Category Archives: CES Research

Cranial electrotherapy stimulation as a treatment for anxiety in chemically dependent persons.

60 inpatient alcohol and/or polydrug abusers (mean age = 33.9) volunteered for this double-blind study. 30 were given CES, 10 sham CES, and 20 served as normal hospital routine controls. Dependent measures of anxiety were the Profile of Mood States, the IPAT Anxiety Scale, and the State Trait Anxiety Index. The CES and sham pts received 15 daily, 30 minute treatments. Based on Fisher t-tests of the means, CES treated patients showed significantly greater improvement on all anxiety measures than did either control group. There were no differences in response between older and younger patients, or between the primarily drug or alcohol abusers. No placebo effect was found on any of the measures. The authors concluded that CES is rightfully gaining increasing use in American medicine as it gains increasing confirmation as a significant treatment adjunct for stress and cognitive dysfunction in chemical dependency treatment programs, regardless of the chemical of abuse or the age range of the patients treated. No side effects were reported.

Device: Neurotone 101, 100 Hz, 20% duty cycle, <1 mA, electrodes behind each ear

Schmitt, Richard, Capo, Thomas, Boyd, Elvin. Cranial electrotherapy stimulation as a treatment for anxiety in chemically dependent persons. Alcoholism: Clinical and Experimental

CES as an aid in learning

“Microamperage Electrical Stimulation as an Adjunct in Neurotherapy” by Paul G. Swingle, Ph.D., R. Psych. (Private Practice)

We discovered that CES helps with retention of learned material quite by accident.  In our Practice many clients receive CES units to help with depression, sleep problems, anxiety and addictions.  We started to hear from clients that they felt that they were able to remember things they had read more readily when treating themselves with the CES unit.  They assumption that we made was that the improved retention was a secondary effect of the CES because of the person being more relaxed.  Since the clients who received the CES units would be those who had Theta deficiencies in the back of the brain we thought that anxious clients would be those who benefited from using CES while studying.  However, we also started getting reports from clients that the CES treatments had an invigorating effect and when used mid-afternoon would minimize the typical afternoon slump in attention that many people experience.  I treated myself with the CES after lunch time and did feel that I was more alert and attentive.

We decided to test the effects of CES on learning with a non-clinical population.    The first study (Swingle and Swingle, 200x) looked at vocabulary learning with a young woman who was learning a second language.  The CES was .5 Hz delivered on the earlobe during study sessions.  All sessions were 35 minutes in length and the task was to memorize words from a list.  The client was asked to list all the words she recalled two days after the memorization session.  Without the CES the young woman was able to list 26% of the words whereas with the CES she was able to list 41% which seemed to be a huge benefit to learning the material.

ces-brain

The second study (Swingle and Swingle, 2XXX) looked at the effects of CES on learning vocabulary with a group of ESL (English as a Second Language) students.  Three different conditions were studied:  First a group of students who had a standard three hour classroom study (Group 1); second, a group of students who had 1.5 hours of individual study with CES on the earlobes (Group 2); third, a group of students who had 1.5 hours of individual study with CES presented at location P6 (Group 3).  The stimulation frequency was 100Hz and was continuous during the study period.  The amount learned was measured in two ways.  First, the students were asked to define the word (i.e., give the word meaning) and second, they were asked to use the word in a sentence.  The percentage of correct definitions was 31.5%, 78.3%, and 81.0% for Group 1, Group 2 and Group 3, respectively.  The percentage of words used correctly in a sentence was 35.7%, 75.0%, and 83.3% for groups 1, 2, and 3, respectively.  Thus, the data indicate that CES is a very effective aid to learning and further that the stimulation is at least as effective when applied to the acupuncture point Pericardium 6 as when presented at the more conventional earlobe site.

CES Research: Post-traumatic Amnesia

Clinical reports
One published clinical study reported on the effectiveness of CES in a case of post-traumatic amnesia, in which a 21 year old male who was comatose for weeks following a motorcycle accident recovered much of his tested memory recall functions following three weeks of one hour daily CES treatments. 

Another patient, reported in the same article, was a 58 year old orthopedic surgeon who suffered a closed head injury in a motor vehicle accident.  He was diagnosed with diencephalic amnesia secondary to trauma.  He had difficulty distinguishing between fantasy and reality, and experienced overwhelming anxiety during periods of disorientation.  His amnesia improved 28% on immediate recall and 39% on delayed recall after only one week of daily CES treatments.  These changes were accompanied by several other behavioral improvements, such as better acceptance and compliance with his treatment program, longer periods of lucidity, and more interaction with other patients and staff on the ward .

CES for headaches in your life

CES would intuitively be useful in the treatment of headache, not only because it is stress reducing, a commonly accepted cause for many headaches, but because it stimulates across the theoretical pain message centers in the cortex of the brain.

In the 1970s, a student completed his graduate thesis by studying 18 patients with migraine headaches. The study involved a treatment group, a sham treatment group and a placebo control group.  CES treatment was given 45 minutes a day for 15 days, Monday through Friday, and while the results were highly variable, a significant reduction in intensity and duration of headaches was found among the treated group.  There was no placebo effect from the treatment.

Solomon and his group studied 112 patients with tension headaches.  To be in the study, patients had to have at least four headaches a week for a year, and these had to be so severe they required treatment with prescription medications.  The patients were asked to use CES for 20 minutes each time they had a headache, and if the pain did not go away, to use it for a second 20 minutes.  The study lasted for 10 weeks and the treated patients reported an average pain reduction of 35%, while the sham treated patients reported an 18% improvement.      

Another study of migraine patients compared the effects of CES alone, biofeedback alone, or the two together.  The treatment lasted eight days and the patients were followed monthly for three months, in which they were asked to rate the number and intensity of headaches.  Both biofeedback and CES groups improved significantly more than the controls, and both groups continued to improve at each 30 day follow-up period, but it was found that CES potentiated the biofeedback gain by more than 70% by the third, 90 day period.

Romano studied the ability of CES to reduce headaches in 100 fibromyalgia patients who were asked to use a CES device for four, 20 minute treatment periods each day for up to two months.  In this open clinical study the patients rated their improvement at 50% or greater in terms of reduced headache frequency and intensity.

Forty-seven physicians who treated 151 headache patients with CES rated the treatment gain in 90% of them to be 25% or better.

Patient warranty cards indicate that 118 patients who suffer from migraine headaches improved an average of 61%, while 112 who suffer from tension headaches improved 56%.  That improvement is somewhat lower than in the migraine group, possibly due to neuromuscular involvement in neck or shoulder muscles that did not receive stimulation from CES

The CES Ultra and the Ear – Part 1

PART 1 PART 2

The CES ultra underscores its use of its conductive rubber ear clips. The rationale behind it is some interesting science on the ear; especially the vagus nerve and the special role it plays in the body. Read on.

Ref: Wandering nerve could lead to range of therapies

With outposts in nearly every organ and a direct line into the brain stem, the vagus nerve is the nervous system’s superhighway. About 80 percent of its nerve fibers — or four of its five “lanes” — drive information from the body to the brain. Its fifth lane runs in the opposite direction, shuttling signals from the brain throughout the body.

Doctors have long exploited the nerve’s influence on the brain to combat epilepsy and depression. Electrical stimulation of the vagus through a surgically implanted device has already been approved by the U.S. Food and Drug Administration as a therapy for patients who don’t get relief from existing treatments.

Now, researchers are taking a closer look at the nerve to see if stimulating its fibers can improve treatments for rheumatoid arthritis,
SUPER-HIGHWAY The vagus nerve runs from the brain stem down the neck and into the abdomen, reaching a slew of organs in the process.
Nicole Rager Fuller
heart failure, diabetes and even intractable hiccups. In one recent study, vagus stimulation made damaged hearts beat more regularly and pump blood more efficiently. Researchers are now testing new tools to replace implants with external zappers that stimulate the nerve through the skin.

But there’s a lot left to learn. While studies continue to explore its broad potential, much about the vagus remains a mystery. In some cases, it’s not yet clear exactly how the nerve exerts its influence. And researchers are still figuring out where and how to best apply electricity.

“The vagus has far-reaching effects,” says electrophysiologist Douglas Zipes of Indiana University in Indianapolis. “We’re only beginning to understand them.”

The wanderer

Anchored in the brain stem, the vagus travels through the neck and into the chest, splitting into the left vagus and the right vagus. Each of these roads is composed of tens of thousands of nerve fibers that branch into the heart, lungs, stomach, pancreas and nearly every other organ in the abdomen. This broad meandering earned the nerve its name — vagus means “wandering” in Latin — and enables its diverse influence.

cesultra-ear-nerve

The nerve plays a role in a vast range of the body’s functions. It controls heart rate and blood pressure as well as digestion, inflammation and immunity. It’s even responsible for sweating and the gag reflex. “The vagus is a huge communicator between the brain and the rest of the body,” says cardiologist Brian Olshansky of the University of Iowa in Iowa City. “There really isn’t any other nerve like that.”

The FDA approved the first surgically implanted vagus nerve stimulator for epilepsy in 1997. Data from 15 years of vagus nerve stimulation in 59 patients at one hospital suggest that the implant is a safe, effective approach for combating epilepsy in some people, researchers in Spain reported in Clinical Neurology and Neurosurgery in October. Twenty of the patients experienced at least 50 percent fewer seizures; two of those had a 90 percent drop in seizures. The most common side effects were hoarseness, neck pain and coughing. In other research, those effects often subsided when stimulation was stopped.

Early on, researchers studying the effects of vagus stimulation on epilepsy noticed that patients experienced a benefit unrelated to seizure reduction: Their moods improved. Subsequent studies in adults without epilepsy found similar effects. In 2005, the FDA approved vagus nerve stimulation to treat drug-resistant depression.

Although many details about how stimulation affects the brain remain unclear, studies suggest that vagus stimulation increases levels of the neurotransmitter norepinephrine, which carries messages between nerve cells in parts of the brain implicated in mood disorders. Some antidepressant drugs work by boosting levels of norepinephrine. Silencing norepinephrine-producing brain cells in rats erased the antidepressant effect of vagus nerve stimulation, scientists reported in the Journal of Psychiatric Research in September.

Against the swell

Vagus stimulation for epilepsy and depression attempts to target the nerve fibers that shuttle information from body to brain. But its fifth lane, which carries signals from brain to body, is a major conductor of messages controlling the body’s involuntary functions, including heart rhythms and gut activity. The nerve’s southbound fibers can also be a valuable target for stimulation.

Around 15 years ago, scientists determined that the brain-to-body lane of the vagus plays a crucial role in controlling inflammation. While testing the effects of an anti-inflammatory drug in rats, neurosurgeon Kevin Tracey and his colleagues found that a tiny amount of the drug in the rats’ brains blocked the production of an inflammatory molecule in the liver and spleen. The researchers began cutting nerves one at a time to find the ones responsible for transmitting the anti-inflammatory signal from brain to body.

“When we cut the vagus nerve, which runs from the brain stem down to the spleen, the effect was gone,” says Tracey, president and CEO of the Feinstein Institute for Medical Research in Manhasset, N.Y. Later research indicated that stimulating undamaged vagus fibers also had anti-inflammatory effects in animals.

Vagus stimulation prompts release of acetylcholine, Tracey and colleagues reported in 2000. Acetylcholine, a neurotransmitter like norepinephrine, can prevent inflammation.

In 2011, rheumatologist Paul-Peter Tak, of the University of Amsterdam, and his colleagues implanted vagus nerve stimulators into four men and four women who had rheumatoid arthritis, an autoimmune inflammatory condition that causes swollen, tender joints. After 42 days of vagus stimulation — one to four minutes per day — six of the eight arthritis patients experienced at least a 20 percent improvement in their pain and swelling. Two of the six had complete remission, the researchers reported at an American College of Rheumatology conference in 2012.

“From a scientific perspective, it’s an extremely exciting result,” says Tak, who is also a senior vice president at GlaxoSmithKline pharmaceuticals based in Stevenage, England. Despite advances in treatments over the last two decades, rheumatoid arthritis patients need better options, he says. In 2014, Tak and his colleagues reported that vagus stimulation reduced inflammation and joint damage in rats with arthritis. After a week of once-daily, minute-long stimulation sessions, swelling in the rats’ ankles shrank by more than 50 percent, the scientists reported in PLOS ONE.

If these results hold up in future studies, Tak hopes to see the procedure tested in a range of other chronic inflammatory illnesses, including inflammatory bowel disorders such as Crohn’s disease. Studies in animals have shown promise in this area: In 2011, researchers reported in Autonomic Neuroscience: Basic and Clinical that vagus stimulation prevented weight loss in rats with inflamed colons.

Treating inflammatory conditions with vagus stimulation is fundamentally different from treating epilepsy or depression, Tak says. More research with patients will be necessary to develop the technique. “We are entering a completely unknown area, because it’s such a new approach,” he says. There could be financial hurdles as well, he says. But GlaxoSmithKline, which Tak joined after initiating the arthritis study, has purchased shares of SetPoint Medical, a company in Valencia, Calif., that produces implantable vagus nerve stimulators, Tak says.

As he and others put stimulation to the test for inflammation, some scientists are attempting to see if manipulating the nerve can help heal the heart.

Read more Part 2