Transcranial Electrical Nerve Stimulation for Dementia: Difference between revisions

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== Description  ==
== Description  ==


Although Transcutaneous electrical nerve stimulation is known for non-pharmacological pain control, some scholars showed that it might also be used for brain stimulation in person with  dementia<ref name=":0">[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004032/abstract?__cf_chl_jschl_tk__=825dbba406e2e362cb19738244ae7e0a475486a5-1581864188-0-AQ8RbL_QUahFu9b2bCRFWIkHcLgzgixv5JQTknus7P-t56OnEYoJstiRFPPBo2_YqT6WKd9PW8jnBarcvCYHvdKo7oGeGNg2jTyVpwRJH9AnIS_rbF_a7Hu_8zZZErO2n_3c7Xf2tB8YvxiogzhSUQtlB6miSWx2hOkIKvDd0P1OyxSOfm1q5nrJcebehPZDm1ZRH-NOsZYd-2BffKPueT1DrJBmwLrs4BbEUwd4EhpsS5BfagynqKkEy5yTN1JXk2yQlkx0L6BhAuR5ZyAJcoAyaHn7Yu6q9XaO-wWS_PqU9DXiUQrKfX_oq14gofSYjv9LRGrs1f_iPwaPb66k4iY Cameron] MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).</ref><ref>Schabrun SM. Transcranial direct current stimulation: a place in the future of physiotherapy?. Physical Therapy Reviews. 2010 Aug 1;15(4):320-6.</ref>. Application of TENS electrodes to head is called Cranial Electrical Nerve Stimulation (CES) or transcranial stimulation and it is one of the methods used to stimulate the brain of a person with dementia<ref name=":0" />. Despite a recent evidence that CES alone or combine with physical therapy improves some functional activities in person with possible cognitive impairment<ref name=":1">Yotnuengnit P, Bhidayasiri R, Donkhan R, Chaluaysrimuang J, Piravej K. Effects of transcranial direct current stimulation plus physical therapy on gait in patients with Parkinson disease: a randomized controlled trial. American journal of physical medicine & rehabilitation. 2018 Jan 1;97(1):7-15.[https://journals.lww.com/ajpmr/FullText/2018/01000/Effects_of_Transcranial_Direct_Current_Stimulation.2.aspx]</ref>, trans-cranial electrical nerve stimulation is not a common practice among  physiotherapists who are one of the experts in managing person with dementia. This paper will therefore provide information on the CES method of application to stimulate the brain of a person with dementia.<br>
Although Transcutaneous electrical nerve stimulation is known for non-pharmacological pain control, some scholars showed that it might also be used for brain stimulation in person with  dementia<ref name=":0">[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004032/abstract?__cf_chl_jschl_tk__=825dbba406e2e362cb19738244ae7e0a475486a5-1581864188-0-AQ8RbL_QUahFu9b2bCRFWIkHcLgzgixv5JQTknus7P-t56OnEYoJstiRFPPBo2_YqT6WKd9PW8jnBarcvCYHvdKo7oGeGNg2jTyVpwRJH9AnIS_rbF_a7Hu_8zZZErO2n_3c7Xf2tB8YvxiogzhSUQtlB6miSWx2hOkIKvDd0P1OyxSOfm1q5nrJcebehPZDm1ZRH-NOsZYd-2BffKPueT1DrJBmwLrs4BbEUwd4EhpsS5BfagynqKkEy5yTN1JXk2yQlkx0L6BhAuR5ZyAJcoAyaHn7Yu6q9XaO-wWS_PqU9DXiUQrKfX_oq14gofSYjv9LRGrs1f_iPwaPb66k4iY Cameron MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).]</ref><ref>Schabrun SM. Transcranial direct current stimulation: a place in the future of physiotherapy?. Physical Therapy Reviews. 2010 Aug 1;15(4):320-6.</ref>. Application of TENS electrodes to head is called Cranial Electrical Nerve Stimulation (CES) or transcranial stimulation and it is one of the methods used to stimulate the brain of a person with dementia<ref name=":0" />. Despite a recent evidence that CES alone or combine with physical therapy improves some functional activities in person with possible cognitive impairment<ref name=":1">Yotnuengnit P, Bhidayasiri R, Donkhan R, Chaluaysrimuang J, Piravej K. Effects of transcranial direct current stimulation plus physical therapy on gait in patients with Parkinson disease: a randomized controlled trial. American journal of physical medicine & rehabilitation. 2018 Jan 1;97(1):7-15.[https://journals.lww.com/ajpmr/FullText/2018/01000/Effects_of_Transcranial_Direct_Current_Stimulation.2.aspx]</ref>, trans-cranial electrical nerve stimulation is not a common practice among  physiotherapists who are one of the experts in managing person with dementia. This paper will therefore provide information on the CES method of application to stimulate the brain of a person with dementia.<br>


== Dementia(Major Neurocognitive disorder)  ==
== Dementia(Major Neurocognitive disorder)  ==
DSM-5 detailed  on the definition and diagnosis of  neurocognitive disorders<ref name=":2">American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013 May 22.</ref>..Dementia now addressed as a major neurocognitive disorder according to DSM-5 on neurocognitive disorder, is an impairment in one or more cognitive domain with functional status impairment<ref name=":2" />, which is of concern to both patient and patient relative. A cognitive impairment without significant impact on the functional activities of the person with dementia is termed mild neurocognitive impairment.
DSM-5 detailed  on the definition and diagnosis of  neurocognitive disorders<ref name=":2">American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013 May 22.</ref>..Dementia now addressed as a major neurocognitive disorder according to DSM-5 on neurocognitive disorder, is an impairment in one or more cognitive domain with functional status impairment<ref name=":2" />, which is of concern to both patient and patient relative. A cognitive impairment without significant impact on the functional activities of the person with dementia is termed mild neurocognitive impairment.


Neuropsychological and behavioural characteristics such as anxiety, depression…and sleeping disturbances are prominent feature of dementia<ref>Burke AD, Goldfarb D, Bollam P, Khokher S. Diagnosing and Treating Depression in Patients with Alzheimer’s Disease. Neurology and therapy. 2019 Aug 1:1-26.[https://link.springer.com/article/10.1007/s40120-019-00148-5]</ref><ref>Müller-Spahn F. Behavioral disturbances in dementia. Dialogues in clinical neuroscience. 2003 Mar;5(1):49.[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181717/]</ref>. This characteristics including neurocognitive impairment might improve with trans cranial electrical nerve stimulation<ref>Cameron MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).[https://www.researchgate.net/publication/6286772_Transcutaneous_Electrical_Nerve_Stimulation_TENS_for_Dementia]</ref><ref>Das N, Spence JS, Aslan S, Vanneste S, Mudar R, Rackley A, Quiceno M, Chapman SB. Cognitive training and transcranial direct current stimulation in mild cognitive impairment: A randomized pilot trial. Frontiers in Neuroscience. 2019;13:307.[https://www.frontiersin.org/articles/10.3389/fnins.2019.00307/full]</ref><ref>[https://www.sciencedirect.com/science/article/pii/B9780124047044000028 Moreno-Duarte I, Gebodh N, Schestatsky P, Guleyupoglu B, Reato D, Bikson M, Fregni F. Transcranial electrical stimulation: transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial pulsed current stimulation (tPCS), and transcranial random noise stimulation (tRNS). InThe stimulated brain 2014 Jan 1 (pp. 35-59). Academic Press.]</ref>(Cameron 2003; '''''Moreno-Duarte;'''''). Scholars affirmed that TENS might stimulate brain and improve both the cognitive impairment and the neuropsychological characteristics of the dementia().
Neuropsychological and behavioural characteristics such as anxiety, depression…and sleeping disturbances are prominent feature of dementia<ref>Burke AD, Goldfarb D, Bollam P, Khokher S. Diagnosing and Treating Depression in Patients with Alzheimer’s Disease. Neurology and therapy. 2019 Aug 1:1-26.[https://link.springer.com/article/10.1007/s40120-019-00148-5]</ref><ref>Müller-Spahn F. Behavioral disturbances in dementia. Dialogues in clinical neuroscience. 2003 Mar;5(1):49.[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181717/]</ref>. This characteristics including neurocognitive impairment might improve with trans cranial electrical nerve stimulation<ref>Cameron MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).[https://www.researchgate.net/publication/6286772_Transcutaneous_Electrical_Nerve_Stimulation_TENS_for_Dementia]</ref><ref>Das N, Spence JS, Aslan S, Vanneste S, Mudar R, Rackley A, Quiceno M, Chapman SB. Cognitive training and transcranial direct current stimulation in mild cognitive impairment: A randomized pilot trial. Frontiers in Neuroscience. 2019;13:307.[https://www.frontiersin.org/articles/10.3389/fnins.2019.00307/full]</ref><ref name=":3">[https://www.sciencedirect.com/science/article/pii/B9780124047044000028 Moreno-Duarte I, Gebodh N, Schestatsky P, Guleyupoglu B, Reato D, Bikson M, Fregni F. Transcranial electrical stimulation: transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial pulsed current stimulation (tPCS), and transcranial random noise stimulation (tRNS). InThe stimulated brain 2014 Jan 1 (pp. 35-59). Academic Press.]</ref>. Scholars affirmed that TENS might stimulate brain and improve both the cognitive impairment and the neuropsychological characteristics of the dementia<ref name=":0" /><ref name=":0" />.


== '''Cognitive Impairment Assessment''' ==
== '''Cognitive Impairment Assessment''' ==
add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures. Evaluating the person with dementia requires standardised neuropsychological assessment tools. Among this tools, the most common one universally use is Mini Mental Status Examination () and for functional status, Functional Activities Questionnaire (FAQ) for older adults might be used ('''Ann M. Mayo'''). More so, this tools can be used to monitor the person with major neurocognitive impairment  progress on the intervention.
add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures. Evaluating the person with dementia requires standardised neuropsychological assessment tools. Among this tools, the most common one universally use is Mini Mental Status Examination<ref>[https://www.ncbi.nlm.nih.gov/pubmed/1202204 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975 Nov 1;12(3):189-98.]</ref>  and for functional status, Functional Activities Questionnaire (FAQ) for older adults might be used<ref>[https://consultgeri.org/try-this/dementia/issue-d13 Mayo AM. Use of the Functional Activities Questionnaire in older adults with dementia. Try This: Best Practices in Nursing Care to Older Adults with Dementia D. 2012;13.]</ref>. More so, this tools can be used to monitor the person with major neurocognitive impairment  progress on the intervention.


== '''Cranial Electrical Nerve Stimulation (CES) intervention''' ==
== '''Cranial Electrical Nerve Stimulation (CES) intervention''' ==
Using electrotherapy modalities like TENS requires assessment like skin sensation test to determine if the intervention will be appropriate. CES application requires several parameter based on the objectives to achieve in the person with dementia('''''Moreno-Duarte;''''' <ref>Peterchev AV, Wagner TA, Miranda PC, Nitsche MA, Paulus W, Lisanby SH, Pascual-Leone A, Bikson M. Fundamentals of transcranial electric and magnetic stimulation dose: definition, selection, and reporting practices. Brain stimulation. 2012 Oct 1;5(4):435-53.</ref>). . '''''Moreno-Duarte''''' affirmed that low level intensity transcranial electrical nerve stimulation is the major documented intensity level of CES application and there are four methods to this: transcranial direct current stimulation (tDCS), transcranial pulsed current stimulation (tPCS), transcranial alternating current stimulation(tACS), and transcranial random noise stimulation (tRNS)(see figure one for the summary of the parameters used by this authors. Although, there is still some controversial in the use of CES among person with dementia, yet there are supporting evidence that  using CES either combined with physiotherapy intervention  or not improves cognitive, physical activities and behavioural characteristics<ref name=":1" /><ref>Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke. Cochrane Database of Systematic Reviews. 2016(3).[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009645.pub3/abstract]</ref>
Using electrotherapy modalities like TENS requires assessment like skin sensation test to determine if the intervention will be appropriate. CES application requires several parameter based on the objectives to achieve in the person with dementia<ref name=":3" /> <ref>[https://www.ncbi.nlm.nih.gov/pubmed/22305345 Peterchev AV, Wagner TA, Miranda PC, Nitsche MA, Paulus W, Lisanby SH, Pascual-Leone A, Bikson M. Fundamentals of transcranial electric and magnetic stimulation dose: definition, selection, and reporting practices. Brain stimulation. 2012 Oct 1;5(4):435-53.]</ref> . '''''[https://www.ncbi.nlm.nih.gov/pubmed/22305345 Moreno-Duarte]''''' affirmed that low level intensity transcranial electrical nerve stimulation is the major documented intensity level of CES application and there are four methods to this: transcranial direct current stimulation (tDCS), transcranial pulsed current stimulation (tPCS), transcranial alternating current stimulation(tACS) and transcranial random noise stimulation (tRNS)(see figure 1 for the summary of the parameters used)<ref name=":3" />. Although, there is still some controversial in the use of CES among person with dementia, yet there are supporting evidence that  using CES either combined with physiotherapy intervention  or not improves cognitive, physical activities and behavioural characteristics<ref name=":1" /><ref>Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke. Cochrane Database of Systematic Reviews. 2016(3).[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009645.pub3/abstract]</ref>


== Resources  ==
== Resources  ==

Revision as of 19:57, 17 February 2020

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! 17/02/2020

Original Editor - Tolulope ADENIJI

Description[edit | edit source]

Although Transcutaneous electrical nerve stimulation is known for non-pharmacological pain control, some scholars showed that it might also be used for brain stimulation in person with  dementia[1][2]. Application of TENS electrodes to head is called Cranial Electrical Nerve Stimulation (CES) or transcranial stimulation and it is one of the methods used to stimulate the brain of a person with dementia[1]. Despite a recent evidence that CES alone or combine with physical therapy improves some functional activities in person with possible cognitive impairment[3], trans-cranial electrical nerve stimulation is not a common practice among physiotherapists who are one of the experts in managing person with dementia. This paper will therefore provide information on the CES method of application to stimulate the brain of a person with dementia.

Dementia(Major Neurocognitive disorder)[edit | edit source]

DSM-5 detailed  on the definition and diagnosis of  neurocognitive disorders[4]..Dementia now addressed as a major neurocognitive disorder according to DSM-5 on neurocognitive disorder, is an impairment in one or more cognitive domain with functional status impairment[4], which is of concern to both patient and patient relative. A cognitive impairment without significant impact on the functional activities of the person with dementia is termed mild neurocognitive impairment.

Neuropsychological and behavioural characteristics such as anxiety, depression…and sleeping disturbances are prominent feature of dementia[5][6]. This characteristics including neurocognitive impairment might improve with trans cranial electrical nerve stimulation[7][8][9]. Scholars affirmed that TENS might stimulate brain and improve both the cognitive impairment and the neuropsychological characteristics of the dementia[1][1].

Cognitive Impairment Assessment[edit | edit source]

add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures. Evaluating the person with dementia requires standardised neuropsychological assessment tools. Among this tools, the most common one universally use is Mini Mental Status Examination[10] and for functional status, Functional Activities Questionnaire (FAQ) for older adults might be used[11]. More so, this tools can be used to monitor the person with major neurocognitive impairment  progress on the intervention.

Cranial Electrical Nerve Stimulation (CES) intervention[edit | edit source]

Using electrotherapy modalities like TENS requires assessment like skin sensation test to determine if the intervention will be appropriate. CES application requires several parameter based on the objectives to achieve in the person with dementia[9] [12] . Moreno-Duarte affirmed that low level intensity transcranial electrical nerve stimulation is the major documented intensity level of CES application and there are four methods to this: transcranial direct current stimulation (tDCS), transcranial pulsed current stimulation (tPCS), transcranial alternating current stimulation(tACS) and transcranial random noise stimulation (tRNS)(see figure 1 for the summary of the parameters used)[9]. Although, there is still some controversial in the use of CES among person with dementia, yet there are supporting evidence that  using CES either combined with physiotherapy intervention  or not improves cognitive, physical activities and behavioural characteristics[3][13]

Resources[edit | edit source]

add appropriate resources here, including text links or content demonstrating the intervention or technique

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Cameron MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).
  2. ↑ Schabrun SM. Transcranial direct current stimulation: a place in the future of physiotherapy?. Physical Therapy Reviews. 2010 Aug 1;15(4):320-6.
  3. ↑ 3.0 3.1 Yotnuengnit P, Bhidayasiri R, Donkhan R, Chaluaysrimuang J, Piravej K. Effects of transcranial direct current stimulation plus physical therapy on gait in patients with Parkinson disease: a randomized controlled trial. American journal of physical medicine & rehabilitation. 2018 Jan 1;97(1):7-15.[1]
  4. ↑ 4.0 4.1 American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013 May 22.
  5. ↑ Burke AD, Goldfarb D, Bollam P, Khokher S. Diagnosing and Treating Depression in Patients with Alzheimer’s Disease. Neurology and therapy. 2019 Aug 1:1-26.[2]
  6. ↑ Müller-Spahn F. Behavioral disturbances in dementia. Dialogues in clinical neuroscience. 2003 Mar;5(1):49.[3]
  7. ↑ Cameron MH, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia. Cochrane Database of Systematic Reviews. 2003(3).[4]
  8. ↑ Das N, Spence JS, Aslan S, Vanneste S, Mudar R, Rackley A, Quiceno M, Chapman SB. Cognitive training and transcranial direct current stimulation in mild cognitive impairment: A randomized pilot trial. Frontiers in Neuroscience. 2019;13:307.[5]
  9. ↑ 9.0 9.1 9.2 Moreno-Duarte I, Gebodh N, Schestatsky P, Guleyupoglu B, Reato D, Bikson M, Fregni F. Transcranial electrical stimulation: transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial pulsed current stimulation (tPCS), and transcranial random noise stimulation (tRNS). InThe stimulated brain 2014 Jan 1 (pp. 35-59). Academic Press.
  10. ↑ Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975 Nov 1;12(3):189-98.
  11. ↑ Mayo AM. Use of the Functional Activities Questionnaire in older adults with dementia. Try This: Best Practices in Nursing Care to Older Adults with Dementia D. 2012;13.
  12. ↑ Peterchev AV, Wagner TA, Miranda PC, Nitsche MA, Paulus W, Lisanby SH, Pascual-Leone A, Bikson M. Fundamentals of transcranial electric and magnetic stimulation dose: definition, selection, and reporting practices. Brain stimulation. 2012 Oct 1;5(4):435-53.
  13. ↑ Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke. Cochrane Database of Systematic Reviews. 2016(3).[6]
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