Higher-order power harmonics of pulsed electrical stimulation modulates corticospinal contribution of peripheral nerve stimulation

Peripheral nerve stimulation (PNS) involves the application of electrical stimulation near the proximity of peripheral nerves. Although the mechanism of action remains unknown, PNS likely modulates both the central and peripheral nervous systems to provide analgesia for a wide variety of pain disorders involving the head, extremities, and trunk. Historically, PNS was not utilized widely due to underwhelming results from earlier studies. However, significant innovations in device technologies, including improved implantation techniques, hardware miniaturization, and externalized pulse generators, have led to the resurgence of PNS in the field of pain medicine. This editorial briefly reviews the evolution of PNS in the field of pain medicine and highlights areas for future investigation.

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Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke

Frontiers in Neurology ◽

10.3389/fneur.2021.610434 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shih-Yen Tsai ◽

Jennifer A. Schreiber ◽

Natalie S. Adamczyk ◽

Joanna Y. Wu ◽

Son T. Ton ◽

...

Keyword(s):

Spinal Cord ◽

Blood Flow ◽

Electrical Stimulation ◽

Peripheral Nerve ◽

Functional Outcome ◽

Median Nerve ◽

Nerve Stimulation ◽

Peripheral Nerve Stimulation ◽

Post Stroke ◽

Axonal Tracing

Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are widely used with limited success. The purpose of this study was to examine the effect of electrical stimulation on the impaired upper extremity to improve functional recovery after stroke. We developed a rodent model using an electrode cuff implant onto a single peripheral nerve (median nerve) of the paretic forelimb and applied daily electrical stimulation. The skilled forelimb reaching test was used to evaluate functional outcome after stroke and electrical stimulation. Anterograde axonal tracing from layer V pyramidal neurons with biotinylated dextran amine was done to evaluate the formation of new neuronal connections from the contralesional cortex to the deafferented spinal cord. Rats receiving electrical stimulation on the median nerve showed significant improvement in the skilled forelimb reaching test in comparison with stroke only and stroke with sham stimulation. Rats that received electrical stimulation also exhibited significant improvement in the latency to initiate adhesive removal from the impaired forelimb, indicating better sensory recovery. Furthermore, axonal tracing analysis showed a significant higher midline fiber crossing index in the cervical spinal cord of rats receiving electrical stimulation. Our results indicate that direct peripheral nerve stimulation leads to improved sensorimotor recovery in the stroke-impaired forelimb, and may be a useful approach to improve post-stroke deficits in human patients.

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Enhancing osteoblast survival through pulsed electrical stimulation and implications for osseointegration

Scientific Reports ◽

10.1038/s41598-021-01901-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Emily Pettersen ◽

Furqan A. Shah ◽

Max Ortiz-Catalan

Keyword(s):

Electrical Stimulation ◽

Peripheral Nerve ◽

Cell Survival ◽

Nerve Stimulation ◽

Peripheral Nerve Stimulation ◽

Dependent Manner ◽

Stimulation Parameters ◽

Wide Range ◽

The Impact

AbstractElectrical stimulation has been suggested as a means for promoting the direct structural and functional bonding of bone tissue to an artificial implant, known as osseointegration. Previous work has investigated the impact of electrical stimulation in different models, both in vitro and in vivo, using various electrode configurations for inducing an electric field with a wide range of stimulation parameters. However, there is no consensus on optimal electrode configuration nor stimulation parameters. Here, we investigated a novel approach of delivering electrical stimulation to a titanium implant using parameters clinically tested in a different application, namely peripheral nerve stimulation. We propose an in vitro model comprising of Ti6Al4V implants precultured with MC3T3-E1 preosteoblasts, stimulated for 72 h at two different pulse amplitudes (10 µA and 20 µA) and at two different frequencies (50 Hz and 100 Hz). We found that asymmetric charge-balanced pulsed electrical stimulation improved cell survival and collagen production in a dose-dependent manner. Our findings suggest that pulsed electrical stimulation with characteristics similar to peripheral nerve stimulation has the potential to improve cell survival and may provide a promising approach to improve peri-implant bone healing, particularly to neuromusculoskeletal interfaces in which implanted electrodes are readily available.

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