Tourette syndrome (TS) is a disorder characterized by childhood onset multiple motor and vocal tics often accompanied by features of obsessive compulsive disorder, attention deficit hyperactivity disorder (ADHD), or other behavioral manifestations. Tics may be simple or complex, and may include motor and vocal components. Abnormal function of the basal ganglia is thought to be an important underlying cause of tics and other movement disorders. Treatment of TS requires a thorough understanding of the phenomenology of the disease for the individual patient, and should focus on symptoms that are especially troubling. Some nonpharmacologic approaches may help to improve tic severity, including conditioning techniques, relaxation training, and hypnosis. Options for pharmacotherapy include dopamine blockers and depleters, benzodiazepines, central alpha-adrenergic blockers, and botulinum toxin. Many patients require therapy for comorbid conditions such as anxiety, depression, or ADHD. In case studies and small patient series, deep brain stimulation has been shown to markedly reduce tic severity and functional impairment associated with TS. While onset is most frequently in childhood, TS should not be considered exclusively a disorder of pediatric patients. The complications and comorbidities that are encountered in children and adolescents often persist into adulthood.

Cleve Clin J Med. 2012 Jul;79 Suppl 2:S35-9. Galvez-Jimenez N. Department of Neurology, Chief, Movement Disorders Section, Cleveland Clinic Florida, Weston, FL 33331, USA. galvezn@ccf.org

by Tim Brunson PhD

It should be no surprise that our brain responds to novelty and surprise. This is because the neural centers that define our consciousness receive sufficient stimuli to be activated. However, what happens when our mind is lulled into complacency by routine sensory input? The answer is simple. It is ignored because this activation does not occur. Then there is no impact. Or, so we think.

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Assistant Professor, Department of Family Dentistry, The University of Iowa College of Dentistry, Iowa City, Iowa Private Practice of General Dentistry, Ankeny, Iowa Professor, Department of Pediatric Dentistry and Director of the Biostatistics Unit for the College of Dentistry Professor and Head, Department of Family Dentistry Biostatistician, Dows Institute for Dental Research, The University of Iowa College of Dentistry, Iowa City, Iowa Professor, Department of Internal Medicine, The University of Iowa College of Medicine, Iowa City, Iowa Associate Professor and Director of Dental Pharmacy, The University of Iowa College of Dentistry, Iowa City, Iowa.

This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population. More than three-quarters (76.1%) of the respondents reported using at least one CAM treatment in the past 12 months; 93.3% reported using at least one CAM treatment at some time in their lives. High rates of chiropractic use were found in this population. Tooth pain was the most frequently reported dental condition motivating CAM use. About 10% of dental school clinic patients use topical oral herbal and/or natural products to treat dental conditions, most frequently for preventive/oral health reasons or for tooth pain.

Spec Care Dentist. 2012 Sep;32(5):177-183. doi: 10.1111/j.1754-4505.2012.00273.x. Spector ML, Fischer M, Dawson DV, Holmes DC, Kummet C, Nisly NL, Baker KA.

Autism is a chronic neurodevelopmental disorder of unknown cause that affects approximately 1-3 percent of children and four times more boys than girls. Its prevalence is global and its social impact is devastating. In autism, the brain is unable to process sensory information normally. Instead, simple stimuli from the outside world are experienced as overwhelmingly intense and strain the emotional centers of the brain. A stress response to the incoming information is initiated that destabilizes cognitive networks and short-circuits adequate behavioral output. As a result, the child is unable to respond adequately to stimulation and initiate social behavior towards family, friends, and peers. In addition, these children typically face immune-digestive disorders that heighten social fears, anxieties, and internal conflicts. While it is critical to treat the physical symptoms, it is equally vital to offer an evidence-based holistic solution that harmonizes both their emotional and physical well-being as they move from childhood into adult life. Here, we summarize evidence from clinical studies and neuroscience research that suggests that an approach built on yogic principles and meditative tools is worth pursuing. Desired outcomes include relief of clinical symptoms of the disease, greater relaxation, and facilitated expression of feelings and skills, as well as improved family and social quality of life.

Autism Res Treat. 2012;2012:835847. Epub 2012 Jun 4. Sequeira S, Ahmed M. Office of Clinical Research, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.

Herbal remedies and dietary supplements have become an important area of research and clinical practice in orthopaedics and rheumatology. Understanding the risks and benefits of using herbal medicines in the treatment of arthritis, rheumatic diseases, and musculoskeletal complaints is a key priority of physicians and their patients. This review discusses the latest advances in the use of herbal medicines for treating osteoarthritis (OA) by focusing on the most significant trends and developments. This paper sets the scene by providing a brief introduction to ethnopharmacology, Ayurvedic medicine, and nutrigenomics before discussing the scientific and mechanistic rationale for targeting inflammatory signalling pathways in OA by use of herbal medicines. Special attention is drawn to the conceptual and practical difficulties associated with translating data from in-vitro experiments to in-vivo studies. Issues relating to the low bioavailability of active ingredients in herbal medicines are discussed, as also is the need for large-scale, randomized clinical trials.

Curr Rheumatol Rep. 2012 Sep 18. Mobasheri A. Musculoskeletal Research Group, School of Veterinary Medicine and Science, Faculty of Medicine and Health Sciences, The University of Nottingham, Sutton Bonington Campus, Sutton Bonington, LE12 5RD, UK, ali.mobasheri@nottingham.ac.uk.

Functional neuroimaging studies show that hypnosis affects attention by modulating anterior cingulate cortex activation and uncoupling conflict monitoring and cognitive control function. Considering functional changes in the activation of the occipital and temporal cortices, precuneus, and other extrastriate visual areas, which account for hypnosis-induced altered reality perception, the role of mental imagery areas appears to be central under hypnosis. This is further stressed by the fact that motor commands are processed differently in the normal conscious state, deviating toward the precuneus and extrastriate visual areas. Functional neuroimaging also shows that posthypnotic suggestions alter cognitive processes. Further research should investigate the effects of hypnosis on other executive functions and personality measures.

Int J Clin Exp Hypn. 2012 Jul;60(3):286-317. Del Casale A, Ferracuti S, Rapinesi C, Serata D, Sani G, Savoja V, Kotzalidis GD, Tatarelli R, Girardi P. University of Rome La Sapienza, School of Medicine and Psychology, NESMOS Department (Neurosciences, MentalHealth, and Sensory Organs), Saint Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy. antonio.delcasale@uniroma1.it

Previous studies showed that hypnotized individuals underestimate temporal intervals in the range of several seconds to tens of minutes. However, no previous work has investigated whether duration perception is equally disorderly when shorter time intervals are probed. In this study, duration perception of a hypnotic virtuoso was tested using repeated standard temporal generalization and duration estimation tasks. When compared to the baseline state, hypnosis affected perception of intervals spread around 600 ms in the temporal generalization task but did not alter perception of slightly longer intervals spread around 1000 ms. Furthermore, generalization of temporal intervals was more orderly under hypnosis than in the baseline state. In contrast, the hypnotic virtuoso showed a typical time underestimation effect when perception of longer supra-second intervals was tested in the duration estimation task, replicating results of the previous hypnosis studies.

Int J Clin Exp Hypn. 2012 Jul;60(3):318-37. Noreika V, Falter CM, Arstila V, Wearden JH, Kallio S. Centre for Cognitive Neuroscience, Department of Behavioural Sciences and Philosophy, University of Turku, Assistentinkatu 7, 20014 Turku, Finland. valnoreika@gmail.com

This is a clinical trial which aims to evaluate the efficiency of massage in the reduction of occupational low back pain, and its influence on the performance of work and life activities for the nursing team. The sample consisted of 18 employees who received seven to eight sessions after their work period. From the Numerical Pain Rating Scale, significant improvements were found between the 3rd and 1st evaluations (p=0.000) and between the 3rd and 2nd (p=0.004), using the Wilcoxon test. Regarding the Oswestry Disability Index, the paired t test showed a statistical difference (p=0.02) between the baseline, with a mean of 21.33% and the second evaluation (18.78%), which was also seen between the second and third evaluation (16.67%). The score for the Handling and Transfer Risk Evaluation Scale was 18 points (medium risk). It is concluded that massage was effective in reducing occupational low back pain, and provided improvement in activities of work and life. Clinical Trials Identifier: NCT01315197.

Rev Lat Am Enfermagem. 2012 Jun;20(3):511-9.Borges TP, Greve JM, Monteiro AP, Silva RE, Giovani AM, Silva MJ. Escola de Enfermagem, Universidade de São Paulo, Brazil.

Full title: Effect of oriental medicine music therapy on patients with Hwa-byung: a study protocol for a randomized controlled trial.

Hwa-byung, a Korean culture-bound syndrome with both psychological and somatic symptoms, is also known as 'anger syndrome'. It includes various physical symptoms including anxiety, a feeling of overheating, a sensation of pressure on the chest, heart palpitations, respiratory stuffiness, insomnia, and anxiety.Methods/designThe proposed study is a single-center, double-blind, randomized, controlled trial with two parallel arms: an oriental medicine music therapy (OMMT) group and a control music therapy (CMT) group. In total, 18 patients will be enrolled into the trial. The first visit will be the screening visit. At baseline (visit 2), all participants fulfilling both the inclusion and the exclusion criteria will be split and randomly divided into two equal groups: the OMMT and the CMT (n = 24 each). Each group will receive treatment sessions over the course of 4 weeks, twice per week, for eight sessions in total. The primary outcome is the State-Trait Anxiety Inventory (STAI), and the secondary outcomes are the Hwa-byung scale (H-scale), the Center for Epidemiologic Studies Depression Scale (CES-D), the Hwa-byung visual analogue scale (H-VAS) for primary symptoms, the World Health Organization Quality of Life scale, brief version (WHOQOL-BREF), and levels of salivary cortisol. Patients will be asked to complete questionnaires at the baseline visit (visit 2), after the last treatment session (visit 9), and at 4 weeks after the end of all trial sessions (visit 10). From the baseline (visit 2) through the follow-up (visit 10), the entire process will take a total of 53 days. DISCUSSION: This proposed study targets patients with Hwa-byung, especially those who have exhibited symptoms of anxiety. Therefore, the primary outcome is set to measure the level of anxiety. OMMT is music therapy combined with traditional Korean medicinal theories. Unlike previously reported music therapies, for which patients simply listen to music passively, in OMMT, patients actively move their bodies and play the music. Because Hwa-byung is caused by an accumulation of blocked emotions and anger inside the body, OMMT, because of its active component, is expected to be more efficacious than pre-existing music therapies.Trial registrationCurrent Controlled Trials ISRCTN11939282.

Trials. 2012 Sep 11;13(1):161. Park JS, Park S, Cheon CH, Jang BH, Lee SH, Chung SY, Kim JW, Jeon CY, Park JH, Shin YC, Ko SG.

Full title: Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell's palsy.

To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis. The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The authors gave acupuncture treatment according to the state of the disease without artificially setting the treatment period. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process. Fifty-three cases out of 68 patients with Bell's palsy were cured and the overall rate of efficacy was 97%. Statistically significant differences (P<0.01) were perceived among the efficacy of five levels of facial nerve dysfunction. Efficacy was correlated with the damage level of the disease (correlation coefficient r=0.423, P<0.01). The course of treatment also extended with the severity of facial nerve dysfunction (P<0.01). Differences exist in patients with Bell's palsy in terms of severity of facial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease.

Zhong Xi Yi Jie He Xue Bao. 2012 Sep;10(9):997-1002. Zhou ZL, Li CX, Jiang YB, Zuo C, Cai Y, Wang R. Department of Acupuncture and Moxibustion, General Hospital of the People's Liberation Army, Beijing 100853, China; E-mail: zhouzhangling@sina.com.

Paul is a lifetime New Englander, a registered nurse with ten years of medical experience and a leader in the field of clinical hypnosis. His work has been published, he's been a regular guest on WBZ radio, been featured on TV's Chronicle and hosts his own cable television program called Healthy Hypnosis.

Paul is trained in medical, metaphysical and regression hypnosis and is a certified specialist in treating symptoms of irritable bowel syndrome. He is a member of the National Guild of Hypnotists and does annual continuing education to maintain his training at a high level.

From his Burlington, MA office Paul assists clients with weight loss, smoking, irritable bowel syndrome, public speaking, pain, stress, hypertension, fear of flying, test anxiety, alcohol excess, surgical hypnosis, skin conditions such as psoriasis and warts, emotional trauma, phobias, sales, attitude, past life regression, motivation and more.

For more information, please visit http://burlingtonhypnosis.com/.

Labour is a normal physiological process, but is usually associated with pain and discomfort. Numerous methods are used to relieve labour pain. These include pharmacological (e.g. epidural, opioids, inhaled analgesia) and non-pharmacological (e.g. hypnosis, acupuncture) methods of pain management. Non-opioid drugs are a pharmacological method used to control mild to moderate pain. To summarise the evidence regarding the effects and safety of the use of non-opioid drugs to relieve pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised controlled trials (RCTs) using non-opioid drugs (non-steroidal anti-inflammatory drugs (NSAIDs); paracetamol; antispasmodics; sedatives and antihistamines) in comparison with placebo or standard care; different forms of non-opioid drugs (e.g. sedatives versus antihistamines); or different interventions (e.g. non-opioids versus opioids) for women in labour. Quasi-RCTs and trials using a cross-over design were not included. Cluster-randomised RCTs were eligible for inclusion but none were identified for inclusion. Two review authors independently assessed for inclusion all studies identified by the search strategy, carried out data extraction and assessed risk of bias. We resolved any disagreement through discussion with a third author. Data were checked for accuracy. Nineteen studies randomising a total of 2863 women were included in this review. There were three main comparison groups: 15 studies compared non-opioid drugs with placebo or no treatment (2133 women); three studies compared non-opioid drugs with opioids (563 women); and three studies compared one type of non-opioid drug with a different type or dose of non-opioid drug (590 women). Some of the studies included three or more groups and so have been put in more than one comparison. Overall, there was little difference between groups for most of the comparisons. Any differences observed for outcomes were mainly limited to one or two studies. Non-opioid drugs (sedatives) were found to offer better pain relief (mean difference (MD) -22.00; 95% confidence interval (CI) -35.86 to -8.14, one trial, 50 women), better satisfaction with pain relief (sedatives and antihistamines) (risk ratio (RR) 1.59; 95% CI 1.15 to 2.21, two trials, 204 women; RR 1.80; 95% CI 1.16 to 2.79, one trial, 223 women) and better satisfaction with the childbirth experience (RR 2.16; 95% CI 1.34 to 3.47, one trial, 40 women) when compared with placebo or no treatment. However, women having non-opioid drugs (NSAIDs or antihistamines) were less likely to be satisfied with pain relief compared with women having opioids (RR 0.50; 95% CI 0.27 to 0.94, one trial, 76 women; RR 0.73; 95% CI 0.54 to 0.98, one trial, 223 women). Women receiving the antihistamine hydroxyzine were more likely to express satisfaction with pain relief compared with the antihistamine promethazine (RR 1.21; 95% CI 1.02 to 1.43, one trial, 289 women). Women receiving sedatives were more likely to express satisfaction with pain relief compared with antihistamines (RR 1.52; 95% CI 1.06 to 2.17, one study, 157 women). The majority of studies were conducted over 30 years ago. The studies were at unclear risk of bias for most of the quality domains.Opioids appear to be superior to non-opioids in satisfaction with pain relief, while non-opioids appear to be superior to placebo for pain relief and satisfaction with the childbirth experience. There were little data and no evidence of a significant difference for any of the comparisons of non-opioids for safety outcomes. Overall, the findings of this review demonstrated insufficient evidence to support a role for non-opioid drugs on their own to manage pain during labour.

Cochrane Database Syst Rev. 2012 Jul 11;7:CD009223. Othman M, Jones L, Neilson JP. Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK. mothman12399@yahoo.com.

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications. To identify and review all relevant data to determine the effects of TT on healing acute wounds. For this fourth update, we searched The Cochrane Wounds Group Specialised Register (searched 27 January 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1); Ovid MEDLINE (2010 to January Week 2 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, January 26, 2012); Ovid EMBASE (2010 to 2012 Week 03); and EBSCO CINAHL (2010 to January 6 2012). All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria. No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias. There is no robust evidence that TT promotes healing of acute wounds.

Cochrane Database Syst Rev. 2012 Jun 13;6:CD002766. O'Mathúna DP, Ashford RL. School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland. donal.omathuna@dcu.ie

Arthritis is considered the leading cause of disability among adults in the United States today and contributes substantially to the rising cost of health care. Residents of rural areas are especially affected. The purposes of this article are to describe chiropractic use by rural and nonrural individuals with arthritis and to identify differences in other health care use and health status by those using chiropractic care plus conventional care or conventional care alone. A longitudinal cohort from panel 12 (N = 12440) of the Medical Expenditure Panel Survey spanning 2007 to 2008 was selected for this study to represent changes in health care expenditures and use and outcomes throughout this period. The population was stratified by self-reported physician-diagnosed arthritis and rural status and compared across demographics, health status, and health care use and expenditures, including use of chiropractic services plus conventional care or conventional care alone. Twice as many rural people with arthritis had 1 or more visits with a doctor of chiropractic compared with nonrural persons with arthritis. More rural chiropractic users with arthritis reported their perceived health status as excellent, very good, or good compared with nonrural chiropractic users with arthritis and to rural people with arthritis who reported no chiropractic visits. Health care expenditures for other physician services were higher among rural chiropractic users with arthritis than nonrural users with arthritis. Differences in chiropractic use were observed between rural and nonrural individuals with arthritis. More studies are needed to investigate these differences and the impact on health care use and expenditures and outcomes of individuals with arthritis.

J Manipulative Physiol Ther. 2012 Aug 27. Enyinnaya EI, Anderson JG, Merwin EI, Taylor AG. Postdoctoral Research Fellow, Center for the Study of Complementary and Alternative Therapies, School of Nursing, University of Virginia, Charlottesville, VA.

Full title: Evidence and potential mechanisms for mindfulness practices and energy psychology for obesity and binge-eating disorder.

Obesity is a growing epidemic. Chronic stress produces endocrine and immune factors that are contributors to obesity's etiology. These biochemicals also can affect appetite and eating behaviors that can lead to binge-eating disorder. The inadequacies of standard care and the problem of patient noncompliance have inspired a search for alternative treatments. Proposals in the literature have called for combination therapies involving behavioral or new biological therapies. This manuscript suggests that mind-body interventions would be ideal for such combinations. Two mind-body modalities, energy psychology and mindfulness meditation, are reviewed for their potential in treating weight loss, stress, and behavior modification related to binge-eating disorder. Whereas mindfulness meditation and practices show more compelling evidence, energy psychology, in the infancy stages of elucidation, exhibits initially promising outcomes but requires further evidence-based trials.

Explore (NY). 2012 Sep;8(5):271-6. Sojcher R, Gould Fogerite S, Perlman A. Institute for Complementary and Alternative Medicine, School of Health-Related Professions, University of Medicine and Dentistry of New Jersey, Newark, NJ.

Congenital adrenal hyperplasia (CAH) is a well-characterised family of disorders of the adrenal cortices, resulting in varying degrees of cortisol, aldosterone and androgen deficiency or androgen excess, depending on the enzyme(s) affected and the degree of quantitative or functional enzyme deficit. Withania somnifera (WS), commonly known as Ashwagandha, is a medicinal plant that has been employed for centuries in ayurvedic medicine. Preclinical studies have shown that WS increases circulating cortisol levels and improves insulin sensitivity. We report the case of a 57-year-old woman with non-classical adrenal hyperplasia due to both 3-ß-ol dehydrogenase deficiency and aldosterone synthase deficiency who was self-treated with WS for 6 months. After 6 months of treatment her serum 18-OH-hydroxycorticoserone, 17-OH-pregnenolone, corticosterone and 11-deoxycortisol decreased by 31%, 66%, 69% and 55%, respectively. The biochemical improvement was accompanied by a noticeable reduction in scalp hair loss.

BMJ Case Rep. 2012 Sep 17;2012. pii: bcr2012006989. doi: 10.1136/bcr-2012-006989. Kalani A, Bahtiyar G, Sacerdote A. Department of Internal Medicine, Woodhull Medical Center, Brooklyn, New York, USA.

Dyslexia (or developmental dyslexia or specific reading disability) is a specific learning disorder that has a neurobiological origin. It is marked by difficulties with accurate or fluent recognition of words and poor spelling in people who have average or above average intelligence and these difficulties cannot be attributed to another cause, for example, poor vision, hearing difficulty, or lack of socio-environmental opportunities, motivation, or adequate instruction. Studies have correlated reading skills with musical abilities. It has been hypothesized that musical training may be able to remediate timing difficulties, improve pitch perception, or increase spatial awareness, thereby having a positive effect on skills needed in the development of language and literacy. To study the effectiveness of music education on reading skills (that is, oral reading skills, reading comprehension, reading fluency, phonological awareness, and spelling) in children and adolescents with dyslexia. We searched the following electronic databases in June 2012: CENTRAL (2012, Issue 5), MEDLINE (1948 to May Week 4 2012 ), EMBASE (1980 to 2012 Week 22), CINAHL (searched 7 June 2012), LILACS (searched 7 June 2012), PsycINFO (1887 to May Week 5 2012), ERIC (searched 7 June 2012), Arts and Humanities Citation Index (1970 to 6 June 2012), Conference Proceedings Citation Index - Social Sciences and Humanities (1990 to 6 June 2012), and WorldCat (searched 7 June 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and reference lists of studies. We did not apply any date or language limits. We planned to include randomized controlled trials. We looked for studies that included at least one of our primary outcomes. The primary outcomes were related to the main domain of the reading: oral reading skills, reading comprehension, reading fluency, phonological awareness, and spelling, measured through validated instruments. The secondary outcomes were self esteem and academic achievement. Two authors (HCM and RBA) independently screened all titles and abstracts identified through the search strategy to determine their eligibility. For our analysis we had planned to use mean difference for continuous data, with 95% confidence intervals, and to use the random-effects statistical model when the effect estimates of two or more studies could be combined in a meta-analysis. We retrieved 851 references via the search strategy. No randomized controlled trials testing music education for the improvement of reading skills in children with dyslexia could be included in this review. There is no evidence available from randomized controlled trials on which to base a judgment about the effectiveness of music education for the improvement of reading skills in children and adolescents with dyslexia. This uncertainty warrants further research via randomized controlled trials, involving a interdisciplinary team: musicians, hearing and speech therapists, psychologists, and physicians.

Cochrane Database Syst Rev. 2012 Aug 15;8:CD009133. Cogo-Moreira H, Andriolo RB, Yazigi L, Ploubidis GB, Brandão de Ávila CR, Mari JJ. Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil. hugocogobr@gmail.com.

Complementary and alternative medicine (CAM) is commonly used by persons with stroke throughout the world, particularly in Asia. Objective: The objectives of this study were to determine the frequency of CAM use and the factors that predict the use of CAM in stroke patients. Methods: This study was carried out in the stroke units of Christian Medical College, Ludhiana, and Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, from June 2010 to December 2010. Participants were interviewed using a structured questionnaire (=6 months post stroke). Outcomes were assessed using a modifi ed Rankin Scale (mRS). Results: Three hundred fourteen stroke patients were interviewed; mean age was 57.4 ± 12.9 years, and 230 (73.2%) patients were men. Of 314 patients, 114 (36.3%) had used the following CAM treatments: ayurvedic massage, 67 (59.3%); intravenous fl uids, 22 (19.5%); herbal medicines, 17 (15%); homeopathy, 15 (13.3%); witchcraft, 3 (2.7%); acupuncture, 3 (2.7%); opium intake, 10 (8.8%); and other nonconventional treatments, 10 (8.8%). Patients with severe stroke (P < .0001), limb weakness (P < .0001), dysphagia (P = .02), dyslipidemia (P = .007), hypertension (P = .03), or hemorrhagic stroke (P<.0001) and patients with poor outcome (mRS >2;P < .0001) often used CAM treatments. Conclusion: More than one-third of the patients in this study opted for CAM. Presence of limb weakness, dysphagia, dyslipidemia, hypertension, hemorrhagic stroke, severe stroke, and poor outcome predicted the use of CAM.

Top Stroke Rehabil. 2012 Sep-Oct;19(5):384-94. Pandian JD, Toor G, Arora R, Kaur P, Dheeraj KV, Bhullar RS, Sylaja PN. Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.

This study proposes an adaptive control architecture based on an accurate regression method called Locally Weighted Projection Regression (LWPR) and on a bio-inspired module, such as a cerebellar-like engine. This hybrid architecture takes full advantage of the machine learning module (LWPR kernel) to abstract an optimized representation of the sensorimotor space while the cerebellar component integrates this to generate corrective terms in the framework of a control task. Furthermore, we illustrate how the use of a simple adaptive error feedback term allows to use the proposed architecture even in the absence of an accurate analytic reference model. The presented approach achieves an accurate control with low gain corrective terms (for compliant control schemes). We evaluate the contribution of the different components of the proposed scheme comparing the obtained performance with alternative approaches. Then, we show that the presented architecture can be used for accurate manipulation of different objects when their physical properties are not directly known by the controller. We evaluate how the scheme scales for simulated plants of high Degrees of Freedom (7-DOFs).

Biol Cybern. 2012 Oct;106(8-9):507-22. Epub 2012 Aug 21. Tolu S, Vanegas M, Luque NR, Garrido JA, Ros E. CITIC-Department of Computer Architecture and Technology, ETSI Informática y de Telecomunicación, University of Granada, Granada, Spain, stolu@atc.ugr.es.

A book review by Tim Brunson, PhD

Although many times a person needs professional help when addressing life's challenges, it is indeed possible for a person to embark on a self-help journey – provided that they have the correct tools. In Why do I Keep Doing This!!?: End Bad Habits, Negativity and Stress with Self-Hypnosis and NLP Judith E. Pearson, PhD, presents readers with a comprehensive, well-communicated, and effective guide. She addresses sixteen specific issues, most of which are very common to people in the western world.

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Jean Fain is a licensed psychotherapist and a certified hypnotherapist. She has trained in several therapeutic approaches, all of which fall under the umbrella of behavioral medicine or mind-body medicine. Hers is an integrative approach that combines cognitive-behavioral therapy and psychodynamic psychotherapy, among other schools of therapy.

Jean has an appointment with the Department of Psychiatry at Harvard Medical School. Through the Behavioral Medicine Department at the Cambridge Health Alliance, a teaching affiliate of Harvard Medical School, she teaches and supervises professionals and advanced trainees in hypnosis.

She got my BA in English Literature from Brandeis University; her MSW from Simmons School for Social Work. She has practiced psychotherapy for the last 15 years in a variety of settings, including state prisons, community mental health centers, public hospitals and private practice. Currently, I see clients solely at my Concord, Massachusetts, private practice.

Jean is licensed to practice psychotherapy in Massachusetts as a licensed independent clinical social worker (LICSW). She is a member of the National Association of Social Workers, the Society for Clinical and Experimental Hypnosis, and the New England Society for Clinical Hypnosis. As a hypnotherapist, Jean is certified by the American Society for Clinical Hypnosis, the major association for practicing hypnotherapists founded by Milton Erickson.

For more information, please visit http://www.jeanfain.com/

Full title: The mirror neuron system under hypnosis - Brain substrates of voluntary and involuntary motor activation in hypnotic paralysis.

The neurobiological basis of non-organic movement impairments is still unknown. As conversion disorder and hypnotic states share many characteristics, we applied an experimental design established in conversion disorder to investigate hypnotic paralysis. Movement imitation and observation were investigated by functional magnetic resonance imaging (fMRI) in 19 healthy subjects with and without hypnotically induced paralysis of their left hand. Paralysis-specific activation changes were explored in a multivariate model and functional interdependencies of brain regions by connectivity analysis. Hypnotic paralysis during movement imitation induced hypoactivation of the contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum and increased activation of anterior cingulate cortex (ACC), frontal gyrus and insula. No paralysis-specific effects were revealed during movement observation. Hyperactivation of ACC, middle frontal gyrus (MFG), and insula might reflect attention (MFG), conflict-detection (ACC) and self-representation processes (insula) during hypnotic paralysis. The lack of effects in movement observation suggests that early motor processes are not disturbed due to the transient nature of the hypnotic impairment.

Cortex. 2012 Jun 20. [Epub ahead of print] Burgmer M, Kugel H, Pfleiderer B, Ewert A, Lenzen T, Pioch R, Pyka M, Sommer J, Arolt V, Heuft G, Konrad C. Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.

by Tim Brunson PhD

There are many myths about hypnotizability. The first one that I encounter is that gullible and less intelligent individuals are more susceptible to being hypnotized. And secondly, some individuals believe that they cannot be hypnotized. The truth is that normally the person who has more intelligence, i.e., is more cognizant of his or her mental processes, is more likely to be willingly placed into a trance by a hypnosis operator. Likewise, since (to use a simplification of the generally accepted – by the AMA and APA – definition of hypnosis as an "altered state") hypnosis is generally any state other than that represented by full awareness (Beta brain wave frequency) and sleep (Delta brain wave frequency) it is obvious that to be human is to be capable of being hypnotized. Obviously, there must be a state between full concentration and awareness and the sleep state. Therefore, anyone can be hypnotized!

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This case study reported the conservative management of a patient presenting with left sided low back and leg pain diagnosed as a left sided L5-S1 disc prolapse/herniation. A 31-year-old male recreational worker presented with left sided low back and leg pain for the previous 3-4 months that was exacerbated by prolonged sitting. The plan of management included interferential current, soft tissue trigger point and myofascial therapy, lateral recumbent manual low velocity, low amplitude traction mobilizations and pelvic blocking as necessary. Home care included heat, icing, neural mobilizations, repeated extension exercises, stretching, core muscle strengthening, as well as the avoidance of prolonged sitting and using a low back support in his work chair. The patient responded well after the first visit and his leg and back pain were almost completely resolved by the third visit. Conservative chiropractic care appears to reduce pain and improve mobility in this case of a L5-S1 disc herniation. Active rehabilitative treatment strategies are recommended before surgical referral.

J Can Chiropr Assoc. 2012 Sep;56(3):225-32. Howell ER. Ashbridge's Health Centre, 1522 Queen St. East, Toronto, ON M4L 1E3. E-mail: dremilyhowell@hotmail.com .

According to the World Health Organization (WHO), stress-related chronic diseases are the main source of death in developed countries. During the last decade, e-mental health, telepsychology or telepsychiatry interventions are showing its growing potential due to the gradual global adoption of the internet and mobile phone technologies. A significant number of studies have concluded that mindfulness helps to reduce physical and psychological symptoms of stress related to various health concerns and that it is a psychological skill that can be trained. The purpose of this online research study is to gather the participants' socio-demographics as well as stress and mindfulness data during an online mindfulness training program. Sustained attention and the state of mindfulness experienced in single meditation sessions are also tracked and stored. Correlational analysis yielded to a statistically significant relationship between high scores in stress and low scores in mindfulness facets (p < .001) and between state and trait aspects of mindfulness (p < .01).

Stud Health Technol Inform. 2012;181:143-8. Quintana M, Rivera O. Complutense University of Madrid.

Ayurveda, an ancient medical science originating in India, also is practiced in the United States. The authors conducted a study primarily to explore the involvement of ayurvedic practitioners in treating oral diseases. Eighty-five practitioners participated in this cross-sectional survey. The authors obtained self-reported data on demographics of the practitioners, the general and oral health conditions they treated, and the treatment modalities used. They performed descriptive statistical and logistic regression analyses by using statistical software. Participants predominantly were female and white or non-Hispanic, as well as part-time practitioners. Their educational backgrounds ranged from a 5½-year bachelor's degree in ayurveda to short-term training. Of the 60 respondents who answered the question about treating oral diseases, 25 (42 percent) reported that they did so. Conditions treated were related to oral malodor, gingival or periodontal disease and toothache. Ayurvedic treatments administered for these conditions primarily were preventive in nature. Ayurvedic practitioners in the United States treat a variety of oral diseases by using predominantly preventive traditional care. Ayurvedic practitioners of Asian origin and those who practiced for a longer duration were more likely to report that they treated oral diseases. Larger, population-based studies are needed to understand more fully the current role of ayurvedic practitioners in oral health care. Ayurvedic treatment modalities aimed at oral diseases need to be evaluated through rigorous randomized controlled trials for safety and effectiveness. Practice Implications Patients with limited or no access to oral health care might seek ayurvedic treatment, and those who have access to conventional oral health care might wish to complement it with ayurvedic treatment. Practitioners can incorporate preventive ayurvedic treatments, which are based mainly on natural products, into overall preventive care regimens, if proven safe and effective.

J Am Dent Assoc. 2012 Oct;143(10):1120-6. Brar BS, Norman RG, Dasanayake AP. Dr. Brar is a junior research scientist, Department of Epidemiology and Health Promotion, College of Dentistry, New York University, 250 Park Ave. South, 6th Floor, New York, N.Y. 10003, bsb276@nyu.edu.

After rapid hypnotic induction, 12 healthy volunteers underwent hypnotic deepening with relaxation or with fractionation (without relaxation) in a random latin-square protocol. Electroencephalographic occipital alpha activity was measured, low-resolution brain electromagnetic tomography was performed, and hemodynamics (stroke volume, heart rate, cardiac output, mean arterial blood pressure, forearm arterial flow and resistance) were monitored in basal conditions and after deepening. After relaxation, both forearm flow (-18%) and blood pressure (-4%) decreased; forearm resistance remained unchanged. After fractionation, a forearm flow decrease comparable to that recorded after relaxation was observed, but blood pressure remained unchanged, leading to an increase of forearm resistance (+51%). Central hemodynamics did not change. Alpha activity increased in the precuneus after fractionation only. In conclusion, both relaxation and fractionation have vasoconstrictor effects, but fractionation is also associated with an increase in peripheral resistance.

Int J Clin Exp Hypn. 2012 Jul;60(3):338-55. Casiglia E, Tikhonoff V, Giordano N, Regaldo G, Facco E, Marchetti P, Schiff S, Tosello MT, Giacomello M, Rossi AM, De Lazzari F, Palatini P, Amodio P. Department of Medicine, University of Padova and Italian Centre for Clinical and Experimental Hypnosis, Torino, Italy. edoardo.casiglia@unipd.it

Full title: Group music therapy for patients with persistent post-traumatic stress disorder - an exploratory randomized controlled trial with mixed methods evaluation.

Objectives. Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. Design. The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Method. Patients with significant PTSD symptoms (n= 17) following completion of CBT were randomly assigned to treatment (n= 9) or control groups (n= 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Results. Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (-20.18; 95% confidence interval [CI]: [-31.23, -9.12]) and a marginally significant reduction in depression (-11.92; 95%CI: [-24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Conclusions. Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment.

Psychol Psychother. 2012 Jun;85(2):179-202. doi: 10.1111/j.2044-8341.2011.02026.x. Epub 2011 Jun 20. Carr C, d'Ardenne P, Sloboda A, Scott C, Wang D, Priebe S. East London Foundation NHS Trust, London, UK Unit for Social and Community Psychiatry, Queen Mary, University of London Guildhall School of Music & Drama, London, UK London School of Hygiene and Tropical Medicine, London, UK.

Full Title: Efficacy of acupuncture for chronic knee pain: protocol for a randomised controlled trial using a Zelen-design randomised controlled trial.

Chronic knee pain is a common and disabling condition in people over 50 years of age, with knee joint osteoarthritis being a major cause. Acupuncture is a popular form of complementary and alternative medicine for treating pain and dysfunction associated with musculoskeletal conditions. This pragmatic Zelen-design randomised controlled trial is investigating the efficacy and cost-effectiveness of needle and laser acupuncture, administered by medical practitioners, in people with chronic knee pain. Two hundred and eighty two people aged over 50 years with chronic knee pain have been recruited from metropolitan Melbourne and regional Victoria, Australia. Participants originally consented to participate in a longitudinal natural history study but were then covertly randomised into one of four treatment groups. One group continued as originally consented (ie natural history group) and received no acupuncture treatment. The other three were treatment groups: i) laser acupuncture, ii) sham laser or, iii) needle acupuncture. Acupuncture treatments used a combined Western and Traditional Chinese Medicine style, were delivered by general practitioners and comprised 8--12 visits over 12 weeks. Follow-up is currently ongoing. The primary outcomes are pain measured by an 11-point numeric rating scale (NRS) and self-reported physical function measured by the Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index subscale at the completion of treatment at 12 weeks. Secondary outcomes include quality of life, global rating of change scores and additional measures of pain (other NRS and WOMAC subscale) and physical function (NRS). Additional parameters include a range of psychosocial measures in order to evaluate potential relationships with acupuncture treatment outcomes. Relative cost-effectiveness will be determined from health service usage and outcome data. Follow-up assessments will also occur at 12 months. The findings from this study will help determine whether laser and/or needle acupuncture is efficacious, and cost-effective, in the management of chronic knee pain in older people.

BMC Complement Altern Med. 2012 Sep 19;12(1):161. Hinman RS, McCrory P, Pirotta M, Relf I, Crossley KM, Reddy P, Forbes A, Harris A, Metcalf BR, Kyriakides M, Novy K, Bennell KL.

by Tim Brunson PhD

If you use hypnosis, hypnotherapy or NLP in your practice, there are people and organizations out there who want to permanently shut you down! Even if you're a coach or consultant and not a hypnotherapist, if you ask someone to visualize a certain state of accomplishment – especially if they become glassy-eyed or shed a tear or two – someone may complain that you are practicing hypnosis and find a law somewhere that will justify incessant criminal or civil prosecution. Imagine helping someone improve their golf swing and then finding out that you have tens of thousands of dollars in legal fees and may lose your right to practice. And, if you already have a mental health or medical license, don't think you are immune from persecution. Many authorities in those fields routinely use their ignorance of hypnosis to ban its use and would like to see any of their colleagues who cross the line permanently banned from practicing. Licensees who so ardently study the ways of the late Milton Erickson, MD, need not to be reminded that the good doctor's license was once threatened because he dared to use any form of hypnosis in psychiatry.

Recently I was asked to make a statement as an expert in this field so that I could support the defense of Zoilita Grant, a friend and colleague for which I have great respect. She also asked for help from Michael Ellner and Tony De Marco, two practitioners who I rate as being among the best in the world. It appears that Zoilita has been unjustly targeted by the Colorado Mental Health Board. They incorrectly claim that all hypnosis is either stage hypnosis or psychotherapy. Somehow they also found an "expert" witness who was willing – probably for a fee – to support their claim. (Michael, Tony, and I were not compensated for our support.)

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Erik Bragg is a professional hypnotist and received his training at The Hypnotherapy Training Institute, in Corte Madera, California (with Randal Churchill, Marleen Mulder and Ormond McGill); The Banyan Hypnosis Center, in Singapore (with Calvin Banyan); and The Omni Hypnosis Center, in Deland, Florida (with Jerry Kein and Bob Brenner), along with other hypnosis trainings.

He is certified by the American Council of Hypnotist Examiners (ACHE), and the National Guild of Hypnotists (NGH). He is a Master Practitioner of Neuro-Linguistic Programming (NLP) and a 7th Path Self-Hypnosis instructor. Erik has studied a variety of other healing systems in China, Japan, America, and the Philippines. He has been a resident of Japan since 1987.

For more information, please visit http://www.hypnosis-japan.org/.

Following brain damage, typically of the right hemisphere, patients can show reduced awareness of sensory events occurring in the space contralateral to the brain damage. The present work shows that a hypnotic suggestion can temporarily reduce tactile extinction to double bilateral stimulation, i.e., a loss of contralesional stimuli when these are presented together with ipsilesional ones. Patient EB showed an improved detection of contralesional targets after a single 20-min hypnosis session, during which specific suggestions were delivered with the aim of increasing her insight into somatosensory perception on both sides of the body. Simple overt attention orienting toward the contralesional side, or a hypnotic induction procedure not accompanied by specifically aimed suggestions, were not effective in modulating extinction. The present result is the first systematic evidence that hypnosis can temporarily improve a neuropsychological condition, namely Extinction, and may open the way for the use of this technique as a fruitful rehabilitative tool for brain-damaged patients affected by neuropsychological deficits.

Front Hum Neurosci. 2012;6:210. Epub 2012 Jul 17. Maravita A, Cigada M, Posteraro L. Department of Psychology, University of Milano-Bicocca Milano, Italy.

by Tim Brunson PhD

The tendency for any organization or profession to mislabel a hypnotic practitioner as a "lay" person is harmful to the general public and does nothing but question the credibility of the self-styled authority. Actually it is impossible to have a "lay" designation without the acceptance that hypnosis (or hypnotherapy) is a valid, unique profession.

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To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernest (J Roy Soc Med 100:330--338, 2007). Replication of a 2007 Ernest paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine. The review of the 32 papers discussed by Ernest found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulation therapy (SMT) as chiropractic treatment when it had been reported in the original paper as delivered by a non-chiropractic provider (e.g. Physician).The original case reports often omitted to record the time lapse between treatment and the adverse event, and other significant clinical or risk factors. The country of origin of the original paper was also overlooked, which is significant as chiropractic is not legislated in many countries. In 21 of the cases reported by Ernest to be chiropractic treatment, 11 were from countries where chiropractic is not legislated. The number of errors or omissions in the 2007 Ernest paper, reduce the validity of the study and the reported conclusions. The omissions of potential risk factors and the timeline between the adverse event and SMT could be significant confounding factors. Greater care is also needed to distinguish between chiropractors and other health practitioners when reviewing the application of SMT and related adverse effects.

Chiropr Man Therap. 2012 Sep 21;20(1):30. Tuchin P.

The ability to accurately infer others' mental states from facial expressions is important for optimal social functioning and is fundamentally impaired in social cognitive disorders such as autism. While pharmacologic interventions have shown promise for enhancing empathic accuracy, little is known about the effects of behavioral interventions on empathic accuracy and related brain activity. This study employed a randomized, controlled and longitudinal design to investigate the effect of a secularized analytical compassion meditation program, cognitive-based compassion training (CBCT), on empathic accuracy. Twenty-one healthy participants received functional MRI scans while completing an empathic accuracy task, the Reading the Mind in the Eyes Test (RMET), both prior to and after completion of either CBCT or a health discussion control group. Upon completion of the study interventions, participants randomized to CBCT and were significantly more likely than control subjects to have increased scores on the RMET and increased neural activity in the inferior frontal gyrus (IFG) and dorsomedial prefrontal cortex (dmPFC). Moreover, changes in dmPFC and IFG activity from baseline to the post-intervention assessment were associated with changes in empathic accuracy. These findings suggest that CBCT may hold promise as a behavioral intervention for enhancing empathic accuracy and the neurobiology supporting it.

Soc Cogn Affect Neurosci. 2012 Sep 29. Mascaro JS, Rilling JK, Tenzin Negi L, Raison CL. Department of Psychiatry, University of Arizona College of Medicine, 1501 North Campbell Avenue, PO Box 245017 Tucson, AZ 85724, USA. craison@email.arizona.edu.

The objective of this study was to compile existing scientific evidence regarding the effects of essential oils (EOs) administered via inhalation for the alleviation of nausea and vomiting. CINAHL, PubMed, and EBSCO Host and Science Direct databases were searched for articles related to the use of EOs and/or aromatherapy for nausea and vomiting. Only articles using English as a language of publication were included. Eligible articles included all forms of evidence (nonexperimental, experimental, case report). Interventions were limited to the use of EOs by inhalation of their vapors to treat symptoms of nausea and vomiting in various conditions regardless of age group. Studies where the intervention did not utilize EOs or were concerned with only alcohol inhalation and trials that combined the use of aromatherapy with other treatments (massage, relaxations, or acupressure) were excluded. Five (5) articles met the inclusion criteria encompassing trials with 328 respondents. Their results suggest that the inhaled vapor of peppermint or ginger essential oils not only reduced the incidence and severity of nausea and vomiting but also decreased antiemetic requirements and consequently improved patient satisfaction. However, a definitive conclusion could not be drawn due to methodological flaws in the existing research articles and an acute lack of additional research in this area. The existing evidence is encouraging but yet not compelling. Hence, further well-designed large trials are needed before confirmation of EOs effectiveness in treating nausea and vomiting can be strongly substantiated.

J Altern Complement Med. 2012 Jun;18(6):534-40. Lua PL, Zakaria NS. Centre for Clinical and Quality of Life Studies, Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia. peilinlua@unisza.edu.my