PMID: 10321152 [PubMed - indexed for MEDLINE]

Neurosci Biobehav Rev 1999 Mar;23(4):529-38 Related Articles, Books,

Transcutaneous cranial electrical stimulation (TCES): a review 1998.

Limoge A, Robert C, Stanley TH.

Laboratoire d'Electrophysiologie, Universite Rene Descartes de Paris,
Montrouge, France.

The Transcutaneous Cranial Electrical Stimulation (TCES) technique
appeared at the beginning of the 1960s and is aimed to act at the
level of the central nervous system. The current, composed of high
frequency pulses interrupted with a repetitive low frequency, is
delivered through three electrodes (a negative electrode placed
between the eyebrows while two positive electrodes are located in the
retro-mastoid region). Due to the characteristics of the current
delivered, shortcomings encountered with previous electrical
stimulation techniques are avoided. The main property of TCES is to
potentiate some drug effects, especially opiates and neuroleptics,
during anesthetic clinical procedures. This potentiation effect
permits drastic reduction of pharmacological anesthetic agent and
reduces post-operative complications. Animal studies performed with
TCES demonstrated that this stimulation releases 5-hydroxy-indol-
acetic acid and enkephalins. Despite numerous clinical and animal
studies performed with this technique for several decades, TCES
mechanisms are not completely elucidated but results obtained without
undesirable effect are encouraging signs to continue investigations
of this particular technique.

Publication Types:
Review, Academic

PMID: 10073891 [PubMed - indexed for MEDLINE]
: Presse Med 1999 Dec 11;28(39):2197-203 Related Articles, Books,

[Electricity in pain management].

[Article in French]

Limoge A.

Laboratoire d'Electrophysiologie, Universite Rene Descartes de Paris.

AVAILABLE TECHNIQUES: For more than thirty years there has been a
revival of electrotherapy in the treatment of pain. Analgesia by
electrical current is now based on transcutaneous or percutaneous
nerve stimulation, deep stimulation, posterior spinal cords
stimulation, and transcutaneous cranial stimulation. EFFICACY: It is
now scientifically proven that electrostimulation of certain
peripheral fibers and of different structures of the central nervous
system plays an undeniable role in filtration and control of painful
messages. However, precise indications are a prerequisite.
Transcutaneous electrical nerve stimulation is only effective if it
acts on neurogenic pain, only if the nerve pathways to be stimulated
are superficial, and only if the conduction pathways between the area
of stimulation and the superior centers are intact. Neurosurgical
electrostimulation techniques should only be proposed after failure
of simple therapies. INDICATIONS: For acute pain, electrostimulation
of certain intracerebral structures and transcutaneous cranial
electrostimulation may be indicated. Clinicians have a multitude of
electrostimulators at their disposal but generally, the parameters
recommended for their use have no serious scientific basis. The
selected electrical neurostimulator must provide effective nerve
stimulation without causing lesions. Electrostimulation could be
considered as an adjunct to medicinal treatment for pain relief.

PMID: 10629701 [PubMed - indexed for MEDLINE]
: NeuroRehabilitation 2000;14(2):85-94 Books

The use of cranial electrotherapy stimulation in the management of
chronic pain: A review.

Kirsch DL, Smith RB.


Cranial Electrotherapy Stimulation (CES) has a growing history of
applications in rehabilitation medicine in the United States dating
back to early 1970. As a recognized non-drug treatment of anxiety,
depression and insomnia, CES gained its first major application in
the field of addiction treatment and rehabilitation. By the mid 1980s
research was showing additional important uses of CES in the
treatment of closed head injured patients, and in paraplegic and
quadriplegic patients. The most recent research is showing CES to be
highly effective in the management of chronic pain patients. It may
be elevating the pain threshold due to its stress reducing effects
when anxiety and depression are reduced below clinical levels. Modern
theorists of a pain neuromatrix in the cerebral cortex may provide an
additional basis for understanding CES mechanisms in the control of
pain related disorders.

PMID: 11455071 [PubMed - as supplied by publisher]

: J Nerv Ment Dis 1997 Dec;185(12):766-7 Related Articles, Books,

Comment on:
J Nerv Ment Dis. 1995 Jul;183(7):478-84

Cranial electrostimulation for headache: meta-analysis.

McCrory DC.

Publication Types:

PMID: 9442190 [PubMed - indexed for MEDLINE]
Krankenpfl J 1998 Dec;36(12):497 Related Articles, Books, LinkOut

[Fighting pain gently. Electrostatic energy has an effect on nerve

[Article in German]

PMID: 10095556 [PubMed - indexed for MEDLINE]
IEEE Trans Biomed Eng 1996 Sep;43(9):939-43 Related Articles, Books,

Potential and current density distributions of cranial electrotherapy
stimulation (CES) in a four-concentric-spheres model.

Ferdjallah M, Bostick FX Jr, Barr RE.

Electrical Engineering Department, University of Texas at Austin
78712, USA.

Cranial electrotherapy stimulation (CES) has been successfully used
for treatment of many psychiatric diseases. Its noninvasive nature is
its major advantage over other forms of treatments such as drugs. It
is postulated that the low electric current of CES causes the release
of neurotransmitters. However, the current pathways have not been
extensively investigated. In the following paper, analytical and
numerical methods are used to determine the distribution of potential
and current density in a four zone concentric spheres model of the
human head when excited by two electrodes diametrically opposite to
each other. Because of the azimuthal symmetry, which is assumed in
this study, a two-dimensional (2-D) finite difference approximation
is derived in the spherical grid. The current density distribution is
projected around the center of the model, where the thalamus is
modeled as a concentric sphere. All dimensions and electrical
properties of the model are adapted from clinical data. Results of
this simulation indicate that, in contrast to previous beliefs, a
small fraction of the CES current does reaches the thalamic area and
may facilitate the release of neurotransmitters.

PMID: 9214809 [PubMed - indexed for MEDLINE]
: Integr Physiol Behav Sci 1996 Apr-Jun;31(2):88-95 Related Articles,
Books, LinkOut

Physiological and therapeutic effects of high frequency electrical

Liss S, Liss B.

Publication Types:
Clinical Trial

PMID: 8809593 [PubMed - indexed for MEDLINE]
: Acupunct Electrother Res 1995 Apr-Jul;20(2):117-32 Related
Articles, Books, LinkOut

Clinical and experimental evaluation of cranial TENS in the U.S.: a

Taylor DN.

Center for Behavioral Medicine, New York, NY 10028, USA.

A review of studies evaluating therapeutic applications of cranial
TENS in clinical populations reveals frequent use of unreliable self-
report outcome measures, insufficient description of treatment
protocol, invalid double-blind and placebo conditions and often a
lack of adequate description of the electrical parameters used. A
review of the experimental literature indicates that cranial TENS is
capable of modulating central nervous system activity. It is
suggested that the inconclusiveness of the clinical literature may be
due to incomplete research design rather than to the questionable
nature of the treatment, and that cranial TENS merits continued

Publication Types:
Review, Tutorial

PMID: 7491849 [PubMed - indexed for MEDLINE]