Wang Chenxi, Gao Lanqi, Zhang Chuan, Li Jun, Liu Jixin
School of Life Science and Technology, Xidian University, Xi'an, China.
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
J Med Internet Res. 2025 Mar 19;27:e63137. doi: 10.2196/63137.
Enhancing the effectiveness of current pain relief strategies is a persistent clinical challenge. Although transcutaneous electrical nerve stimulation (TENS) is used in various painful conditions, its effectiveness may decline over time, requiring additional pain management strategies. Immersive virtual reality (VR) with personalized visuo-tactile stimulation has demonstrated analgesic properties. Nevertheless, whether visuo-tactile stimulation can enhance the pain-relieving outcomes of TENS and its underlying neurophysiological mechanisms remains largely unknown.
The study aims to investigate whether the integration of visuo-tactile stimulation with TENS can enhance the pain-relieving outcomes of TENS alone, and we also aim to explore the brain mechanisms underlying the analgesic effect of this integrated intervention.
In this study, 75 healthy participants were enrolled and randomly assigned to 1 of 3 groups: congruent TENS-VR (TENS-ConVR) and 2 control groups (incongruent TENS-VR [TENS-InVR] and TENS alone). In the context of TENS-ConVR, we combined TENS and VR by connecting TENS-induced paresthesia with personalized visual bodily feedback. The visual feedback was designed to align with the spatiotemporal patterns of the paresthesia induced by TENS. A pain rating task and a 32-channel electroencephalography were applied.
Two-way ANOVAs showed that TENS-ConVR exhibited a statistically greater reduction in pain rating (F=6.84; P=.01) and N2 amplitude (F=5.69; P=.02) to high-intensity pain stimuli before and after stimulation than TENS alone. The reduction of brain activity was stronger in participants who reported stronger pain-relieving outcomes. TENS-ConVR reduced the brain oscillation in the gamma band, whereas this result was not found in TENS alone.
This study observed that combining TENS and visual stimulation in a single solution could enhance the pain-relieving effect of TENS, which has the potential to improve the effectiveness of current pain management treatments.
Chinese Clinical Trial Registry ChiCTR2500098834; https://www.chictr.org.cn/showprojEN.html?proj=254171.
提高当前疼痛缓解策略的有效性是一项持续存在的临床挑战。尽管经皮电刺激神经疗法（TENS）被用于各种疼痛状况，但其有效性可能会随着时间而下降，这就需要额外的疼痛管理策略。具有个性化视觉触觉刺激的沉浸式虚拟现实（VR）已显示出镇痛特性。然而，视觉触觉刺激是否能增强TENS的疼痛缓解效果及其潜在的神经生理机制在很大程度上仍不为人知。
本研究旨在调查视觉触觉刺激与TENS相结合是否能增强单独使用TENS的疼痛缓解效果，我们还旨在探索这种综合干预镇痛效果背后的脑机制。
在本研究中，招募了75名健康参与者，并将他们随机分配到3组中的1组：一致性TENS-VR（TENS-ConVR）组和2个对照组（不一致性TENS-VR [TENS-InVR]组和单独TENS组）。在TENS-ConVR的背景下，我们通过将TENS诱发的感觉异常与个性化视觉身体反馈相连接，将TENS和VR结合起来。视觉反馈被设计为与TENS诱发的感觉异常的时空模式相匹配。应用了疼痛评分任务和32通道脑电图。
双向方差分析表明，与单独使用TENS相比，TENS-ConVR在刺激前后对高强度疼痛刺激的疼痛评分（F=6.84；P=.01）和N2波幅（F=5.69；P=.02）的降低在统计学上更显著。在报告疼痛缓解效果更强的参与者中，大脑活动的减少更明显。TENS-ConVR降低了γ波段的脑振荡，而单独使用TENS未发现此结果。
本研究观察到在单一方案中结合TENS和视觉刺激可增强TENS的止痛效果，这有可能提高当前疼痛管理治疗的有效性。
中国临床试验注册中心ChiCTR2500098834；https://www.chictr.org.cn/showprojEN.html?proj=254171 。
