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The combined effect of transcutaneous electrical nerve stimulation and transcutaneous auricular vagus nerve stimulation on pressure and heat pain thresholds in pain-free subjects: a randomized cross-over trial.

作者信息

Liebano Richard E, Awad Noura, Bellino Christopher, Bray Katherine, Rosentrater Heidi, Roy Joshua, Tate Camryn

机构信息

Department of Rehabilitation Sciences, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA.

出版信息

Trials. 2024 Jul 31;25(1):516. doi: 10.1186/s13063-024-08352-x.


DOI:10.1186/s13063-024-08352-x
PMID:39085951
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11290061/
Abstract

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality that utilizes electrical currents to modulate pain in populations with acute and chronic pain. TENS has been demonstrated to produce hypoalgesic effects in postoperative pain, fibromyalgia, knee osteoarthritis, and healthy subjects. Transcutaneous auricular vagus nerve stimulation (TaVNS) is a non-invasive modality that modulates the vagus nerve by stimulating its auricular branches. The effects of the combination of TENS and TaVNS on producing an analgesic response have not been studied. Considering that TENS and TaVNS both stimulate similar analgesic pathways but through different means of activation, we can hypothesize that a combination of both methods can produce a more pronounced analgesic response. Therefore, the objective of this study is to assess the hypoalgesic effect of a combination of TENS and TaVNS in pain-free subjects. METHODS/DESIGN: The study will be a simple crossover design conducted at the University of Hartford. Subjects will be recruited from the University of Hartford population via oral communication, digital flyers, and posters on campus. Thirty participants will undergo two sessions in a crossover manner with one week in between. During one session, the participants will receive TENS with active TaVNS and the other session will be a placebo procedure (TENS with placebo TaVNS). The order of these sessions will be randomized. Importantly, the pressure pain threshold (PPT) and heat pain threshold (HPT) assessors will be blinded to the treatment category. For active TaVNS, a frequency of 25 Hz will be applied with a pulse duration of 200 µs. For placebo TaVNS, the intensity will be increased to a sensory level and then decreased to 0 mA. High-frequency TENS of 100 Hz will be applied in both sessions, with a pulse duration of 200 µsec, asymmetrical biphasic square waveform, and intensity of maximal tolerance without pain. TENS and TaVNS will be turned on for 30 min after a baseline measurement of outcomes. TENS and TaVNS will then be turned off, but the electrodes will remain on until completion of post-treatment assessment. Pressure pain threshold, heat pain threshold, blood pressure, oxygen saturation, and heart rate will be tested 4 times: Once pre-intervention, once during intervention, once immediately after the intervention, and once 15 min post-intervention. Statistical analysis of the data obtained will consider a significance level of p < 0.05. DISCUSSION: This study will provide evidence concerning the combined effects of TENS and TaVNS on pain threshold in pain-free participants. Based on the outcomes, a greater understanding of how TENS and TaVNS, when used in conjunction, can modulate pain pathways. TRIAL REGISTRATION: ClinicalTrials.gov NCT06361381. Registered on 09 April 2024.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/340c375312b1/13063_2024_8352_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/3b9649945ec3/13063_2024_8352_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/0ac5953ae6d1/13063_2024_8352_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/340c375312b1/13063_2024_8352_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/3b9649945ec3/13063_2024_8352_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/0ac5953ae6d1/13063_2024_8352_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e646/11290061/340c375312b1/13063_2024_8352_Fig3_HTML.jpg

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引用本文的文献

[1]
Application of transcutaneous electrical nerve stimulation in monitored anesthesia care during foraminoscopy: a randomized double-blind controlled trial.

Front Med (Lausanne). 2025-6-26

本文引用的文献

[1]
Transcutaneous auricular branch vagal nerve stimulation as a non-invasive add-on therapeutic approach for pain in systemic sclerosis.

RMD Open. 2023-8

[2]
Effect of transauricular nerve stimulation on perioperative pain: a single-blind, analyser-masked, randomised controlled trial.

Br J Anaesth. 2023-4

[3]
Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis.

Sci Rep. 2022-12-21

[4]
Using TENS for Pain Control: Update on the State of the Evidence.

Medicina (Kaunas). 2022-9-22

[5]
Effect of Transcutaneous Vagus Nerve Stimulation in Erosive Hand Osteoarthritis: Results from a Pilot Trial.

J Clin Med. 2022-2-18

[6]
Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study).

BMJ Open. 2022-2-10

[7]
The effect of transcutaneous auricular vagus nerve stimulation on HRV in healthy young people.

PLoS One. 2022

[8]
A cross-sectional analysis of persistent low back pain, using correlations between lumbar stiffness, pressure pain threshold, and heat pain threshold.

Chiropr Man Therap. 2021-9-3

[9]
Effects of Electrical Transcutaneous Vagus Nerve Stimulation on the Perceived Intensity of Repetitive Painful Heat Stimuli: A Blinded Placebo- and Sham-Controlled Randomized Crossover Investigation.

Anesth Analg. 2018-6

[10]
Transcutaneous electrical nerve stimulation for postoperative pain control after total knee arthroplasty: A meta-analysis of randomized controlled trials.

Medicine (Baltimore). 2017-9

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