EVIDENCE

Bibliography

BIOFEEDBACK
There is a great number of scientific research studies demonstrating Biofeedback as one of the most effective approaches to treating a wide range of mental health conditions that are published in The Journal of Neurotherapy; Journal of Applied Psychophysiology and Bio-feedback; Biological Psychiatry; Child Study Journal; Brain and Cognition; Clinical Neurophysiology; Neuropsychology; International Journal of Psychophysiology; Canadian Journal of Clinical Medicine; Journal of Head Trauma; and many others.

For a comprehensive bibliography of Neurofeedback and Biofeedback Research, please visit the International Society for Neurofeedback and Research (ISNR)


ANXIETY

1. Moore, N. (2000). A Review of EEG Biofeedback Treatment of Anxiety Disorders. Clinical Electroencephalography, 31(1), pp.1-6.

ABSTRACT: Alpha, theta, and alpha-theta enhancements are effective treatments of anxiety disorders. Alpha suppression is also effective.

2. Rice, K., Blanchard, E. and Purcell, M. (1993). Biofeedback treatments of generalized anxiety disorder: Preliminary results. Biofeedback and Self-Regulation, 18(2), pp.93-105.

ABSTRACT: All treated subjects showed significant reductions in STAI-Trait Anxiety and psychophysiological symptoms on the Psychosomatic Symptom Checklist. Only alpha-increase biofeedback subjects showed significant reductions in heart rate reactivity to stressors at a separate psychophysiological testing session. Decreased self-report of anxiety was maintained at 6 weeks post-treatment.

3. Atkinson, Amber L.(2017)., “The Effect of Biofeedback on Coping for Patients with Depression”. Honors in the Major Theses. 167.

ABSTRACT: Studies that used biofeedback as an intervention for depression reported significant physical benefits for patients, including decreased heart rate variability and respiratory rate, as well as improved function

4. Vitasari, P., Wahab, M., Herawan, T. and Sinnadurai, S. (2011). Psychophysiological treatment in reduced anxiety with biofeedback training for university students. Procedia – Social and Behavioral Sciences, 30, pp.629-633.

ABSTRACT: From the training, it is shown that after the 10th session, students be able to control their heartbeat and respiration to reduce the anxiety levels. It is concluded that the psychophysiological treatment with biofeedback training is an effective method to reduce anxiety for university students.

5. Ratanasiripong, P., Sverduk, K., Prince, J. and Hayashino, D. (2012). Biofeedback and Counseling for Stress and Anxiety Among College Students. Journal of College Student Development, 53(5), pp.742-749.

ABSTRACT: Results indicated that participants who received biofeedback training and counseling had a greater reduction in anxiety symptoms than did participants who received counseling alone. Implications for augmenting biofeedback training to traditional college counseling models are discussed.

AUTISM SPECTRUM DISORDER AND ASPERGER’S

6. Scolnick, B. (2005). Effects of electroencephalogram biofeedback with Asperger??s syndrome. International Journal of Rehabilitation Research, 28(2), pp.159-163.

ABSTRACT: This article reports the pilot study of electroencephalogram (EEG) biofeedback to improve focusing and decrease anxiety in 10 adolescent boys diagnosed with Asperger’s syndrome attending a therapeutic day school

7. Coben, R. and Myers, T. (2009). The Relative Efficacy of Connectivity Guided and Symptom Based EEG Biofeedback for Autistic Disorders. Applied Psychophysiology and Biofeedback, 35(1), pp.13-23.

ABSTRACT: Our findings suggest that an approach guided by QEEG based connectivity assessment may be more efficacious in the treatment of autism. This permits the targeting and amelioration of abnormal connectivity patterns in the brains of people who are autistic.

8. Coben, R., Sherlin, L., Hudspeth, W., McKeon, K. and Ricca, R. (2014). Connectivity-Guided EEG Biofeedback for Autism Spectrum Disorder: Evidence of Neurophysiological Changes. NeuroRegulation, 1(2), pp.109-130.

ABSTRACT: Significant reductions in neural coherence across frontotemporal regions and source localized power changes were evident in frontal, temporal, and limbic regions following this treatment. Concurrently, there were significant improvements on objective neuropsychological tests and parents reported positive gains (decreases in symptoms) following the treatment. These findings further validate EEG biofeedback as a therapeutic modality for autistic children and suggest that changes in coherence anomalies may be related to the mechanism of action.

9. Kouijzer, M., van Schie, H., Gerrits, B., Buitelaar, J. and de Moor, J. (2012). Is EEG-biofeedback an Effective Treatment in Autism Spectrum Disorders? A Randomized Controlled Trial. Applied Psychophysiology and Biofeedback, 38(1), pp.17-28.

ABSTRACT: EEG-biofeedback seems to be an applicable tool to regulate EEG activity and has specific effects on cognitive flexibility, but it did not result in significant reductions in symptoms of ASD. An important finding was that no nonspecific effects of EEG-biofeedback were demonstrated.

COGNITIVE ENHANCEMENT

10. Jackson, G. and Eberly, D. (1982). Facilitation of performance on an arithmetic task as a result of the application of a biofeedback procedure to suppress alpha wave activity. Biofeedback and Self-Regulation, 7(2), pp.211-221.

ABSTRACT: Analysis of intrasubject and intersubject data revealed an overall significant decrease in the number of alpha events and percent of the time in alpha wave activity as compared to baseline conditions. Such a decrease indicated facilitated attention by EEG definition

11. Linden, M., Habib, T. and Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback and Self-Regulation, 21(3), pp.297-297.

ABSTRACT: Eighteen children with ADD/ADHD, some of whom were also LD, ranging in ages from 5 through 15 were randomly assigned to one of two conditions. The significant improvements in intellectual functioning and attentive behaviors might be explained as a result of the attentional enhancement affected by EEG biofeedback training.

12. Tinius, T. and Tinius, K. (2000). Changes After EEG Biofeedback and Cognitive Retraining in Adults with Mild Traumatic Brain Injury and Attention Deficit Hyperactivity Disorder. Journal of Neurotherapy, 4(2), pp.27-44.

ABSTRACT: The treatment model used in this study showed significant improvement in the sustained attention of individuals diagnosed with mTBI and ADHD after twenty treatment sessions.

13. Alvarez, J., Granoff, D., and Lundy, A. (2011). Efficacy of EEG Biofeedback in Addressing Cognitive Dysfunction in Cancer Survivors.

ABSTRACT: This study examined the efficacy of EEG biofeedback (neurofeedback) in addressing the cognitive sequelae of cancer therapy, commonly known as “chemobrain” or “chemofog.” Neurofeedback, unlike compensatory strategies currently recommended by the National Cancer Institute and major cancer centers, has the potential to restore cognitive function.

DEPRESSION AND MOOD DISORDERS

14 Uhlmann, C. and Fröscher, W. (2001). Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation. Seizure, 10(1), pp.34-38.

ABSTRACT: Results show that in patients with refractory epilepsy depression is highly correlated with the locus of control, in a way that external control orientation relates to high depression scores. Biofeedback is able to improve internal control orientation through personal success mediation.

15. Ratanasiripong, P., Kaewboonchoo, O., Ratanasiripong, N., Hanklang, S. and Chumchai, P. (2015). Biofeedback Intervention for Stress, Anxiety, and Depression among Graduate Students in Public Health Nursing. Nursing Research and Practice, 2015, pp.1-5.

ABSTRACT: Biofeedback intervention is a cost-effective tool to help graduate students in public health nursing manage their stress, anxiety, and depression

PAIN

16 Eid, M., Aly, S. and El-Shamy, S. (2016). Effect of Electromyographic Biofeedback Training on Pain, Quadriceps Muscle Strength, and Functional Ability in Juvenile Rheumatoid Arthritis. American Journal of Physical Medicine & Rehabilitation, 95(12), pp.921-930.

ABSTRACT: Electromyographic biofeedback may be a useful intervention modality to reduce pain, improve quadriceps strength, and functional performance in JRA

17 Arsenault, M., Piché, M., Duncan, G. and Rainville, P. (2013). Self-regulation of acute experimental pain with and without biofeedback using spinal nociceptive responses. Neuroscience, 231, pp.102-110.

ABSTRACT: Biofeedback training is an efficient means to gain control over a physiological function typically considered involuntary. Results indicate that participants in all three groups could gain control over RIII-reflex (p<0.001), data-preserve-html-node=”true” data-preserve-html-node=”true” resulting in the modulation of pain intensity (p<0.001) data-preserve-html-node=”true” data-preserve-html-node=”true” and pain unpleasantness (p<0.001). data-preserve-html-node=”true” data-preserve-html-node=”true”

18 Angoules, A., Balakatounis, K., Panagiotopoulou, K., Mavrogenis, A., Mitsiokapa, E. and Papagelopoulos, P. (2011). Effectiveness of Electromyographic Biofeedback in the Treatment of Musculoskeletal Pain. Orthopedics.

ABSTRACT: Electromyographic biofeedback may provide pain relief for chronic musculoskeletal pain due to cumulative trauma, and may be proposed as an additional intervention to exercise in patellofemoral pain syndrome and acute sciatic pain.

19 Jensen, M., Barber, J., Romano, J., Hanley, M., Raichle, K., Molton, I., Engel, J., Osborne, T., Stoelb, B., Cardenas, D. and Patterson, D. (2009). Effects of Self-Hypnosis Training and EMG Biofeedback Relaxation Training on Chronic Pain in Persons with Spinal-Cord Injury. International Journal of Clinical and Experimental Hypnosis, 57(3), pp.239-268.

ABSTRACT: Participants in both treatment conditions reported substantial, but similar, decreases in pain intensity from before to after the treatment sessions.

20 Muller, J., Karl, A., Denke, C., Mathier, F., Dittmann, J., Rohleder, N. and Knaevelsrud, C. (2009). RETRACTED ARTICLE: Biofeedback for Pain Management in Traumatised Refugees. Cognitive Behaviour Therapy, 38(3), pp.184-190.

ABSTRACT: The authors examined the feasibility and efficacy of short-term cognitive-behavioural biofeedback (BF) addressing CP in traumatized refugees. Pre-post effects were small to medium for increased pain management and associated heart rate reactivity but large for coping with pain

21**. Pelletier, K. and Peper, E. (1977). Developing a biofeedback model: Alpha EEG feedback as a means for pain control. International Journal of Clinical and Experimental Hypnosis, 25(4), pp.361-371.

ABSTRACT: 3 adept meditators voluntarily inserted steel needles into their bodies while physiological measures (EEG, EMG, GSR, EKG, and respiration) were recorded. Although each adept used a different passive attention technique, none reported pain. During the insertion, 2 of the 3 Ss increased their alpha EEG activity

22. Ham, L. and Packard, R. (1996). A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback and Self-Regulation, 21(2), pp.93-104.

ABSTRACT: A stepwise regression analysis found that chronicity of the disorder and number of treatment sessions significantly affected response to treatment. Data suggest that biofeedback-assisted relaxation should at least be considered when planning treatment strategies for posttraumatic headaches.

23. Stokes, D. and Lappin, M. (2010). Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study. Behavioral and Brain Functions, 6(1), p.9.

ABSTRACT: These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine.

24. Pagé, I., Marchand, A., Nougarou, F., O’Shaughnessy, J. and Descarreaux, M. (2015). Neuromechanical Responses After Biofeedback Training in Participants With Chronic Low Back Pain: An Experimental Cohort Study. Journal of Manipulative and Physiological Therapeutics, 38(7), pp.449-457.

ABSTRACT: Biofeedback training led to decreases in lumbar paraspinal muscle activity in full trunk flexion and increases in lumbopelvic range of motion in participants with chronic nonspecific low back pain. Although the neuromechanical changes were mostly observed at the early stage of the program, the presence of a decrease in the fear of movement suggests that the participants’ initially limited ROMs may have been modulated by fear-avoidance behaviors.

25. Tan, G., Rintala, D., Jensen, M., Fukui, T., Smith, D. and Williams, W. (2014). A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. European Journal of Pain, 19(2), pp.271-280.

ABSTRACT: The findings indicate that two sessions of self-hypnosis training with audio recordings for home practice may be as effective as eight sessions of hypnosis treatment. If replicated in other patient samples, the findings have important implications for the application of hypnosis treatment for chronic pain management.

POST-TRAUMATIC STRESS DISORDER

26. Nelson, D. and Esty, M. (2015). Neurotherapy of Traumatic Brain Injury/Post-Traumatic Stress Symptoms in Vietnam Veterans. Military Medicine, 180(10), pp.e1111-e1114.

ABSTRACT: Comparisons of pre-and post-treatment questionnaire assessments revealed notable decreases for all symptoms, suggesting improvements across the broad domains of cognition, pain, sleep, fatigue, and mood/emotion, including post-traumatic stress symptoms, as well as for overall activity levels

27. Rosaura Polak, A., Witteveen, A., Denys, D. and Olff, M. (2015). Breathing Biofeedback as an Adjunct to Exposure in Cognitive Behavioral Therapy Hastens the Reduction of PTSD Symptoms: A Pilot Study. Applied Psychophysiology and Biofeedback, 40(1), pp.25-31.

ABSTRACT: Based on previous studies (Zucker et al. 2009; Lande et al. 2010), we hypothesize that both breathing biofeedback and treatment, as usual, will lead to a significant decrease of PTSD symptoms when compared to pre-treatment PTSD symptoms.

SLEEP DISORDER

28. Bell, J. (1979). The use of EEG theta biofeedback in the treatment of a patient with sleep-onset insomnia. Biofeedback and Self-Regulation, 4(3), pp.229-236.

ABSTRACT: A significant increase in theta density was accompanied by reports of a decrease in sleep latency and an increase in total sleep time. This improvement was maintained after withdrawal of medication and at 3-month follow-up.

TRAUMATIC BRAIN INJURY, STROKE, COMA, AND CEREBRAL PALSY

29. Yasuda, K., Saichi, K., Kaibuki, N., Harashima, H. and Iwata, H. (2018). Haptic-based perception-empathy biofeedback system for balance rehabilitation in patients with chronic stroke: Concepts and initial feasibility study. Gait & Posture, 62, pp.484-489.

ABSTRACT: Post-training, patients demonstrated marginally reduced postural spatial variability (i.e., 95% confidence elliptical area), and clinical balance performance significantly improved at post-training

30. Kim, S., Rath, J., Zemon, V., Cavallo, M., McCraty, R., Sostre, A., and Foley, F. (2018). Problem-solving, biofeedback, and severe brain injury: The moderating role of positive affect. Rehabilitation Psychology, 63(1), pp.148-154.

ABSTRACT: Participants who had the most positive emotions made the most gains in the HRV biofeedback training and performed better posttreatment on a test designed to measure problem-solving ability. Results indicate that positive affect can improve cognition, specifically mental flexibility, and abstract thinking

31. Park, Y. and Kim, J. (2017). Effects of kinetic chain exercise using EMG-biofeedback on balance and lower extremity muscle activation in stroke patients. Journal of Physical Therapy Science, 29(8), pp.1390-1393.

ABSTRACT: This study showed that closed kinetic chain exercise using EMG-biofeedback is effective for improving balance ability and lower extremity muscle activation in stroke patients. .

32 Thatcher, R. (2000). EEG Operant Conditioning (Biofeedback) and Traumatic Brain Injury. Clinical Electroencephalography, 31(1), pp.38-44.

ABSTRACT: A review is presented of the currently sparse literature about EEG operant conditioning or biofeedback as a treatment to reduce symptomology and patient complaints following a traumatic brain injury. The paper also evaluates the general use of quantitative EEG (QEEG) to assess traumatic brain injury and to facilitate EEG biofeedback treatment.

33. Nelson, D. and Esty, M. (2015). Neurotherapy of Traumatic Brain Injury/Post-Traumatic Stress Symptoms in Vietnam Veterans. Military Medicine, 180(10), pp.e1111-e1114.

ABSTRACT: Comparisons of pre-and post-treatment questionnaire assessments revealed notable decreases for all symptoms, suggesting improvements across the broad domains of cognition, pain, sleep, fatigue, and mood/emotion, including post-traumatic stress symptoms, as well as for overall activity levels. Findings suggest FNS treatment may be of potential benefit for the partial amelioration of symptoms, even in some individuals for whom symptoms have been present for decades.

34 Heymen, S., Scarlett, Y., Jones, K., Ringel, Y., Drossman, D. and Whitehead, W. (2007). Randomized, Controlled Trial Shows Biofeedback to be Superior to Alternative Treatments for Patients with Pelvic Floor Dyssynergia-Type Constipation. Diseases of the Colon & Rectum, 50(4), pp.428-441.

ABSTRACT: Biofeedback patients had significantly more unassisted bowel movements at follow-up compared to Placebo (p = .005), with a trend favoring biofeedback. Biofeedback patients reduced pelvic floor electromyography during straining significantly more than patients on the medication (p < 0.001).

MICROCURRENT THERAPY
There is a great number of research studies demonstrating Microcurrent Therapy as an effective approach to treating a wide range of physical and mental health conditions.

For a comprehensive bibliography of Microcurrent Therapy Research, please visit the links below:

www.alpha-stim.com/healthcare-professionals/research-and-reports

https://www.alpha-stim.com/wp-content/uploads/2014/08/Bibliography-as-of-January-2018.pdf


ANXIETY DISORDERS

1. LU Ling, HU Jun. A Comparative study of anxiety disorders treatment with Paroxetine in combination with cranial electrotherapy stimulation therapy. Medical Innovation of China, 11(08):080-082, 2014

ABSTRACT: The results of this study showed that six weeks of combining paroxetine with daily CES treatments, yielded significant improvement over paroxetine alone on the HAM-A scale from baseline to 6 weeks out.

2. Kolesos ON, Osionwo HO, Akkhigbe. The role of relaxation therapy and cranial electrotherapy stimulation in the management of dental anxiety in Nigeria. ISOR Journal of Dental and Medical Sciences. 2013; 10(4): 51-57

ABSTRACT:The combination of relaxation and cranial electrotherapy stimulation significantly reduced dental anxiety and found beneficial for alleviating dental anxiety among dental patients.

3. Strentzsch, Julie A. An examination of cranial electrotherapy stimulation (CES) on alpha-amylase levels, cortisol levels and state-trait anxiety scores in the chronically mentally ill. Doctoral Dissertation, Saint Mary’s University, San Antonio, Texas, 2008

ABSTRACT: A total of 45 subjects were enrolled and 38 subjects completed all post-test requirements; active CES group (N=15), sham group (N=15). The active CES group had significantly lower scores on the State Anxiety Index (SAI), indicating less state anxiety than the sham group (P=.02, d = -.41) or control group.

4. Voris, Marshall D. An investigation of the effectiveness of cranial electrotherapy stimulation in the treatment of anxiety disorders among outpatient psychiatric patients, impulse control parolees, and pedophiles. Delos Mind/Body Institute Newsletter. 1995. Dallas and Corpus Cristi, Texas

ABSTRACT: A total of 105 subjects completed the study consisting of an active CES group (N= 38), sham group (N=35). The active CES group had significantly lower anxiety scores on the State Anxiety Inventory (SAI) compared to the sham group (p=.0001, d = -1.60).

5. Kim, Hyun Jung, Kim, Woon Young, Lee, Yoon Sook, Chang, Moon Seok, Kim, Jae Hwan, and Park, Young Cheol The Effect of Cranial Electrotherapy Stimulation on Preoperative Anxiety and Hemodynamic Responses. Korean Journal of anesthesiology. 2008; 55(6): 657- 661

ABSTRACT: Sixty (60) adults between the ages of 18-65 were subjects in this study. The CES group had lower anxiety scores on the Likert scale compared to the control group at the endpoint of the study (p < 0.01, d = -.88).

INSOMNIA

6. Taylor, Ann Gill, Anderson, Joel G., Riedel, Shannon L., Lewis, Jante E., Kinser, Patricia A., and Bourguignon, Cheryl. Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia. Pain Management Nursing. 2013 Dec;14(4):327-335

ABSTRACT: Those individuals using the active CES device had a greater decrease in average pain (p 1⁄4 .023), fatigue (p 1⁄4 .071), and sleep disturbance (p 1⁄4 .001) than individuals using the sham device or those receiving usual care alone over time. In addition- ally individuals using the active CES device had improved functional status versus the sham device and UC groups over time (p 1⁄4 .028).

7. Lichtbroun, Alan S., Raicer, Mei-Ming C., and Smith, Ray B. The Treatment of Fibromyalgia with Cranial Electrotherapy Stimulation. Journal of Clinical Rheumatology. 2001; 7(2):72-78. Presented at the Fifteenth Annual International Symposium on Acupuncture and Electro-Therapeutics, Columbia University, New York, October 1999.

ABSTRACT:The active CES group had significant findings on 8 of the 11 variables compared to the sham group: significantly lower anxiety scores (p=0.04, d = -.60), higher quality of sleep scores (p = 0.02,d = .45), lower pain scores (p = .004, d = .65), higher feelings of well-being scores (p = .007, d = .73)

8. Lande, R. Gregory, and Gragnani, Cynthia. Efficacy of cranial electric stimulation for the treatment of insomnia: A randomized pilot study. Complementary Therapies in Medicine, 21(1):8-13, 2013

ABSTRACT:
The researchers identified a nearly significant increase in total time slept after three cranial electric stimulation treatments among all study subjects

9. Yennurajalingam S, Kang D-H, Hwu W-J, Padhye NS, Masino C, Dibaj SS, Liu DD, Williams JL, Lu Z, Bruera E. Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study. Journal of Pain and Symptom Management. E-published ahead of print, September 2017.

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.

DEPRESSION AND MOOD DISORDERS

10. Barclay TH, Barclay RD. A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression. Journal of Affective Disorders. 2014; 164:171-177. Presented at the American Psychological Association National Conference, Honolulu, HI, July 2013

ABSTRACT:
Analysis of covariance revealed a significant difference between the active CES group and the sham CES group on anxiety (p1⁄40.001, d1⁄40.94) and on depression (p1⁄40.001, d1⁄40.78) from baseline to endpoint of study in favor of the active CES group. CES significantly decreases anxiety and comorbid depression. Subjects reported no adverse events during the study.

11. Mellen, Ronald R., and Mackey, Wade. Reducing Sheriff’s Officers’ Symptoms of Depression Using Cranial Electrotherapy Stimulation (CES): A Control Experimental Study. The Correctional Psychologist. 2009; 41(1):9-15

ABSTRACT: The active CES group had significantly lower depression scores on the BDI (p<0.05) data-preserve-html-node=”true” and the BSI-D (p< 0.01) than the sham group. The finding suggested a broad trend toward reductions in the full range of clinical symptoms

12. Chen Yixin, Yu Lin, Zhang Jiuping, Li Lejia, Chen Tunong, Chen Yi. Results of cranial electrotherapy stimulation to children with mixed anxiety and depressive disorder. Shanghai Archives of Psychiatry. 2007; 19(4):203-205

ABSTRACT: CES is effective for treating children with MAD. CES can affect brain electrical activity mapping of the occipital lobe.

13. Yennurajalingam S, Kang D-H, Hwu W-J, Padhye NS, Masino C, Dibaj SS, Liu DD, Williams JL, Lu Z, Bruera E. Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study. Journal of Pain and Symptom Management. E-published ahead of print, September 2017

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.

14. Lu XY, Wang AH, Li Y, Zhang JS, Liu BX. Safety and effectiveness of cranial electrotherapy stimulation in treating children with emotional disorders. Chinese Journal of Clinical Rehabilitation. 2005; 9(8):96-7.

ABSTRACT: CES is a new technique for the treatment of emotional disorders; it has the advantages of fast effect, significant efficacy, as well as the characteristics of accumulative effect, fewer relapse, and no side effects.

PAIN

15. Taylor, Ann Gill, Anderson, Joel G., Riedel, Shannon L., Lewis, Jante E., Kinser, Patricia A., and Bourguignon, Cheryl. Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia. Pain Management Nursing. 2013 Dec;14(4):327-335

ABSTRACT:
Those individuals using the active CES device had a greater decrease in average pain (p 1⁄4 .023), fatigue (p 1⁄4 .071), and sleep disturbance (p 1⁄4 .001) than individuals using the sham device or those receiving usual care alone over time. In addition, individuals using the active CES device had improved functional status versus the sham device and UC groups over time (p 1⁄4 .028).

16. Lichtbroun, Alan S., Raicer, Mei-Ming C., and Smith, Ray B. The Treatment of Fibromyalgia with Cranial Electrotherapy Stimulation. Journal of Clinical Rheumatology. 2001; 7(2):72-78. Presented at the Fifteenth Annual International Symposium on Acupuncture and Electro-Therapeutics, Columbia University, New York, October 1999.

ABSTRACT: The active CES group had significant findings on 8 of the 11 variables compared to the sham group: significantly lower anxiety scores (p=0.04, d = -.60), higher quality of sleep scores (p = 0.02,d = .45), lower pain scores (p = .004, d = .65), higher feelings of well-being scores (p = .007, d = .73)

17. Taylor, Ann Gill, Anderson, Joel G., Riedel, Shannon L., Lewis, Janet E. and Bourguignon, Cheryl. A randomized, controlled, double-blind pilot study of the effects of cranial electrical stimulation on activity in brain pain processing regions in individuals with fibromyalgia. Explore. 2013; 9(1):32-40

ABSTRACT:
The observed decrease in activation in the pain processing regions may indicate a decrease in neural activity in these regions that may be related to decreased pain. This is the first randomized, controlled trial of CES in patients diagnosed with fibromyalgia to report functional magnetic resonance im- aging data.

18. Tan, Gabriel, Rintala, Diana, Jensen, Mark P., Richards, J. Scott, Holmes, Sally Ann, Parachuri, Rama, Lashgari-Saegh, Shamsi and Price, Larry R. Efficacy of cranial electrotherapy stimulation for neuropathic pain following spinal cord injury: a multi-site randomized controlled trial with a secondary 6-month open-label phase. The Journal of Spinal Cord Medicine. 2011; 34(3):285-296.

ABSTRACT:
On average, CES appears to have provided a small but statistically significant improvement in pain intensity and pain interference with few troublesome side effects. Individual results varied from no pain relief to a great deal of relief.

19. Tan, Gabriel, Rintala, Diana H., Thornby, John, Yang, June, Wade, Walter, and Vasilev, Christine. Using Cranial Electrotherapy Stimulation to Treat Pain Associated with Spinal Cord Injury. Journal of Rehabilitation Research and Development. 2006; 43(4):461-474. Presented at the South Central VA Health Care Network’s Pain Management Initiative 2nd Annual Pain Management Symposium: Campaign Against Pain. Jackson, Mississippi, April 7, 2006

ABSTRACT: Cranial electro- therapy stimulation (CES), a non-invasive technique that delivers a microcurrent to the brain via ear clip electrodes, has been shown to effectively treat several neurological and psychiatric disorders. The results suggest that CES can effectively treat chronic pain in persons with SCI

NEUROFEEDBACK

There is a great number of scientific research studies demonstrating Neurofeedback as one of the most effective approaches to treating a wide range of mental health conditions that are published in The Journal of Neurotherapy; Journal of Applied Psychophysiology and Bio-feedback; Biological Psychiatry; Child Study Journal; Brain and Cognition; Clinical Neuro-physiology; Neuropsychology; International Journal of Psycho-physiology; Canadian Journal of Clinical Medicine; Journal of Head Trauma; and many others.

For a comprehensive bibliography of Neurofeedback and Biofeedback Research, please visit the International Society for Neurofeedback and Research (ISNR)


ADD/ADHD

1. Kaiser, D. and Othmer, S. (2000). Effect of Neurofeedback on Variables of Attention in a Large Multi-Center Trial. Journal of Neurotherapy, 4(1), pp.5-15.

ABSTRACT: Neurofeedback training produced significant improvement in attentiveness, impulse control, and response variability. Significant clinical improvement in one or more measures was seen in eighty-five percent of those subjects with moderate pre-training deficits.

2. Arns, M., de Ridder, S., Strehl, U., Breteler, M. and Coenen, A. (2009). Efficacy of Neurofeedback Treatment in ADHD: The Effects on Inattention, Impulsivity and Hyperactivity: A Meta-Analysis. Clinical EEG and Neuroscience, 40(3), pp.180-189.

ABSTRACT: In line with the AAPB and ISNR guidelines for rating clinical efficacy, we conclude that neurofeedback treatment for ADHD can be considered “Efficacious and Specific” (Level 5) with a large ES for inattention and impulsivity and a medium ES for hyperactivity.

3. Lubar, J., Swartwood, M., Swartwood, J. and O’Donnell, P. (1995). Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback and Self-Regulation, 20(1), pp.83-99.

ABSTRACT: This study is significant in that it examines the effects of neurofeedback training on both objective and subjective measures under relatively controlled conditions. Our findings corroborate and extend previous research, indicating that neurofeedback training can be an appropriate and efficacious treatment for children with ADHD.

4. Barabasz, A. and Barabasz, M. (1995). Attention Deficit Hyperactivity Disorder:. Journal of Neurotherapy, 1(1), pp.1-10.

ABSTRACT: Neurotherapy (or EEG feedback), which addresses the frontal lobe dysfunction, has shown significant, long-term results, by teaching patients to normalize their brainwave responses to stimuli.

5. Nash, J. (2000). Treatment of Attention Deficit Hyperactivity Disorder with Neurotherapy. Clinical Electroencephalography, 31(1), pp.30-37.

ABSTRACT: Neurotherapy for ADHD offers an effective alternate for patients whose treatment is limited by side effects, poor medication response and in cases in which the patients and/or their parents refuse to consider medications. Studies indicate clinical improvement is largely related to measurable improvements in the EEG signature, evidenced by declining theta/beta ratios over frontal/central cortex and/or reduced theta/alpha band amplitudes.

ANXIETY DISORDERS

6. HAMMOND, D. (2005). Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America, 14(1), pp.105-123.

ABSTRACT: A review of more recent research finds that pharmacologic treatment may not be as effective as previously believed. A more recent neuroscience technology, electroencephalographic (EEG) biofeedback (neurofeedback), seems to hold promise as a methodology for retraining abnormal brain wave patterns.

7. Keller, I. (2001). Neurofeedback Therapy of Attention Deficits in Patients with Traumatic Brain Injury. Journal of Neurotherapy, 5(1-2), pp.19-32.

ABSTRACT: After ten sessions the analyses of beta activity showed that eight patients were able to increase their beta activity while the remaining four patients showed a decrease of beta activity. Mean duration of beta activity was prolonged about 50% after training. Patients who received NFT improved significantly more in the attention tests than control patients.

8. Mennella, R., Patron, E. and Palomba, D. (2017). Frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety. Behaviour Research and Therapy, 92, pp.32-40.

ABSTRACT: Frontal alpha asymmetry has been proposed to underlie the balance between approach and withdrawal motivation associated to each individual’s affective style. Neurofeedback of EEG frontal alpha asymmetry represents a promising tool to reduce negative affect. These findings provide a strong rationale for the use of frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety in clinical settings

9. McKnight, J. and Fehmi, L. (2001). Attention and Neurofeedback Synchrony Training: Clinical Results and Their Significance. Journal of Neurotherapy, 5(1-2), pp.45-61.

ABSTRACT: Analysis of 132 cases using this dual approach found that more than 90 percent of the patients reported an alleviation of symptoms. These positive results were found with stress-induced headache, joint pain, and gastrointestinal disease.

10. White, E., Groeneveld, K., Tittle, R., Bolhuis, N., Martin, R., Royer, T. and Fotuhi, M. (2017). Erratum to: Combined Neurofeedback and Heart Rate Variability Training for Individuals with Symptoms of Anxiety and Depression: A Retrospective Study. NeuroRegulation, 4(2), pp.99-99.

ABSTRACT: We present evidence that NFB+HRV training may provide an effective, nonpharmaceutical intervention to reduce symptoms of anxiety and depression in children and adults. Additionally, NFB+HRV training may improve EEG, blood pressure, resting breathing rate, and HRV.

AUTISM SPECTRUM DISORDER AND ASPERGER’S

11. Baruth, J., Casanova, M., El-Baz, A., Horrell, T., Mathai, G., Sears, L. and Sokhadze, E. (2010). Low-Frequency Repetitive Transcranial Magnetic Stimulation Modulates Evoked-Gamma Frequency Oscillations in Autism Spectrum Disorder. Journal of Neurotherapy, 14(3), pp.179-194.

ABSTRACT: We proposed that ‘slow’ rTMS may have increased cortical inhibitory tone which improved discriminatory gamma activity at early stages of visual processing. rTMS has the potential to become an important therapeutic tool in ASD treatment and has shown significant benefits in treating core symptoms of ASD with few, if any side effects.

12. Coben, R., Mohammad-Rezazadeh, I. and Cannon, R. (2014). Using quantitative and analytic EEG methods in the understanding of connectivity in autism spectrum disorders: a theory of mixed over- and under-connectivity. Frontiers in Human Neuroscience, 8.

ABSTRACT: Neuroimaging technologies and research has shown that autism is largely a disorder of neuronal connectivity. While advanced work is being done with fMRI, MRI-DTI, SPECT and other forms of structural and functional connectivity analyses, the use of EEG for these purposes is of additional great utility.

13. Knezevic, B., Thompson, L. and Thompson, M. (2010). Pilot Project to Ascertain the Utility of Tower of London Test to Assess Outcomes of Neurofeedback in Clients with Asperger’s Syndrome. Journal of Neurotherapy, 14(1), pp.3-19.

ABSTRACT: Following the training, clients with AS were able to plan more efficiently, inhibit premature responses, and shift set with greater ease, as well as solve problems more quickly as measured by their ToLDX scores. On CPTs, clients with AS showed a trend toward less impulsivity.

14. Kouijzer, M., de Moor, J., Gerrits, B., Buitelaar, J. and van Schie, H. (2009). Long-term effects of neurofeedback treatment in autism. Research in Autism Spectrum Disorders, 3(2), pp.496-501.

ABSTRACT: Neurofeedback mediated suppression of theta power is supposed to promote more flexible functioning of the brain by enhancing activation in the medial prefrontal cortex and improving flexibility of activation in the default mode network supporting the improvement of executive functions and theory of mind in ASD.

15. Pineda, J., Brang, D., Hecht, E., Edwards, L., Carey, S., Bacon, M., Futagaki, C., Suk, D., Tom, J., Birnbaum, C. and Rork, A. (2008). Positive behavioral and electrophysiological changes following neurofeedback training in children with autism. Research in Autism Spectrum Disorders, 2(3), pp.557-581.

ABSTRACT: Two electrophysiological studies tested the hypothesis that operant conditioning of mu rhythms via neurofeedback training can renormalize mu suppression, an index of mirror neuron activity, and improve behavior in children diagnosed with autism spectrum disorders

COGNITIVE ENHANCEMENT

16. Ros, T., Moseley, M., Bloom, P., Benjamin, L., Parkinson, L. and Gruzelier, J. (2009). Optimizing microsurgical skills with EEG neurofeedback. BMC Neuroscience, 10(1), p.87.

ABSTRACT: By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance.

17. Lecomte, G. and Juhel, J. (2011). The Effects of Neurofeedback Training on Memory Performance in Elderly Subjects. Psychology, 02(08), pp.846-852.

ABSTRACT: Results showed that the members of the Neurofeedback group learned to increase the spectral power of the alpha frequency range as well as the alpha/thêta ratio, and that compared with the members of the two other groups, neurofeedback training resulted in a more pronounced decrease, albeit without any relation to changes in EEG activity and the level of stress and anxiety of participants undergoing such training

18. Becerra, J., Fernández, T., Harmony, T., Caballero, M., Garcia, F., Fernández-Bouzas, A., Santiago-Rodriguez, E. and Prado-Alcalá, R. (2006). Follow-Up Study of Learning-Disabled Children Treated with Neurofeedback or Placebo. Clinical EEG and Neuroscience, 37(3), pp.198-203.

ABSTRACT: This report is a 2-year follow-up to a previous study describing positive behavioral changes and a spurt of EEG maturation with theta/alpha neurofeedback (NFB) training in a group of Learning Disabled (LD) children. In a control paired group, treated with placebo, behavioral changes were not observed and the smaller maturational EEG changes observed were easily explained by increased age.

19. Ros, T., Théberge, J., Frewen, P., Kluetsch, R., Densmore, M., Calhoun, V. and Lanius, R. (2013). Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback. NeuroImage, 65, pp.324-335.

ABSTRACT: Our findings provide neurobehavioral evidence for the brain’s exquisite functional plasticity, and for a temporally direct impact of NFB on a key cognitive control network, suggesting a promising basis for its use to treat cognitive disorders under physiological conditions.

20. Hanslmayr, S., Sauseng, P., Doppelmayr, M., Schabus, M. and Klimesch, W. (2005). Increasing Individual Upper Alpha Power by Neurofeedback Improves Cognitive Performance in Human Subjects. Applied Psychophysiology and Biofeedback, 30(1), pp.1-10.

ABSTRACT: Training success (extent of NFT-induced increase in upper alpha power) was positively correlated with the improvement in cognitive performance. Furthermore, the EEG of NFT responders showed a significant increase in reference upper alpha power.

DEPRESSION AND MOOD DISORDERS

21. Baehr, E., Rosenfeld, J. and Baehr, R. (1997). The Clinical Use of An Alpha Asymmetry Protocol in the Neurofeedback Treatment of Depression. Journal of Neurotherapy, 2(3), pp.10-23.

ABSTRACT: Using an Alpha Asymmetry protocol, the purpose of this training was to determine if depression could be alleviated when the subjects learned to increase the activation of the left hemisphere and/ or decrease the activation of the right hemisphere. The results suggest that Alpha Asymmetry neurofeedback training may be an effective adjunct to psychotherapy in the treatment of certain types of mood disorders.

22. Cheon, E., Koo, B. and Choi, J. (2015). The Efficacy of Neurofeedback in Patients with Major Depressive Disorder: An Open Labeled Prospective Study. Applied Psychophysiology and Biofeedback, 41(1), pp.103-110.

ABSTRACT: Neurofeedback treatment could improve depressive symptoms significantly. In addition, anxiety symptoms and clinical illness severity decreased significantly after neurofeedback treatment. Despite its several limitations, such as, small sample size and lack of a control group, this study suggested neurofeedback has significant effects in patients with major depressive disorder

23. Cantor, D. and Stevens, E. (2009). QEEG Correlates of Auditory-Visual Entrainment Treatment Efficacy of Refractory Depression. Journal of Neurotherapy, 13(2), pp.100-108.

ABSTRACT: The purpose of this study was to examine the use of auditory-visual EEG entrainment (AVE) at a 14 Hz (beta) frequency to decrease symptoms of depression with corresponding changes in neurophysiology. The findings indicate that AVE therapy may be a viable nonmedication therapeutic intervention.

24. Young, K., Siegle, G., Zotev, V., Phillips, R., Misaki, M., Yuan, H., Drevets, W. and Bodurka, J. (2017). Randomized Clinical Trial of Real-Time fMRI Amygdala Neurofeedback for Major Depressive Disorder: Effects on Symptoms and Autobiographical Memory Recall. American Journal of Psychiatry, 174(8), pp.748-755.

ABSTRACT: rtfMRI-nf training to increase the amygdala hemodynamic response to positive memories significantly decreased depressive symptoms and increased the percent of specific memories recalled on an autobiographical memory test. These data support a role of the amygdala in recovery from depression.

25. Hammond, D. (2000). Neurofeedback Treatment of Depression with the Roshi. Journal of Neurotherapy, 4(2), pp.45-56.

ABSTRACT: The very first Roshi session produced positive changes, and within five sessions the patient reported feeling less depressed and more energetic. At the conclusion of thirty training sessions, objective testing documented dramatic reductions in depression, somatic symptoms, over emotionality, anxiety, rumination, and fatigue. Obsessive-Compulsive Disorder

26. Hammond, D. (2003). QEEG-Guided Neurofeedback in the Treatment of Obsessive Compulsive Disorder. Journal of Neurotherapy, 7(2), pp.25-52.

ABSTRACT: An MMPI was ad- ministered pre-post to one patient, and she showed dramatic improve- ments not only in OCD symptoms, but also in depression, anxiety, somatic symptoms, and in becoming extroverted rather than introverted and withdrawn.

27. Barzegary, L., Yaghubi, H. and Rostami, R. (2011). The effect of QEEG- guided neurofeedback treatment in decreasing of OCD symptoms. Procedia – Social and Behavioral Sciences, 30, pp.2659-2662.

ABSTRACT: This research proves that neurofeedback training is an effective method for decreasing OCD symptoms. This research’s result is consistent to Hommnd’s studies (2003, 2004). Then, we can use neurefeedback for decreasing obsession and compulsion.

28. Sürmeli, T. and Ertem, A. (2011). Obsessive Compulsive Disorder and the Efficacy of qEEG-Guided Neurofeedback Treatment: A Case Series. Clinical EEG and Neuroscience, 42(3), pp.195-201.

ABSTRACT: According to follow-up interviews conducted with them and/or their family members 19 of the subjects maintained the improvements in their OCD symptoms. This study provides good evidence for the efficacy of NF treatment in OCD. The results of this study encourage further controlled research in this area.

SLEEP DISORDER

29. Kunola, O. and Malley, O. (2007). EFFECTIVENESS OF NEUROFEEDBACK TRAINING IN CHRONIC INSOMNIA. 30th ed. [ebook] SLEEP 2007;30(Supplement):A265. Available at: https://neuroptimal.com/wp-content/uploads/2016/07/ZIN_okunola_insom_abstract_OMalley.pdf.

ABSTRACT: Early neurofeedback (EEG biofeedback) training protocols have been shown to be effective therapy for insomnia (Hauri et al 1982) and it is an integral component of CBT for insomnia.

30. Hoedlmoser, Pecherstorfer, Gruber, Anderer, Doppelmayr, Klimesch and Schabus (2008). Instrumental Conditioning of Human Sensorimotor Rhythm (12-15 Hz) and Its Impact on Sleep as Well as Declarative Learning. Sleep.

ABSTRACT: Relative SMR amplitude increased over 10 instrumental conditioning sessions (in the experimental group only) and this “shaping of one’s own brain activity” improved subsequent declarative learning and facilitated the expression of 12-15 Hz spindle oscillations during sleep. Most interestingly, these electrophysiological changes were accompanied by a shortened sleep onset latency.

31. Berner, I., Schabus, M., Wienerroither, T. and Klimesch, W. (2006). The Significance of Sigma Neurofeedback Training on Sleep Spindles and Aspects of Declarative Memory. Applied Psychophysiology and Biofeedback, 31(2), pp.97-114.

ABSTRACT: We conclude that the short NFT before sleep was not sufficient to efficiently enhance phasic spindle activity and/or to influence memory processing. NFT was, however, successful in increasing sigma power, presumably because sigma NFT effects become more easily evident in actually trained frequency bands than in associated phasic spindle activity

TRAUMATIC BRAIN INJURY, STROKE, COMA, AND CEREBRAL PALSY

32. Kober, S., Schweiger, D., Witte, M., Reichert, J., Grieshofer, P., Neuper, C. and Wood, G. (2015). Specific effects of EEG based neurofeedback training on memory functions in post-stroke victims. Journal of NeuroEngineering and Rehabilitation, 12(1).

ABSTRACT: Post-stroke victims with memory deficits could benefit from NF training as much as healthy controls. The used NF training protocols (SMR, Upper Alpha) had specific as well as unspecific effects on memory. Hence, NF might offer an effective cognitive rehabilitation tool improving memory deficits of stroke survivors.

33. Reichert, J., Kober, S., Schweiger, D., Grieshofer, P., Neuper, C. and Wood, G. (2016). Shutting Down Sensorimotor Interferences after Stroke: A Proof-of-Principle SMR Neurofeedback Study. Frontiers in Human Neuroscience, 10.

ABSTRACT: Neurofeedback can be successfully applied in a stroke patient and in healthy elderly persons. We suggest that SMR neurofeedback leads to a shutting-down of sensorimotor interferences which benefits semantic encoding and retrieval.

34. Bearden TS, e. (2003). Neurofeedback training for a patient with thalamic and cortical infarctions. – PubMed – NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12964455.

ABSTRACT: Over the course of the training, significant reductions in theta amplitude occurred from the training sites as assessed from the post-session baseline periods. Posttraining, a relative normalization of the QEEG was observed from the left posterior head region.

35. Renton, T., Tibbles, A. and Topolovec-Vranic, J. (2015). Neurofeedback as a Form of Cognitive Rehabilitation Therapy Following Stroke: A Systematic Review. Archives of Physical Medicine and Rehabilitation, 96(12), p.e27.

ABSTRACT: Overall, modest positive improvements to a number of cognitive domains were identified following NFT initiation in a stroke population

36. Nelson, D. and Esty, M. (2012). Neurotherapy of Traumatic Brain Injury/Posttraumatic Stress Symptoms in OEF/OIF Veterans. The Journal of Neuropsychiatry and Clinical Neurosciences, 24(2), pp.237-240.

ABSTRACT: The Flexyx Neurotherapy System (FNS), a novel variant of EEG biofeedback, was adapted for intervention with seven treatment-refractory Afghanistan/Iraq war veterans, and brought about significant decreases in bothersome neurobehavioral and posttraumatic stress symptoms. FNS may help ameliorate mixed trauma spectrum syndromes.

38. Kim, S., Rath, J., Zemon, V., Cavallo, M., McCraty, R., Sostre, A. and Foley, F. (2018). Problem-solving, biofeedback, and severe brain injury: The moderating role of positive affect. Rehabilitation Psychology, 63(1), pp.148-154.

ABSTRACT: Participants who had the most positive emotions made the most gains in the HRV biofeedback training and performed better posttreatment on a test designed to measure problem-solving ability. Results indicate that positive affect can improve cognition, specifically mental flexibility and abstract thinking. Addressing factors that shape negative affect such as irrational beliefs and self-doubt is an important target for therapeutic intervention even in those with severe, chronic deficits.

CHRONIC PAIN

39. Weiwei Peng, 2020,Individual variation in alpha neurofeedback training efficacy predicts pain modulation, Neuroimage Clin. 2020;28:102454. doi: 10.1016/j.nicl.2020.102454. Epub 2020 Sep 29.

ABSTRACT: NFB training decreased the sensory-discriminative aspect of pain, but increased the affective-motivational aspect of pain, whereas both pain modulations were dependent upon the NFB training efficacy. Importantly, correlation analysis across all participants revealed that a greater NFB training efficacy predicted a greater increase in pain thresholds particularly at hand contralateral to NFB target site.

40. Aleksandra Vučković, 2019, EEG Correlates of Self-Managed Neurofeedback Treatment of Central Neuropathic Pain in Chronic Spinal Cord Injury, Front Neurosci. 2019 Jul 25;13:762. doi: 10.3389/fnins.2019.00762. eCollection 2019.

ABSTRACT: Twelve participants achieved statistically significant reduction in pain and in eight participants this reduction was clinically significant (larger than 30%). The most successfully regulated frequency band during NFB was alpha. However, most participants upregulated their individual alpha band, that had an average dominant frequency at αp = 7.6 ± 0.8 Hz (median 8 Hz) that is lower than the average of the general population, which is around 10 Hz. Ten out of fifteen participants significantly upregulated their individual alpha power (αp ± 2 Hz) as compared to 4 participants who upregulated the power in the fixed alpha band (8-12 Hz). Eight out of the twelve participants who achieved a significant reduction of pain, significantly upregulated their individual alpha band power. There was a significantly larger increase in alpha power (p < 0.0001) and decrease of theta power (p < 0.04) in participant specific rather than in fixed frequency bands.

41. Alicja Kubik, 2013, Neurofeedback therapy in patients with acute and chronic pain syndromes–literature review and own experience, Przegl Lek. 2013;70(7):440-2

ABSTRACT: Pain management is based mainly on pharmacotherapy which has many limitations. Non-pharmacological techniques, like neurofeedback (EEG-biofeedback) are alternative methods of pain treatment. Data from literature confirm high efficacy of neurofeedback in pain syndromes treatment, chronic and acute as well. Neurofeedback plays an important role in management of post stroke, post traumatic headaches and in primary headaches like tension type headaches or migraine.

42. Kirsten Emmert, 2017, Active pain coping is associated with the response in real-time fMRI neurofeedback during pain, Brain Imaging Behav. 2017 Jun;11(3):712-721. doi: 10.1007/s11682-016-9547-0.

ABSTRACT: During neurofeedback, the pain coping was positively correlated with activation in the anterior cingulate cortex, prefrontal cortex, hippocampus and visual cortex. Thermode temperature was negatively correlated with anterior insula and dorsolateral prefrontal cortex activation. In conclusion, self-reported pain coping mechanisms and pain sensitivity are a source of variance during rt-fMRI neurofeedback possibly explaining variations in regulation success. In particular, active coping seems to be associated with successful pain regulation.

43. Mark P Jensen 1, Ann Gianas 1, Holly R George, 2016, Use of Neurofeedback to Enhance Response to Hypnotic Analgesia in Individuals With Multiple Sclerosis, Int J Clin Exp Hypn. 2016;64(1):1-23
ABSTRACT: This proof of principle study examined the potential benefits of EEG neurofeedback for increasing responsiveness to self-hypnosis training for chronic pain management. Participants were randomly assigned to have the prerecorded sessions preceded by either (a) EEG biofeedback (neurofeedback) training to increase left anterior theta power (NF-HYP) or (b) a relaxation control condition (RLX-HYP). Eighteen participants completed all treatment sessions and assessments. NF-HYP participants reported greater reductions in pain than RLX-HYP participants. The findings provide support for the potential treatment-enhancing effects of neurofeedback on hypnotic analgesia and also suggest that effective hypnosis treatment can be provided very efficiently.

MEMORY DISORDERS AND DEMENTIA
44. Guangying Pei , Ruoshui Yang, 2020, Enhancing Working Memory Based on Mismatch Negativity Neurofeedback in Subjective Cognitive Decline Patients: A Preliminary Study, Front Aging Neurosci. 020 Sep 29;12:263. doi: 10.3389/fnagi.2020.00263. eCollection 2020.
ABSTRACT: Mismatch negativity (MMN) is suitable for studies of preattentive auditory discriminability and the auditory memory trace. Subjective cognitive decline (SCD) is an ideal target for early therapeutic intervention because SCD occurs at preclinical stages many years before the onset of Alzheimer’s disease (AD). Notably, after neurofeedback training, the working memory (WM) performance was significantly enhanced in the auditory tone 3-back test. Moreover, improvements in the accuracy of all WM tests relative to the baseline were observed. Our results suggest that MMN neurofeedback may represent an effective treatment for intervention in SCD patients and the elderly with aging memory decline.

FUNCTIONAL MEDICINE & NUTRITION
ADHD / ADD
Annelies A J Verlaet

Nutrients. 2018 Mar 24;10(4):405. doi: 10.3390/nu10040405.

Rationale for Dietary Antioxidant Treatment of ADHD

Increasing understanding arises regarding disadvantages of stimulant medication in children with ADHD (Attention-Deficit Hyperactivity Disorder). This review presents scientific findings supporting dietary antioxidant treatment of ADHD and describes substantial alterations in the immune system, epigenetic regulation of gene expression, and oxidative stress regulation in ADHD. Therefore, modulation of immune system activity and oxidant-antioxidant balance using nutritional approaches might have potential in ADHD treatment. Dietary polyphenols, for example, have antioxidant capacities as well as immunoregulatory effects and, therefore, appear appropriate in ADHD therapy.


Klaudia Konikowska

Rocz Panstw Zakl Hig. 2012;63(2):127-34.

The influence of components of diet on the symptoms of ADHD in children

In most children with ADHD the cause of the disease is not exactly known, and its etiology is multifactorial. There is much evidence to indicate that it is linked to nutritional factors. Chronic deficiencies of certain minerals such as zinc, iron, magnesium and iodine and insufficient dietary intake of long-chain polyunsaturated fatty acids may have a significant impact on the development and deepening of the symptoms of ADHD in children. In this article the issues concerning the role of the diet in treatment of the children with diagnosed ADHD and the importance of deficiency of certain minerals and long-chain polyunsaturated fatty acids in pregnancy and child growth was discussed.


Michael Huss

Lipids Health Dis. 2010 Sep 24;9:105. doi: 10.1186/1476-511X-9-105.

Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems – an observational cohort study

Polyunsaturated fatty acids are essential nutrients for humans. They are structural and functional components of cell membranes and pre-stages of the hormonally and immunologically active eicosanoids. Our results suggest a beneficial effect of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc consumption on attentional, behavioural, and emotional problems of children and adolescents. Thus, considering the behavioural benefit in combination with the low risk due to a good safety profile, the dietary supplementation with polyunsaturated fatty acids in combination with zinc and magnesium can be recommended.


B Starobrat-Hermelin

Ann Acad Med Stetin. 1998;44:297-314.

[The effect of deficiency of selected bioelements on hyperactivity in children with certain specified mental disorders]

Shortage of bioelements such as magnesium, copper, zinc, calcium and iron occurs more often among hyperactive children than among those being healthy, and deficiency of magnesium is the most frequent in this respect. The findings herein presented indicate that it is necessary to take into consideration a possible bioelements deficiency among children with ADHD. Consequently, the accomplished study proves that there is a need of magnesium supplementation in ADHD children irrespectively of other mental disorders. The supplementation of that kind of magnesium supplementation together with standard traditional mode of treatment gives us the opportunity to extend the methods of therapy of ADHD children who are the “children of the risk” in connection with their educational, emotional and social problems.


Laura J Stevens

Clin Pediatr (Phila). 2011 Apr;50(4):279-93. doi: 10.1177/0009922810384728. Epub 2010 Dec 2.

Dietary sensitivities and ADHD symptoms: thirty-five years of research

Artificial food colors (AFCs) have not been established as the main cause of attention-deficit hyperactivity disorder (ADHD), but accumulated evidence suggests that a subgroup shows significant symptom improvement when consuming an AFC-free diet and reacts with ADHD-type symptoms on challenge with AFCs. Oligoantigenic diet studies suggested that some children in addition to being sensitive to AFCs are also sensitive to common nonsalicylate foods (milk, chocolate, soy, eggs, wheat, corn, legumes) as well as salicylate-containing grapes, tomatoes, and orange. A trial elimination diet is appropriate for children who have not responded satisfactorily to conventional treatment or whose parents wish to pursue a dietary investigation.


Liang-Jen Wang

Eur Child Adolesc Psychiatry. 2020 Mar;29(3):287-297. doi: 10.1007/s00787-019-01352-2. Epub 2019 May 22.

Gut microbiota and dietary patterns in children with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, but the underlying pathophysiological mechanisms of ADHD remain unclear. Gut microbiota has been recognized to influence brain function and behaviors. Therefore, this study aimed to determine whether imbalanced gut microbiomes identified by a 16S rRNA sequencing approach are involved in the pathophysiology of ADHD. Of all participants, S. stercoricanis demonstrated a significant association with the intake of dairy, nuts/seeds/legumes, ferritin and magnesium. B. ovatus and S. stercoricanis were positively correlated to ADHD symptoms. In conclusion, we suggest that the gut microbiome community is associated with dietary patterns, and linked to the susceptibility to ADHD.


ANXIETY DISORDERS
Ioannis Kyrou 1 2 3 4, Aimilia Christou 1, Demosthenes Panagiotakos

Eur Child Adolesc Psychiatry. 2020 Mar;29(3):287-297. doi: 10.1007/s00787-019-01352-2. Epub 2019 May 22.

Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: a randomized, placebo-controlled, double-blind, crossover pilot study

The Humulus lupulus L. plant (hops) is used as a herbal medicinal product for anxiety/mood disorders. 36 participants (Females/Males: 31/5; age: 24.7±0.5 years) completed the study intervention (attrition: 6/42). No significant changes in body weight and composition or morning circulating cortisol were noted with the hops or placebo. Significantly decreased DASS-21 anxiety, depression and stress scores were documented with hops. In otherwise healthy young adults reporting at least mild depression, anxietyand stress symptoms, daily supplementation with a hops dry extract can significantly improve all these symptoms over a 4-week period. These beneficial effects agree with the indication of hops for anxiety/mood disorders and restlessness.


Graham Kell

Hormones (Athens). 2017 Apr;16(2):171-180. doi: 10.14310/horm.2002.1738.

affron ® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial

In recent years phytotherapy has been explored as a source for alternative treatments for mood disorders. One potential candidate is saffron (Crocus sativus L.), whose main bioactive components are crocins and safranal. Analysis indicated a significant decrease in negative mood and symptoms related to stress and anxiety at a 28mg/day dose (with a significant difference between 28mg/day and placebo on the POMS Total Mood Disturbance scale. Saffron increased mood, reduced anxiety and managed stress without side effects, offering a natural alternative to standard treatments.


Graham Kell

Complement Ther Med. 2017 Aug;33:58-64. doi: 10.1016/j.ctim.2017.06.001. Epub 2017 Jun 13.

affron ® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial

In recent years phytotherapy has been explored as a source for alternative treatments for mood disorders. One potential candidate is saffron (Crocus sativus L.), whose main bioactive components are crocins and safranal. Analysis indicated a significant decrease in negative mood and symptoms related to stress and anxiety at a 28mg/day dose (with a significant difference between 28mg/day and placebo on the POMS Total Mood Disturbance scale. Saffron increased mood, reduced anxiety and managed stress without side effects, offering a natural alternative to standard treatments.


AUTISM SPECTRUM DISORDER
Mengxian Zhao

Biomed Res Int. 2018 Jan 15;2018:1825046. doi: 10.1155/2018/1825046. eCollection 2018.

The Effects of Structured Physical Activity Program on Social Interaction and Communication for Children with Autism

The purpose of this study was to investigate the effects of structured physical activity program on social interaction and communication of children with autism spectrum disorder (ASD). The study concluded that the special structured physical activity program positively influenced social interaction and communication skills of children with ASD, especially in social skills, communication, prompt response, and frequency of expression.


Roberta Grimaldi

Microbiome. 2018 Aug 2;6(1):133. doi: 10.1186/s40168-018-0523-3.

A prebiotic intervention study in children with autism spectrum disorders (ASDs)

Different dietary approaches, such as gluten and casein free diets, or the use of probiotics and prebiotics have been suggested in autistic spectrum disorders in order to reduce gastrointestinal (GI) disturbances. The results showed that children on exclusion diets reported significantly lower scores of abdominal pain and bowel movement, as well as lower abundance of Bifidobacterium spp. and Veillonellaceae family, but higher presence of Faecalibacterium prausnitzii and Bacteroides spp. In addition, significant correlations were found between bacterial populations and faecal amino acids in this group, compared to children following an unrestricted diet. We observed improvements in anti-social behaviour, significant increase of Lachnospiraceae family, and significant changes in faecal and urine metabolites.


Ryan W Y Lee

Physiol Behav. 2018 May 1;188:205-211. doi: 10.1016/j.physbeh.2018.02.006. Epub 2018 Feb 5.

A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorde

The ketogenic diet is a low-carbohydrate, moderate protein, high-fat diet that has emerged as a potential treatment for autism spectrum disorder. A modified ketogenic gluten-free diet regimen with supplemental MCT was completed in 15 children ages 2 to 17 years for 3 months. Conclusion: A modified ketogenic gluten-free diet regimen with supplemental MCT was completed in 15 children ages 2 to 17 years for 3 months


Faezeh Ghalichi

World J Pediatr. 2016 Nov;12(4):436-442. doi: 10.1007/s12519-016-0040-z. Epub 2016 Jun 10.

Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial

Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders (ASD). This study was undertaken to investigate the effect of gluten free diet (GFD) on gastrointestinal symptoms and behavioral indices in children with ASD. In this randomized clinical trial, 80 children diagnosed with ASD by the Autism Diagnostic Interview-Revised (ADI-R) were assigned into GFD (n=40) and regular diet (RD) (n=40) groups for 6 weeks. GFD intervention resulted in a significant decrease in behavioral disorders (80.03±14.07 vs. 75.82±15.37, P < 0.05) but an insignificant increase in the RD group (79.92±15.49 vs. 80.92±16.24). This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.


DEPRESSION AND MOOD DISORDERS
Maria Ines Pinto-Sanchez

Gastroenterology. 2017 Aug;153(2):448-459.e8. doi: 10.1053/j.gastro.2017.05.003. Epub 2017 May 5.

Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome

We performed a randomized, double-blind, placebo-controlled study of 44 adults with IBS and diarrhea or a mixed-stool pattern (based on Rome III criteria) and mild to moderate anxiety and/or depression (based on the Hospital Anxiety and Depression scale) at McMaster University in Canada, from March 2011 to May 2014. At week 6, 14 of 22 patients in the BL group had reduction in depression scores of 2 points or more on the Hospital Anxiety and Depression scale, vs 7 of 22 patients in the placebo group. These improvements were associated with changes in brain activation patterns that indicate that this probiotic reduces limbic reactivity.


T C Birdsall

Altern Med Rev. 1998 Aug;3(4):271-80.

5-Hydroxytryptophan: a clinically-effective serotonin precursor

5-Hydroxytryptophan (5-HTP) is the intermediate metabolite of the essential amino acid L-tryptophan (LT) in the biosynthesis of serotonin. Intestinal absorption of 5-HTP does not require the presence of a transport molecule, and is not affected by the presence of other amino acids; therefore it may be taken with meals without reducing its effectiveness. Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.


K Linde

BMJ. 1996 Aug 3;313(7052):253-8. doi: 10.1136/bmj.313.7052.253.

St John’s wort for depression–an overview and meta-analysis of randomised clinical trials

The objetive of this study was to investigate if extracts of Hypericum perforatum (St John’s wort) are more effective than placebo in the treatment of depression, are as effective as standard antidepressive treatment, and have fewer side effects than standard antidepressant drugs. Hypericum extracts were significantly superior to placebo (ratio = 2.67; 95% confidence interval 1.78 to 4.01) and similarly effective as standard antidepressants (single preparations 1.10; 0.93 to 1.31, combinations 1.52; 0.78 to 2.94). There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders.


Chun-Xiao Dai

Medicine (Baltimore). 2018 Sep;97(39):e12421. doi: 10.1097/MD.0000000000012421.

Role of Ginkgo biloba extract as an adjunctive treatment of elderly patients with depression and on the expression of serum S100B

The objetive of this study was to explore the effect of ginkgo biloba extract (EGb) as an adjunctive treatment of elderly patients with depression and the effect on the expression of serum S100B. EGb, as an adjunctive treatment, can effectively improve depressive symptoms and reduce expression of serum S100B, which is a marker of brain injury, suggesting that EGb restores neurologic function during the treatment of depression in elderly patients and S100B participates in the therapeutic mechanism. EGb combined with depressive drugs plays synergistic role, and the time of onset of efficacy is faster than single antidepressants


Marta Martin-Subero

CNS Spectr. 2016 Apr;21(2):184-98. doi: 10.1017/S1092852915000449. Epub 2015 Aug 26.

Comorbidity between depression and inflammatory bowel disease explained by immune-inflammatory, oxidative, and nitrosative stress; tryptophan catabolite; and gut-brain pathways

The nature of depression has recently been reconceptualized, being conceived as the clinical expression of activated immune-inflammatory, oxidative, and nitrosative stress (IO&NS) pathways, including tryptophan catabolite (TRYCAT), autoimmune, and gut-brain pathways. IO&NS pathways are similarly integral to the pathogenesis of inflammatory bowel disease (IBD). The increased depression prevalence in IBD associates with a lower quality of life and increased morbidity in IBD, highlighting the role of depression in modulating the pathophysiology of IBD.This review covers data within such a wider conceptualization that better explains the heightened co-occurrence of IBD and depression. This supports the perspective that there is a spectrum of IO&NS disorders that includes depression, both as an emergent comorbidity and as a contributor to IO&NS processes. Such a frame of reference has treatment implications for IBD when “comorbid” with depression.


HEADACHES AND MIGRAINES
A Straube

Schmerz. 2004 Aug;18(4):300-5. doi: 10.1007/s00482-004-0311-9.

[Sleeping behaviour and headache attacks in cases of primary headache. Possible pathological mechanisms]

Headache is connected with sleep quality, e.g. hypnic headache and chronic paroxysmal headache attacks occur preferentially during REM sleep; this is possibly also true for cluster headache and migraine. REM sleep is typically characterized by the occurrence of ponto-geniculo-occipital spikes (PGOs). Interestingly, illnesses that are comorbid with migraine cause an increase in the amount of REM sleep; conversely, various drugs administered prophylactically for these illnesses reduce the quantity of REM sleep.


Costantini Antonio

Case Rep Neurol Med. 2018 Apr 18;2018:3901619. doi: 10.1155/2018/3901619. eCollection 2018.

Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache

Cluster headache is a rare painful primary disorder occurring in either episodic or chronic patterns. Several authors found that the hypothalamus, the brain region regulating endocrine function and autonomic system, is involved in the pathophysiology of cluster headache. Considering the role of thiamine in brain function, in energetic metabolism, and in pain modulation, we treated a patient affected by cluster headache with oral high-dose thiamine. We report a 41-year-old man suffering from primary chronic cluster headache since the age of 15 years. The patient began oral therapy with high-dose thiamine in December 2016. Oral thiamine supplementation led to a dramatic improvement of the symptoms. Our observation suggests that a thiamine deficiency due to enzymatic abnormalities or to dysfunction of the circulation of thiamine in the intracellular space could cause a neuronal selective impairment in the centers that are involved in this disease and could have an important role in the pathogenesis of the symptoms of cluster headache.


Lotte Skytte Krøll

J Headache Pain. 2017 Dec;18(1):46. doi: 10.1186/s10194-017-0753-y. Epub 2017 Apr 18.

Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition.Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co-existing tension-type headache and neck pain may require more individually tailored interventions to increase the level of physical activity, and to improve psychological well-being, perceived stress and self-rated health.


Lotte Skytte Krøll

Cephalalgia. 2018 Oct;38(12):1805-1816. doi: 10.1177/0333102417752119. Epub 2018 Jan 15.

The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial

The aim of this study was to evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.


TRANSCRANIAL MAGNETIC STIMULATION (TMS)
DEPRESSION AND MOOD DISORDERS
Roumen V Milev

Can J Psychiatry. 2016 Sep;61(9):561-75. doi: 10.1177/0706743716660033. Epub 2016 Aug 2.

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments

“The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals.
RESULTS: There is increasing evidence for efficacy, tolerability, and safety of neurostimulation treatments. rTMS is now a first-line recommendation for patients with MDD who have failed at least 1 antidepressant”


Cong Fu

“Ont Health Technol Assess Ser. 2021 May 6;21(4):1-232. eCollection 2021.”

Repetitive Transcranial Magnetic Stimulation for People With Treatment-Resistant Depression: A Health Technology Assessment

We included 58 primary studies, 9 systematic reviews, and 1 network meta-analysis in the clinical evidence review. Most Repetitive Transcranial Magnetic Stimulation modalities were more effective than sham treatment for all outcomes (GRADE: Moderate to High)


Christopher E Hines

J ECT. 2021 Apr 26. doi: 10.1097/YCT.0000000000000767. Online ahead of print.

REM Sleep and Total Sleep Time Improvement After Routine Repetitive Transcranial Magnetic Stimulation in Active Duty Service Members With Depression

Comparison of baseline and postintervention PSG sleep parameters highlight that total rapid eye movement sleep improved after a course of TMS. Total sleep time also improved, but only in the TMS responders subgroup. The Public Health Questionnaire-9 showed statistically significant improvement as did the Insomnia Severity Index and some components of the RAND Medical Outcomes Short Form 36.


Pradipta Majumder

“Cureus. 2021 Apr 19;13(4):e14564. doi: 10.7759/cureus.14564.”

The Safety and Efficacy of Repetitive Transcranial Magnetic Stimulation in the Treatment of Major Depression Among Children and Adolescents: A Systematic Review

The study subjects appear to tolerate the rTMS treatment well with some minor and mostly self-limited side effects. Risks of treatment-emergent hypomanic symptoms and seizure appear to be very low. There is no evidence of worsening of suicidal ideation or cognitive decline during rTMS treatment.


Philip NS, Doherty RA, Faucher C, Aiken E, van ‘t Wout-Frank M.

J Trauma Stress. 2021 May 11. doi: 10.1002/jts.22686. Online ahead of print.

Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder and Major Depression: Comparing Commonly Used Clinical Protocols

Transcranial magnetic stimulation (TMS) is increasingly being used to treat posttraumatic stress disorder (PTSD) comorbid with major depressive disorder (MDD). Data from prior controlled trials of iTBS, with increased stimulation exposure, have appeared to provide comparable clinical outcomes compared with 5 Hz TMS. The present findings provide important information for clinicians using TMS to treat these commonly comorbid disorders.


Gaynes BN, Lloyd SW, Lux L, Gartlehner G, Hansen RA, Brode S, Jonas DE, Swinson Evans T, Viswanathan M, Lohr KN.

J Clin Psychiatry. 2014 May;75(5):477-89; quiz 489. doi: 10.4088/JCP.13r08815

Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis

rTMS was beneficial compared with sham for all outcomes. rTMS produced a greater decrease in depressive severity (high strength of evidence), averaging a clinically meaningful decrease on the Hamilton Depression Rating Scale (HDRS). rTMS resulted in greater response rates (high strength of evidence); those receiving rTMS were more than 3 times as likely to respond as patients receiving sham. Finally, rTMS was more likely to produce remission (moderate strength of evidence); patients receiving rTMS were more than 5 times as likely to achieve remission as those receiving sham.


G Hasey

Can J Psychiatry. 2001 Oct;46(8):720-7. doi: 10.1177/070674370104600804

Transcranial magnetic stimulation in the treatment of mood disorder: a review and comparison with electroconvulsive therapy

repetitive transcranial magnetic stimulation (rTMS) may selectively increase or decrease neuronal activity over discrete brain regions. As a result of this focused intervention with TMS, the potential for unwanted side effects is substantially reduced, compared with ECT. In open trials, rTMS and ECT are reported to be equally efficacious for patients having depression without psychosis, but the therapeutic benefits reported in double-blind sham-rTMS controlled trials are more modest.


Margaret G O’Connor

Cogn Behav Neurol. 2005 Dec;18(4):223-7.

The effects of repetitive transcranial magnetic stimulation (rTMS) on procedural memory and dysphoric mood in patients with major depressive disorder

Findings suggest that repetitive transcranial magnetic stimulation (rTMS) over a 2-week period improves performance on tasks of response speed and procedural memory in patients with major depressive disorder. These cognitive effects are greater in those patients who showed a significant antidepressant effect to rTMS intervention.



Brian C Kavanaugh, Scott T Aaronson

J ECT. 2018 Dec;34(4):258-265


Neurocognitive Effects of Repetitive Transcranial Magnetic Stimulation With a 2-Coil Device in Treatment-Resistant Major Depressive Disorder

There were no observed negative neurocognitive effects of the 2-coil repetitive transcranial magnetic stimulation (rTMS) device. A significant effect of active rTMS was observed on the quality of episodic memory. There were no observed effects for attention or working memory. The 2-coil rTMS device is a cognitively safe treatment for treatment-resistant depression that may possess episodic memory-enhancing capabilities. Furthermore, baseline episodic memory may reflect an important predictor of subsequent depression treatment response/remission to rTMS.



John P O’Reardon

Biol Psychiatry. 2007 Dec 1;62(11):1208-16


Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial

Transcranial magnetic stimulation was effective in treating major depression with minimal side effects reported. It offers clinicians a novel alternative for the treatment of this disorder.



Tyler S Kaster

Neuropsychopharmacology. 2018 Oct;43(11):2231-2238


Efficacy, tolerability, and cognitive effects of deep transcranial magnetic stimulation for late-life depression: a prospective randomized controlled trial

Late-life depression (LLD) is a growing worldwide problem due to demographic changes, with limited treatment options due to high rates of pharmacotherapy adverse effects, accessibility of psychotherapy, and tolerability of electroconvulsive therapy. The objective of this study is to determine the efficacy, tolerability, and cognitive effects of high-dose deep repetitive transcranial magnetic stimulation (rTMS) in LLD. Fifty-two participants were randomized to active (n = 25) or sham H1 coil (n = 27). Remission rate was significantly higher with active than sham rTMS (40.0% vs 14.8%) with a number needed to treat of 4.0 (95% CI: 2.1-56.5). There was no change on any measure of executive function and no serious adverse events showing that high-dose deep rTMS appears to be safe, well tolerated, and efficacious in the treatment of LLD.



Antonio H Iglesias

Curr Neurol Neurosci Rep. 2020 Feb 4;20(1):1. doi: 10.1007/s11910-020-1021-0


Transcranial Magnetic Stimulation as Treatment in Multiple Neurologic Conditions

This is a review of the uses of TMS in diverse neurological conditions, including stroke and spasticity, migraine, and dementia. TMS is a device that utilizes non-invasive brain stimulation, and it has shown promising results with objective clinical and basic science data. Its ability to trigger neuronal plasticity and potentiating synaptic transmission gives it incredible therapeutic potential.



D J L G Schutter

Psychol Med. 2010 Nov;40(11):1789-95. doi: 10.1017/S003329171000005X


Quantitative review of the efficacy of slow-frequency magnetic brain stimulation in major depressive disorder

Slow-frequency repetitive transcranial magnetic stimulation (rTMS) to the frontal cortex has been suggested as a safer and better tolerable alternative to fast-frequency rTMS in the treatment of major depressive disorder (MDD). The findings suggest that slow-frequency rTMS to the frontal cortex is more effective than sham treatment and may be equally effective as fast-frequency rTMS in the treatment of MDD.


OBSESSIVE COMPULSIVE DISORDER

Lusicic A

Neuropsychiatr Dis Treat. 2018 Jun 29;14:1721-1736. doi: 10.2147/NDT.S121140. eCollection 2018.


Transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: current perspectives

deep transcranial magnetic stimulation (dTMS) allows direct stimulation of deeper subcortical structures and larger brain volume than conventional Repetitive transcranial magnetic stimulation (rTMS). Underlying neurobiological mechanisms related to transcranial magnetic stimulation are still under evaluation, but appear to offer a novel “third” way of addressing symptoms via localized electrical stimulation compared to pharmacotherapy and psychotherapy approaches.



Carmi L, Tendler A

Am J Psychiatry. 2019 Nov 1;176(11):931-938. doi: 10.1176/appi.ajp.2019.18101180. Epub 2019 May 21.


Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial

High-frequency deep transcranial magnetic stimulation (dTMS) over the medial prefrontal cortex and anterior cingulate cortex significantly improved OCD symptoms and may be considered as a potential intervention for patients who do not respond adequately to pharmacological and psychological interventions.



Simone Rehn

Psychiatr Q. 2018 Sep;89(3):645-665. doi: 10.1007/s11126-018-9566-7


A Meta-Analysis of the Effectiveness of Different Cortical Targets Used in Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Obsessive-Compulsive Disorder (OCD)

Our meta-analysis implies that low frequency repetetive transcranial magnetic stimulation (rTMS) applied over the supplementary motor area may offer the greatest effectiveness in the treatment of OCD. The therapeutic effects of rTMS also appear to persist post-treatment and may offer beneficial long-term effectiveness.



Khurshid A Khurshid

Med Hypotheses. 2020 Apr;137:109529. doi: 10.1016/j.mehy.2019.109529. Epub 2019 Dec 13.


High frequency repetitive transcranial magnetic stimulation of supplementary motor cortex for obsessive compulsive disorder

Transcranial magnetic stimulation (TMS) can not only offer a noninvasive treatment modality for many of these patients but can also specifically and beneficially affect involved neuronal areas. TMS stimulation of various brain areas including supplementary motor cortex, dorsolateral prefrontal cortex, orbitofrontal cortex and anterior cingulate cortex has been found to be beneficial in alleviating OCD symptoms in various studies. Low frequency and less often high frequency TMS of these areas has been found to be effective



Kumar S, Singh S

J ECT. 2018 Jun;34(2):e16-e19. doi: 10.1097/YCT.0000000000000462.


The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation at Orbitofrontal Cortex in the Treatment of Patients With Medication-Refractory Obsessive-Compulsive Disorder: A Retrospective Open Study

There was a significant decrease in mean Yale-Brown Obsessive Compulsive Scale score at the end of 20 sessions of repetetive transcranial magnetic stimulation (rTMS) compared with baseline (7.04 ± 5.07; P < 0.001), with no further significant change during the subsequent 1-month follow-up period (0.20 ± 1.38; P = 0.47). Thirteen patients (52%) met criteria for partial response, of which 11 patients (44%) showed complete response. Furthermore, higher number of failed medication trials was found to be significantly associated with greater chances of nonresponse to rTMS treatment.



Dong-Dong Zhou

J Affect Disord. 2017 Jun;215:187-196. doi: 10.1016/j.jad.2017.03.033


An updated meta-analysis: Short-term therapeutic effects of repeated transcranial magnetic stimulation in treating obsessive-compulsive disorder

Based on this study, the short-term therapeutic effects of repetetive transcranial magnetic stimulation (rTMS) are superior to those of sham treatments. The site of stimulation, stimulation frequency and intensity and sham condition were identified as potential factors modulating short-term therapeutic effects.



Marcelo T Berlim

J Psychiatr Res. 2013 Aug;47(8):999-1006. doi: 10.1016/j.jpsychires.2013.03.022


Repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD): an exploratory meta-analysis of randomized and sham-controlled trials

We pursued the present systematic review and meta-analysis to assess the efficacy of repetetive transcranial magnetic stimulation (rTMS) for OCD and to generate hypotheses for more robustly powered RCTs. Our exploratory analyses show that active rTMS seems to be efficacious for treating OCD. Moreover, LF-rTMS and protocols targeting the orbitofrontal cortex or the supplementary motor area seem to be the most promising.


POST-TRAUMATIC STRESS DISORDER

Noah S Philip, Jennifer Barredo, Emily Aiken, Victoria Larson, Richard N Jones, M Tracie Shea, Benjamin D Greenberg, Mascha van ‘t Wout-Frank

Am J Psychiatry. 2019 Nov 1;176(11):939-948.


Theta-Burst Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a highly prevalent psychiatric disorder associated with disruption in social and occupational function. Transcranial magnetic stimulation (TMS) represents a novel approach to PTSD, and intermittent theta-burst stimulation (iTBS) is a new, more rapid administration protocol. iTBS appears to be a promising new treatment for PTSD. Consistent with previous neuroimaging studies of TMS, default mode network connectivity played an important role in response prediction.



Bo Søndergaard Jensen, Mahmoud Ashkanian

Ugeskr Laeger. 2017 Apr 17;179(16):V09160670.


Repetitive transcranial magnetic stimulation treatment for post-traumatic stress disorder

Repetitive transcranial magnetic stimulation (rTMS) is already known to be safe in depression treatment. Research results of the past 15 years indicate that rTMS induced to the right dorsolateral prefrontal cortex may have a potential to treat the symptoms of PTSD. Furthermore, high-frequency rTMS seems to be superior to low-frequency rTMS. The effect of rTMS on PTSD symptoms could be mediated by increasing the level of brain-derived neurotrophic factor.



Patricia Cirillo

Brain Behav. 2019 Jun;9(6):e01284. doi: 10.1002/brb3.1284


Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis

We reviewed the literature that has evaluated TMS as a treatment for anxiety and trauma-related disorders. Among anxiety and trauma-related disorders, TMS has been most widely studied as a treatment for PTSD. TMS demonstrated large overall treatment effect for both PTSD and GAD, including applying high frequency over the right dorsolateral prefrontal cortex. Our meta-analysis suggests that TMS may be an effective treatment for GAD and PTSD.



Ethan F Karsen

Brain Stimul. Mar-Apr 2014;7(2):151-7. doi: 10.1016/j.brs.2013.10.006


Review of the effectiveness of transcranial magnetic stimulation for post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a psychiatric condition with significant morbidity and limited treatment options. Transcranial magnetic stimulation (TMS) has been shown to be an effective treatment for mental illnesses. Meta-analysis shows significant effect size on PTSD symptoms that may be correlated with total number of stimulations. TMS for PTSD appears to be an effective and well-tolerated treatment that warrants additional study to further define treatment parameters, course, and side effects.



Moshe Isserles

Brain Stimul. 2013 May;6(3):377-83


Effectiveness of deep transcranial magnetic stimulation combined with a brief exposure procedure in post-traumatic stress disorder–a pilot study

Significant improvement was demonstrated in the intrusive component of the CAPS scale in patients administered deep transcranial magnetic stimulation after exposure to the traumatic event script, while patients in the control groups showed no significant improvement. Similar trend was demonstrated in the Total-CAPS score as in the other rating scales. Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder induced by traumatic experiences. To date, psychotherapy and drug treatment achieve only partial success, indicating need for further development of treatment strategies. Recent research has found that impaired acquired fear extinction capability serves as an important factor at the pathogenesis of the disorder.


POST STROKE

Caili Ren

Biomed Res Int. 2019 Jul 29;2019:4589056


The Effect of rTMS over the Different Targets on Language Recovery in Stroke Patients with Global Aphasia: A Randomized Sham-Controlled Study

To evaluate and compare the effects of repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis of the posterior inferior frontal gyrus (pIFG) and the right posterior superior temporal gyrus (pSMG) in global aphasia following subacute stroke. Inhibitory rTMS targeting the right pIFG and pSTG can be an effective treatment for subacute stroke patients with global aphasia. The effect of rTMS may depend on the stimulation site. Low-frequency rTMS inhibited the right pSTG and significantly improved language recovery in terms of auditory comprehension and repetition,



Hui Zhang

Medicine (Baltimore). 2017 Aug;96(32):e7399


rTMS treatments combined with speech training for a conduction aphasia patient: A case report with MRI study

Our findings suggest that rTMS combined with speech training improved the speech-language ability of this chronic conduction aphasia patient and enhanced the cerebral functional and microstructural reorganization.



M León Ruiz

Neurologia (Engl Ed). 2018 Sep;33(7):459-472. doi: 10.1016/j.nrl.2016.03.008. Epub 2016 May 6


Current evidence on transcranial magnetic stimulation and its potential usefulness in post-stroke neurorehabilitation: Opening new doors to the treatment of cerebrovascular disease

Identifying stroke patients who are eligible for rTMS is essential to accelerate their recovery. rTMS has proven to be safe and effective for treating stroke complications. Functional brain activity can be optimised by applying excitatory or inhibitory electromagnetic pulses to the hemisphere ipsilateral or contralateral to the lesion, respectively, as well as at the level of the transcallosal pathway to regulate interhemispheric communication.



Xiang Liao

Clin Rehabil. 2017 Mar;31(3):289-298. doi: 10.1177/0269215516644771. Epub 2016 Jul 10.


Repetitive transcranial magnetic stimulation as an alternative therapy for dysphagia after stroke: a systematic review and meta-analysis

This meta-analysis indicates that repetitive transcranial magnetic stimulation has a positive effect on dysphagia after stroke. Compared with low-frequency repetitive transcranial magnetic stimulation, high-frequency repetitive transcranial magnetic stimulation may be more beneficial to the patients. This meta-analysis also supports that repetitive transcranial magnetic stimulation on an unaffected – or bilateral – hemisphere has a significant therapeutic effect on dysphagia.



Eunhee Park

Brain Stimul. Jan-Feb 2017;10(1):75-82. doi: 10.1016/j.brs.2016.08.005. Epub 2016 Aug 11.


Effects of Bilateral Repetitive Transcranial Magnetic Stimulation on Post-Stroke Dysphagia

The aim of the present study is to investigate the effects of high-frequency rTMS at the bilateral motor cortices over the cortical representation of the mylohyoid muscles in the patients with post-stroke dysphagia. The results of the present study provide substantial evidence that 10 Hz rTMS at the bilateral motor cortices over the cortical areas projecting to the mylohyoid muscles is effective as an additional treatment strategy to traditional dysphagia therapies.



Eunhee Park

Brain Stimul. Jan-Feb 2017;10(1):75-82. doi: 10.1016/j.brs.2016.08.005. Epub 2016 Aug 11.


Effects of Bilateral Repetitive Transcranial Magnetic Stimulation on Post-Stroke Dysphagia

The aim of the present study is to investigate the effects of high-frequency rTMS at the bilateral motor cortices over the cortical representation of the mylohyoid muscles in the patients with post-stroke dysphagia. The results of the present study provide substantial evidence that 10 Hz rTMS at the bilateral motor cortices over the cortical areas projecting to the mylohyoid muscles is effective as an additional treatment strategy to traditional dysphagia therapies.


ALZHEIMER’S DISEASE

Giacomo Koch

2018 Apr 1;169:302-311. doi: 10.1016/j.neuroimage.2017.12.048. Epub 2017 Dec 19.


Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer’s disease

Memory loss is one of the first symptoms of typical Alzheimer’s disease (AD), for which there are no effective therapies available. The precuneus (PC) has been recently emphasized as a key area for the memory impairment observed in early AD, likely due to disconnection mechanisms within large-scale networks such as the default mode network (DMN). Our findings show that high-frequency repetitive transcranial magnetic stimulation of the PC is a promising, non-invasive treatment for memory dysfunction in patients at early stages of AD. This clinical improvement is accompanied by modulation of brain connectivity, consistently with the pathophysiological model of brain disconnection in AD.



Junwu Zhao

Oncotarget. 2017 May 16;8(20):33864-33871. doi: 10.18632/oncotarget.13060.


Repetitive transcranial magnetic stimulation improves cognitive function of Alzheimer’s disease patients

Repetitive transcranial magnetic stimulation (rTMS) acts as a kind of widely-applied and non-invasive method in the intervention of some neurological disorders. In conclusion, our findings suggested that repetitive transcranial magnetic stimulation improves cognitive function, memory and language level of AD patients, especially in the mild stage of AD. Thus, rTMS can be recommended as a promising adjuvant therapy combined with cholinesterase inhibitors at the mild stage of AD patients.



Yan Lin

J Neurol Sci. 2019 Mar 15;398:184-191. doi: 10.1016/j.jns.2019.01.038. Epub 2019 Jan 24.


The role of repetitive transcranial magnetic stimulation (rTMS) in the treatment of cognitive impairment in patients with Alzheimer’s disease: A systematic review and meta-analysis

Repetitive transcranial magnetic stimulation (rTMS) can significantly improve cognitive ability in patients with mild to moderate AD. Stimulation of multiple sites and long-term treatment are better at improving AD-associated cognitive performance. Furthermore, some novel interventional targets, like precuneus (PC), may be a more effective therapeutic site to improve memory in AD.



Xin Wang

J Neurol. 2020 Mar;267(3):791-801. doi: 10.1007/s00415-019-09644-y. Epub 2019 Nov 23.


Repetitive transcranial magnetic stimulation for cognitive impairment in Alzheimer’s disease: a meta-analysis of randomized controlled trial

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique for Alzheimer’s disease (AD). rTMS, with high- or low-frequency, is thought to enhance or inhibit the cortical activities, respectively. Ten studies with 15 trials involving 240 patients were included. Compared with sham stimulation, rTMS could significantly improve cognition in AD. Based on the current evidence, rTMS was an effective therapy for cognitive impairment in AD.



Wan-Yu Hsu

Neurobiol Aging. 2015 Aug;36(8):2348-59. doi: 10.1016/j.neurobiolaging.2015.04.016. Epub 2015 May 1.


Effects of noninvasive brain stimulation on cognitive function in healthy aging and Alzheimer’s disease: a systematic review and meta-analysis

The study aimed to evaluate the effects of noninvasive brain stimulation on cognitive function in healthy older adults and patients with Alzheimer’s disease. A significant effect size of 1.35 was found for the cognitive outcomes. Subgroup analyses indicated more pronounced effects for studies applying the stimulation during the execution of the task compared with studies delivering the stimulation before the execution of the task. Noninvasive brain stimulation has a positive effect on cognitive function in physiological and pathological aging.


ADDICTION

Jiajin Yuan

JAMA Netw Open. 2020 Mar 2;3(3):e200910. doi: 10.1001/jamanetworkopen.2020.0910.


Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Impulse Inhibition in Abstinent Patients With Methamphetamine Addiction: A Randomized Clinical Trial

To evaluate changes in impulse inhibition elicited by repetitive transcranial magnetic stimulation (rTMS) in patients with MA addiction. These findings suggest that repeated rTMS sessions have sustained effects on impulse inhibition in patients with MA addiction and provide novel data on impulsivity management strategies for addiction rehabilitation.



James J Mahoney 3rd

J Neurol Sci. 2020 Nov 15;418:117149. doi: 10.1016/j.jns.2020.117149. Epub 2020 Sep 20.


Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment

The following article provides a review of several forms of neuromodulation which warrant consideration as potential treatments for substance use disorder. Search criteria for Addiction included the following terminology: addiction, substance use disorder, substance-related disorder, cocaine, methamphetamine, amphetamine, alcohol, nicotine, tobacco, smoking, marijuana, cannabis, heroin, opiates, opioids, and hallucinogens. In summary, given promising findings in reducing substance use and craving, neuromodulation may provide a non-pharmacological option as a potential treatment and/or treatment augmentation for substance use disorder.



Christine Ibrahim

Front Pharmacol. 2019 Jul 2;10:720. doi: 10.3389/fphar.2019.00720. eCollection 2019.


The Insula: A Brain Stimulation Target for the Treatment of Addiction

Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation.



Katharine Dunlop

Ann N Y Acad Sci. 2017 Apr;1394(1):31-54. doi: 10.1111/nyas.12985. Epub 2016 Feb 5.


Noninvasive brain stimulation treatments for addiction and major depression

Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico-striatal-thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control.



Mera S Barr

Int Rev Psychiatry. 2011 Oct;23(5):454-66. doi: 10.3109/09540261.2011.618827.


Repetitive transcranial magnetic stimulation and drug addiction

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that is now being tested for its ability to treat addiction. The results of this review indicate that rTMS is effective in reducing the level of cravings for smoking, alcohol, and cocaine when applied at high frequencies to the dorsolateral prefrontal cortex (DLPFC). Furthermore, these studies suggest that repeated sessions of high frequency rTMS over the DLPFC may be most effective in reducing the level of smoking and alcohol consumption.


EATING DISORDERS

Frederique Van den Eynde

Biol Psychiatry. 2010 Apr 15;67(8):793-5. doi: 10.1016/j.biopsych.2009.11.023. Epub 2010 Jan 8.


Repetitive transcranial magnetic stimulation reduces cue-induced food craving in bulimic disorders

High-frequency rTMS of the left DLPFC lowers cue-induced food cravings in people with a bulimic eating disorder and may reduce binge eating. These results provide a rationale for exploring rTMS as a treatment for bulimic eating disorders.



F Van den Eynde

Eur Psychiatry. 2013 Feb;28(2):98-101. doi: 10.1016/j.eurpsy.2011.06.002. Epub 2011 Aug 30.


Repetitive transcranial magnetic stimulation in anorexia nervosa: a pilot study

The search for new treatments to improve outcome in people with anorexia nervosa continues. This pilot study investigated whether one session of high frequency repetitive transcranial magnetic stimulation (rTMS) delivered to the left dorsolateral prefrontal cortex reduces eating disorder related symptoms following exposure to visual and real food stimuli. rTMS was safe and well-tolerated, and resulted in reduced levels of feeling full, feeling fat and feeling anxious. Thus, rTMS may reduce core symptoms of anorexia nervosa.



Rebecca Dendy

Curr Diab Rep. 2019 Dec 2;19(12):152. doi: 10.1007/s11892-019-1250-2.


Brain Stimulation to Modulate Food Intake and Eating Behavior

Appetitive behaviors are mediated through homeostatic and reward signaling of brain circuits. Non-invasive techniques have been shown to successfully reduce food craving, hunger ratings, and calorie intake as well as binge/purge symptoms in eating disorders. Brain stimulation offers promising results for treating symptoms associated with eating disorders and modifying appetitive behaviors including craving and caloric consumption.



A M Claudino

Psychol Med. 2011 Jun;41(6):1329-36. doi: 10.1017/S0033291710001881. Epub 2010 Oct 7.


Repetitive transcranial magnetic stimulation reduces cortisol concentrations in bulimic disorders

In people with bulimic eating disorders, exposure to high-calorie foods can result in increases in food craving, raised subjective stress and salivary cortisol concentrations. This cue-induced food craving can be reduced by repetitive transcranial magnetic stimulation (rTMS). Salivary cortisol concentrations following real rTMS were significantly lower compared with those following sham rTMS. These results suggest that rTMS applied to the left DLPFC alters HPAA activity in people with a bulimic disorder.



Peter A Hall

Appetite. 2018 May 1;124:78-88. doi: 10.1016/j.appet.2017.03.006. Epub 2017 Mar 11.


Non-invasive brain stimulation for food cravings, consumption, and disorders of eating: A review of methods, findings and controversies

Excitatory NIBS-particularly rTMS-can reliably reduce food cravings in single and multi-session format. For multi-session treatment of clinical conditions, more studies are needed for both rTMS and tDCS, particularly in relation to obesity, bulimia, and binge eating disorder.


ANXIETY DISORDERS

Nicholas L Balderston

Transl Psychiatry. 2020 Feb 17;10(1):68. doi: 10.1038/s41398-020-0751-8.


Low-frequency parietal repetitive transcranial magnetic stimulation reduces fear and anxiety

Results suggest that reducing IPS excitability during shock threat is sufficient to reduce physiological arousal related to both fear and anxiety, and are consistent with our previous research showing hyperexcitability in this region during threat. By extension, these results suggest that 1 Hz parietal stimulation may be an effective treatment for clinical anxiety,



Eleanor Clarke

J Affect Disord. 2019 Jun 1;252:435-439. doi: 10.1016/j.jad.2019.03.085. Epub 2019 Mar 30.


Efficacy of repetitive transcranial magnetic stimulation in the treatment of depression with comorbid anxiety disorders

The presence of comorbid anxiety is generally associated with poorer treatment outcomes in people with depression. Repetitive transcranial magnetic stimulation (rTMS) has been shown to be effective for treatment resistant depression. Our study indicates that rTMS is an effective treatment for Major Depressive Disorder in people who have comorbid anxiety disorders.



Kevin A Caulfield

Neuromodulation. 2020 Apr;23(3):380-383. doi: 10.1111/ner.13024. Epub 2019 Aug 1.


Therapeutic High-Frequency Repetitive Transcranial Magnetic Stimulation Concurrently Improves Mood and Anxiety in Patients Using Benzodiazepines

rTMS was an effective treatment of depression for all patients (p < 0.001). rTMS also reduced anxiety scores from pre- to posttreatment (p = 0.002). Furthermore, reductions in depression and anxiety were correlated (p = 0.002). rTMS concurrently improved both depression and anxiety, and changes in these measures correlated with patients using benzodiazepines.



Chris Griffiths

Ann Clin Psychiatry. 2019 Nov;31(4):236-241.


Impact of repetitive transcranial magnetic stimulation on generalized anxiety disorder in treatment-resistant depression

Published evidence indicates the value of repetitive transcranial magnetic stimulation (rTMS) for generalized anxiety disorder in patients with treatment-resistant depression (TRD). As a part of routine clinical service, patients with TRD received right dorsolateral prefrontal cortex (DLPFC) inhibitory rTMS immediately prior to left DLPFC depression treatment delivered according to a US Food and Drug Administration protocol. Results indicate the potential value of rTMS in treating anxiety in patients who are referred for rTMS for TRD.



N Vennewald

Repetitive transcranial magnetic stimulation (rTMS) for anxiety disorders–a possible therapeutic option?


Fortschr Neurol Psychiatr. 2013 Oct;81(10):550-60. doi: 10.1055/s-0033-1335979. Epub 2013 Sep 30.

Anxiety disorders rank among the most frequent psychiatric disorders. Effective psychotherapeutic and psychopharmacological interventions exist, although a considerable number of patients does not respond to standard interventions. Repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity locally and non-invasively. Overall, these studies suggest beneficial effects of rTMS on anxiety symptoms.


FIBROMYALGIA

Á Conde-Antón

Neurologia (Engl Ed). 2020 Oct 15;S0213-4853(20)30278-4. doi: 10.1016/j.nrl.2020.07.024. Online ahead of print.


Effects of transcranial direct current stimulation and transcranial magnetic stimulation in patients with fibromyalgia. A systematic review

Fibromyalgia syndrome (FM) is a chronic pathology characterized by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in pressure pain threshold, catastrophizing and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex.



Suman Tanwar

Adv Rheumatol. 2020 Jun 29;60(1):34. doi: 10.1186/s42358-020-00135-7.


Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up

“Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed.
RESULT: Right dorsolateral prefrontal cortex rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation .”



Elif Umay Altas

Somatosens Mot Res. 2019 Mar;36(1):56-62. doi: 10.1080/08990220.2019.1587400. Epub 2019 Apr 8.


Is high-frequency repetitive transcranial magnetic stimulation of the left primary motor cortex superior to the stimulation of the left dorsolateral prefrontal cortex in fibromyalgia syndrome?

“To investigate effectiveness of two different high-frequency repetitive transcranial magnetic stimulation (rTMS) protocols on pain, fatigue, quality of life (QoL) and depression in female patients with fibromyalgia.
Significant improvements in pain, QoL, and depression scores were observed in three groups. However, improvements in depression, physical functioning, physical role functioning, and general health perceptions were greater in active rTMS groups than in sham group. Significant improvements in physical role functioning, physical functioning, depression, and general health perceptions were achieved in active rTMS groups.”



B M Fitzgibbon, K E Hoy, L A Knox

Eur J Pain. 2018 Aug;22(7):1255-1267. doi: 10.1002/ejp.1213. Epub 2018 Apr 10.


Evidence for the improvement of fatigue in fibromyalgia: A 4-week left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation randomized-controlled trial

High-frequency rTMS applied daily for 4 weeks to the left DLPFC induces significant relief from fatigue and a greater chance of clinically meaningful improvement in pain intensity in patients with fibromyalgia. These results suggest DLPFC rTMS may be a relevant therapy for fibromyalgia.



Wen-Hsuan Hou

Rheumatology (Oxford). 2016 Aug;55(8):1507-17. doi: 10.1093/rheumatology/kew205. Epub 2016 May 5.


The effects of add-on non-invasive brain stimulation in fibromyalgia: a meta-analysis and meta-regression of randomized controlled trials

The effects of non-invasive brain stimulation (NBS), including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (TDCS), in treating FM remain inconclusive. The aim of this study was to investigate present evidence of using NBS as an add-on treatment in treating FM. Conclusion: Both rTMS and TDCS may be feasible and safe modalities for treating FM. The general effects of rTMS and TDCS are compatible in FM patients. M1 stimulation may be better in pain reduction and the dorsolateral prefrontal cortex may be better in depression improvement.


AUTISM SPECTRUM DISORDER & ADHD

Fumi Masuda

Autism. 2019 Oct;23(7):1614-1629. doi: 10.1177/1362361318822502. Epub 2019 Jan 20.


Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children and adolescents with neurodevelopmental disorders: A systematic review

Neurodevelopmental disorders, including autism spectrum disorder, are common in children and adolescents. In patients with attention deficit/hyperactivity disorder, low-frequency repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex and high-frequency repetitive transcranial magnetic stimulation applied to the right dorsolateral prefrontal cortex may target inattention, hyperactivity, and impulsivity. This systematic review suggests that repetitive transcranial magnetic stimulation may be a promising intervention for children and adolescents with neurodevelopmental disorders.



Maria T Acosta

Curr Med Res Opin. 2003;19(2):125-30. doi: 10.1185/030079903125001541.


Repetitive transcranial magnetic stimulation (rTMS): new tool, new therapy and new hope for ADHD

Attention-deficit hyperactivity disorder (ADHD) is the most common developmental disorder that is associated with environmental and genetic factors. Neurobiological evidence suggests that fronto-striatum-cerebellum circuit abnormalities, mainly in the right hemisphere, are responsible for most of the disturbed sensorimotor integration. Repetitive transcranial magnetic stimulation (rTMS), a new and useful option for the clinical/research investigation of several neuropsychiatric disorders involving dopamine circuits, has yet to be considered as a therapeutic tool and possible drug-free option for ADHD. Here the authors explore the available evidence that makes this tool a rational therapeutic possibility for patients with ADHD, calling attention to safety issues, while highlighting the potentials of such an approach and the new hope it may bring for patients, parents, researchers and clinicians.



Steve W Wu

Pediatr Neurol. 2012 Sep;47(3):177-85. doi: 10.1016/j.pediatrneurol.2012.06.003.


Transcranial magnetic stimulation measures in attention-deficit/hyperactivity disorder

Children affected by attention-deficit/hyperactivity disorder demonstrate diminished intrahemispheric inhibition (short interval cortical inhibition), as measured by transcranial magnetic stimulation. This study determined whether interhemispheric inhibition (ipsilateral silent period latency) correlates with clinical behavioral rating and motor control deficits of affected children. The deficit in this inhibitory measure may underlie developmental, behavioral, and motor impairments in children with attention-deficit/hyperactivity disorder.



Laurel Weaver

J ECT. 2012 Jun;28(2):98-103. doi: 10.1097/YCT.0b013e31824532c8.


Transcranial magnetic stimulation (TMS) in the treatment of attention-deficit/hyperactivity disorder in adolescents and young adults: a pilot study

Transcranial magnetic stimulation (TMS) uses a medical device that applies magnetic pulses noninvasively to the cortex of the brain to depolarize neurons. Transcranial magnetic stimulation was found to be safe, with no serious adverse events observed in this pilot study. Improvement in symptoms was observed across the combined phases of the study. There was an overall significant improvement in the clinical global impression of improvement and the ADHD-IV scales across the study phases (active and sham TMS combined; P 0.01.



Peter G Enticott

J ECT. 2011 Mar;27(1):41-3. doi: 10.1097/YCT.0b013e3181f07948.


Deep repetitive transcranial magnetic stimulation associated with improved social functioning in a young woman with an autism spectrum disorder

“There are currently no biomedical treatments targeting the core symptoms of autism spectrum disorders (ASDs). Considering evidence for cortical dysfunction in ASD, repetitive transcranial magnetic stimulation (rTMS) has been discussed as a potential therapeutic technique.
Conclusions: Deep rTMS in ASD may serve to remediate aspects of cortical dysfunction (as standard rTMS seems to do in depression and schizophrenia) and provides a potential new avenue for the development of a biomedical treatment of impaired social relating in ASD.”



L Bokovza

https://www.brainstimjrnl.com/article/S1935-861X(18)30752-6/fulltext


Clinical and electrophysiological effects of two dTMS protocols in ADHD

Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neuropsychiatric disorder. The right prefrontal cortex (rPFC) which plays a central role in regulation of behavior and attention is one of the primary areas showing deficits in ADHD. Paired associative stimulation treatment causes significant reduction in mean power of theta band during rest EEG (N=8 for each group). High-frequency dTMS increases laterality of theta and gamma bands, and reverses laterality of alpha activity, during rest EEG (N=9). Multiple dTMSsessions appear to induce lasting alterations in resting state activity in the brain.



Larissa Hauer

J Clin Med. 2019 Mar 27;8(4):416. doi: 10.3390/jcm8040416.


Effects of Repetitive Transcranial Magnetic Stimulation over Prefrontal Cortex on Attention in Psychiatric Disorders: A Systematic Review

Repetitive transcranial magnetic stimulation (rTMS) may be effective for enhancing cognitive functioning. The beneficial effects on attention and other executive functions suggest that rTMS has the potential to target core features of ASD. No evidence for cognitive adverse effects was found in all the included rTMS studies. This review suggests that prefrontal rTMS could exert procognitive effects on attention in patients with many psychiatric disorders.



Peter G Enticott

Brain Stimul. Mar-Apr 2014;7(2):206-11. doi: 10.1016/j.brs.2013.10.004. Epub 2013 Oct 27.


A double-blind, randomized trial of deep repetitive transcranial magnetic stimulation (rTMS) for autism spectrum disorder

Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions. Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety.



Manuel F Casanova

Semin Pediatr Neurol. 2020 Oct;35:100832. doi: 10.1016/j.spen.2020.100832. Epub 2020 Jun 24.


Transcranial Magnetic Stimulation in Autism Spectrum Disorders: Neuropathological Underpinnings and Clinical Correlations

TMS improves executive function skills related to self-monitoring behaviors and the ability to apply corrective actions. These improvements manifest themselves as a reduction of stimulus bound behaviors and diminished sympathetic arousal. Results become more significant with increasing number of sessions and bear synergism when used along with neurofeedback. When applied at low frequencies in individuals with ASD, TMS appears to be safe and to improve multiple patient-oriented outcomes.



Pingping Liu

2020 Jul 4;2020:9857987. doi: 10.1155/2020/9857987. eCollection 2020.


Increased Accuracy of Emotion Recognition in Individuals with Autism-Like Traits after Five Days of Magnetic Stimulation

Individuals with autism-like traits (ALT) belong to a subclinical group with similar social deficits as autism spectrum disorders (ASD). Their main social deficits include atypical eye contact and difficulty in understanding facial expressions, both of which are associated with an abnormality of the right posterior superior temporal sulcus (rpSTS). Resting-state functional connectivity (rsFC) between the rpSTS and the left cerebellum significantly decreased in the real group than the sham group after iTBS. Our findings indicated that iTBS of the rpSTS could improve emotion perception of ALT individuals by modulating associated neural networks. This stimulation protocol could be a vital therapeutic strategy for the treatment of ASD.c