Cranial Electrotherapy Stimulation for the Management of Depression, Anxiety, Sleep Disturbance, and Pain in Patients With Advanced Cancer: A Preliminary Study

Yennurajalingam, Sriram; Kang, Duck Hee; Hwu, Wen Jen; Padhye, Nikhil; Masino, Charles; Dibaj, Seyedeh; Liu, Diane D.; Williams, Janet L.; Lu, Zhanni; Bruera, Éduardo

doi:10.1016/j.jpainsymman.2017.08.027

Cited by 46 publications

(47 citation statements)

References 66 publications

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“…In a recent commentary, Ownsworth described some of the exciting recent psychosocial advancements in the management of primary brain tumors as well as future directions that take into account logistical barriers to providing face‐to‐face psychotherapy, such as tele‐health and family‐based support. Additionally, some of the most recent efforts toward supportive care interventions that may show promise at improving HRQoL in patients with brain tumors include a rehabilitation intervention of physical and occupational therapy, ketogenic diets, cranial electrotherapy stimulation, and virtual reality . All of these efforts provide hope for this growing field.…”

Section: Resultsmentioning

confidence: 99%

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

et al. 2018

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Objectives The objectives of this systematic review were to (a) identify supportive‐care (psychosocial/behavioral, pharmacological, complementary, or alternative) interventions that have been evaluated via randomized controlled trials (RCTs) to improve patient‐reported health‐related quality of life (HRQoL) among adults with brain tumors, (b) evaluate the quality of the intervention studies, and (c) evaluate if developed interventions have been efficacious at improving HRQoL, as compared with control conditions in RCTs. Methods This systematic review was conducted using preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Four databases were searched for RCTs of supportive‐care interventions for adults with brain tumors, primary or metastatic, that included a patient‐reported HRQoL outcome. Quality of the included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results Ten RCTs involving 640 patients with either a primary or metastatic brain tumor investigating supportive‐care interventions with a HRQoL outcome were identified. In terms of quality, three of the studies received a “strong” rating, three received a “moderate” rating, and four of the studies received a “weak” rating. Only two of the interventions (ie, a home‐based psychosocial intervention and individualized acupuncture with standard rehabilitation) demonstrated improvements in HRQoL over control conditions. Conclusions HRQoL is of the utmost importance when treating patients with brain tumors. Yet there is a notable paucity of research to inform clinical decisions and evidence‐based practice. More high‐quality studies of interventions aimed at improving HRQoL are needed.

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Section: Resultsmentioning

confidence: 99%

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

et al. 2018

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“…Many of the previous studies were conducted with a specific population such as military person, cancer patients or severe depression. 17,21,22 Our study excluded the patient with severe medical or psychiatric illness which made the effect of CES on sleep to be revealed more clearly.…”

Section: Discussionmentioning

confidence: 99%

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

et al. 2019

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To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. Methods: This study was designed as a prospective, doubleblinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. Results: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. Conclusions: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.

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“…The PRISMA flow chart of the reviewing process is shown in Figure 1. The participants in the studies selected were healthy adults, shift workers, adults with obstructive sleep apnea syndrome (OSAS) [40][41][42], adults with advanced stage cancer [43], adults with migraine [44], adults with chronic kidney failure (CRF) [45], and children and adolescent populations among which there were people with diagnoses included in the DSM-V [46,47]. The sample characteristics, sleep instruments, primary outcomes related to salivary biomarkers and sleep alterations are shown in Table 1.…”

Section: Studies Selection and Analysismentioning

confidence: 99%

“…IL-6 was measured in 9 of the 13 articles analyzed [41,43,[45][46][47][48][49][50]52]. According to the study published by Li Zhang et al [49] on nurses who did shift work, IL-6 levels were correlated with the ISI (Insomnia Severity Index).…”

Section: Salivary Inflammatory Markers Measured In the Analyzed Studiesmentioning

confidence: 99%

Salivary Inflammatory Molecules as Biomarkers of Sleep Alterations: A Scoping Review

et al. 2021

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Poor sleep quality and sleep disorders are the most common problems in people, affecting health-related quality of life. Various studies show an association between sleep disorders and altered levels of stress hormones and inflammatory cytokines measured in saliva. The main objective of this article is to provide an analysis of the current evidence related to changes in inflammatory markers in the saliva and their associations with sleep quality measurement (both objective and subjective methods) in healthy subjects and in sleep-related disorders. To that end, a scoping review was carried out, following the PRISMA criteria in the bibliographic search in several databases: PubMed, EBSCO, and SCOPUS. Eleven of the articles are from the adult population and two from the child-youth population. They mainly measure the relationship between sleep and interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα) alpha, as well as other inflammatory markers such as myeloperoxidase (MPO) and prostaglandin-endoperoxide synthase 2. An analysis shows the relationship between these salivary biomarkers and sleep quality, especially in the case of IL-6 in both healthy subjects and several pathologies associated with sleep-disorders. The results for TNFα and IL-1β measurements are still inconclusive and the difference with IL-6 was assessed. Two studies reported interventions that result in sleep improvement and are accompanied by the normalization of inflammatory changes detected in the saliva. As it is an easy-to-apply and non-invasive method, the measurement of salivary cytokines can be very useful in chronobiology studies. Further studies are required to determine the sensitivity of salivary inflammatory markers in monitoring biological rhythms and acting as biomarkers in the detection of sleep disorders and sleep interventions.

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Cranial Electrotherapy Stimulation for the Management of Depression, Anxiety, Sleep Disturbance, and Pain in Patients With Advanced Cancer: A Preliminary Study

Abstract: In this preliminary study, we found that the use of CES was safe and feasible in ACP. The use of CES was associated with significant improvement of depression, anxiety, pain, and sleep scores. These findings support further studies of CES in ACP for symptom control.

Cited by 46 publications

References 66 publications

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

Salivary Inflammatory Molecules as Biomarkers of Sleep Alterations: A Scoping Review

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