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From pulse width modulated TENS to cortical modulation: based on EEG functional connectivity analysis.

Armita Faghani Jadidi¹, Winnie Jensen¹, Ali Asghar Zarei¹

¹Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark.

Frontiers in Neuroscience

|August 21, 2023

Summary

Pulse width modulated (PWM) transcutaneous electrical nerve stimulation (TENS) shows long-lasting effects on brain networks for pain relief. This novel TENS approach enhances cortical connectivity, supporting its therapeutic potential in neurorehabilitation.

Keywords:

functional brain connectivity graph theory modulated TENS neurorehabilitation pain

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Combined Transcranial Magnetic Stimulation and Electroencephalography of the Dorsolateral Prefrontal Cortex

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Area of Science:

Neuroscience
Rehabilitation Medicine
Biomedical Engineering

Background:

Transcutaneous electrical nerve stimulation (TENS) modulation, particularly pulse width modulation (PWM), is a developing area in pain management and neurorehabilitation.
Previous studies explored PWM TENS effects on sensory perception and corticospinal activity, but its impact on cortical networks for pain alleviation remains unclear.

Purpose of the Study:

To investigate the underlying mechanisms of PWM TENS on cortical networks and its potential for pain alleviation.
To compare the effects of PWM TENS on cortical functional connectivity with conventional TENS.

Main Methods:

Electroencephalography (EEG) was used to record cortical activity in 12 healthy subjects.
Functional connectivity between eight brain regions involved in sensory and pain processing was analyzed using phase lag index and Spearman correlation.
Graph theory was applied to assess network segregation and integration changes post-stimulation.

Main Results:

PWM TENS induced statistically significant changes in cortical networks compared to conventional TENS.
Specifically, increased local network strength and efficiency in the high gamma band were observed in somatosensory areas one hour after PWM TENS.
These network alterations suggest a sustained effect of PWM TENS.

Conclusions:

PWM TENS demonstrates potential for long-lasting therapeutic effects on cortical networks.
The findings support the investigation of PWM TENS as a viable intervention in clinical pain and neurorehabilitation research.