http://www.china.org.cn/world/2019-04/21/content_74705009.htm

The U.S. Food and Drug Administration (FDA) approved this week the first medical device to treat attention deficit hyperactivity disorder (ADHD) for children.

The device called the Monarch external Trigeminal Nerve Stimulation (eTNS) System is the first non-drug treatment for ADHD authorized for marketing by the FDA.

The prescription-only device is indicated for patients ages 7 to 12 years old who are not taking ADHD medication.

"This new device offers a safe, non-drug option for treatment of ADHD in pediatric patients through the use of mild nerve stimulation, a first of its kind," said Carlos Pena, director of the Division of Neurological and Physical Medicine Devices in the FDA's Center for Devices and Radiological Health.

ADHD is a common disorder that begins in childhood. ADHD patients have difficulty in staying focused and paying attention.

The cell-phone sized device generates a low-level electrical pulse and connects via a wire to a small patch that adheres to a patient's forehead, just above the eyebrows, according to FDA.

The device delivers the low-level electrical stimulation to the branches of the trigeminal nerve, sending therapeutic signals to the parts of the brain thought to be involved in ADHD.

Brain imaging showed that eTNS increases activity in the brain regions that are known to be important in regulating attention, emotion and behavior, but the exact mechanism of eTNS is not yet known.

The stimulation feels like a tingling sensation on the skin, and the device should be used in the home under the supervision of a caregiver during periods of sleep. Clinical trials suggest that a response to eTNS may take up to four weeks to become evident.

http://www.monarch-etns.com/faqs

Where was the treatment developed?

eTNS was invented by a team of doctors and researchers at the University of California, Los Angeles (UCLA). UCLA physicians were involved in some of the original studies of vagus nerve stimulation (VNS) for the treatment of epilepsy, and began to develop eTNS as a non-invasive alternative to VNS. eTNS has now been used for a decade in clinical studies at UCLA. NeuroSigma is making this treatment available to patients throughout the European Union and Canada.

How much does the Monarch eTNS System cost?

The Monarch eTNS System can be purchased directly from NeuroSigma. The starter kit is €800 and includes everything a patient needs to begin therapy and a 4-week supply of electric patches. Additional patches can be purchased from NeuroSigma for €5.

http://www.startribune.com/new-evidence-gets-mistrial-in-montana-senator-s-nephew-death/508860012/

SPOKANE, Wash. — The discovery of new evidence prompted a judge to declare a mistrial in the prosecution of a Spokane man charged with killing the nephew of U.S. Sen. Jon Tester of Montana in a sword attack, a newspaper reported.

Court records show a sheriff's detective found a text message in the case file while preparing to give testimony that had not been turned over to the defense, the Spokesman-Review in Spokane reported Friday.

John A. Radavich, 24, has pleaded not guilty to killing Robert J. Tester, 35, the senator's nephew, in the 2016 attack at the younger Tester's home in Spangle, Washington. Prosecutors have said Radavich was seeking revenge because he believed Tester had assaulted a 17-year-old girl that he had previously dated.

Radavich told the friend he had killed Tester because he believed Tester had assaulted his ex-girlfriend.

During the same recorded phone call, Radavich said the only other person he told of the killing was the former girlfriend.

"I needed her to help cover my tracks," Radavich said, the newspaper reported.

While preparing for his testimony, Spokane County sheriff's Detective Robert Satake found a text message the girlfriend had sent on the night of the killing to a man identified in court records as Christopher Santucci.

https://www.ncbi.nlm.nih.gov/pubmed/26818103

Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder.

Cook IA1,2,3,4, Abrams M1,2, Leuchter AF1,2.

Abstract 2016 Apr;19

OBJECTIVES:

External stimulation of the trigeminal nerve (eTNS) is an emerging neuromodulation therapy for epilepsy and depression. Preliminary studies suggest it has an excellent safety profile and is associated with significant improvements in seizures and mood. Neuroanatomical projections of the trigeminal system suggest eTNS may alter activity in structures regulating mood, anxiety, and sleep. In this proof-of-concept trial, the effects of eTNS were evaluated in adults with posttraumatic stress disorder (PTSD) and comorbid unipolar major depressive disorder (MDD) as an adjunct to pharmacotherapy for these commonly co-occurring conditions.

MATERIALS AND METHODS:

Twelve adults with PTSD and MDD were studied in an eight-week open outpatient trial (age 52.8 [13.7 sd], 8F:4M). Stimulation was applied to the supraorbital and supratrochlear nerves for eight hours each night as an adjunct to pharmacotherapy. Changes in symptoms were monitored using the PTSD Patient Checklist (PCL), Hamilton Depression Rating Scale (HDRS-17), Quick Inventory of Depressive Symptomatology (QIDS-C), and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q).

RESULTS:

Over the eight weeks, eTNS treatment was associated with significant decreases in PCL (p = 0.003; median decrease of 15 points; effect size d 1.5), HDRS-17 (p < 0.001; 42% response rate, 25% remission; d 2.1), and QIDS-C scores (p < 0.001; d 1.8), as well as an improvement in quality of life (Q-LES-Q, p < 0.01). eTNS was well tolerated with few treatment emergent adverse events.

CONCLUSIONS:

Significant improvements in PTSD and depression severity were achieved in the eight weeks of acute eTNS treatment. This novel approach to wearable brain stimulation may have use as an adjunct to pharmacotherapy in these disorders if efficacy and tolerability are confirmed with additional studies.

© 2016 International Neuromodulation Society.

Could be good news for vets with ptsd