Viudes-Sarrión Nuria, Aleixandre-Carrera Fernando, Beltrá Patricia, Ortega Francisco Javier, Molina-Payá Francisco Javier, Velasco Enrique, Delicado-Miralles Miguel
Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.
Human Movement Biomechanics Research Group, Deptartment of Movement Sciences, KU Leuven, Leuven, Belgium.
Eur J Clin Invest. 2024 Jan;54(1):e14091. doi: 10.1111/eci.14091. Epub 2023 Sep 7.
The vasculature function is mainly regulated by the autonomic nervous system. Importantly, the sensory-motor nervous system also innervates peripheral vessels and has the capacity to modulate vascular tone. Here we investigated the effects of electrical stimulation of a mixed nerve trunk on blood flow in deep arteries and muscle perfusion. Our hypothesis is that stimulation of a mixed nerve can modify blood flow.
Twenty-nine healthy participants were included into a randomized-crossover and blinded clinical trial. Each subject received a placebo and two percutaneous peripheral nerve stimulation (pPNS) protocols on the median nerve: Pain Threshold continuous Low Frequency (PT-cLF) and Sensory Threshold burst High Frequency (ST-bHF). Blood flow was then assessed bilaterally using Power Doppler Ultrasonography at the main arteries of the arm, and blood perfusion at the forearm muscles. Afterwards, blood flow was quantified using a semi-automatized software, freely shared here.
Placebo, consisting in needle insertion, produced an immediate and generalized reduction on peak systolic velocity in all arteries. Although nerve stimulation produced mainly no effects, some significant differences were found: both protocols increased the relative perfusion area of the forearm muscles, the ST-bHF protocol prevented the reduction in peak systolic velocity and TAMEAN of the radial artery produced by the control protocol and PT-cLF produced a TAMEAN reduction of the ulnar artery.
Therefore, the arterial blood flow in the arm is mainly impervious to the electrical stimulation of the median nerve, composed by autonomic and sensory-motor axons, although it produces mild modifications in the forearm muscles perfusion.
血管功能主要由自主神经系统调节。重要的是，感觉运动神经系统也支配外周血管，并有调节血管张力的能力。在此，我们研究了混合神经干电刺激对深部动脉血流和肌肉灌注的影响。我们的假设是，混合神经刺激可改变血流。
29名健康参与者被纳入一项随机交叉双盲临床试验。每位受试者接受一次安慰剂以及两种针对正中神经的经皮外周神经刺激（pPNS）方案：痛阈连续低频（PT-cLF）和感觉阈爆发高频（ST-bHF）。然后使用功率多普勒超声双侧评估手臂主要动脉的血流以及前臂肌肉的血液灌注。之后，使用在此免费共享的半自动软件对血流进行量化。
仅为针刺的安慰剂导致所有动脉的收缩期峰值速度立即出现全身性降低。尽管神经刺激主要未产生影响，但仍发现了一些显著差异：两种方案均增加了前臂肌肉的相对灌注面积，ST-bHF方案可防止对照方案导致的桡动脉收缩期峰值速度和平均血流速度降低，而PT-cLF导致尺动脉平均血流速度降低。
因此，由自主神经和感觉运动轴突组成的正中神经电刺激对手臂的动脉血流基本无影响，尽管它会使前臂肌肉灌注产生轻微改变。
