Neuromodulation : journal of the International Neuromodulation Society
-
Transcutaneous electrical nerve stimulation (TENS) is a noninvasive electrical stimulation therapy indicated for pain control that has been applied for the regeneration of nerves. This systematic review aimed to analyze the evidence on TENS effectiveness on nerve regeneration. ⋯ Although there is some heterogeneous evidence in animal research, TENS seems to be a promising treatment for nerve injury that should be better explored. It is still necessary to improve the analysis of its application parameters, which can lead to the most satisfactory regeneration results and improve the understanding of its mechanisms on peripheral nerve regeneration.
-
Review
Neuromodulation for Storage Lower Urinary Tract Symptoms in Parkinson Disease: A Systematic Review.
Bladder symptoms are common in Parkinson disease (PD), affecting quality of life. Medications commonly used such as antimuscarinics can cause frequently intolerable side effects, and therefore, new, better tolerated approaches are needed. Neuromodulation techniques have an established role in urologic disorders; these techniques include tibial nerve stimulation (TNS) and sacral neuromodulation (SNM), which are localized therapies lacking the side effects associated with medication. ⋯ Evidence from case series suggests benefit from TNS in PD, with limited literature on SNM or TMS. Placebo effect from neuromodulation is a concern, and only limited controlled data exist. Future well-designed and sham-controlled studies need to be completed to provide definitive data on the benefit of neuromodulation in PD. Definitively proving the utility of a neuromodulation modality will allow better treatment of bladder symptoms without the need for pharmacologic measures that cause side effects.
-
Gastric electrical stimulation (GES) is a widely accepted therapy for gastroparesis symptoms, but how a brief cutaneous electrogastrogram (EGG) can be used in conjunction with GES has not been well defined. We evaluated the clinical importance of EGG, its correlation with mucosal electrograms (mEGs), gastric emptying tests (GETs), and gastrointestinal symptoms before and after temporary GES (tGES). ⋯ The Clinicaltrials.gov registration number for the study is NCT03876288.
-
There is a wealth of literature supporting the use of median nerve stimulation (MNS) for modulating autonomic nervous system (ANS) dysfunction such as in hypoxia, recovery after heart valve replacement, ischemia, and cardiac contractibility. Heart rate variability (HRV) is considered a gold standard for measuring autonomic modulation and dynamic nonlinear ANS processes through the use of an electrocardiogram (ECG). Although the use of MNS on HRV in animals and humans has been documented, optimal stimulation parameters are yet to be outlined. ⋯ Finding the optimal stimulation parameters for MNS is crucial for improving HRV. This will in turn contribute to normalizing ANS function impaired in numerous clinical conditions, such as epilepsy or diabetes.
-
Randomized Controlled Trial
Higher Pain Sensitivity Predicts Efficacy of a Wearable Transcutaneous Electrical Nerve Stimulation Device for Persons With Fibromyalgia: A Randomized Double-Blind Sham-Controlled Trial.
This study investigated the efficacy of a transcutaneous electrical nerve stimulation (TENS) device (Quell®) for persons with symptoms due to fibromyalgia (FM). ⋯ This study found no differences between those who were exposed to maximal-frequency active stimulation or minimal-frequency sham stimulation from a wearable TENS in reducing FM-related symptoms. However, those with greater hypersensitivity showed most benefit from TENS. Additional studies to help determine the role individual differences play in the use of TENS in managing FM-related symptoms are needed.