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Updated: Jul 10, 2026
Studying the Coding Profiles of Somatic Stimulation on Cardiac-locked Neuronal Responses in the Rat Spinal Dorsal Horn
Published on: May 23, 2025
Sacral nerve stimulation modulates disease activity and autonomic function in active rheumatoid arthritis: a
Xiaoqin Wang1, Bingguo Xu2, Guoxin Wang2
1Department of Rheumatology and Immunology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Objective:
To evaluate the feasibility and safety as well as potential effects of percutaneous sacral nerve stimulation (SNS) via acupuncture needles in patients with active rheumatoid arthritis (RA).
Methods:
Twenty-one patients with active RA were allocated to receive either active SNS (n = 11) or sham stimulation (n = 10) for 60 min daily over 14 days. Primary outcomes were changes in disease activity, assessed by the Disease Activity Score in 28 joints (DAS-28), tender joint count (TJC), swollen joint count (SJC), pain intensity on a visual analogue scale (VAS), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Secondary outcomes included the following: (1) patient-reported outcomes for joint function, fatigue, anxiety, and depression; (2) serum levels of inflammatory cytokines; and (3) heart rate variability (HRV) parameters as a measure of autonomic function.
Results:
In this pilot study, the SNS group showed significant within-group improvements in TJC, VAS, DAS28-ESR, and DAS28-CRP. However, an analysis of covariance (ANCOVA) adjusting for baseline values revealed no significant between-group differences in clinical and inflammatory parameters. The SNS group showed a significant increase in rMSSD (parasympathetic marker), with the between-group difference sustained after baseline adjustment. No significant differences were observed in functional and psychological scores or serum cytokine levels between the two groups.
Conclusion:
This first-in-human study indicates that percutaneous SNS is feasible and safe, with a possible modulatory effect on autonomic function in active RA. Further large‑scale, adequately powered trials are warranted to confirm the clinical efficacy and mechanisms of SNS in RA.
Trial Registration:
This study was registered at ClinicalTrials.gov on March 25, 2021 under the identifier NCT04821050 (Protocol ID: 202002053). Key Points • First-in-human pilot study of percutaneous sacral nerve stimulation (SNS) in active RA. • SNS was associated with significant within-group improvements in tender joint count, pain VAS, and DAS28, but between-group differences did not reach statistical significance after baseline adjustment. • SNS significantly enhances parasympathetic activity (rMSSD) compared with sham stimulation, an effect that remained significant after adjusting for baseline differences. • Percutaneous SNS was safe and well-tolerated, with no serious adverse events reported.
