Richard. QEEG Analysis of Cranial Electrotherapy: A Pilot Study. Presented
at the International Society for Neuronal Regulation annual conference, September
18-21, 2003 in Houston, Texas.
Key words: cranial electrotherapy stimulation, CES, QEEG, depression, anxiety, pain, sleep disorders.
Digital EEG for QEEG analysis was obtained from 30 research
volunteers using a Neurodata-24 digital EEG system. CES was providing with
Alpha-Stim 100 cranial electrotherapy units set to .5 hertz. QEEG data was
processed and analyzed with the NeuroGuide system. Statistical
analysis of the data was conducted with the NeuroGuide, SPSS and JMP statistical
electrotherapy stimulation (CES) is the use of low level
electrical current applied to the head for therapeutic purposes. Cranial
electrotherapy stimulation is also known as electrosleep, cranial electrotherapy
(CET), cranial stimulation (CS), transcranial electrotherapy
(TCET), neuroelectric therapy (NET), cranial TENS and auricular
electrical stimulation. The FDA authorizes the production and sale of medical
devices for cranial electrotherapy in the United States for the treatment
of pain, depression, anxiety, and sleep disorders. To
date 112 of 126 published studies in the US on CES have had positive outcomes,
involving 4,541subjects (in all 126 studies) without significant side effects
from the treatment (Kirsch, 2002). The current study
was conducted to determine the effect of cranial electrotherapy on cortical
activity as measured by QEEG before and after a single 20-minute use of CES.
This pilot study is being followed up by a double blind
placebo controlled study of cortical activation changes from baseline with
three and six weeks of CES treatment.
Digital EEG, blood pressure, heart rate, electrodermal
activity and finger temperature was acquired during a baseline condition,
during cranial electrotherapy, immediately after electrotherapy, and after
three weeks of daily use of cranial electrotherapy.
CES at 0.5 Hz significant increases were seen across the entire cortex in
delta and gamma frequencies, this effect was uniform for all volunteers.
After a single 20-minute session of CES decreases were
seen in delta and theta frequency activity with concomitant significant increase
in alpha activity. The study volunteers generally reported feeling more relaxed
after 20-minutes of CES. Some volunteers reported feeling
as if their head had cleared and they felt more awake. Research volunteers
who reported pain or anxiety before the single session of CES treatment reported
significant reductions in pain and anxiety after the
This pilot study indicates that CES at 0.5 Hz entrains delta and gamma frequencies during active stimulation. After a single
treatment with CES there is a significant increase in alpha frequency activity
and a significant decrease in delta and theta activity. The post treatment
maps indicate the effect of single session cranial electrotherapy
treatment on QEEG is congruent with the reports of the research volunteers
of decreased anxiety, increased alertness and increased relaxation.
Kirsch, D. L. (2002). The Science Behind Cranial Electrotherapy
Stimulation. Edmonton, Alberta: Medical Scope Publishing Corporation.
above is a representation of the electrical activity of the brain by frequency
after 20 minutes of use of Alpha-Stim CES at 0.5 Hz. The EEG of 30 research
volunteers was averaged
and analyzed by computer to generate the average of brain changes in brain
activity after 20 minutes of Alpha-Stim. This is a difference brain map,
where a decrease in activity
after the use of Alpha-Stim is shown in shades of blue and an increase in
activity is seen in shades of yellow and red (green indicates no change).
The above map shows that there is a
decrease in delta, the 1, 2, and 3 Hz frequencies associated
in waking individuals with impaired cognitive functioning. Significant increases
are seen in alpha frequencies with peak activity at 9 Hz.
Increases were also seen in activity at
12, 13 and 14 Hz, with 13 and 14 Hz activity centering on C3. It is common
practice in EEG biofeedback (Neurotherapy) to train increases of 13-15 Hz
activity (SMR) at C3 to
create increased relaxation and treat epilepsy, ADHD, attentional problems
and other disorders (http://www.eegspectrum.com/Applications/ADHD-ADD/EfficacySMR-BetaIntro2/).
The pattern of changes seen
after a single session of Alpha-Stim in the 30 research volunteers is congruent
with the self reports of increased relaxation with improved cognitive functioning.
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above map is a relative power map, which is a percentage map showing activity
in the brain at each frequency as a percentage of 100% (all activity of the
brain). The activity changes
represented by the relative power map show the same general pattern of decreases
in slow waves associated with sleep and cognitive impairment and increases
in alpha and SMR frequencies,
which are associated with relaxation.