Upload
francesca-nicolay
View
215
Download
2
Tags:
Embed Size (px)
Citation preview
An Evaluation of the Psycho-physiological Concommitants of Increasing Alpha Wave Amplitude in Anxiety and Stress Disorders
ISNR 21st Annual Conference 2013
Dallas, Texas L.A.Parkinson, A.J.Parkinson.
BrainHealth, London
OUTLINE The Importance of Alpha Brain Waves The Brainstem involvement Sensory –Cognitive Integration Arousal What is Cranial Electrotherapy Stimulation? The Alpha-Stim The Pilot Study Summary Mediating Mechanisms Re -evaluation
The Importance of Alpha BrainWaves
Hans Berger first described the Alpha Waveband in 1929 (8-11Hz, rhythmic)
For many years thought to be associated with calm relaxation – even “zoned out” or idling state of the brain
Parkinson (1973) used alpha-wave training to induce relaxation in patients with agoraphobia.
WHAT is ALPHA ACTIVITY?Basanova 2009
Objectives
1. Brain dominant oscillations frequency in posterior area
2. Amplitude suppression in response to eyes open
3. Alpha bursting spindles
1. Brain dominant oscillations frequency in posterior area
2. Amplitude suppression in response to eyes open
3. Alpha bursting spindles eyes closed - EC eyes open - EO
Psychometric characteristics associated with alpha activity indices
Alpha-activity indices Cognitive data Reference
Individual peak frequency (Hz)
Fluency in creative thinking, mental rotation task performance
Hanslmayr et al 2005; Bazanova & Aftanas, 2007
Power in upper alpha range in eyes closed resting (mkV2)
Cognitive and psychomotor peak performance
Hummel et al 2004; Bazanova et al 2003;
Alpha amplitude suppression (log%)
Attention, sport and musical peak performance
Barry et al 2007, Shmelkina 2003
Individual alpha band width (Hz)
Plasticity in creative thinking, efficiency in BFB training
Bazanova & Aftanas, 2007
Alpha bursting segments length
Academic achievements,Cognitive productivity
Maltsev et al 1997; Bazanova & Aftanas, 2007
Amplitude variability intra alpha bursting segment
Self actualization, self control ability
Tatcher 2007Bazanova et al, 2007
Also Sensory Motor Strip Rhythm
Mountcastle(1992) found that the alpha-wave band facilitates the integration of brain activity triggered by sensory stimuli with the activation of the neural images of current or past experience
Mountcastle(1998) “Using brain oscillations has become one of the most important conceptual and analytic tools for the understanding of cognitive processes.”
Gebber et al(1995)found that the alpha-wave has the best test – retest reliability of all brain waves and is an intra individual stable trait.
Basar(2011) “Alpha is one of the fundamental functional operators of the brain for signal processing and communication in the sensory-cognitive field”.
Barman and Gebber(1993&2007) Alpha operating oscillations are found also in the spinal cord
The Brainstem
Hernandez-Peon(1961) The brainstem reticular system is a region where all sensory modalities converge
Basar(2012) The core of the brainstem may be viewed as a form of “high command” which constantly receives and controls all information from the external and internal environments.
The Alpha Rhythm
Steriade et al (2001) : is generally considered an index of
vigilance or arousal. Vecchiato et al (2011) :is widely used as an index of evaluation
for relaxation or pleasure in neuromarketing.
Alpha Rhythm and ANS
Pineda(2005) Rhythmic oscillations in alpha become coherently engaged in transforming perception into action …a 10Hz rhythm reflects the organisation of a brainstem network that governs Sympathetic Nervous System overflow.
Fight Flight or Freeze . Anxiety/Fear Response
What is Cranial Electrotherapy Stimulation(CES)?
It is the use of variable current (0.5Hz pulses per second) applied to the brain with the aim of inducing the cortex to produce an increase in alpha-wave activity.
It also activates neurons in the brainstem.
The Alpha-Stim AID
The Alpha-Stim M For Pain
Research With Alpha-Stim
Approx. over 100 research reports
The Science of CES
www.Alpha-Stim.com
Key Findings on the Use of the Alpha-Stim 100/M Pain
That nerve pathways that project into the brain and spinal cord were activated.
Including the Serotonergic (5-HT) Raphe nucleii which inhibit the cholinergic and nor-adrenergic systems
Thalamo-cortical activity was suppressed reducing arousal and agitation
The Use of The Alpha-Stim 100
Alters sensory processing and induces alpha-wave activity
Modulates pain perception
Alters pain perception, cognitions and emotionality through the limbic fore-brain
The Study Procedure
Patient population complaining of Stress or Anxiety but not on any medication or UDS
DASS – Depression, Anxiety & Stress Scale (Lovibond & Lovibond 1995) Excluded if scored 14+ on Dep Subscale 16 participants (8 males, 8 females) Age Range 24 – 63 years
Baseline CNS monitoring at Cz Midline of SMS
delta 1 – 4 Hz theta 4 - 7 Hz alpha 8 – 11 Hz lo-beta 12 – 15 Hz beta 16 - 20 Hz hi-beta 21- 30 Hz gamma 38 – 42 Hz
Put on one month waiting list Then Re-Assessed : CNS and DASS Provided with Alpha-Stim for 2 months
Home Use – 20 minutes per day. Re – Assessed CNS and DASS
Results
Mean Alpha Wave Amplitudes
T1 T2 T3
3.71 4.23 6.52
T1 to T2 ns T2 to T3 p < 0.05
Results
Mean Alpha Wave Amplitudes
3.714.23
6.52
01234567
T1 T2 T3
T1 to T2 ns T2 to T3 p < 0.05
Results: DASS Mean Scores
Depression
T1 T2 T3
10.2 9.8 8.4
(mild) (normal) (normal)
Results: DASS Mean ScoresDepression
10.2 9.88.4
0
24
6
810
12
T1 T2 T3
(Mild) (Normal) (Normal)
Anxiety Mean Scores
T1 T2 T3
15.6 15.2 8.2 (severe) (severe) (mild)
T1 to T2 ns T2 to T3 p< 0.01
ResultsAnxiety Mean Scores
15.6 15.2
8.2
0
5
10
15
20
T1 T2 T3
T1 to T2 ns T2 to T3 p < 0.01
(Severe) (Severe) (Mild)
Stress Mean Scores
T1 T2 T3
26.7 28.2 16.2 (severe) (severe) (mild)
T1 to T2 ns T2 to T3 p< 0.01
Results
T1 to T2 ns T2 to T3 p < 0.01
(Severe) (Severe) (Mild)
Stress Mean Scores
26.7 28.2
16.2
0
5
1015
20
25
30
T1 T2 T3
Summary So Far Using CES led to a significant increase in alpha -
wave activity and to a significant decrease in self – report measures of stress and anxiety.
The importance of the alpha – wave in therapeutic progress should not be under estimated in view of its role in the sensory – cognitive field, the processing of unwanted images and the amelioration in levels of stress and anxiety.
This was a pilot study and further research is needed.
There is likely to be greater clinical applicability than is currently realised.
Mediating Mechanisms?
Why Does It Work?
What Is Going On?
Omata et al(2013)Department of Functional Brain Research, Tokyo Using EEGs and FMRIs with alpha rhythm The slow fluctuation component is
correlated with signal changes in the brainstem, the medial thalamus and ACC
The fast fluctuation component is correlated with signal changes in the lateral part of the thalamus and the ACC but NOT the brainstem
Some Other Clinical Applications
Depression Insomnia Addiction Withdrawal Multiple Sclerosis As a Potentiator Pain
Methadone Self Withdrawal Study
Gomez et al (1979) Brit. J. Psychiatry 28 Heroin Addicts 3 groups – CES, Sham CES, Placebo Over 10 day period CES group reduced
Heroin significantly from 42mg to 12mg Sham from 42mg to 37mg Placebo Control (WL) from 42mg to 41mg
Mood, Addiction and CES
USA retrospective study.
200 patients with alcohol, cocaine, heroin or prescription meds addictions in 28 day in-patient setting.
Profile of Mood States % Improvement Pre-Post
State Without CES With CESAnxiety 20 92Depression 19 142Anger 27 58Lethargy 5 38Fatigue -20 78Confusion 2 76
Fibromyalgia
Lichtbroun et al (2002)
Double blind study: Alpha Stim, Sham or Control
Significant improvement in pre to post tender point pain ratings in CES group
La Jolla CES Open Clinical StudyTyers (2000) 28 Started study: daily 60 minute CES
treatment for 3 weeks 19 completed and found improvement in:- Tender points, self rated pain, sleep,
feeling of well being, quality of life. All changes significant
Tyers (2000) cont:
Significant improvements in the 19 :-
Anxiety, Depression, Anger, Lethargy, Fatigue, Confusion, Total Mood Disturbance
Multiple Sclerosis
Pilot study
Daily 60 minute CES treatment for 1 month Improvements in spasticity, vision, fatigue,
pain, left hand, right hand
Multiple Sclerosis
Potentiation of Anaesthesia
Stanley et al (1982) 50 subjects with urology surgery
2 Groups: Anaesthesia with CES, Anaesthesia alone
CES patients needed less anaesthesia
Alpha Impact Mechanism
EEG and FMRI Study found:-
Positive Correlations between the Alpha Rhythm and the Central deep-lying brain regions such as the thalamus, amygdala and insula as well as the anterior cingulate cortex and cerebellum.(Sadato et al 1998)
Alpha Oscillations
Related to 3 different types of cortex areas:-
The generators of the cortical rhythm-the occipital cortex –ADPF
Areas of the circuit but not direct generators – thalamus
Those areas of the cortex linked to arousal
(Salah-Haddadi et al 2003)
Summary Using CES led to a significant increase in alpha-wave
activity and a significant reduction in self – report measures of anxiety and stress.
The importance of the alpha-wave in therapeutic progress should not be underestimated in view of its role in the sensory- cognitive field, the processing of images the amelioration of stress, anxiety, depression, insomnia, addictions, fibro-myalgia and female neuro-endocrine dysfunction.
This was a pilot study and further research is needed. There IS greater applicability than currently realised, and
the mediating mechanisms are better understood.