and withdrawal responses to rocuronium injection. However, it does not have a significant effect on hemodynamic responses.

Effects of cranial electrotherapy stimulation on anxiety and sleep qualities among elderly patients with chronic sleep disorders

Objective To explore the effects of cranial electrotherapy stimulation (CES) on anxiety and sleep qualities among elderly patients with chronic sleep disorders. Methods From February 2018 to February 2019, we selected 120 elderly patients with chronic sleep disorders at the First Affiliated Hospital of Chongqing Medical University by convenience sampling as subjects. All of the patients were randomly divided into control group and treatment group, 60 cases in each group. Control group carried out routine medical treatment. Treatment group implemented CES 20 minutes every time, one time every day and 12 weeks constituting a course of treatment. Sleep qualities and anxiety of patients of two groups were evaluated with the Pittsburgh Sleep Quality Index (PSQI) and Hamilton's Depression Scale (HAMA) before treatment and after a course of treatment. Results A total of 52 cases of control group and 55 cases of treatment group completed the research. After intervention, the total scores of PSQI of treatment group were (7.08±0.98) higher than those of control group (8.97±1.38) , and dimension has statistical differences (P<0.001) . After intervention, the total and each item scores of HAMA of treatment group was lower than that of control group, In addition to the items of cardiovascular, the scores of total and other items were statistically significant (P<0.001) . Conclusions Compared with routine medical treatment, CES can better improve sleep qualities of elderly patients with chronic sleep disorders and relieve their anxiety which provides a reference for treatment for elderly patients with chronic sleep disorders. Key words: Aged; Sleep disorders; Anxiety; Cranial electrotherapy stimulation

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

Effects of Cranial Electrotherapy Stimulation on Electrocephalogram

Background: Although cranial electrotherapy stimulation (CES) is reported to have positive effects on mental functions such as depression and sleep improvement, detailed studies regarding awakening, attention and concentration among brain waves reflecting brain activity are lacking. Objective: To examine the effects of cranial electrotherapy stimulation (CES) on various electroencephalograms (EEGs) reflecting brain activities. Design: Randomized controlled clinical trial (single blind) Methods: This study selected 30 healthy adult women in their 20s who volunteered for this experiment. A total of 30 subjects were randomly assigned to three groups (Sham group, 0.5 Hz CES group, and 100 Hz CES group). EEGs were measured before and after the single CES, and the results were compared and analyzed. Results: The relative theta, alpha, and gamma waves indicated no significant differences in the interaction effects between time and group. The relative fast alpha wave only showed significant differences in the interaction effects between time and group in P4. The relative slow beta wave only indicated statistically significant differences in the interaction effects between time and group in T3 and T4. The relative mid and fast beta waves showed statistically significant differences in the interaction effects between time and group in all areas. Conclusions: These results suggest that a CES of 0.5 Hz awakens consciousness and has a positive influence on brain activity, while a CES of 100 Hz has a positive influence on thinking activity accompanying mental load during concentrating on one subject.

A Pilot Study of Safety and Efficacy of Cranial Electrotherapy Stimulation in Treatment of Bipolar II Depression.

This double-blind, sham-controlled study sought to investigate the effectiveness of cranial electrotherapy stimulation (CES) for the treatment of bipolar II depression (BD II). After randomization, the active group participants (n = 7) received 2 mA CES treatment for 20 minutes five days a week for 2 weeks, whereas the sham group (n = 9) had the CES device turned on and off. Symptom non-remitters from both groups received an additional 2 weeks of open-label active treatment. Active CES treatment but not sham treatment was associated with a significant decrease in the Beck Depression Inventory (BDI) scores from baseline to the second week (p = 0.003) maintaining significance until week 4 (p = 0.002). There was no difference between the groups in side effects frequency. The results of this small study indicate that CES may be a safe and effective treatment for BD II suggesting that further studies on safety and efficacy of CES may be warranted.

Effects of Cranial Electrical Stimulation on Activity in Regions of the Basal Ganglia in Individuals with Fibromyalgia

F ibromyalgia (FM) is a chronic syndrome characterized by widespread pain that affects up to 4% of the U.S. population. Neuroimaging studies suggest FM may be linked to dysregulation of brain activity. However, the crosssectional nature of these findings do not address whether this dysregulation is the cause or consequence of pain and symptoms of FM, or of chronic pain generally. On the basis of evidence that brain processing of pain is disturbed in FM, treatment with actions targeted toward the brain should be particularly promising. Over the years, several types of electrical stimulation of the brain have been used to reduce pain or depression. One such device, AlphaStim (Electromedical Products International, Inc., Mineral Wells, TX), is a Food and Drug Administration (FDA)– approved (FDA K903014) medical device for pain relief, suitable for at-home use. The effects of cranial electrotherapy stimulation (CES) are believed to be primarily mediated through direct action on the brain, likely at the limbic system, hypothalamus, thalamus, or reticular activating system. However, few data exist on the potential neural correlates of mechanisms by which CES may affect pain in general or, more specifically, in those with FM. Thus, the goal of the current study was to examine the effects of CES therapy using a double-blind, randomized, controlled design to collect functional magnetic resonance imaging (fMRI) data on activation in brain regions. Potential participants were recruited as part of a larger study and remained on their usual care regimen during the study. Participants were assigned randomly to one of three groups: usual care alone, usual care plus a sham CES device, or usual care plus an active CES device. Participants in the two device groups were instructed to use the Alpha-Stim CES device for 60 continuous minutes each day for 8 weeks. Participants in the active CES device group received devices that were preset to provide a modified square-wave biphasic stimulation below the level of perception. Participants in the sham device group received devices that appeared to be activated but did not deliver any stimulation. A subset of participants in each of the two device groups (active CES, n = 6; sham CES, n = 6) underwent fMRI at baseline and week 8 to measure brain activation at rest and during a pain stimulation procedure. Motion-corrected functional data (Digital Imaging and Communications in Medicine format) for each patient were loaded into BrainVoyager QX (Brain Innovations, Maastricht, the Netherlands) for preprocessing and converted to BrainVoyager’s internal data format for analysis as previously described. Regions of interest, both a priori and a posteriori, were identified by using areas of the brain in which changes in blood oxygen level dependence (BOLD) were significantly different from baseline to week 8 between the two device groups. As previously reported, persons using the active device had a greater decrease in average pain, fatigue, and sleep disturbance and an improvement in functional status over time than those using the sham device or usual care alone ( p < 0.05). Preliminary analyses of fMRI data showed that persons using an active CES device had decreased activation of pain-processing regions of the brain compared with those using a sham device. In addition to changes in regions of the brain reported previously, decreased activity was observed in the basal ganglia (caudate, putamen, and globus pallidus) and parahippocampal gyrus in individuals using the active CES versus the sham device ( p < 0.05). Recently, the role of the basal ganglia in pain perception has been revealed. Increased neural activity as evidenced by fMRI has been shown in the basal ganglia in persons with FM. Additional findings indicate a role for the basal ganglia in pain suppression with regard to dopamine receptors, which may be impaired in patients with FM. In the current study, the decreased activity observed in the basal ganglia of the active CES device group may be related to the decreased pain observed over time in these persons. Moreover, differences in regional brain activity in the basal ganglia may affect other symptoms of FM affected by CES use, particularly the observed decrease in fatigue. Patients with multiple sclerosis who experience chronic fatigue displayed increased activation in the basal ganglia, while persons diagnosed with chronic fatigue demonstrated increased activation in the parahippocampal gyrus, regions that displayed decreased activity in response to active CES in the current study. As increasing evidence points toward dysregulation of neural networks in the pathophysiology of FM, neuroimaging

Effects of cranial electrotherapy stimulation on preoperative anxiety, pain and endocrine response

Cranial electrotherapy stimulation (CES) is used as a treatment for depression and anxiety, and as an adjunctive intervention for pain management. This prospective study investigated whether CES could decrease preoperative anxiety, the injection pain of rocuronium, postoperative pain and stress hormone levels. Female patients undergoing thyroidectomy were randomly assigned to two groups, to receive either no pretreatment (control group) or CES pretreatment. Anxiety score, withdrawal response on rocuronium injection, and pain scores at 1, 4, 12 and 24 h post surgery were evaluated. Adrenocorticotrophic hormone (ACTH), cortisol and glucose levels were measured. Patients were blinded to the treatment condition. Fifty patients entered the study (n = 25 per group). Anxiety score and withdrawal responses during rocuronium injection were significantly reduced in the CES group compared with the control group. Pain score was significantly lower in the CES group than in the control group, 1 h and 4 h post surgery. There were no significant differences in ACTH, cortisol and glucose levels. CES pretreatment appears to reduce the level of preoperative anxiety, injection pain of rocuronium and postoperative pain. However, CES pretreatment did not affect stress hormone responses.

Quantitative Electroencephalography Analysis (qEEG) of Neuro-Electro-Adaptive Therapy 12™ [NEAT12] Up-Regulates Cortical Potentials in an Alcoholic during Protracted Abstinence: Putative Anti-Craving Implications.

IntroductionCranial electrotherapy stimulation (CES) is a noninvasive therapy that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. The effectiveness of CES has been questioned by many and its use is considered controversial. In this study we are presenting data on one alcoholic patient using a newly engineered device we call Neuro-Electro-Adaptive Therapy 12™ [NEAT12]. This hybrid device utilizes TENS current characteristics yielding CES effects. This device has been found to primarily target the excitation of the Cingulate Gyrus region of the brain.Case presentationThis is a 42 year old male who has been abstinent from alcohol for approximately two months. The data presented herein represents the pre to post qEEG differences of an alcoholic in protracted abstinence. This subject was evaluated both before and after using the NEAT-12 device. The pre to post comparisons suggest that the cortical potentials especially at the Cingulate Gyrus are up regulated after using the device. The absolute power changes obtained shows a decrease of more than 2 SD as noted in the delta wave spectrum. Also noted is an overall cortical increase in the alpha spectrum. The resting alert state of a neuro typical population is most prominently marked by a regulation of 7.5-11 Hz alpha throughout the cortex. The decreased in delta and theta suggests an up regulation of the prefrontal cortex and the anterior Cingulate Gyrus a site involved in substance use disorder (SUD).ConclusionA presence of dominant slow waves through the prefrontal cortex and the anterior Cingulate Gyrus is often associated with OCD, anxiety, impulsivity and cravings in addicted populations. It is conceivable that our initial finding of altered electrical activity of the brain using qEEG analysis suggests the NEAT-12 may induce a “normalization” of aberrant electrical activity of the cortical region of the brain known to occur during protracted abstinence of alcoholics. It may have utility as a putative anti-craving CES device and therefore warrants intensive investigation.

Effects of cranial electrotherapy stimulation on resting state brain activity

Cranial electrotherapy stimulation (CES) is a U.S. Food and Drug Administration (FDA)-approved treatment for insomnia, depression, and anxiety consisting of pulsed, low-intensity current applied to the earlobes or scalp. Despite empirical evidence of clinical efficacy, its mechanism of action is largely unknown. The goal was to characterize the acute effects of CES on resting state brain activity. Our primary hypothesis was that CES would result in deactivation in cortical and subcortical regions. Eleven healthy controls were administered CES applied to the earlobes at subsensory thresholds while being scanned with functional magnetic resonance imaging in the resting state. We tested 0.5- and 100-Hz stimulation, using blocks of 22 sec “on” alternating with 22 sec of baseline (device was “off”). The primary outcome measure was differences in blood oxygen level dependent data associated with the device being on versus baseline. The secondary outcome measures were the effects of stimulation on connectivity within the default mode, sensorimotor, and fronto-parietal networks. Both 0.5- and 100-Hz stimulation resulted in significant deactivation in midline frontal and parietal regions. 100-Hz stimulation was associated with both increases and decreases in connectivity within the default mode network (DMN). Results suggest that CES causes cortical brain deactivation, with a similar pattern for high- and low-frequency stimulation, and alters connectivity in the DMN. These effects may result from interference from high- or low-frequency noise. Small perturbations of brain oscillations may therefore have significant effects on normal resting state brain activity. These results provide insight into the mechanism of action of CES, and may assist in the future development of optimal parameters for effective treatment.

Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder: A Pilot Study of Two Military Veterans

This case study investigated the effects of cranial electrotherapy stimulation (CES) on the prevalence and intensity of posttraumatic stress disorder (PTSD) symptoms and self- perceived improvement of performance and satisfaction in daily activities in war veterans. Two male Caucasian veterans (ages 54 and 38) diagnosed with PTSD participated in these case studies with a pretest–posttest design. The Canadian Occupational Performance Measure (COPM) and the PTSD Symptom Scale–Interview (PSS-I) were administered before and after the 4-week CES treatment. The participants self-administered the 4-week CES treatment protocol using Alpha-Stim SCS CES device in their home for 20 to 60 min a day, 3 to 5 days a week with a comfortable, self-selected, current level between 100 and 500 microamperes. They were asked to document the settings and responses in a daily treatment log. Through visual trend analysis and change scores, the results revealed daily PTSD symptoms decreased in frequency and severity for both parti...

Analysis of the effectiveness of cranial electrotherapy stimulation on children with mixed anxiety and depressive disorder

目的 探讨分析微量生物电脑导入刺激(CES)治疗儿童混合性焦虑抑郁障碍的疗效.方法 经抑郁自评量表(SDS)和焦虑自评量表(SAS)评分均大于40分、符合ICD-10混合性焦虑抑郁障碍(MAD)特点的门诊8～16岁初诊儿童30例作为实验组,予CES治疗;南京市MAD30例儿童作为对照组,予象征?性地CES治疗,2组儿童均接受3个疗程的规范化治疗,并分别于每个疗程结束时复查SAS和SDS量表.结果 30例实验组儿童经CES治疗后,显效23例,有效7例,无效0例,总有效率100%.30例对照组儿童经CES象征性治疗后,显效5例,有效7例,无效18例,总有效率40%;2组疗效有显著差异.结论 CES治疗儿童混合性焦虑抑郁障碍安全有效。