Cervical Electrical Stimulation Research Articles

Effects of adding electro-massage to manual therapy for the treatment of individuals with myofascial temporomandibular pain: a randomized controlled trial.

To evaluate the effect of the addition of dynamic cervical electrical stimulation (electro-massage, ES) to manual therapy (MT), compared to MT by itself, in individuals with myofascial temporomandibular pain. A total of 46 participants with bilateral myofascial temporomandibular pain for at least three months were distributed into two groups. Group 1 (n=21) received local MT consisting of soft tissue mobilization and release techniques over the neck and temporomandibular regions. Group 2 (n=25) received an ES procedure in the cervical region combined with the same intervention as group 1. All participants underwent a 2-week protocol. The primary outcomes were pain intensity (Visual Analogue Scale), pressure pain threshold (PPT) at the masseter and upper trapezius muscles (algometer), and pain-free vertical mouth opening (manual gauge). The secondary outcome was active cervical range-of-movement. Measurements were taken at baseline, immediately after intervention, and at a 4-week follow-up. The ANOVA revealed significant changes over group*time, with better results for group 2 (large effect sizes) regarding pain intensity (p< 0.001; η2>0.14), pressure pain sensitivity and mouth opening (p<0.001; η2>0.14). Similar findings were observed for active cervical range-of-movement in all directions (p<0.001; η2>0.14), except rotation (p≥0.05). Electrical stimulation therapy over the cervical region combined with a MT protocol over the neck and temporomandibular joint shows better clinical benefits than MT by itself in subjects with myofascial temporomandibular pain. Registration code: NCT04098952.

Engaging cervical spinal circuitry with non-invasive spinal stimulation and buspirone to restore hand function in chronic motor complete patients

The combined effects of cervical electrical stimulation alone or in combination with the monoaminergic agonist buspirone on upper limb motor function were determined in six subjects with motor complete (AIS B) injury at C5 or above and more than one year from time of injury. Voluntary upper limb function was evaluated through measures of controlled hand contraction, handgrip force production, dexterity measures, and validated clinical assessment batteries. Repeated measure analysis of variance was used to evaluate functional metrics, EMG amplitude, and changes in mean grip strength. In aggregate, mean hand strength increased by greater than 300% with transcutaneous electrical stimulation and buspirone while a corresponding clinically significant improvement was observed in upper extremity motor scores and the action research arm test. Some functional improvements persisted for an extended period after the study interventions were discontinued. We demonstrate that, with these novel interventions, cervical spinal circuitry can be neuromodulated to improve volitional control of hand function in tetraplegic subjects. The potential impact of these findings on individuals with upper limb paralysis could be dramatic functionally, psychologically, and economically.

Abstracts from The 34(th) Annual National Neurotrauma Symposium June 26-29, 2016 Lexington, Kentucky.

Abstracts from The 34(th) Annual National Neurotrauma Symposium June 26-29, 2016 Lexington, Kentucky.

Airway effects of direct left-sided cervical vagal stimulation in patients with complex partial seizures

Airway nerves have been implied in obstructive lung diseases for many years. In experimental animals, vagal stimulation produces several features of asthma, including airflow obstruction and airway plasma exudation. Vagal stimulation is a novel and effective therapy in patients with refractory epilepsy. We evaluated the airway response to left-sided cervical electrical stimulation using 1 Hz (low stimulation: 30 s, once every 90 min) and 30 Hz (high stimulation: 30 s, every 5 min) in a randomized double-blinded fashion for 3 months in epileptic patients participating in a phase two efficacy study. In eight patients with high stimulation and six with low stimulation, no effect on FEV1 (forced expiratory volume in 1 s) was seen over 3 months chronic stimulation. In a follow-up, up to 9 months, no further deterioration of lung function was observed. Of five patients without concomitant lung disease who consented to more extended experiments, one patient produced a reduction of FEV1 with variable frequency and current stimulation (10–87 Hz and 0.5–2.5 mA respectively). In one patient with obstructive lung disease, however, increased frequency and current stimulation led to a stimulation-dependent decrease in FEV1. After the addition of inhaled ipratropium bromide (160 μg, dry powder) to this patient, there was a clear improvement of baseline FEV1, but only a slight improvement of the stimulation-induced deterioration of FEV1. We conclude that long-term vagal stimulation in patients without concomitant lung disease does not induce any significant changes in FEV1. However, in patients with obstructive lung disease, intense vagal stimulation can cause a deterioration of lung function. To our knowledge, this may be the first observation of the involvement of bronchoconstrictive vagal nerves in man.

Motor evoked potentials following cervical electrical stimulation in brachial plexus lesions

The diagnostic relevance of recording motor evoked potentials (MEPs) after electrical stimulation of the cervical region, as compared with conventional needle electromyography (EMG), was evaluated in 26 patients with brachial plexus (BP) damage of different aetiology, severity and topography. MEP abnormalities (absence or latency increase) were observed in at least one muscle of all the patients, with a global incidence of 61.5% of the muscles examined. Neurogenic EMG signs were present in all but one patient with an incidence of 62.2% of the muscles examined. Combining the two methods, the global incidence of abnormalities rose to 69.9%. MEP abnormalities were consistent with the clinical topography and severity of BP lesions and were fairly parallel with EMG findings. Recording MEPs after percutaneous electrical stimulation of the cervical region may be regarded as a rapid, non-invasive method for quantitative electrophysiological assessment of BP damage.

Direct spinal effect of intrathecal acetaminophen on visceral noxious stimulation in rabbits.

The aim of this study was to investigate the effect of intrathecal acetaminophen on visceral and somatic noxious stimulation in the intact, non-anesthetized rabbit. Sixteen rabbits had intrathecal catheters implanted surgically. Visceral noxious stimulation was induced by intestinal distension of the distal colon and somatic stimulation with increasing electrical current through skin electrodes placed in either the cervical or the lumbar area. The effect on visceral noxious stimulation was assessed following intrathecal injection of 0.5, 2.5 and 5 mg of acetaminophen and following 10 and 50 mg acetaminophen intravenously. Naloxone 0.2 mg and yohimbine 0.1 mg were administered intrathecally prior to intrathecal injection of acetaminophen 5 mg. A dose-dependent effect of intrathecal acetaminophen against the visceromotor reflex produced by intestinal distension was shown. No effects on thresholds to lumbar or cervical electrical stimulation or intestinal distension were observed following i.v. administration. Thresholds to noxious electrical stimulation were only significantly elevated at the lumbar level following i.t. injection of 5 mg acetaminophen. Naloxone failed to antagonize the effect of intrathecal acetaminophen, whereas intrathecal yohimbine attenuated the effect of intrathecal acetaminophen in both tests. In conclusion, a spinal, dose-dependent, naloxone-irreversible, and yohimbine-reversible effect of intrathecal acetaminophen on electrical and visceral noxious stimulation was demonstrated.

Electrophysiological findings in a case of severe intrathecal baclofen overdose

Multimodality evoked potentials were examined in a case of serious accidental intrathecal baclofen overdose in a patient who suffered from severe spasticity due to a traumatic brain lesion. Electrophysiological findings during, before and after the intoxication were compared. Transcranial electrical stimulation up to 750 V did not evoke any responses in thenar muscles on the first day of intoxication. An improvement to normal values was observed within 3 days, paralleled by an amelioration of the patient's clinical condition. Cervical electrical stimulation was largely unaffected by baclofen. Median nerve somatosensory and brain-stem acoustic evoked potentials revealed few or no differences during intoxication compared to pre- and post-intoxication responses.