Sessions Of Electrical Stimulation Research Articles

Eight sessions of transcranial electrical stimulation for postural response in people with Parkinson’s disease: A randomized trial

BackgroundImpairments in postural responses to perturbation are common in people with Parkinson’s disease (PwPD) and lack effective treatment. We recently showed that a single session of transcranial direct current stimulation (tDCS) promotes acute improvement of postural response to perturbation in PwPD. However, the effects of multiple tDCS sessions remain unclear. Research questionWhat is the efficacy of eight sessions of anodal tDCS on postural responses to external perturbation in PwPD? MethodsTwenty-two PwPD participated in this randomized, double-blind, parallel-arm, and sham-controlled study. Participants were randomly distributed into active (a-tDCS; n=11) or sham stimulation (s-tDCS; n=11). Eight tDCS sessions were applied over the primary motor cortex (M1), with the a-tDCS group receiving 2 mA for 20 minutes. Postural responses to external perturbations were assessed before, 48 hours after, and one month after (follow-up) the completion of tDCS sessions. Primary outcome measures included the onset latency of medial gastrocnemius (MG) muscle and range of center of pressure. Secondary outcomes included electromyography and CoP parameters, and prefrontal cortex (PFC) activity. ResultsANOVA revealed a trend for Group*Moment interaction for MG onset latency (p=0.058). a-tDCS tended to have shorter MG onset latency at post-test (p=0.040; SRM = −0.63) compared to pre-test. For the secondary outcomes, only a-tDCS decreased the time taken to recover balance after the perturbation at post-test and follow-up compared to pre-test (both p<0.001; SRM=-1.42 and −1.53, respectively). Also, only a-tDCS demonstrated lower PFC activity at post-test compared to pre-test (p=0.017; SRM = −0.82) and follow-up (p=0.001). SignificanceEight sessions of tDCS over M1 improved postural response to perturbation in PwPD. Some benefits lasted for at least a month. Neuromuscular and behavioral changes observed after the intervention were accompanied by decreased PFC activity (executive-attentional control), suggesting that tDCS applied over M1 can improve movement automaticity.

Preservation of vision by transpalpebral electrical stimulation in mice with inherited retinal degeneration.

The potential neuroprotective and regenerative properties of electrical stimulation (ES) were studied in rhodopsin knockout mice (Rho -/- ), a murine model of inherited retinal degeneration. The study focused on assessing the impact of varying ES frequencies on visual functions and photoreceptor cell survival in Rho -/- mice. To elucidate the impact of electrical stimulation on cone survival, Rho -/- mice received either sham or transpalpebral ES using biphasic ramp or rectangular waveforms at 100µA amplitude, starting at sixweeks of age. The treatment duration spanned from one to three weeks. The optimal treatment frequency of ES sessions was determined by applying ES every one, two, or three days in three separate groups of Rho -/- mice. The sham group received daily treatments without the application of ES. Our study revealed significant improvement of visual function in Rho -/- mice following daily or every-other-day noninvasive transpalpebral ES, as evidenced by electroretinogram and optomotor response-based visual behavior assays. Concurrently, assessment of outer nuclear thickness and immunohistochemistry for the cone photoreceptor cell marker PNA demonstrated pronounced increases in the survival of rods and cones and improvement in the morphology of the inner and outer segments. This study underscores the protective effect of non-invasive ES in rhodopsin knockout-induced retinal degenerative disorders, providing a foundation for developing targeted therapeutic interventions for retinitis pigmentosa.

Effects of a Single Electrical Stimulation Session on Foot Force Production, Foot Dome Stability, and Dynamic Postural Control.

Effects of a Single Electrical Stimulation Session on Foot Force Production, Foot Dome Stability, and Dynamic Postural Control.

Effects of Adding Four Sessions of Ultrasound-Guided Percutaneous Electrical Nerve Stimulation to an Exercise Program in Patients with Shoulder Pain: A Randomized Controlled Trial.

Objective: Percutaneous electrical nerve stimulation (PENS) appears to be effective for the treatment of musculoskeletal pain. The aim of this trial was to investigate the effects on disability and pain, as well as on the psychological aspects of adding PENS into an exercise program in patients with subacromial pain syndrome. Methods: A randomized, parallel-group clinical trial was conducted. Sixty patients with subacromial pain were allocated into exercise alone (n = 20), exercise plus PENS (n = 20), or exercise plus placebo PENS (n = 20) groups. Patients in all groups performed an exercise program twice daily for 3 weeks. Patients allocated to the PENS group also received four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves. Patients allocated to the exercise plus placebo PENS received a sham PENS application. The primary outcome was related disability (Disabilities of the Arm, Shoulder, and Hand, DASH). Secondary outcomes included mean pain, anxiety levels, depressive symptoms, and sleep quality. They were assessed at baseline, one week after, and one and three months after. An analysis was performed using intention-to-treat with mixed-models ANCOVAs. Results: The results revealed no between-group differences for most outcomes (related disability: F = 0.292, p = 0.748, n2p = 0.011; anxiety: F = 0.780, p = 0.463, n2p = 0.027; depressive symptoms: F = 0.559, p = 0.575, n2p = 0.02; or sleep quality: F = 0.294, p = 0.747, n2p = 0.01); both groups experienced similar changes throughout the course of this study. Patients receiving exercise plus PENS exhibited greater improvement in shoulder pain at one month than those in the exercise (Δ -1.2, 95%CI -2.3 to -0.1) or the placebo (Δ -1.3, 95%CI -2.5 to -0.1) groups. Conclusions: The inclusion of four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves into an exercise program did not result in better outcomes in our sample of patients with subacromial pain syndrome at one and three months after treatment.

Efeito agudo da cinesioterapia e da eletroestimulação neuromotora sobre a variação térmica de indivíduos com insuficiência venosa crônica

Abstract Introduction: Chronic venous insufficiency (CVI) is a change in the venous system that can be caused by dysfunction in the triceps surae muscles. Objective: To evaluate the acute effect of neuromuscular electrical stimulation and kinesio-therapy on ankle joint flexibility, infrared radiation and triceps surae strength in individuals with CVI. Methods: We conducted a comparative study, in which ankle flexibility, dorsiflexion and plantar flexion strength and thermal variations of the calf were evaluated. An electrical stimulation session (1 kHz Aussie current with burst = 2 ms) was performed on the right lower limb (EG - electrostimulation group) and kinesio-therapy on the lower limb left (KG - kinesiotherapy group), with stretching and metabolic exercises involving the ankle. Results: Nineteen female patients were evaluated. Analysis of ankle flexibility did not demonstrate significant changes. In the assessment of muscle strength, there was no difference between groups, and in the intragroup assessment, only KG showed an increase for dorsiflexion (before treatment: 11.6 ± 3.5; 24 h after: 13.5 ± 3.0; p = 0.02), and for plantar flexion (before: 11.8 ± 6.3; 24 h later: 14.4 ± 5.06; p = 0.04). Regarding thermography, there was no intragroup difference, while in the intergroup assessment, KG showed an increase in temperature immediately and 24 h later (0.44 ± 0.68, p = 0.01 and 0.25 ± 0.83, p = 0.07, respectively). When analyzing the correlation between dorsiflexion and plantar flexion strength of both lower limbs with total range of motion of the right and left ankle, a positive correlation was observed only between the plantar flexion strength immediately after and 24 h later with range of motion and ankle in KG (r = 0.49, p = 0.03 and r = 0.51, p = 0.03, respectively). Conclusion: There were no significant differences between kinesiotherapy and electrotherapy when analyzing joint flexibility and muscle strength, but kinesiotherapy was superior in increasing calf temperature before and after 24 h of intervention.

Effectiveness of functional electrical stimulation machine in managing neurological diseases - A retrospective study.

Cerebrovascular Accident (CVA) or stroke, Spinal Cord injury can lead to neurological diseases resulting in major loss in motor function causing hemiplegia or tetraplegia. In 2019, according to The Global Burden of Diseases (GBD) CVA/Stroke is the second leading cause of death and the third leading cause of death and disability combined, globally. Its prevalence vary drastically among South Asian countries. The objective of this study was to determine the effectiveness of Functional Electrical Stimulation (FES) machine on neurologically impaired patients at the Physical Therapy department at IHHN, Karachi, Pakistan. In this retrospective study data was extracted from August 2016 to February 2022 on patients with neurological symptoms i.e. hemiplegia or paraplegia with muscle power of two or less on Manual Muscle Testing (MMT). The parameters for evaluating patients progress pre and post treatment were MMT results and their mobility status. The number of sessions ranged between 40 to 100 sessions of Functional Electrical Stimulation (FES) provided on alternate days according to the patient's need. Data of 51 patients who had completed their treatment were extracted and analyzed. The mean age of patients who completed treatment was 49.62 ± 17.26 years. Out of 51(100%), 30 (58.8%) were male and 21 (41.2%) were female. Pre- and post-treatment median (IQR) showed remarkable improvement in MMT of upper limb muscle (from 1.0 to 4.0) and lower limb muscle (from 2.0 to 4.0). FES cycling is an effective treatment for patients with neurological impairments, as it resulted in improvement in both upper and lower limb muscle strength, along with mobility status.

Assessing the Impact of Electrosuit Therapy on Cerebral Palsy: A Study on the Users' Satisfaction and Potential Efficacy.

The aim of this study is to evaluate the effectiveness of electrosuit therapy in the clinical treatment of children with Cerebral Palsy, focusing on the effect of the therapy on spasticity and trunk control. Moreover, the compliance of caregivers with respect to the use of the tool was investigated. During the period ranging from 2019 to 2022, a total of 26 children (18 M and 8 F), clinically stable and affected by CP and attending the Neurorehabilitation Unit of the "Padre Pio Foundation and Rehabilitation Centers", were enrolled in this study. A subset of 12 patients bought or rented the device; thus, they received the administration of the EMS-based therapy for one month, whereas the others received only one-hour training to evaluate the feasibility (by the caregivers) and short-term effects. The Gross Motor Function Classification System was utilized to evaluate gross motor functions and to classify the study sample, while the MAS and the LSS were employed to assess the outcomes of the EMS-based therapy. Moreover, between 80% and 90% of the study sample were satisfied with the safety, ease of use, comfort, adjustment, and after-sales service. Following a single session of electrical stimulation with EMS, patients exhibited a statistically significant enhancement in trunk control. For those who continued this study, the subscale of the QUEST with the best score was adaptability (0.74 ± 0.85), followed by competence (0.67 ± 0.70) and self-esteem (0.59 ± 0.60). This study investigates the impact of the employment of the EMS on CP children's ability to maintain trunk control. Specifically, after undergoing a single EMS session, LSS showed a discernible improvement in children's trunk control. In addition, the QUEST and the PIADS questionnaires demonstrated a good acceptability and satisfaction of the garment by the patients and the caregivers.

Effect of Facial Emotional Feedback Through Facial Electrical Stimulation on Mood Change and Its Clinical Application in Participants with Mild Depression: A Multiple Baseline Case Study

Background: The facial feedback hypothesis proposes that facial expressions influence people's emotional experiences. Objectives: The current study, conducted in 2022, aimed to investigate the impact of facial feedback on the nature and magnitude of changes in emotion, mood, and cognitive-emotional factors among individuals with mild depression. This was achieved through the use of electrical stimulation of the facial muscles. This study aimed to investigate the impact of bilateral electrical stimulation on the frontalis muscles (which act as inhibitory muscles of the corrugator) and zygomaticus muscles on the emotions and moods of individuals with mild depression. Methods: In a single-subject experimental study with multiple baselines, six individuals with mild depression underwent daily sessions of facial electrical stimulation for 28 consecutive days. The stimulation was administered at two different sites, with three different baseline periods of 3, 6, and 9 days at each site. Specifically, three participants received electrical stimulation of the zygomaticus muscle, while the other three participants received electrical stimulation of the frontalis muscle. Visual analysis (diagrams and figures), within-phase examination, and between-phase examination were used to analyze longitudinal data using mixed model analysis (P &lt; 0.05). Results: Mixed model analysis revealed significant changes in negative affect (P = 0.019), mood (P = 0.017), depression (P = 0.005), and symbol search (P &lt; 0.001) among participants who received frontalis muscle stimulation. Additionally, the mood of participants who received zygomaticus muscle stimulation showed significant changes (P = 0.047) from pre-intervention to post-intervention. At the intervention and follow-up stages (one month after the last intervention session), all three participants who underwent frontalis muscle electrical stimulation met the standardized recovery criteria established by Segger et al. The reliable change index was measured at 8.46. A qualitative analysis of the depression scores revealed a significant difference in the post-intervention phase when frontalis muscle electrical stimulation was applied. Participants 4, 5, and 6 scored 9, 11, and 8, respectively. Conclusions: This preliminary study provides empirical evidence on using electrical stimulation of facial muscles to reduce negative mood and depression. Given the various factors that play a role, more research and focused controlled studies are needed to test these findings.

Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Objectives We investigated whether a specific exercise program for the neck–shoulder region reduces headache intensity, frequency, and duration, and how it influences neck disability among women with chronic headache compared to a control group. Design Two-center randomized controlled trial. Subjects 116 working-age women. Intervention The exercise group (n = 57) performed a home-based program with six progressive exercise modules, over 6 months. The control group (n = 59) underwent six placebo-dosed transcutaneous electrical nerve stimulation sessions. Both groups performed stretching exercises. Main measures The primary outcome was pain intensity of headache, assessed using the Numeric Pain Rating Scale. Secondary outcomes were frequency and duration of weekly headaches, and neck disability assessed using the Neck Disability Index. Generalized linear mixed models were used. Results Mean pain intensity at baseline was 4.7 (95% CI 4.4 to 5.0) in the exercise group and 4.8 (4.5 to 5.1) in the control group. After 6 months the decrease was slight with no between-group difference. Headache frequency decreased from 4.5 (3.9 to 5.1) to 2.4 (1.8 to 3.0) days/week in the exercise group, and from 4.4 (3.6 to 5.1) to 3.0 (2.4 to 3.6) in the control group (between-group p = 0.017). Headache duration decreased in both groups, with no between-group difference. Greater improvement in the Neck Disability Index was found in the exercise group (between-group change −1.6 [95% CI −3.1 to −0.2] points). Conclusion The progressive exercise program almost halved headache frequency. The exercise program could be recommended as one treatment option for women with chronic headache.

The Effect of Electrical Stimulation Therapy on Brain Derived Neurotrophic Factor in Patients with Tinnitus.

Introduction: The aim of this study was to determine the effect of electric stimulation therapy on brain-derived neurotrophic factor (BDNF) in patients with tinnitus. Materials and methods: In this before-after clinical trial study, 45 patients aged 30-80 years old with tinnitus were involved. The hearing threshold, loudness, and frequency of tinnitus were assessed. Tinnitus Handicap Inventory (THI) questionnaire was completed by the patients. Before holding electrical stimulation sessions, the patients were evaluated for serum brain-derived neurotrophic factor (BDNF) level. Patients underwent five electrical stimulation sessions of 20min for 5 consecutive days. After completion of electrical stimulation session, THI questionnaire was re-completed by the patients and they were evaluated for serum BDNF level. Results: Mean BDNF level before and after the intervention was (1238 ± 494.2) and (1148.2 ± 496.7), respectively (P = 0.04). Mean loudness score before and after the intervention was (6.36 ± 1.47) and (5.27 ± 1.68), respectively (P = 0.01). Mean THI score before and after the intervention was (58.21 ± 11.8) and (53.17 ± 15.19), respectively (p = 0.01). In patients with severe THI1, there was a significant difference between serum BDNF level (p = 0.019) and loudness (p = 0.003) before and after the intervention. However, in patients with mild, moderate, and very severe THI1, no such effect was observed (p > 0.05). Conclusion: According to the results of the present study, electrical stimulation therapy significantly decreased the mean plasma BDNF level in patients with tinnitus, especially in patients with severe tinnitus so it can be used as a marker to define the response to treatment and determine the severity of tinnitus in primary evaluations.

Multiple Sessions of Therapeutic Electrical Stimulation Using Implantable Thin-Film Wireless Nerve Stimulators Improve Functional Recovery after Sciatic Nerve Isograft Repair.

Although therapeutic electrical stimulation (TES) of injured peripheral nerve promotes axon regeneration and functional recovery, clinical applications of this therapy are limited to the intraoperative timeframe. Implantable, thin-film wireless nerve stimulators offer a potential solution to this problem by enabling delivery of electrical stimuli to an injured nerve over a period of several days post-surgery. The aim of this study was to determine the optimal time course of stimulation for maximizing functional recovery in a rat sciatic nerve isograft repair model. Adult male Lewis rats underwent thin-film wireless nerve stimulator implantation following sciatic nerve transection and 40 mm nerve isograft repair. Immediately after surgery, animals began a daily regimen of TES for up to 12 consecutive days. Functional recovery was assessed by compound muscle action potential (CMAP), evoked muscle force, wet muscle mass, and axon counting. Serial CMAP measurements increased in amplitude over the course of the study, yet no significant difference between cohorts for serial or terminal CMAPs was observed. Axon counts and wet muscle mass measurements were greatest in the 6-day stimulation group, which correlated with a significant increase in evoked muscle force for the 6-day stimulation group at the terminal time point. 6 daily sessions of TES were found to be most effective for augmenting functional recovery compared to other time courses of stimulation. Future studies should incorporate additional subjects and track axonal sprouting or measure neurotrophin levels during the therapeutic window to further elucidate the mechanisms behind, and ideal amount of, TES. This article is protected by copyright. All rights reserved.

Does Electrode Sensor Positioning over Motor Points Affect Different Portions of Quadriceps Muscle Architecture during Submaximal Evoked Torque?

Background and Objectives. Few studies have evaluated differences in muscle architecture in quadriceps femoris constituents with sensor electrodes positioned over vastus lateralis (VL) and vastus medialis (VM) motor points during a neuromuscular electrical stimulation (NMES) session. We aimed to investigate the changes in muscle architecture of the rectus femoris (RF), VL, VM, and vastus intermedius (VI) portions during evoked contractions with sensor electrodes placed over VL and VM motor points. Materials and Methods. The study is a crossover, repeated‐measure design, conducted with healthy males aged 24.0 ± 4.6 years. Ultrasonography at rest and evoked contraction at 40% of maximum voluntary contraction (MVC) were used to assess the pennation angle (θp) and fascicle length (Lf) of RF, VL, VM, and VI portions. Results. The mean torque observed was 201.14 ± 50.22 N.m during MVC and at 40% of MVC was 80.45 ± 20.08 N.m. There was no difference for θp comparing four components of the quadriceps femoris (p = 0.27). There was a significant (p &lt; 0.05) muscle evoked contraction interaction for Lf without relevant clinical importance to the study. Conclusions. There is no difference in the changes in the muscle architecture of quadriceps femoris constituents during stimulation with the electrodes placed on the VL and VM motor points. Therefore, clinicians can choose either VL or VM motor points for sensor electrode positioning and expect similar muscle architecture adaptation for a given evoked torque. Future clinical studies should be conducted to establish the optimal electrode positioning over different portions of the quadriceps muscle to optimize more rational NMES clinical settings.

Effect Of Transcutaneous Electrical Spinal Cord Stimulation On The Functional Activity Of Reciprocal And Presynaptic Inhibition In Healthy Subjects

The objective of our research was to examine an effect of 20-minute electrical stimulation session of the spinal cord (tESCS) on the manifestation of reciprocal and presynaptic inhibition in the system of shin antagonist muscles in healthy individuals in a state of a relative muscle rest and weak muscle effort, along with possible physiological mechanisms of these manifestations. Material and Methods — The study involved 10 healthy men 27 to 35 years of age. Reciprocal and presynaptic inhibition was evaluated by suppressing the amplitude of testing H-reflex of m. soleus under conditions of conditioning stimulation of n. peroneus profundus and testing stimulation of n. tibialis with interstimulus intervals of 3 ms and 100 ms, respectively. Reciprocal inhibition and presynaptic inhibition were recorded during a 20-minute tESCS in the area of T11-T12 thoracic vertebrae at rest, in combination with voluntary muscular effort (5% of the maximum voluntary contraction), and after the stimulation. Results — During 20-minute electrical stimulation of the spinal cord at rest, the severity of reciprocal inhibition decreased, inverting to reciprocal facilitation, while presynaptic inhibition weakened only at the twentieth minute of stimulation; and in the postactivation period, the activity of spinal inhibition processes in the antagonist muscle system corresponded to background values. The most pronounced effect of prolonged tESCS was observed when performing a weak isometric contraction, which was accompanied by an increase in reciprocal inhibition activity during 10 minutes of exposure and 10 minutes after the end of stimulation. The severity of presynaptic inhibition during and after the spinal cord stimulation remained unchanged and complied with background values. The presynaptic inhibition activity was expressed to a greater extent during prolonged stimulation of the spinal cord at rest, and when performing a weak voluntary effort, as well as during the postactivation period. Conclusion — Changes in the spinal inhibitory interactions in the system of antagonist muscles on the basis of tESCS effects during arbitrary muscle tension could probably be explained by the fact that in this case, the inhibitory interneuron circuits of spinal cord were exposed to a wider range supraspinally descending and ascending peripheral effects, compared with spinal cord stimulation in a state of a relative muscle rest.

Torque and Discomfort During Electrically Evoked Muscle Contractions in Healthy Young Adults: Influence of Stimulation Current and Pulse Frequency

ObjectiveTo investigate (1) how current and pulse frequency of electrical stimulation (ES) as well as contraction mode (isometric, concentric, and eccentric) influence torque output and discomfort and (2) how familiarization by repeated ES sessions influences ratings of perceived discomfort. DesignAn experimental study, 3 sessions. SettingA university laboratory. ParticipantsEight healthy participants (5 men, 3 women; mean age 25.2 years; N=8). InterventionsParticipants completed 3 trial days, each including 17 electrically evoked thigh muscle contractions. On each trial day, the first 6 contractions consisted of 2 isometric, 2 concentric, and 2 eccentric muscle contractions randomly ordered with a fixed stimulation current and pulse frequency (200 mA, 20 Hz), while the remaining 11 muscle contractions were all isometric with randomly ordered combinations of current (100-250 mA) and pulse frequency (20-100 Hz). Main Outcome MeasuresTorque and perceived discomfort were measured for each ES-evoked contraction. ResultsOverall, the findings revealed that a higher stimulation frequency was associated with an increased torque without increased discomfort, while higher currents were associated with increases of both torque and discomfort. Contraction type did not influence level of discomfort, despite eccentric contractions eliciting higher torque compared with concentric and isometric contractions (P<.001). Finally, a significant familiarization to ES (P<.001) was observed after just 1 of 3 identical stimulation sessions. ConclusionsThe outlined data suggest that to elicit high torque levels while minimizing levels of discomfort in young subjects, eccentric muscle contractions evoked with a low stimulation current, and a high pulse frequency are preferable. Furthermore, a single familiarization session significantly lowers rating of perceived discomfort during ES.

Short-Term Cortical Electrical Stimulation during the Acute Stage of Traumatic Brain Injury Improves Functional Recovery.

Functional restoration is an important issue in the treatment of traumatic brain injury (TBI). Various electrical stimulation devices and protocols have been applied in preclinical studies and have shown therapeutic potential for brain trauma. Short-term invasive cortical electrical stimulation during the acute stage of TBI might be a feasible adjuvant therapy for patients with moderate-to-severe brain injury receiving neurosurgical treatment in the intensive care unit. However, the therapeutic effects of short-term multisession cortical electrical stimulation for brain trauma are not clear. This study explored the therapeutic effects of acute-stage short-term cortical electrical stimulation on TBI. We conducted seven sessions of one-hour cortical electrical stimulation from day 0 to day 6 in rats after brain trauma by controlled cortical impact and then evaluated the functional outcome and histopathological changes. Our data showed that short-term cortical electrical stimulation improved motor coordination, short-term memory, and learning ability and attenuated neurological severity after brain trauma. Lesion volume, apoptosis, and gliosis after brain trauma were reduced, and trauma-induced neurogenesis in the hippocampus for the innate neural reparative response was increased. Our study demonstrated that short-term cortical electrical stimulation applied in the acute stage of traumatic brain injury is a potential adjuvant therapy to improve the recovery of neurological deficits.

Responses of some matrix metalloproteinases activities to an acute session of endurance exercise and electrical stimulation in induced myocardial infarction in Wistar rats.

Myocardial infarction is the irreversible cell death of cardiac muscle that takes place after the blood flow is cut off to a specific region of the heart muscle. The molecular angiogenesis process that may follow after the incidence, due to any activity or its intensity, is unknown. The purpose of this research was to examine some of the matrix metalloproteinase (MMP) responses to an acute course of endurance exercise and electrical stimulation in induced myocardial infarcted Wistar rats. In this experimental case-control study, 40 induced myocardial infarcted Wistar rats (8-week-old, mean weight 130±30 g) were randomly assigned into 4 conditions: endurance exercise, exercise + electrical stimulation, only electrical stimulation, and control group. The infarction was induced 24 hours after the subcutaneous injection of 150 mg/kg of Isoproterenol. The exercise and exercise plus electrical stimulation groups performed a session of endurance exercise on an animal treadmill, at 20 m/min for one hour. The electrical stimulation was delivered by foot shock, set with the intensities of 0.5 mA for 20 minutes. Immediately after the cessation of the treatment protocol, MMP1, MMP2, and MMP9 were measured by the ELISA method. Data analysis was performed by using Two-way ANOVA and significance was set at α = 0.05. One session of endurance exercise or electric stimulation, or their combination, had no significant effect on the level of MMPs. One session of acute endurance exercise, stimulation, or their combination, elicited no significant effect on the level of MMPs of artificially induced myocardial infarcted Wistar rats.

Déjà-vu evoked by electrical stimulation of the insula: Stimulation-induced insular déjà-vu.

Déjà-vu is a mental phenomenon commonly experienced during temporal lobe seizures and can be evoked by electrical stimulation of the temporal lobe. We analyzed reproducible déjà-vu experiences evoked by stimulating the insula in two patients with pharmacoresistant temporal lobe epilepsy. We reviewed video-electroencephalography (EEG) recordings from extraoperative electrical cortical stimulation sessions. In addition, we performed the directed transfer function (DTF) effective connectivity measure of monopolar signals in Patient 1. To highlight elective changes due to each stimulation, we subtracted pre-stimulation DTF matrices from early poststimulation matrices. This analysis was performed for both non-inducing-déjàvu stimulation (control matrix) and déjà-vu-inducing stimulation (active matrix). Finally, the control matrix was subtracted from the active matrix. Comparison of effective connectivity during control stimulation versus déjà-vu-inducing stimulation revealed a reversal of connectivity levels in three main regions: the contralateral inferior insula (the ipsilateral insula could not be analyzed), bilateral mesiotemporal regions and the ipsilateral superior frontal gyrus. The drivers of evoked déjà-vu were the mesiotemporal regions (mainly ipsilateral) and the ipsilateral superior frontal gyrus. Although our findings are possibly anecdotal, the insula may (in rare instances) remotely generate unexpected déjà-vu. If confirmed by further studies, this might change the assessment strategy for possible causes of anterior temporal lobectomy failure.

Similarity effects of two types of adaptogens (transcutaneous electrical stimulation with the device “VEB” ® and using of bioactive Naftussya water) on the human body

Background. The studies of the Truskavetsian Scientific School of Balneology have shown that both the Naftussya bioactive water and the standard balneotherapy complex (Naftussya drink, ozokerite applications, mineral baths) exhibit the properties of adaptogens, similar to such ginseng and phytocompositions. At the same time, in the process of researching the influence of devices for transcutaneous electrical stimulation on the human body, we found that changes in the parameters of the neuro-endocrine-immune complex and metabolism also have an adaptogenic character. The purpose of this study is to find effects common to adaptogens of chemical and physical nature. Materials and Methods. The object of observation were 29 women 30-76 (50±13) y and 28 men 25-69 (48±13) y without a clinical diagnosis, but with the deviations from the norm in a number of parameters of the neuro-endocrine-immune complex as a manifestation of dysadaptation. Parameters of biophotonics, acupuncture points, EEG, HRV, immunity, metabolism, blood pressure and hormones levels before and after a four-day transcutaneous electrical stimulation session or one-week course of drinking of Naftussya water registered. Results. Screening revealed that 43 variables respond to the action of adaptogens according to the law of the initial level, at the same time, 4 initially elevated and 9 normal variables show further growth. Caused by adaptogens changes in 7 EEG and 7 HRV parameters determine favorable changes in 2 endocrine, 10 immune, 3 metabolic, 2 hemodynamic and 3 biophotonics parameters by 83,5%. Conclusion. The adaptogens both of chemical and physical nature, activating the receptors of the gut mucosa or the skin, respectively, have similar favorable effects on the parameters of the neuroendocrine-immune complex, metabolism, hemodynamics and biophotonics.

Rehabilitation of Patients with Moderate Knee Osteoarthritis Using Hyaluronic Acid Viscosupplementation and Physiotherapy

Knee osteoarthritis (KOA) is one of the most common public health problems which cannot be cured and ultimately leads to disability. Current management is largely limited to the treatment of the symptoms. To avoid the late stages of KOA that lead to knee replacement, the key point is to control and reduce destructive processes using efficient pharmacological products combined with physiotherapy (PT). Herein, we perform a monocentric observational study to compare the effect of combining a multi-modal physiotherapy regime and intra-articular (IA) injection with hyaluronic acid (HA) on the non-surgical treatment of KOA. Patients with mild KOA were randomly assigned to two groups to receive an HA injection with PT or an HA injection only. The assessment tools for pain, clinical disease severity, and disability were the total score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (scores range from 0 to 96, with higher scores indicating worse pain, function, and stiffness), knee range of motion (ROM), pain on the visual analog scale (VAS), and muscle strength testing (MST). All tests were evaluated every 3 months up to 1 year from the baseline. The study enrolled 52 patients with ages between 47 and 61 years who were divided into two groups. Thirty-seven (n = 37) patients were randomized in the pilot group (PG) and received IA injections with the viscoelastic hyaluronic acid product (HA) combined with a multi-modal PT regime. The PT program included 10 sessions of transcutaneous electrical nerve stimulation, low-level laser therapy, ultrasound, physical exercise, and cryotherapy. Fifteen patients (n = 15) from the control group (CG) received the IA HA injections only. All patients were confirmed with mild KOA of Kellgren–Lawrence grade 2 on radiographs at the beginning of the treatment. The baseline characteristics, including the severity of pain and level of disability, were similar in the two groups. At baseline, the mean (±SD) WOMAC scores reported were 64.6 ± 4.08 in the CG and 64.5 ± 2.99 in the PG. Notably, at only 3 months into the study, the mean scores were significantly improved to 56.7 ± 5 in the CG and 48.27 ± 2.13 in the PG (mean between-group difference = 16.19 points; 95% confidence interval), finding favor for the combination of HA injections and physiotherapy. At the study’s endpoint (12 months), the scores were improved in both groups, with the mean between-group difference remaining significant (7.08 points, 95% confidence interval). A decrease in pain, as evaluated by the VAS scale, was reported for both groups, with the PG reporting a better VAS score that decreased from 5.7 to 2 when compared to the CG, which decreased from 5.7 to 3. The physical assessment parameters (ROM and MST) followed the same trend, with a rapid improvement in the ROM in the PG, changing from 98° to 115° in the first 3 months, and a slower and more steady evolution in the CG group, changing from 100° to 112° in 9 months. Herein, we report on the combination therapy of an intra-articularly administered HA viscoelastic product and a multi-modal physiotherapy regime, which can play a key role in the non-surgical treatment of KOA, effectively controlling pain, stiffness, and the ROM value and improving patients’ quality of life.

Effects of transcutaneous electrical stimulation with the device “VEB” ® on the human body

Background. In 2015, a generator for electrotherapy and stimulation oh human nerve centers was created, called “VEB-1”®. Preliminary observation of volunteers revealed a modulating effect of a four-day course of electrical stimulation on the parameters of electroencephalogram, metabolism, as well as gas-discharge visualization (GDV). In this message, we present the results of the approbation of the device on an expanded contingent of volunteers with the use of additional research methods and a new modification of the device. Material and research methods. The object of observation were employees of the sanatorium “Moldova”, patients with chronic cholecystitis: 19 women 30-62 y and 19 men 25-63 y. In the morning registered HRV (“CardioLab+HRV”, “KhAI-Medica”, Kharkiv, UA), EEG (“NeuroCom Standard”, “KhAI-Medica”, Kharkiv, UA), kirlianogram by the method of GDV (“GDV Chamber”, “Biotechprogress”, SPb, RF), electroconductivity of skin in three pairs of points of acupuncture (“Medissa”), electrokinetic index of buccal epithelium ("Biotest", Kharkiv State University), as well as some endocrine, immune and metabolic parameters. After the initial testing, an transcutaneous electrical stimulation session was performed with a “VEB-1”® or a “VEB-2” devices. The next morning after completing the four-day course, retesting was performed. Results. Electrical stimulation causes a sympathotonic shift in the sympatho-vagal balance and an increase in PSD of delta-rhythm generating neurons combined with a decrease in PSD of beta- and theta-rhythm generating neurons. This is accompanied by increase in phagocytosis and favorable changes in immune, biochemical and biophysical parameters as well as increase in testosterone level in men only. The integral effects on the constellation of registered body parameters of both device modifications do not differ significantly. Conclusion. The "VEB" device exerts an adaptogenic effect on the body through transcutaneous electrical stimulation of neurons.