Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

Cook, Ian A.; Abrams, Michelle; Leuchter, Andrew F.

doi:10.1111/ner.12399

Cited by 60 publications

(39 citation statements)

References 55 publications

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“…Our previous studies have shown a rapid antidepressant effect of EA on forehead acupoints and a long‐lasting enhancement of the antidepressant effects of EA in the treatment of major depressive disorder. Moreover, transcutaneous electrical stimulation on trigeminal branches‐innervated forehead was effective in reducing epilepsy, depression, and attention deficit hyperactivity disorder …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, transcutaneous electrical stimulation on trigeminal branchesinnervated forehead was effective in reducing epilepsy, depression, and attention deficit hyperactivity disorder. [26][27][28][29] It thus appears that a combination of DCEAS and body acupuncture particularly with electrical stimulation on forehead acupoints could produce additive and even synergistic effects by broadly modulating neurochemical pathways and brain regions. Indeed, it is well documented that acupuncture with intense stimulation robustly modulates catecholaminergic and endogenous opiate neuropeptides of the brain.…”

Section: Discussionmentioning

confidence: 99%

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Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Zhang

Zhao

Jin

et al. 2019

Psychiatry Clin Neurosci

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Aim Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. Methods In this assessor‐ and participant‐blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline‐to‐end‐point change in score of the 17‐item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery–Åsberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. Results DCEAS+BA‐treated patients showed strikingly greater end‐point reduction than MAS‐treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline‐to‐end‐point reduction in 17‐item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA‐treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel‐Index‐measured disability than that without electrical stimulation. Conclusion DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Zhang

Zhao

Jin

et al. 2019

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

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“…For example, one study (62)(n=60) did not find efficacy of a single tDCS session for ADHD, and several case series or open label studies suggested potential efficacy of tCS for working memory in PTSD (63), and symptoms of comorbid PTSD and MDD (64). There are also a growing number of studies for nonpsychiatric conditions that may be of interest to psychiatrists, described elsewhere (14; 65).…”

Section: Section 2: Review Of Published Randomized Controlled Trialsmentioning

confidence: 99%

Low-Intensity Transcranial Current Stimulation in Psychiatry

Philip

Nelson

Fröhlich

et al. 2017

AJP

110

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Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation (CES) devices – the only category of tCS devices cleared for use in psychiatric disorders - is supported by low quality evidence.

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“…Trigeminal nerve stimulation (TNS) has also been an active area of research in a variety of disease processes, and has shown efficacy in the treatment of epilepsy and depression 17, 18 . Its role in other pathological conditions such as posttraumatic stress disorder (PTSD), trigeminal neuralgia, and migraine headaches is ongoing 19–21 .…”

Section: Introductionmentioning

confidence: 99%

“…It projects directly or indirectly to several areas of the brain, such as the locus coeruleus, nucleus tractus solitaries (NTS), rostral ventrolateral medullar (RVLM), thalamus and the cerebral cortex 21, 22 . There are two important properties of the trigeminal nerve that make it a potentially viable target in TBI management.…”

Section: Introductionmentioning

confidence: 99%

Neuroprotective Effects of Trigeminal Nerve Stimulation in Severe Traumatic Brain Injury

Chiluwal

Narayan

Chaung

et al. 2017

Sci Rep

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Following traumatic brain injury (TBI), ischemia and hypoxia play a major role in further worsening of the damage, a process referred to as ‘secondary injury’. Protecting neurons from causative factors of secondary injury has been the guiding principle of modern TBI management. Stimulation of trigeminal nerve induces pressor response and improves cerebral blood flow (CBF) by activating the rostral ventrolateral medulla. Moreover, it causes cerebrovasodilation through the trigemino-cerebrovascular system and trigemino-parasympathetic reflex. These effects are capable of increasing cerebral perfusion, making trigeminal nerve stimulation (TNS) a promising strategy for TBI management. Here, we investigated the use of electrical TNS for improving CBF and brain oxygen tension (PbrO2), with the goal of decreasing secondary injury. Severe TBI was produced using controlled cortical impact (CCI) in a rat model, and TNS treatment was delivered for the first hour after CCI. In comparison to TBI group, TBI animals with TNS treatment demonstrated significantly increased systemic blood pressure, CBF and PbrO2 at the hyperacute phase of TBI. Furthermore, rats in TNS-treatment group showed significantly reduced brain edema, blood-brain barrier disruption, lesion volume, and brain cortical levels of TNF-α and IL-6. These data provide strong early evidence that TNS could be an effective neuroprotective strategy.

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Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

Cited by 60 publications

References 55 publications

Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Low-Intensity Transcranial Current Stimulation in Psychiatry

Neuroprotective Effects of Trigeminal Nerve Stimulation in Severe Traumatic Brain Injury

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