• 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.

• 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 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.

• 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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• 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.

• 대한물리의학회지
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• 제8권1호
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• pp.79-89
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• 2013

PURPOSE: To identify the effects of single trial transcutaneous electrical nerve stimulation (TENS) application on chronic neuropathic pain and the repeated TENS application to development of neuropathic pain following peripheral nerve injury. METHODS: First, 20 rats were given the median nerve ligation to induce chronic neuropathic pain. After the ligation, neuropathic pain was assessed by measuring the forepaws withdrawal threshold to von Frey filaments for 3 weeks. Afterward, rats were randomly divided into TENS group and placebo-TENS group. TENS (frequency 100Hz, pulse width $200{\mu}s$) was applied to the forearm for 20 minutes. Second, 34 rats were randomly allocated into two group after median nerve ligation: TENS group and placebo-TENS group. Both interventions were applied to the forearm for 20 minutes from 1 day to 3 weeks after injury. Neuropathic pain to mechanical was measured on each rat for 3 weeks. RESULTS: Exeprimental rats showed a clear neuropathic pain-like behaviors, such as reduced forepaw withdrawal threshold to mechanical stimulation for 3 weeks, after median nerve ligation. And, TENS decreased effectively the chronic neuropathic pain originated from median nerve injury. TENS also diminished the development of neuropathic pain after nerve injury. CONCLUSION: Our animal model studying for neuropathic pain following median nerve injury may be useful to investigate peripheral neuropathic pain in human. Also, TENS may be used to mediate chronic neuropathic pain and to prevent the development of neuropathic pain following median nerve injury.

• The Journal of Korean Physical Therapy
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• 제18권4호
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• pp.19-26
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• 2006

Purpose: This study aimed the effects of percutaneous electric nerve stimulation (PENS) applied to different parts of the streptozotocin-induced diabetic rats on the change of glucose and nerve. Methods: rats (ten weeks old) were selected as the subjects; the normal group was five rats, and the diabetes induction group II, III and IV were five rats, respectively, which were randomly sampled from the twenty-five streptozotocin-administered rats with more than $240\;d{\ell}/m{\ell}$ of blood sugar. For PENS, electric current with 2 Hz of stimulation frequency and $200\;{\mu}s$ of pulse duration was applied to the subjects for fifteen minutes a day, six days a week, for three weeks. Calculation of glucose and weight, and nerve conduction test were conducted forty-eight hours and three weeks after streptozotocin administration, respectively. Results: As for change of glucose and weight, the group III with stimulation to the acupoints and the group IV with stimulation to non-acupoints showed significant differences from the control group II (p<0.05). As for MNCV (motor nerve conduction velocity), the group III with stimulation to the acupoints showed significant differences from the group IV with stimulation to non-acupoints and the control group II (p<0.05). Conclusion: PENS had the effects of inhibiting increase of glucose, change of weight and decrease of nerve conductive function between the distal and proximal ends of the peripheral nerve in the STZ-induced diabetic rats.

• The Journal of Korean Physical Therapy
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• 제19권4호
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• pp.33-41
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• 2007

Purpose: To investigate environmental enrichment and nerve stimulation follows in application times with the change of BDNF & Trk-B receptor in the motor cortex and spinal cord. Methods: Experimental groups were divided into the five groups. Group I: normal control group, Group II: experiment control group, Group III: sciatic never electrical stimulation after MCAO, Group IV: application of only environmental enrichment after MCAO, Group V: never electrical stimulation with environmental enrichment after MCAO. Histologic observation and coronal sections were processed individually in goat polyclonal antibody phosphorylated BDNF and rabbit polyclonal antibody Trk-B receptor. Results: In immunohistochemistric response of BDNF and Trk-B, group II were showed that lower response effect at postischemic 1 days, 3 days, and 7 days. Group V were showed that increase response effect at postischemic 3 days, 7 days and 14 days. Specially showed that the most response effect at postischemic 14 days. In neurobehavioral assessment, group V were significantly difference from other groups on between-subject effects. Conclusion: The above results suggest that combined environmental enrichment with peripheral nerve electrical stimulation in focal ischemic brain injury were more improved that the change of BDNF & Trk-B receptor expression than non treatment.

• The Korean Journal of Physiology and Pharmacology
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• 제9권3호
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• pp.143-147
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• 2005

Following peripheral nerve injury, excessive nociceptive inputs result in diverse physiological alterations in the spinal cord substantia gelatinosa (SG), lamina II of the dorsal horn. Here, I report the alterations of excitatory or inhibitory transmission in the SG of a rat model for neuropathic pain ('spared nerve injury'). Results from whole-cell recordings of SG neurons show that the number of distinct primary afferent fibers, identified by graded intensity of stimulation, is increased at 2 weeks after spared nerve injury. In addition, short-term depression, recognized by paired-pulse ratio of excitatory postsynaptic currents, is significantly increased, indicating the increase of glutamate release probability at primary afferent terminals. The peripheral nerve injury also increases the amplitude, but not the frequency, of spontaneous inhibitory postsynaptic currents. These data support the hypothesis that peripheral nerve injury modifies spinal pain conduction and modulation systems to develop neuropathic pain.

• The Journal of Korean Physical Therapy
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• 제12권1호
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• pp.49-56
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• 2000

The purpose of this study was to investigate the influnce of afferent stimuli, transcutaneous electrical nerve stimulation and ultra sound, on the electrdiagnostic study of normal subjects. Electrodiagnostic study was performed before and after the application of afferent stimulation of the right popliteal fossa on 18 healthy female volunteers. After the transcutaneous electrical nerve stimulation, there is no significantly change of latencies and amplitudes of SEP, H-reflex, peroneal nerve F-wave, and sensory nerve conduction. After the ultra sound, there is no significantly change of latencies and amplitudes of SEP, H-reflex, peroneal nerve F-wave, and sensory nerve conduction. Tibial nope F-wave and motor nerve shows prolonged latency after TENS and US (p<0.01). Ultrasound may have a similar mechanism of action compared to transcutaneous electrical nerve stimulation by having localized inhibitory effects of the peripheral nerve. However, further investigation is needed to assess their mechanism of action and the precise relevance of stimulation modality.