Pulsed Transdermal Electrical Stimulation (pTES) involves the use of low voltage electric current to modulate nerves for therapeutic purposes.  pTES technology includes devices also known as Transcutaneuous Electrical Nerve Stimulation (TENS) and Cranial Electrotherapy Stimulation (CES).  These units are typically small, battery powered instruments that connect to the skin using two or more electrodes. Traditionally, TENS therapy has been used for the treatment of chronic pain while CES units has been used for relief from anxiety, improving sleep or reducing symptoms of depression.   Recent studies have demonstrated that pTES can also be used to modulate the trigeminal and the C2/C3 cervical nerves to suppress sympathetic nervous system activity to reduce stress, increase physiological relaxation and improve sleep quality. When compared to placebo, these studies have demonstrated:

  • Significant physiological stress response reduction by >30%
  • Significant decrease in alpha-amylase activity (stress biomarker) by >25%
  • Significant increase in vasodilation and skin temperature
  • Significant decrease in heart rate and galvanic skin responses to stressful stimuli
  • Significantly increase in relaxation
  • Significant improvement in quality of sleep
digital illustration neurons

The Locus Coeruleus (LC) and the Pedunculopontine nucleus (PPN) represent two major nuclei of the Reticular Activating System (RAS) that regulate attention, awareness and sleep/wake cycles. Afferent inputs from the sensory components of the trigeminal nerve branches project to the trigeminal sensory nuclear complex (TSNC), which in turn, has direct synaptic connections to the LC and PPN. It is therefore believed that pTES of the trigeminal nerve via high frequency, low intensity electrical waveforms can be used as a novel approach to reduce stress and improve sleep quality.

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