Center for Neuroplasticity and Pain (CNAP) Department of Health Science and Technology, Aalborg University, Denmark.
Department of Health Science and Technology, Aalborg University, Denmark.
Neuroscience. 2022 Mar 1;485:53-64. doi: 10.1016/j.neuroscience.2022.01.004. Epub 2022 Jan 11.
Conventional transcutaneous electrical nerve stimulation (TENS) has been reported to effectively alleviate chronic pain, including phantom limb pain (PLP). Recently, literature has focused on modulated TENS patterns, such as pulse width modulation (PWM) and burst modulation (BM), as alternatives to conventional, non-modulated (NM) sensory neurostimulation to increase the efficiency of rehabilitation. However, there is still limited knowledge of how these modulated TENS patterns affect corticospinal (CS) and motor cortex activity. Therefore, our aim was to first investigate the effect of modulated TENS patterns on CS activity and corticomotor map in healthy subjects. Motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) were recorded from three muscles before and after the application of TENS interventions. Four different TENS patterns (PWM, BM, NM 40 Hz, and NM 100 Hz) were applied. The results revealed significant facilitation of CS excitability following the PWM intervention. We also found an increase in the volume of the motor cortical map following the application of the PWM and NM (40 Hz). Although PLP alleviation has been reported to be associated with an enhancement of corticospinal excitability, the efficiency of the PWM intervention to induce pain alleviation should be validated in a future clinical study in amputees with PLP.
传统经皮神经电刺激（TENS）已被报道可有效缓解慢性疼痛，包括幻肢痛（PLP）。最近，文献集中于调制 TENS 模式，如脉冲宽度调制（PWM）和爆发调制（BM），作为替代传统非调制（NM）感觉神经刺激的方法，以提高康复效率。然而，对于这些调制 TENS 模式如何影响皮质脊髓（CS）和运动皮层活动，我们的了解仍然有限。因此，我们的目的是首先研究调制 TENS 模式对健康受试者 CS 活动和皮质运动图的影响。通过经颅磁刺激（TMS）记录 TENS 干预前后三个肌肉的运动诱发电位（MEP）。应用了四种不同的 TENS 模式（PWM、BM、NM 40Hz 和 NM 100Hz）。结果表明，PWM 干预后 CS 兴奋性显著增强。我们还发现，PWM 和 NM（40Hz）应用后，运动皮质图的体积增加。尽管已经报道 PLP 的缓解与皮质脊髓兴奋性的增强有关，但在未来有 PLP 的截肢患者的临床研究中，应验证 PWM 干预诱导疼痛缓解的效率。
