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HOW ALPHA-STIM CRANIAL ELECTROTHERAPY SIMILATION (CES) WORKS
How Alpha-Stim® Cranial Electrotherapy Stimulation (CES) Works
James Giordano, Ph.D.

How does Alpha-Stim® Cranial Electrotherapy Stimulation (CES) work? The exact mechanism by which Alpha-Stim® produces effects is not fully known. However, based on previous and ongoing studies, it appears that the Alpha-Stim® microcurrent waveform activates particular groups of nerve cells that are located at the brainstem, a site at the base of the brain that sits atop of the spinal cord. These groups of nerve cells produce the chemicals serotonin and acetylcholine, which can affect the chemical activity of nerve cells that are both nearby and at more distant sites in the nervous system. In fact, these cells are situated to control the activity of nerve pathways that run up into the brain and that course down into the spinal cord. By changing the electrical and chemical activity of certain nerve cells in the brainstem, Alpha-Stim® appears to amplify activity in some neurological systems, and diminish activity in others. This neurological ‘fine tuning’ is called modulation, and occurs either as a result of, or together with the production of a certain type of electrical activity pattern in the brain known as an alpha state which can be measured on brain wave recordings (called electroencephalograms, abbreviated EEG). Such alpha rhythms are accompanied by feelings of calmness, relaxation and increased mental focus. The neurological mechanisms that are occurring during the alpha state appear to decrease stress-effects, reduce agitation and stabilize mood, and control both sensations and perceptions of particular types of pain.
These effects can be produced after a single treatment, and repeated treatments have been shown to increase the relative strength and duration of these effects. In some cases, effects and chemical changes evoked by Alpha-Stim® have led to a durable re-tuning back to normal function. Electromedical Products International, Inc. is dedicated to using exciting new research technology and advanced, innovative methods to study the exact mechanisms through which Alpha-Stim® can be beneficial to patients with pain, anxiety, depression and sleep disorders.
 
James Giordano, Ph.D. is Director of Science for Electromedical Products International, Inc. of  Mineral Wells, TX, and is Scholar in Residence at the Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC. Dr. Giordano is also Visiting Scholar at the Center for Ethics, Dartmouth Medical School, Hanover, NH, and Invited Lecturer at the Roundtable in Arts and Sciences, Oxford University, UK. As a neuroscientist, Dr. Giordano's ongoing work is focused upon neural mechanisms of pain, the philosophy of pain research and practice of pain medicine, and the neuroethical issues inherent to the development and use of emergent technologies in neurology and psychiatry. Dr. Giordano received a Ph.D. in biological psychology from the City University of New York. He was an NIEHS post-doctoral fellow in neurotoxicology and neuroscience at The Johns Hopkins University, Baltimore, MD, served as Visiting Scientist in the Department of Clinical Neuropharmacology, Max Planck Institute for Psychiatry, Munich, Germany, was an American Psychological Association Visiting Fellow in neuroimaging at the Martinos Center for Advanced Imaging, Harvard University Medical School/Massachusetts General Hospital, and completed post-graduate training in bioethics at the Neiswanger Institute for Bioethics and Health Policy, Loyola University/Stritch Medical School, Chicago, IL. The author of over 65 refereed publications on pain, ethics and medical philosophy, Dr. Giordano serves as Neuroscience Section Editor for the Pain Physician journal, Bioethics Editor for the American Journal of Pain Management, and Ethics Section Editor for the journal Practical Pain Management. Dr. Giordano may be reached at james@epii.com.
 
This material is reproduced with the permission of Electromedical Products International, Inc. © 2006
 


Physician and Patient Surveys

 
Physician Post Marketing Survey of Alpha-Stim® Patients
% Improvement 
 
Condition
N*
Slight
0-24%
Fair
25-49%
Moderate
50-74%
Marked
75-100%
Significant >25%
Anxiety
349
6.30%
11.17%
25.50%
57.02%
94%
Depression
184
10.33%
16.85%
20.65%
52.18%
90%
Stress
259
6.95%
14.29%
27.03%
51.74%
93%
Insomnia
135
20.74%
12.59%
25.19%
41.48%
79%
Results of using Alpha-Stim® technology by physicians. For additional information see the book: The Science Behind Cranial Electrotherapy Stimulation, 2nd Ed. by Dr. Daniel L. Kirsch. Medical Scope Publishing Corporation, Edmonton, Alberta, Canada, 2002.
 

Peer-Reviewed Outcomes on Alpha-Stim
® Patients’ Self-Reports
% Improvement 
 
Condition
N*
Slight
0-24%
Fair
25-49%
Moderate
50-74%
Marked
75-100%
Significant >25%
Anxiety (alone)
128
10.16%
22.66%
32.81%
34.38%
90%
Anxiety (with other)
370
8.92%
22.97%
32.97%
35.14%
91%
Anxiety/Depression
58
5.17%
32.76%
32.76%
29.31%
95%
Depression (alone)
53
13.21%
20.75%
43.40%
22.64%
87%
Depression (with other)
265
10.94%
23.02%
35.09%
30.94%
89%
Stress
123
4.88%
24.39%
31.71%
39.02%
95%
Insomnia
163
6.13%
28.83%
28.83%
36.20%
94%
Results of using Alpha-Stim® technology at home for a minimum of 3 weeks. For additional information see the article: Is microcurrent stimulation effective in pain management? An additional perspective by Dr. Ray B. Smith. American Journal of Pain Management, 11(2):62-66, 2001.
*N refers to number of patients.
 


Alpha Waves

The Alpha-Stim® has been shown in clinical studies to increase the brain's production of serotonin, beta endorphins, and alpha wave activity.  Alpha waves are the brain waves one feels when they are alert yet relaxed. Decreased alpha wave activity is shown in a variety of psychological disorders.  The brain produces five main types of brain waves as shown below:

The five generally accepted brain wave groups:
 
1.  Delta Waves: 0 - 4 Hz  Delta waves are the slowest range of brain waves. They are seen in in deep sleep typically during stage 3 and stage 4 sleep. 
 
2.  Theta Waves:  4 - 8 Hz The sleepy brain waves.  We see these brain waves when we are falling asleep or just waking up and during the early stages of sleep..
 
3.  Alpha Waves:  8 - 12 Hz.  Alpha waves are seen when we are both alert and relaxed.  These waves decrease with concentrated or busy activity.
 
4.  Beta Waves:  12 - 26 Hz.  Beta waves are associated with high stress, high concentration, busy or anxious thinking.
 
5.  Gamma Waves:  26 - 80 Hz.  These waves are thought to be associated with higher level thinking, problem solving, and consciousness.
 
Your brain can produce a variety of these types of wave forms at any given time.  By analyzing brain waves of some people with psychological disorders, there can be obvious flaws.  Some have irregular brain wave patterns while others are dominant in certain frequencies or deficient in others.  High beta wave/low alpha wave activity has been shown in people with depression, stress, anxiety, epilepsy, and even schizophrenia.  Conversely, children with ADHD typically have slower brain waves than most (delta and theta brain wave activity) and decreased power in the alpha bands.  For this reason many are prescribed stimulants in order to speed up their brain wave activity.

Increased alpha wave activity, while not a cure-all,  has shown to help with a variety of mental health issues.  Increasing your alpha waves can also be a means of just managing stress.  Zen Buddhists, biofeedback therapists, and even NASA scientists have all sought ways to increase beneficial alpha wave activity over the years.  As psychotherapy research progresses, alpha wave enhancement may become an important tool in fighting mental illness.

References
1.  Terelak J.  Alpha index and personality traits of pilots. Aviat Space Environ Med. 1976 Feb;47(2):133-6.
2.  Barry RJ, Clarke AR, McCarthy R, Selikowitz M. EEG Coherence Development in Normal and ADHD Children Clinical EEG & Neuroscience Journal (Presented at Annual Meeting 2004).
3.  Becker K, Holtmann M. Role of electroencephalography in attention-deficit hyperactivity disorder (ADHD). Expert Rev Neurother. 2006 May;6(5):731-9.
4.  Diego MA, Field T, Hernandez-Reif M. CES-D depression scores are correlated with frontal EEG alpha asymmetry. Depression and Anxiety. 2001;13(1):32-7
 
Selected Alpha-Stim® Research Studies            Requires Adobe  Reader


1.  Gilula, Marshall F., and Kirsch, Daniel L.
Cranial Electrotherapy Stimulation Review: A Safer Alternative to Psychopharmaceuticals in the Treatment of Depression.  Journal of Neurotherapy, 9(2):7-26, 2005

2.  Kirsch, Daniel, L. and Smith R.
Cranial electrotherapy stimulation for anxiety, depression, insomnia, cognitive dysfunction, and pain. In Bioelectromagnetic Medicine. Paul J. Rosch, Ed. Marcel Dekker, New York, Pp 727-740, 2004
 
3.  Childs, Allen and Price, Larry. Cranial electrotherapy stimulation reduces aggression in violent neuropsychiatric patients.  Primary Psychiatry, 14(3):50-56, 2007.
 
4.  Tan, Gabriel, Monga, Trilok, and Thornby, John. Efficacy of microcurrent electrical stimulation on pain severity, psychological distress, and disability. American Journal of Pain Management, 10(1):35-44, 2000.
 
 
7.  Schroeder, M.J., and Barr, R.E. Quantitative analysis of electroencephalogram during cranial electrotherapy stimulation. Clinical Neurophysiology. 112:2075-2083, 2001. Doctoral dissertation, The Graduate School of the University of Texas at Austin, 191 pages, 1999.
 
8.  Tyers, Steve and Smith, Ray B. A comparison of cranial electrotherapy stimulation alone or with chiropractic therapies in the treatment of fibromyalgia. The American Chiropractor, 23(2):39-41, 2001.
 
9.  Childs, Allen. Cranial electrotherapy stimulation reduces aggression in violent retarded population: a preliminary report. The Journal of Neuropsychiatry and Clinical Neurosciences, 17(4): 548-551, 2005.
 
10.  Cork, Randall C., Wood, Patrick, Ming, Norbert, Shepherd, Clifton, Eddy, James, Price, Larry. The effect of cranial electrotherapy stimulation (CES) on pain associated with fibromyalgia. The Internet Journal of Anesthesiology. 2004; Volume 8, Number 2.
 
10.  Overcash, Stephen J. Cranial electrotherapy stimulation in patients suffering from acute anxiety disorders. American Journal of Electromedicine, 16(1):49-51, 1999.
 
11.  Heffernan, Michael. The effect of variable microcurrents on EEG spectrum and pain control. Canadian Journal of Clinical Medicine, 4(10):4-11, 1997.
 
 
13.  Heffernan, Michael. The effect of a single cranial electrotherapy stimulation on multiple stress measures. The Townsend Letter for Doctors and Patients, 147:60-64, 1995.
 
14.  Brovar, Alan. Cocaine detoxification with cranial electrotherapy stimulation (CES): A preliminary appraisal. International Electromedicine Institute Newsletter, 1(4), July/Aug, 1984. Also in Brain/Mind Bulletin, 9(14), August, 1984.
 
15.  Gibson, Thomas H, et. al. Cranial application of low level transcranial electrotherapy vs. relaxation instruction in anxious patients. American Journal of Electromedicine, 4(1):18-21, 1987.
 
16.  Voris, Marshall D., et. al., and Good, Shirley. Treating sexual offenders using cranial electrotherapy stimulation. Medical Scope Monthly, 3(11):14-18, 1996.
 
 
18.  Smith, Ray B, et. al. The use of cranial electrotherapy stimulation to block fear perception in phobic patients. Journal of Current Therapeutic Research, 51(2):249-253, 1992.
 
 
 
21.  Plotnick, Stephen E. Finding hope: Alpha-Stim 100 may help clinicians yield better fibromyalgia treatment results. Advance for Directors in Rehabilitation, P. 82, May 2005.

22.  Kennerly, R.,
QEEG analysis of cranial electrotherapy: A pilot study.  Journal of Neurotherapy, 8(2):112-113, 2004.
 
23.  Lichtbroun, Alan S., Raicer, Mei-Ming C., and Smith, Ray B. The treatment of fibromyalgia with cranial electrotherapy stimulation. Journal of Clinical Rheumatology, 7(2):72-78, 2001.
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