June 13, 2012

Cranial Electrotherapy Stimulation: Longer Strides, Faster Gait, and Fewer Falls for People with Parkinson's?

Cranial Electrotherapy Stimulation (CES) – a therapy approved by the FDA in 1991 to treat anxiety and depression – has now been shown to increase walking speed and stride length in people with Parkinson’s disease. The good news: those results are encouraging, since the improvements may reduce the falls and movement-related injuries that affect many PWPs. The bad news: the study group was very small – only ten people.

This particular study was conducted by researchers at the Department of Physical Therapy & Rehabilitation at the University of Maryland School of Medicine, and used the Fisher Wallace Stimulator to deliver the “gentle electrical current” through dampened sponge electrodes attached to subjects’ heads. The electrical stimulation apparently encourages the production of serotonin and other neurotransmitters typically associated with elevated mood, ease of sleep, and reduction of anxiety. As it is, those of us with PD often experience problems with sleep and depression – as I have – so this therapy may be useful for us for more than just gait improvements.

Those ten participants each received three different treatments:
  1. 20 minutes of CES, 
  2. 20 minutes walking on a treadmill, 
  3. 20 minutes of CES AND treadmill 
Stride length and walking speed increased MOST for participants after the first – CES only – therapy. We’ll need additional, more thorough, studies to determine whether longer CES sessions (more than 20 minutes), conducted through an expended study period provide additional stride and gait benefits to people with PD.

How CES Works
CES devices are hand-held and battery-operated, and do not require invasive implantation, unlike electrodes used in deep brain stimulation for seizure prevention and treatment of hand tremors, and unlike pacemakers used to regulate cardiac activity.

CES is also very different from electroconvulsive therapy (ECT), used in hospitals to treat deep depressions that have not responded to conventional therapies, like medication. CES doesn’t require anesthesia – as ECT does – and the pulsing current used in CES is more than 1,000 WEAKER than the powerful, steady electrical current ECT requires.

What Patients May Feel
Since they’re fully awake and alert during the procedure, do patients feel anything with CES? According to Dr. Mueller's explanation of CES:
CES causes the patient to experience nothing more than a faint tingling sensation. As the treatment continues, most patients begin to feel less anxious, less distressed, and more relaxed and, yet, mentally alert and focused. Patients with positive response to CES generally sleep better and report improved concentration, increased learning abilities, enhanced recall and a heightened state of well-being after one or a series of CES treatments. Most people can resume normal activities immediately after treatment. Some people may experience a euphoric feeling, or a state of deep relaxation that may temporarily and minimally impair their mental and/or physical abilities for the performance of potentially hazardous tasks, such as motor vehicle operation. In some cases, this may last for up to several hours after treatment. Users may do other things during treatment such as read, watch TV, engage in conversation, or work on a computer.
Sounds good, but I'll adopt a "watchful waiting" approach to this promising therapy, since I'm getting similar benefits from my mindfulness meditation.

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