United States Department of Veterans Affairs
MIRECC Centers

VISN 19 MIRECC Specialties: Complementary and Alternative Medicine

VISN 19 MIRECC
Complementary and Alternative Medicine Resources

Updated: 13 August 2012

 

Research Projects

Using Complementary and Alternative Medicine (CAM) to Promote Stress Resilience in Those with Co-Occurring Mild TBI and PTSD
Research Team: Theresa D. Hernández PhD, Lisa A. Brenner PhD
The research team hypothesizes that, similar to other populations, active acupressure treatments will help promote stress resilience, improve cognition and sleep, helping to reduce suicidal ideation and ultimately suicidal behavior. In addition to these potential functional benefits in Veterans, active acupressure is an independent, portable, safe and no-cost (once learned) intervention that is non-pharmacological and therefore has no side effects. The study aims to address a need (reducing military/Veteran suicidality) that has to date gone largely unmet, a need that is also currently a Department of Defense priority.
Keywords: Complementary and Alternative Medicine, Evidence-Based Treatments, Suicide Prevention
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Recent Publications (since 2009)

McFadden, K. L., Healy, K.M., Dettmann, M. L., Kaye, J. T., Ito, T. A., & Hernández, TD. (2011). Acupressure as a non-pharmacological intervention for traumatic brain injury (TBI). Journal of Neurotrauma, 28, 21-34.
Acupressure is a complementary and alternative medicine (CAM) treatment using fingertips to stimulate acupoints on the skin. Although suggested to improve cognitive function, acupressure has not been previously investigated with a controlled design in traumatic brain injury (TBI) survivors, who could particularly benefit from a non-pharmacological intervention for cognitive impairment. A randomized, placebo-controlled, single-blind design assessed the effects of acupressure (eight treatments over 4 weeks) on cognitive impairment and state of being following TBI, including assessment of event-related potentials (ERPs) during Stroop and auditory oddball tasks. It was hypothesized that active acupressure treatments would confer greater cognitive improvement than placebo treatments, perhaps because of enhanced relaxation response induction and resulting stress reduction. Significant treatment effects were found comparing pre- to post-treatment change between groups. During the Stroop task, the active-treatment group showed greater reduction in both P300 latency (p=0.010, partial η²=0.26) and amplitude (p=0.011, partial η²=0.26), as well as a reduced Stroop effect on accuracy (p=0.008, partial η²=0.21) than did the placebo group. Additionally, the active-treatment group improved more than did the placebo group on the digit span test (p=0.043, Cohen's d=0.68). Together, these results suggest an enhancement in working memory function associated with active treatments. Because acupressure emphasizes self-care and can be taught to novice individuals, it warrants further study as an adjunct treatment for TBI.
Keywords: Traumatic Brain Injury, Complementary and Alternative Medicine 
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McFadden KL, Hernández TD, Ito TA. Attitudes toward complementary and alternative medicine influence its use. Explore (NY). 2010 Nov-Dec;6(6):380-8.
OBJECTIVE: The aim of this study was to explore how attitudes toward complementary and alternative medicine (CAM) and conventional medicine influence CAM use in a healthy population, and how health locus of control and exercise further affect CAM use. DESIGN: A cross-sectional survey design was used. PARTICIPANTS: The sample consisted of 65 healthy graduate students. MAIN OUTCOME MEASURES: Since previous studies have focused on the attitudes of medical providers toward CAM, there are currently no standard, widely used measures of attitudes toward CAM from the perspective of the healthcare recipient. Thus, a new measure, the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS) was created to address how attitudes of healthcare recipients affect CAM use. The Multidimensional Health Locus of Control Scale (MHLC) was used to investigate effects of health locus of control on CAM use, and participants reported which of 17 listed CAM treatments they had used in the past, were currently using, or would likely use in the future. Participants also reported days of exercise in the past month to explore if those engaging in healthy behaviors might report more CAM use. RESULTS: Having a philosophical congruence with CAM and agreement with holistic balance was associated with increased CAM use. Dissatisfaction with conventional medicine was also related to increased CAM use, but to a lesser extent. Those attributing health to personal behaviors (an internal health locus of control) reported more CAM use, as did those engaging in more resistance training in the previous month.
Keywords: Complementary and Alternative Medicine 
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McFadden KL, Hernández TD. Cardiovascular benefits of acupressure (Jin Shin) following stroke. Complement Ther Med. 2010 Feb;18(1):42-8. Epub 2010 Feb 6.
OBJECTIVES: Acupressure, a complementary and alternative medicine (CAM) treatment, uses fingertips, rather than needles, to stimulate acupoints on the skin and has been implicated as a successful treatment for a variety of medical disorders. However, acupressure's underlying mechanisms remain unclear. One theory is that acupoint stimulation modulates autonomic nervous system activity. Previous studies have suggested that acupressure may positively affect heart rate and blood pressure. The current study investigated the effects of a type of acupressure, Jin Shin, on cardiovascular function in stroke survivors, a population that could especially benefit from a treatment promoting cardiovascular health. The study tested the hypothesis that active acupressure treatments would reduce heart rate and blood pressure (i.e., induce a greater relaxation response) above and beyond that seen during placebo acupressure treatments. METHODS: A randomised, placebo-controlled, single-blind crossover design was utilised, in which 16 participants received 8 weeks of either active or placebo acupressure followed by washout and crossover into the opposite treatment condition. Heart rate and blood pressure measurements were taken throughout treatments. RESULTS: Active acupressure treatments were associated with a significantly greater (p=.043, eta(2)=.30) and faster (p=.002, eta(2)=.76) reduction in heart rate compared to that seen during placebo treatments. No treatment effect on blood pressure was found. CONCLUSIONS: Active acupressure reduced heart rate significantly more than did placebo acupressure during treatments. Although no treatment effect on blood pressure was found, this could be due to 67% of participants taking antihypertensive medications during the study.
Keywords: Complementary and Alternative Medicine 
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Streeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., & Renshaw, P.F. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: A randomized controlled MRS study. Journal of Alternative & Complementary Medicine, 16(11), 1145-1152.
OBJECTIVES: Yoga and exercise have beneficial effects on mood and anxiety. γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders. The practice of yoga postures is associated with increased brain GABA levels. This study addresses the question of whether changes in mood, anxiety, and GABA levels are specific to yoga or related to physical activity. METHODS: Healthy subjects with no significant medical/psychiatric disorders were randomized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks. Mood and anxiety scales were taken at weeks 0, 4, 8, 12, and before each magnetic resonance spectroscopy scan. Scan 1 was at baseline. Scan 2, obtained after the 12-week intervention, was followed by a 60-minute yoga or walking intervention, which was immediately followed by Scan 3. RESULTS: The yoga subjects (n=19) reported greater improvement in mood and greater decreases in anxiety than the walking group (n=15). There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels. The yoga group had positive correlations between changes in mood scales and changes in GABA levels. CONCLUSIONS: The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise. This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety. It is also the first time that a behavioral intervention (i.e., yoga postures) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales. Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety, the reported correlations are in the expected direction. The possible role of GABA in mediating the beneficial effects of yoga on mood and anxiety warrants further study.
Keywords: Brain & Biology, Complementary and Alternative Medicine
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