A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

被引:29
作者
Brunye, Tad T. [1 ,2 ]
Patterson, Joseph E. [2 ]
Wooten, Thomas [3 ]
Hussey, Erika K. [1 ,2 ]
机构
[1] US Army Combat Capabil Dev Command Soldier Ctr, Cognit Sci Team, Natick, MA 01760 USA
[2] Tufts Univ, Ctr Appl Brain & Cognit Sci, Medford, MA 02155 USA
[3] Tufts Univ, Dept Psychol, Medford, MA 02155 USA
关键词
non-invasive brain stimulation; neuromodulation; psychiatry; human performance; electrotherapy; NONINVASIVE BRAIN-STIMULATION; VAGUS NERVE-STIMULATION; TRANSCRANIAL MAGNETIC STIMULATION; STATE FUNCTIONAL CONNECTIVITY; MAJOR DEPRESSIVE DISORDER; ELECTRICAL-STIMULATION; DEFAULT-MODE; COGNITIVE ENHANCEMENT; NETWORK ACTIVITY; ACUTE STRESS;
D O I
10.3389/fnhum.2021.625321
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
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.
引用
收藏
页数:16
相关论文
共 123 条
[1]  
Agar N, 2014, BASIC BIOETH, P1, DOI 10.7551/mitpress/9780262026635.001.0001
[2]   Cranial Electrotherapy Stimulation for the Treatment of Chronically Symptomatic Bipolar Patients [J].
Amr, Mostafa ;
El-Wasify, Mahmoud ;
Elmaadawi, Ahmed Z. ;
Roberts, R. Jeannie ;
El-Mallakh, Rif S. .
JOURNAL OF ECT, 2013, 29 (02) :E31-E32
[3]   Catecholamine modulation of prefrontal cortical cognitive function [J].
Arnsten, AFT .
TRENDS IN COGNITIVE SCIENCES, 1998, 2 (11) :436-447
[4]   tACS motor system effects can be caused by transcutaneous stimulation of peripheral nerves [J].
Asamoah, Boateng ;
Khatoun, Ahmad ;
Mc Laughlin, Myles .
NATURE COMMUNICATIONS, 2019, 10 (1)
[5]  
Aseem A., 2019, Sleep Vigil, V3, P101
[6]   A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression [J].
Barclay, Timothy H. ;
Barclay, Raymond D. .
JOURNAL OF AFFECTIVE DISORDERS, 2014, 164 :171-177
[7]   Where does transcranial magnetic stimulation (TMS) stimulate? Modelling of induced field maps for some common cortical and cerebellar targets [J].
Bijsterbosch, Janine D. ;
Barker, Anthony T. ;
Lee, Kwang-Hyuk ;
Woodruff, P. W. R. .
MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 2012, 50 (07) :671-681
[8]   Transcranial electrical stimulation nomenclature [J].
Bikson, Marom ;
Esmaeilpour, Zeinab ;
Adair, Devin ;
Kronberg, Greg ;
Tyler, William J. ;
Antal, Andrea ;
Datta, Abhishek ;
Sabel, Bernhard A. ;
Nitsche, Michael A. ;
Loo, Colleen ;
Edwards, Dylan ;
Ekhtiari, Hamed ;
Knotkova, Helena ;
Woods, Adam J. ;
Hampstead, Benjamin M. ;
Badran, Bashar W. ;
Peterchev, Angel V. .
BRAIN STIMULATION, 2019, 12 (06) :1349-1366
[9]  
Black L., 2004, J NEUROTHER, V8, P107, DOI [10.1300/J184v08n02_11, DOI 10.1300/J184V08N02_11]
[10]   Cognitive Training for Military Application: a Review of the Literature and Practical Guide [J].
Blacker, Kara J. ;
Hamilton, Joseph ;
Roush, Grant ;
Pettijohn, Kyle A. ;
Biggs, Adam T. .
JOURNAL OF COGNITIVE ENHANCEMENT, 2019, 3 (01) :30-51