Repetitive transorbital alternating current stimulation in optic neuropathy

Gall, Carolin; Fedorov, A.; Ernst, L; Borrmann, A; Sabel, Bernhard A.

doi:10.3233/nre-2010-0617

Cited by 53 publications

(28 citation statements)

References 16 publications

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“…60–90 min (Gall et al, 2016). To date, 760 patients with optic neuropathies, e.g., following stroke or with postchiasmatic lesions, have been treated in various clinical trials using this technology (Fedorov et al, 2011; Gall et al, 2013, 2010, 2016, 2011, 2015; Sabel et al, 2011; Schmidt et al, 2013). The most common AEs were skin sensations and irritation, headache, drowsiness, and sleep disturbances.…”

Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

898

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Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1–2 mA and during tACS at higher peak-to-peak intensities above 2 mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity ‘conventional’ TES defined as <4 mA, up to 60 min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3–13 A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10 mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6–7, 2016 and were refined thereafter by email correspondence.

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Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

898

728

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“…Applying the current transorbitally at the individual phosphene thresholds ACS is effective in the therapy following optic nerve injury in human (Gall et al, 2010; Sabel et al, 2011). …”

Section: Applications In Diseasementioning

confidence: 99%

Transcranial alternating current stimulation (tACS)

Antal¹,

Paulus²

2013

Front. Hum. Neurosci.

427

355

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Transcranial alternating current stimulation (tACS) seems likely to open a new era of the field of noninvasive electrical stimulation of the human brain by directly interfering with cortical rhythms. It is expected to synchronize (by one single resonance frequency) or desynchronize (e.g., by the application of several frequencies) cortical oscillations. If applied long enough it may cause neuroplastic effects. In the theta range it may improve cognition when applied in phase. Alpha rhythms could improve motor performance, whereas beta intrusion may deteriorate them. TACS with both alpha and beta frequencies has a high likelihood to induce retinal phosphenes. Gamma intrusion can possibly interfere with attention. Stimulation in the “ripple” range induces intensity dependent inhibition or excitation in the motor cortex (M1) most likely by entrainment of neuronal networks, whereas stimulation in the low kHz range induces excitation by neuronal membrane interference. TACS in the 200 kHz range may have a potential in oncology.

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“…Transcorneal or transorbital electrical stimulation with either contact lens or periorbital skin electrodes can stimulate RGCs in humans to yield visual phenomena such as phosphenes, and have entered early clinical use for optic neuropathies including glaucoma. In one published case report, transorbital electrical stimulation over the course of 10 days gave a suggestion of acutely enhanced visual function, 38 which may act through local RGC enhancement or by stimulating brain plasticity. Together these data have motivated further human trials in optic neuropathies and stroke (e.g.…”

Section: Neuroenhancementmentioning

confidence: 99%

Glaucoma 2.0: Neuroprotection, Neuroregeneration, Neuroenhancement

2012

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Glaucoma is a progressive neurodegenerative disease of retinal ganglion cells (RGCs) associated with characteristic axon degeneration in the optic nerve. Clinically, our only method of slowing glaucomatous loss of vision is to reduce intraocular pressure (IOP), but lowering IOP is only partially effective, and doesn’t address RGCs’ underlying susceptibility to degeneration. Here we review recent steps forward in our understanding of the pathophysiology of glaucoma, and discuss how this understanding has given us a next generation of therapeutic targets by which to maintain RGC survival, protect or rebuild RGC connections in the retina and the brain, and enhance RGC function.

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Repetitive transorbital alternating current stimulation in optic neuropathy

Cited by 53 publications

References 16 publications

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Transcranial alternating current stimulation (tACS)

Glaucoma 2.0: Neuroprotection, Neuroregeneration, Neuroenhancement

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