Cranial-Electrotherapy Stimulation (CES) is a brain-calming technique which delivers small pulses of electrical current to the brain. CES is a subset of transcutaneous Electro-Neural Stimulation (TENS). FDA recognizes and approves its use as a treatment for depression, anxiety, and insomnia since 1979, and CES has been used in clinical in Europe since 1953, and the USA since 1963. Most studies to date have shown CES is a reliable method to reduce anxiety and improve cognition in recovering alcoholics. Additional studies have shown CES to be an effective tool in reducing stress and improving IQ. CES does this by increases neurotransmitters production in our brain. These neurotransmitters are necessary for information processing, memory, energy level and physical well-being. When our neurotransmitters and endorphins are known to necessary levels, it may lead to destructive behaviors and the abuse of substances as a substitute for that “natural high” significant.
Role of Neurotransmitter
Neurotransmitters are chemical messengers that are used throughout our body, especially significance in our brain to facilitate neurotransmission across the chemical synapse. There are estimated more than 100 types of neurotransmitters, with less than 10 of them doing 99% of the work. More well-known neurotransmitter includes endorphins – for pain relief and feeling good, serotonin – a natural mood stabilizer that helps to reduce depression and regulate anxiety, dopamine – correlate with movement and learning, norepinephrine – appetite and alertness, and much other. Unbalanced neurotransmitters can contribute to various conditions like anxiety, depression, impulsiveness, insomnia to even physical conditions like body coordination (i.e., dopamine is know to be lacking in Parkinson patients that cause muscle movement and control involuntarily).
CES was initially studied for sleep related issues and was known as electrosleep therapy. The working of CES in principle is simple. A small electrical current (stimulus) is applied bilaterally across the cranium, usually via electrode placing at each side of the ear lobes at low frequencies (usually from 0.5Hz to 100Hz). CES sends electrical across the brain, stimulating neurotransmitters. CES increases neurotransmitters at any frequency according to studies, but it is believed that 100Hz can help to increase Serotonin (reduce anxiety and improve sleep) more, whereas 0.5Hz-3Hz can help to increase Endorphins more (to reduce pain and promote the feelings of well-being).
Mechanic behind CES
CES exerts its effects on the brain by presenting short negative (cathodic) electrical pulses into the cranium. The pulses alternate from side to side making the current flow back and forth. This back and forth motion constitutes alternating current (AC) similarly to how current alternates back and forth in a common power plug. Because the outside of a neuron is positively charged, a negative pulse will flip its resting state and cause an action potential to occur, and hence the potential increased release of neurotransmitters
Studies on CES
In the book, Cranial Electrotherapy Stimulation – Its First Fifty Years, Plus Three: A Monograph published in 2007, Dr. Ray B. Smith conducted five meta-analyses on most of the CES studies appearing in U.S. scientific literature, which he categorized into Insonmia, Depression, Anxiety, Drug Abstinence, and Cognitive Dysfunction. The table below summarized the overall result of this studies which one can easily observe the signs of the improvement.
|Syndrome||No. of Studies||No. of Subjects||Average Improvement|
Studies on CES for Depression
A meta-analysis study by Gilula & Kirsch (2005) of 290 depressives showed a direct comparison of CES against various depression medications shows that CES reduces depression 63% better over placebo. As the study is done a decade ago, newer drugs might have shown better effectiveness. Regardless we can still appreciate CES as a non-medicated approach to treat depression.
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Hare, Jean P., Misialek, Leah H., Palis, Katy and Wong, Charmin. Using Cranial Electrotherapy Stimulation Therapy to Treat Behavioral Health Symptoms in a Combat Operational Setting. Military Medicine. 2016; 181(11):1410-1412