CRANIAL ELECTROTHERAPY STIMULATION (CES) 

Electromedicine in a variety of forms has been used since the early 1890s.  Although many of these methods showed promise when introduced throughout the past century, technological barriers most likely kept many of them from advancing into mainstream medicine.  Advances in electronics technology have encouraged research into several techniques such as CES that have been applied to a variety of physical and psychological conditions (1). 

Although initial CES studies in the 1970s and 1980s showed promising results, many of these studies are difficult to analyze and compare because of the variability in conditions and instrumentation as well as the multitude of psychiatric conditions exhibited by study participants.  More recent studies after 1990, however, demonstrate more clearly the efficacy of CES in the treatment of conditions such as anxiety and insomnia.  In addition, certain measures of attention and learning have been shown to improve with the use of this technique (1).

How Does CES Work ? 

Although the specific mechanism by which CES exerts its therapeutic effects has not been clearly delineated, several studies suggest that treatment with CES changes frequency domain variables of the EEG spectrum.  More specifically, AlphaStim CES at both the 0.5Hz and 100Hz settings shifts alpha frequencies downward and decreases the beta band power fraction, suggesting beneficial changes in mental state.  These changes in EEG spectra are similar to those achieved for neurofeedback protocols designed to reduce anxiety and promote relaxation.

Clinical Applications 

Recent studies have suggested beneficial results in the treatment of anxiety, insomnia and increased attention.  Some of the most convincing results for the reduction of anxiety have been shown in patients undergoing routine dental procedures. This double-blind placebo-controlled study used both patient and dentist evaluations to measure relative levels of patient anxiety (2).  In another double-blind placebo-controlled study, participants suffering from fibromyalgia showed significant improvement in their rating scores for quality of sleep (3).  In addition, a study of elderly patients showed improved sleep and increased daytime vigilance.  Although there have been numerous anecdotal reports for CES enhancement of attention and ability to learn, a recent study has documented these results through the use of standardized performance tests (5, 6).

Similar to neurofeedback techniques, CES is being investigated for the treatment of a wide variety of psychological conditions.  Results from recent studies that incorporate clear experimental design and appropriate sample populations have indicated the beneficial use of CES in several areas including anxiety, insomnia and perhaps attention / learning.

References

1. Kirsch, DL and Smith, RB.  The use of cranial electrotherapy stimulation in the management of chronic pain: A review. NeuroRehabilitation 14 (2000) 85-94. 

2. Winick, RL.  Cranial electrotherapy stimulation (CES): a safe and effective low cost means of anxiety control in a dental practice.  Gen. Dent. 47 (1999) 50-55. 

3. Lichtbroun, AS, Raicer, —MC and Smith RB.  The treatment of fibromyalgia with cranial electrotherapy stimulation.  J. Clin. Rheumatol.  7 (2001) 72-78. 

4. Hozumi, S, Hori, H, Okawa, M, Hishikawa, Y and Sato, K.  Favorable effect of transcranial electrostimulation on behavior disorders in elderly patients with dementia: a double-blind study.  Inter. J. Neurosci.  88(1996) 1-10. 

5. Southworth, S.  A study of the effects of cranial electrical stimulation on attention and concentration.  Tntegr. Physiol. Behav. Sci.  34 (1999) 43-53. 

6. Schroeder, MJ and Barr RE.  Quantitative analysis of the electroencephalogram during cranial electrotherapy stimulation.  Clin. Neurophysiol.  112 (2001) 2075-2083.