• 재활치료과학
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• 제5권2호
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• pp.11-22
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• 2016

목적: 본 연구는 국외 뇌졸중 환자에게 적용한 한 말초감각신경자극의 효과에 대하여 고찰하기 위한 것으로 국외 학술지를 대상으로 체계적 문헌고찰 연구방법을 시행하였다. 연구방법: 2015년 10월 이전까지 국외 학술지에 게재된 논문을 Pubmed를 통하여 검색하였다. 주요 검색 용어로는 'peripheral nerve stimulation', 'electrical stimulation', 'sensory stimulation', 'somatosensory stimulation', 'stroke', 'hemiplegia', 'hemiparesis' 와 'hand', 'arm', 'upper limb'를 사용하였다. 최초 검색된 논문은 501편이었으나 선정 및 배제기준을 거쳐 10편의 연구가 선정되었다. 결과: 임상적으로 널리 사용되고 있는 말초감각신경자극은 뇌졸중 환자들에게 적용이 될 때에 보다 다양한 중재방법으로 연구에 적용이 되고 있었다. 말초감각신경자극치료는 뇌졸중 환자의 상지 기능에 효과를 나타냈으며, 대뇌피질의 활성화에도 긍정적인 영향을 나타냈다. 결론: 본 연구는 말초감각신경자극치료의 적용에 대한 근거를 제시하며, 향후 국내연구에서는 다양한 중재방법을 적용하여 말초감각신경자극의 효과를 더 정확하게 측정을 할 수 있는 방법에 대한 연구가 필요하다.

• The Korean Journal of Pain
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• 제21권2호
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• pp.155-158
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• 2008

This report presents the application of occipital nerve stimulation in two patients with severe and disabling bilateral occipital neuralgia. Pain persisted despite the use of several procedures and the administration of medication in the patients. The patients underwent peripheral nerve stimulation for the treatment of headache. Peripheral nerve stimulation was accomplished via implantation of a subcutaneous electrode to stimulate the peripheral nerve in the occipital area. The patients reported a 90% improvement in overall pain. These cases illustrate the possible utilization of peripheral nerve stimulation for the treatment of occipital neuralgia.

• The Korean Journal of Physiology
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• 제19권2호
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• pp.227-232
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• 1985

Previously, we had reported that the electrical stimulation of peripheral nerve with stimlatory parameters of 20 V strength and 2 Hz frequency for 60 min resulted in reducing the pain reaction. The present study was performed to evaluate if the pain reaction was affected by the peripheral nerve stimulation with different stimulatory parameters in the decerebrated cat. The flexion reflex was used as an index of the pain reaction. The reflex was elicited by stimulating the sural nerve (stimulus strength of 20 $V\;\times\;0.5$msec) and recorded as a compound action potential from the motor nerve innervated to the posterior biceps femoris muscle. The common perneal nerve was selected as a peripheral nerve on which the electrical stimulation of various intensities and frequencies was applied. The results are summarized as follows : 1) The peripheral nerve stimulation with 100 mV strength, regardless of frequencies, did not affect the pain reaction induced by the sural nerve stimulation. 2) When the stimulus of 1V intensity and slow frequency (2 Hz) was applied to the peripheral nerve for 30 min or 60 min, the pain reaction was significantly reduced comparing to the control. However, this reduced pain reaction by the peripheral nerve stimulation was not reversed by the injection of naloxone (0.02 mg/kg) 3) High frequency stimulus (60 Hz) of 1V intensity for 30 or 60 min did not show any effects of affecting the pain reaction. These results suggest that the stimulus of relatively high intensity (at least 1V) and low frequency (2 Hz) is needed to elicite the analgesic effect by the peripheral nerve stimulation. By the 1V stimulus, $A\delta$ nerve fiber is activated. Therefore, an $A\delta$ or smaller nerve fibers must be activated for showing analgesia by the peripheral nerve stimulation. However, the mechanism of analgesia by the $A\delta$ nerve activation alone was not related to the endogeneous morphine system since the reduced pain reaction by the $A\delta$ fiber activation alone was not reversed by the treatment of naloxone.

• The Korean Journal of Physiology
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• 제17권2호
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• pp.169-176
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• 1983

It is well known that the acupuncture has been used effectively for the relief of certain types of pain. Although the precise mechanism of action of acupuncture analgesia is unknown, it is generally accepted that their analgesic properties are related to the activation of endogenous opiate system in central nervous system. And it is suggested that pain-relieving properties of acupunture may be related to a stimulation of peripheral nerve underlying the acupuncture point on the skin. However, the efficacy of acupuncture has no relationship between the site of pain and the acupuncture point. Consequently, the present study was undertaken to investigate electroacupuncture analgesia in relation to the site of peripheral nerve stimulation. Cats were decerebrated ischemically and the flexion reflex as an index of pain was elicited by stimulating the sural nerve (20V, 0.5 msec duration) and recored as a compound action potential from the nerve innervated to the posterior biceps femoris muscle in the ipsilateral hindlimb. Bilateral common peroneal nerve and contralateral superficial radial nerve were selected as the site of peripheral nerve stimulation. For the stimulation of peripheral nerve, a stimulus of 20 V intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min respectively. The results obtained are summarized as follows: 1) Both stimulation of contralateral common peronal nerve and contralateral superficial radial nerve did not change the flexion reflex and there were no significant differences between them. 2) Stimulation of ipsilateral common peroneal nerve markedly depress the flexion reflex, the effect being reversed by naloxone application. These results suggest that stimulation of ipsilateral common peroneal nerve has the analgesic effect but both stimulation of contralteral common peroneal nerve and contralateral superficial radial nerve to the pain site where flexion reflex was elicited have no analgesic effect.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.221-230
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• 2020

본 연구는 만성 허리통증환자의 라이프 케어 증진을 위해 중추성과 말초성 자극에 따른 감각변화의 차이를 알아보고자 하였다. 12명의 만성 허리통증환자는 중추성 자극군(central stimulation, CS, n=6)과 말초성 자극군(peripheral stimulation, PS, n=6)으로 무작위 할당하여 정량적감각검사(QST), 압력통각역치(PPT) 그리고 요통기능장애지수(ODI)를 정량적으로 측정 및 분석하였다. 연구결과, QST, PPT 그리고 ODI는 시기별 유의한 차이를 나타냈으나(p<.01) 두 군 간의 차이는 나타나지 않았다(p>.05). 따라서, 두 자극 모두 통증으로 인해 민감해진 근육의 감각역치 증가와 기능개선에 유의한 효과를 보여 만성 허리통증환자를 위한 라이프케어 증진에 상당한 의미가 있다고 생각된다.

• 대한물리치료과학회지
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• 제3권1호
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• pp.907-918
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• 1996

Evoked potentials(EP) are defined as electric responses of the nerves system to sensory stimulation. EPs are used mainly to test conduction in the visual, auditory, and somatosensory systems, especially in the central parts of these systems. Somatosensory evoked potentials (SEP) are the potentials elicited by stimulation of peripheral nerves and recorded at various sites along the sensory pathway. SEPs types consist mainly of SEPs to electric stimulation of arm or leg nerves. SEPs to arm stimulation are usually recorded simultaneously from clavicular, cervical, and scalp electrodes; SEPs to leg stimulation are recorded from lumbar, low thoracic, and scalp electrodes. Subject variables that have practical impotance are age, limb length, body height, and temperature. General clinical interpretation of abnormal SEPs wave decreases of peripheral conduction time, and abolition of SEPs recorded from different levels to identify lesions of peripheral nerves, plexus, nerve root, spinal cord, cauda equina, hemispheric brainstem, and cerebral parts of the somatosensory pathway.

• The Journal of Korean Physical Therapy
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• 제11권2호
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• pp.37-42
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• 1999

The purpose of this study was to determine whether percutaneous interferential current stimulation on thoracic sympathetic ganglia with amplitude modulated frequency (AMF) $90\~100$ bps and subthreshold of muscle contraction for 10 minutes on peripheral blood flow velocity in healthy subjects. Thirty-seven healthy volunteers were assigned randomly into an experimental group (n=25) and a control group (n=12). the experimental group received interferential current stimulation with subthreshold of the muscle contraction of current at AMF $90\~100$ bps on $1st\~5th$ thoracic sympathetic ganglial region for 10 minutes. The control group received same handling and electode placement, but no current was applied. Using a Doppler blood flow meter, the radial arterial blood flow velocities and the pulse raters were determined for two-way analysis of variance for repeated measures on time and group. There were no significant difference between the two groups with respect to the changes in arterial blood flow velocity and pulse rate over the four measurement times. Interferential current stimulation did not change in mean blood flow velocity and pulse rate. We conclude that interferential current stimulation on the thoracic sympathetic ganglia, as used in this study, did not dilate peripheral artery. This results suggests that interferential current stimulation dose not alter the activtiy of sympathetic nerve.

• 대한한의학회지
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• 제24권3호
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• pp.108-117
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• 2003

Objective : The central opioid mechanism of acupuncture analgesia has been fairly well documented in acute behavioral experiments, but little electrophysiological study has been performed on the peripheral mechanism and subtypes of opioid receptors responsible for acupuncture-induced antinociception in chronic animal models. In the present electrophysiological experiment, we studied the peripheral mechanism and opioid receptor subtypes which Were implicated in electroacupuncture-induced antinociception in the rat with chronic inflammatory and neurogenic pain. Methods : In the rat with complete Freund's adjuvant-induced inflammation and spinal nerve injury, dorsal horn cell responses to afferent C fiber stimulation were recorded before and after electroacupuncture (EA) stimulation applied to the contralateral Zusanli point for 30 minutes. Also studied Were the effects of specific opioid receptor antagonists and naloxone methiodide, which can not cross the blood-brain barrier, on EA-induced inhibitory action. Results : EA-induced inhibitory action was significantly attenuated by naloxone methiodide, suggesting that EA-induced inhibition was mediated through peripheral mechanism. Pretreatment, but not posttreatment of naltrexone and spinal application significantly blocked EA-induced inhibitory actions. In inflammatory and neurogenic pain models, ${\mu}-$ and ${\delta}-opioid$ receptor antagonists (${\beta}-funaltrexamine$ & naltrindole) significantly reduced EA-induced inhibitory action, but ${\kappa}-opioid$ receptor antagonist had weak inhibitory effect on EA-induced antinociception. Conclusion : These results suggest that 2Hz EA-stimulation induced antinoeiceptive action is mediated through peripheral as well as central mechanism, and mainly through ${\mu}-$ and ${\delta}-opioid$ receptors.

• The Korean Journal of Physiology
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• 제15권2호
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• pp.73-81
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• 1981

Experiments were conducted in ischemic decerebrate cats to study the effects of electroacupuncture and electrical stimulation of peripheral nerve on pain reaction. Flexion reflex was used as an index of pain. The reflex was elicited by stimulating the sural nerve(20 V, 0.5 msec duration) and recorded as a compound action potential from the nerve innervated to the semitendinosus muscle. Electroacupuncture was performed, using a 23-gauge hyperdermic needle, on the tsusanli point in the lateral upper tibia of the ipsilateral hindlimb. The common peroneal nerve was selected as a peripheral nerve which may be associated with electroacupuncture action, as it runs through the tissue portion under the tsusanli point. Both for electroacupuncture and the stimulation of common peroneal nerve a stimulus of 20 V-intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min. The results are summerized as follows: 1) The electroacupuncture markedly depressed the flexion reflex; this effect was eliminated by systemic application of naloxone $(0.02{\sim}0.12\;mg/kg)$, a specific narcotic antagonist. 2) Similarly, the electrical stimulation of the common peroneal nerve significantly depressed the flexion reflex, the effect being reversed by naloxone. 3) When most of the afferent nerves excluding sural nerve in the ipsilateral hindlimb were cut, the effect of electroacupuncture on the flexion reflex was not observed. Whereas direct stimulation of the common peroneal nerve at the proximal end from the cut resulted in a significant reduction of the flexion reflex, again the effect was reversible by naloxone application. 4) Transection of the spinal cord at the thoracic 12 did not eliminate the effect of peripheral nerve stimulation on the flexion reflex and its reversal by naloxone, although the effect was significantly less than that in the animal with spinal cord intact. These results suggest that: 1) the analgesic effect of an electroacupuncture is directly mediated by the nervous system and involves morphine-like substances in CNS, 2) the site of analgesic action of electroacupuncture resides mainly in the brainstem and in part in the spinal cord.

• 대한물리치료과학회지
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• 제1권1호
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• pp.121-127
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• 1994

The purpose of this study was to determine whether vasodilation occurs when interferential current is applied to the cervical sympathetic chain and peripheral sympathetic nerves. A digital thermometer was used to record skin temperature change. The protocols used for interferential stimulation were 90-100 Hz, applied for 20 minutes via two pairs of electrodes 1) to the throat and 2) to the forearm. Forty subjects were stimulated at each of the two sites. There was no significant correlation between inital skin temperature, sex or age and temperature change. Even though there was a statistically significant temperature increase with cervical sympathetic chain stimulation, this had no clinical vasodilatory effect. More research on interferential current stimulation is needed so that the potential benefits to normal subjects and patients is better understood.