Bystritsky Alexander, Kerwin Lauren, Feusner Jamie
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095-6968, USA.
J Clin Psychiatry. 2008 Mar;69(3):412-7. doi: 10.4088/jcp.v69n0311.
Cranial electrotherapy stimulation (CES) is a noninvasive procedure that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. Whether CES is an effective treatment for patients with a DSM-IV diagnosis of generalized anxiety disorder (GAD) has not previously been explored. The goal of this study was to evaluate the efficacy of CES in alleviating anxiety in patients with DSM-IV-diagnosed GAD.
Twelve patients from 29 to 58 years of age with a DSM-IV diagnosis of GAD were enrolled from August 2005 to March 2006 through the University of California, Los Angeles (UCLA) Anxiety Disorders Program. Cranial electrotherapy stimulation treatment was administered for 6 weeks using the Alpha-Stim Stress Control System at 0.5-Hz frequency and 300-muA intensity. The primary efficacy measures were the Hamilton Rating Scale for Anxiety (HAM-A) and the Clinical Global Impressions-Improvement (CGI-I) scale. Response to treatment was defined as a reduction of 50% or more on the HAM-A and a CGI-I score of 1 or 2 ("much improved" or "very much improved," respectively).
Cranial electrotherapy stimulation was associated with a significant decrease in HAM-A scores (t = 3.083, p = .01). At endpoint, 6 patients (50% of the intent-to-treat sample and 67% of completers) had a 50% decrease in HAM-A score and a CGI-I score of 1 or 2. One additional patient significantly improved in anxiety scores but did not meet criteria for response. Adverse events were generally mild in severity, mostly consisting of headache and nausea.
This preliminary study suggests that CES may reduce symptoms of anxiety in GAD. We hope that these preliminary results will encourage further research to explore the use of CES in clinical settings.
clinicaltrials.gov Identifier: NCT00539357.
颅部电刺激疗法(CES)是一种非侵入性治疗方法,在美国已应用数十年,用于治疗普通人群的焦虑、抑郁和失眠。此前尚未探讨CES对诊断为广泛性焦虑症(GAD)的DSM-IV患者是否为有效治疗方法。本研究的目的是评估CES缓解DSM-IV诊断为GAD患者焦虑症状的疗效。
2005年8月至2006年3月期间,通过加利福尼亚大学洛杉矶分校(UCLA)焦虑症项目招募了12名年龄在29至58岁之间、诊断为DSM-IV的GAD患者。使用Alpha-Stim压力控制系统,以0.5赫兹频率和300微安强度进行颅部电刺激疗法治疗,为期6周。主要疗效指标为汉密尔顿焦虑量表(HAM-A)和临床总体印象改善量表(CGI-I)。治疗反应定义为HAM-A评分降低50%或更多,且CGI-I评分为1或2(分别为“明显改善”或“非常明显改善”)。
颅部电刺激疗法与HAM-A评分显著降低相关(t = 3.083,p = 0.01)。在研究终点时,6名患者(占意向性治疗样本的50%,完成治疗者的67%)的HAM-A评分降低了50%,且CGI-I评分为1或2。另有1名患者的焦虑评分显著改善,但未达到反应标准。不良事件严重程度一般较轻,主要包括头痛和恶心。
这项初步研究表明,CES可能减轻GAD患者的焦虑症状。我们希望这些初步结果将鼓励进一步研究,以探索CES在临床环境中的应用。
clinicaltrials.gov标识符:NCT00539357。