Transcutaneous Electrical Nerve Stimulation Induces Vasodilation in Healthy Controls But Not in Refractory Angina Patients

Hallén, Katarina; Hrafnkelsdóttir, Thórdís; Jern, Sverker; Biber, Björn; Mannheimer, Clas; DuttaRoy, Smita

doi:10.1016/j.jpainsymman.2009.12.009

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…Neuromodulation may vary depending on the duration, intensity, and area of application 16 . Previous studies have demonstrated that time of electrical stimulation seem to promote different responses, changes in local circulation 10,[17][18][19] , increase in myocardial oxygen, and reduction in oxygen demand 20 ; however, it is still unclear whether interferential current stimulation can improve blood flow during muscle metaboreflex induction. Indergand and Morgan 10 applied IES for only 10 min 10 , but in our study, the opposite results were obtained when IES was applied for 30 min, suggesting that improvement of blood-flow control might be time-dependent.…”

Section: Introductionmentioning

confidence: 99%

Interferential electrical stimulation improves peripheral vasodilatation in healthy individuals

Santos¹,

Chiappa²,

Vieira³

et al. 2013

Braz. J. Phys. Ther.

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| Background: Interferential electrical stimulation (IES), which may be linked to greater penetration of deep tissue, may restore blood flow by sympathetic nervous modulation; however, studies have found no association between the frequency and duration of the application and blood flow. We hypothesized that 30 min of IES applied to the ganglion stellate region might improve blood flow redistribution. Objectives: The purpose of this study was to determine the effect of IES on metaboreflex activation in healthy individuals. Method: Interferential electrical stimulation or a placebo stimulus (same protocol without electrical output) was applied to the stellate ganglion region in eleven healthy subjects (age 25±1.3 years) prior to exercise. Mean blood pressure (MBP), heart rate (HR), calf blood flow (CBF) and calf vascular resistance (CVR) were measured throughout exercise protocols (submaximal static handgrip exercise) and with recovery periods with or without postexercise circulatory occlusion (PECO+ and PECO -, respectively). Muscle metaboreflex control of calf vascular resistance was estimated by subtracting the area under the curve when circulation was occluded from the area under the curve from the AUC without circulatory occlusion. Results: At peak exercise, increases in mean blood pressure were attenuated by IES (p<0.05), and the effect persisted under both the PECO+ and PECO-treatments. IES promoted higher CBF and lower CVR during exercise and recovery. Likewise, IES induced a reduction in the estimated muscle metaboreflex control (placebo, 21±5 units vs. IES, 6±3, p<0.01). Conclusion: Acute application of IES prior to exercise attenuates the increase in blood pressure and vasoconstriction during exercise and metaboreflex activation in healthy subjects.

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Section: Introductionmentioning

confidence: 99%

Interferential electrical stimulation improves peripheral vasodilatation in healthy individuals

Santos¹,

Chiappa²,

Vieira³

et al. 2013

Braz. J. Phys. Ther.

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“…Decreased vascular resistance may reduce myocardial oxygen consumption and therefore improves oxygen demand/consumption balance. Interesting findings were published by Hallén et al -in their study TENS caused vasodilation only in healthy control patients but not in those with the refractory angina 71 .…”

Section: Transcutaneous Electrical Nerve Stimulation (Tens)mentioning

confidence: 84%

Interventional treatment of pain in refractory angina. A review

Dobias¹,

Michálek²,

Neužil³

et al. 2014

BIOMED PAP

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Background. Refractory angina is characterized by repeated attacks of chest pain in patients on maximal anti-anginal pharmacotherapy, with a professional conscensus that further surgical or radiological revascularization would be futile. Refractory angina is a serious but relatively uncommon health problem, with a reported incidence of approximately 30 patients per million people/year. In this condition simply treating the associated pain alone is important as this can improve exercise tolerance and quality of life.Methods. An extensive literature search using five different medical databases was performed and from this, eightythree papers were considered appropriate to include within this review. Results and Conclusion. Available literature highlights several methods of interventional pain treatment, including spinal cord stimulation and video-assisted upper thoracic sympathectomy which can provide good analgesia whilst improving physical activities and quality of life. The positive effect of spinal cord stimulation on the intensity of pain and quality of life has been confirmed in nine randomized controlled trials. Other potential treatment methods include stellate ganglion blocks, insertion of thoracic epidural or spinal catheters and transcutaneous electrical nerve stimulation. These approaches however appear more useful for diagnostic purposes and perhaps as short-term treatment measures.

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“…Dong et al reported that the changes of perfusion and microcirculation in the stomach were effectively improved after EA given at the Zusanli (ST 36) acupoint [17]. One commonality found in many studies is that TENS has been identified as an effective treatment option to relieve ischemic pain by increasing local blood flow by inducing a vasodilatory effect [16]. In addition, another study also found that TENS can improve the vascular response of aged rats by producing a neurogenic vasodilator effect [35].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies revealed that TENS has become a novel complementary therapy and an alternative to conventional medicine in clinical practice because of its safety and lack of adverse reactions [14], [15]. Accumulating clinical and experimental evidence has demonstrated that TENS and electrical acupuncture stimulation can effectively increase local blood flow and blood perfusion to the stomach and reduce intestinal ischemia [16]–[18]. Additionally, it also can increase blood perfusion to the ovary by modulating central circulatory systems [19].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Electrical Nerve Stimulation Regulates Organ Blood Flow and Apoptosis during Controlled Hypotension in Dogs

et al. 2014

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Transcutaneous electrical nerve stimulation (TENS) is commonly used in clinical practice for alleviating pains and physiological disorders. It has been reported that TENS could counteract the ischemic injury happened in some vital organs. To determine the protective effect of TENS on internal organs during CH in dogs, target hypotension was maintained for 60 min at 50% of the baseline mean arterial pressure (MAP). The perfusion to the brain, liver, stomach, and kidney was recorded and apoptosis within these organs was observed. Results showed that when arriving at the target MAP, and during the maintaining stage for 10 min, perfusion to the stomach and liver in the CH+TENS group was much higher than in the CH group (P<0.05). Perfusion to the cerebral cortex greatly declined in both the controlled pressure groups when compared with the general anesthesia (GA) group (P<0.05). After withdrawing CH, the hepatic blood flow in both the CH and CH+TENS groups, and the gastric and cerebral cortical blood flow in the CH+TENS group, were rapidly increased. By the end of MAP restoration, gastric blood flow in the CH group was still low. At 72 h after applying CH, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)-positive cells in stomach and kidney tissue from the CH group were significantly increased compared with those in the GA group (P<0.05). There was no significant difference in TUNEL-positive cells in the liver and hippocampus among the three groups. Our results demonstrated that CH with a 50% MAP level could cause lower perfusion to the liver, stomach, cerebral cortex, and kidney, with apoptosis subsequently occurring in the stomach and kidney. TENS combined GA is able to improve the blood flow to the liver, stomach, and reduce the apoptosis in the stomach and kidney.

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Transcutaneous Electrical Nerve Stimulation Induces Vasodilation in Healthy Controls But Not in Refractory Angina Patients

Abstract: High-dose TENS induces forearm vasodilation in healthy subjects but not in patients with RAP. These findings suggest that TENS has different vascular effects in patients with severe coronary artery disease compared with healthy controls.

Cited by 16 publications

References 25 publications

Interferential electrical stimulation improves peripheral vasodilatation in healthy individuals

Interferential electrical stimulation improves peripheral vasodilatation in healthy individuals

Interventional treatment of pain in refractory angina. A review

Transcutaneous Electrical Nerve Stimulation Regulates Organ Blood Flow and Apoptosis during Controlled Hypotension in Dogs

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