Habituation to Experimentally Induced Electrical Pain during Voluntary-Breathing Controlled Electrical Stimulation (BreEStim)

Objective

Painful peripheral electrical stimulation to acupuncture points was found to cause sensitization if delivered randomly (EStim), but induced habituation if triggered by voluntary breathing (BreEStim). The objective was to systematically compare the effectiveness of BreEStim and EStim and to investigate the possible mechanisms mediating the habituation effect of BreEStim.

Methods

Eleven pain-free, healthy subjects (6 males, 5 females) participated in the study. Each subject received the BreEStim and EStim treatments in a random order at least three days apart. Both treatments consisted of 120 painful but tolerable stimuli to the ulnar nerve at the elbow on the dominant arm. BreEStim was triggered by voluntary breathing while EStim was delivered randomly. Electrical sensation threshold (EST) and electrical pain threshold (EPT) were measured from the thenar and hypothenar eminences on both hands at pre-intervention and 10-minutes post-intervention.

Results

There was no difference in the pre-intervention baseline measurement of EST and EPT between BreEStim and EStim. BreEStim increased EPT in all tested sites on both hands, while EStim increased EPT in the dominant hypothenar eminence distal to the stimulating site and had no effect on EPT in other sites. There was no difference in the intensity of electrical stimulation between EStim and BreEStim.

Conclusion

Our findings support the important role human voluntary breathing plays in the systemic habituation effect of BreEStim to peripheral painful electrical stimulation.     

Modification of Electrical Pain Threshold by Voluntary Breathing-Controlled Electrical Stimulation (BreEStim) in Healthy Subjects

Background

Pain has a distinct sensory and affective (i.e., unpleasantness) component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of post-amputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli.

Methods

Eleven pain-free healthy subjects (7 males, 4 females) participated in the study. All subjects received BreEStim (100 stimuli) and conventional electrical stimulation (EStim, 100 stimuli) to two acupuncture points (Neiguan and Weiguan) of the dominant hand in a random order. The two different treatments were provided at least three days apart. Painful, but tolerable electrical stimuli were delivered randomly during EStim, but were triggered by effortful inhalation during BreEStim. Measurements of tactile sensation threshold, electrical sensation and electrical pain thresholds, thermal (cold sensation, warm sensation, cold pain and heat pain) thresholds were recorded from the thenar eminence of both hands. These measurements were taken pre-intervention and 10−min post-intervention.

Results

There was no difference in the pre-intervention baseline measurement of all thresholds between BreEStim and EStim. The electrical pain threshold significantly increased after BreEStim (27.5±6.7% for the dominant hand and 28.5±10.8% for the non-dominant hand, respectively). The electrical pain threshold significantly decreased after EStim (9.1±2.8% for the dominant hand and 10.2±4.6% for the non–dominant hand, respectively) (F_{[1, 10]} = 30.992, p = .00024). There was no statistically significant change in other thresholds after BreEStim and EStim. The intensity of electrical stimuli was progressively increased, but no difference was found between BreEStim and EStim.

Conclusion

Voluntary breathing controlled electrical stimulation selectively increases electrical pain threshold, while conventional electrical stimulation selectively decreases electrical pain threshold. This may translate into improved pain control.     

Release of a neurosecretory protein from the corpora cardiaca of Locusta migratoria induced by high potassium saline and compound action potentials

Electrical stimulation of nervus corpus cardiacum I (NCCI) resulted in the propagation of a compound action potential into the storage and glandular lobes of the corpus cardiacum (CC) of Locusta migratoria. The compound action potential was abolished in the presence of both sodium-free saline and tetrodotoxin (TTX). Calcium-free saline had variable effects.The release of a neurosecretory protein (estimated following precipitation with an antiserum directed against neurosectetory protein) was examined after treatment with high potassium saline and electrical stimulation of NCC I. Release was induced by elevated potassium salines and by the propagation of a compound action potential along NCC I. The release was calcium-dependent. TTX and sodium-free saline abolished the electrically-induced release of protein. Concomitant with the release of protein was the release of a factor with diuretic activity, illustrating that hormones are also being released along with the neurosecretory protein. The release of this protein was dependent upon the frequency of electrical stimulation (up to approx. 5 Hz) and the patterning of electrical stimulation. This neurosecretory protein which has previously been shown to be very similar in both size and amino acid composition to the pituitary neurophysins, now also shares the characteristic of being released along with hormone.     

经皮穴位电刺激治疗术后疼痛的研究进展

术后疼痛是术后常见的一种伤害性疼痛,随着舒适化医疗的倡导,经皮穴位电刺激因其无创、安全等优点受到关注。经皮穴位电刺激是将经皮神经电刺激与针灸穴位理论相结合的一种方法,虽有研究证实其频率、波形、强度、刺激时间的设定及不同穴位的配伍对镇痛效果均可产生较大的影响,但在规范化方面仍有不足。本文总结其使用方法及镇痛疗效,以期对经皮穴位电刺激应用于临床提供最优参数及穴位配伍,使之规范化,从而发挥出最佳镇痛效果。     

电刺激联合干细胞修复周围神经损伤的研究进展

周围神经损伤在创伤中较为常见,易造成神经系统部分或全部损伤,从而导致功能丧失和其他神经性疾病．尽管周围神经损伤的治疗效果随着科技的发展有了明显提高,但距离真正的形态和功能重建还相差甚远,神经再生及功能恢复速度缓慢仍是临床治疗的难点．电刺激因使用方便、无创和副作用小等优点越来越受到研究者的青睐,与干细胞联合广泛用于周围神经损伤修复的体外研究．本文论述了电刺激联合干细胞在周围神经损伤修复方面的研究进展,并讨论了其可能的作用机理．特别分析了电刺激联合干细胞在周围神经损伤修复研究中的难点,展望了其发展前景．     

Response of external inspiration to the movements induced by transcutaneous spinal cord stimulation

The dynamic of the parameters of lung ventilation and gas exchange have been studied in 10 young male subjects during involuntary stepping movements induced by transcutaneous spinal cord electrical stimulation applied in the projection of T ₁₁–T ₁₂ vertebrae and during voluntary stepping movements. It has been found that the transcutaneous spinal cord stimulation inducing stepping movements leads to an increase in breathing frequency and a reduction in tidal volume. These effects may be mediated by some neurogenic factors associated with muscular activity during stepping movements, the activation of abdominal expiratory muscles, and the interaction between the stepping pattern and breathing generators.     

Modeling the interactions between stimulation and physiologically induced APs in a mammalian nerve fiber: dependence on frequency and fiber diameter

Electrical stimulation of nerve fibers is used as a therapeutic tool to treat neurophysiological disorders. Despite efforts to model the effects of stimulation, its underlying mechanisms remain unclear. Current mechanistic models quantify the effects that the electrical field produces near the fiber but do not capture interactions between action potentials (APs) initiated by stimulus and APs initiated by underlying physiological activity. In this study, we aim to quantify the effects of stimulation frequency and fiber diameter on AP interactions involving collisions and loss of excitability. We constructed a mechanistic model of a myelinated nerve fiber receiving two inputs: the underlying physiological activity at the terminal end of the fiber, and an external stimulus applied to the middle of the fiber. We define conduction reliability as the percentage of physiological APs that make it to the somatic end of the nerve fiber. At low input frequencies, conduction reliability is greater than 95% and decreases with increasing frequency due to an increase in AP interactions. Conduction reliability is less sensitive to fiber diameter and only decreases slightly with increasing fiber diameter. Finally, both the number and type of AP interactions significantly vary with both input frequencies and fiber diameter. Modeling the interactions between APs initiated by stimulus and APs initiated by underlying physiological activity in a nerve fiber opens opportunities towards understanding mechanisms of electrical stimulation therapies.     

Interactions between spinal cord stimulation and activity blockade in the regulation of synaptogenesis and motoneuron survival in the chick embryo

The present study investigated the effects of spinal cord stimulation, neuromuscular blockade, or a combination of the two on neuromuscular development both during and after the period of naturally occurring motoneuron death in the chick embryo. Electrical stimulation of the spinal cord was without effect on motoneuron survival, synaptogenesis, or muscle properties. By contrast, activity blockade rescued motoneurons from cell death and altered synaptogenesis. A combination of spinal cord stimulation and activity blockade resulted in a marked increase in motoneuron death, and also altered synaptogenesis similar to that seen with activity blockade alone. Perturbation of normal nerve–muscle interactions by activity blockade may increase the vulnerability of developing motoneurons to excessive excitatory afferent input (spinal cord stimulation) resulting in excitotoxic-induced cell death. © 1993 John Wiley & Sons, Inc.     

电刺激引发骨骼肌细胞钙振荡对nAChRγ启动子活性的影响

利用不同电刺激条件模拟神经电活动 ,研究C2C12细胞 (小鼠骨骼肌成肌细胞系 )内Ca2 + 激活的不同形式及其对nAChR基因表达活性的影响 .电刺激分化 1d的C2C12细胞 ,用共聚焦显微镜记录不同电刺激参数引起的细胞内Ca2 + 信号变化 ,共观察到 3种不同形式的Ca2 + 信号 ,称之为整体Ca2 + 振荡、局部Ca2 + 振荡和局部Ca2 + 振荡诱发的整体Ca2 + 振荡 .在此基础上 ,又构建nAChRγ亚基启动子萤光素酶报告基因质粒并转染C2C12细胞 ,进一步检测不同形式Ca2 + 引起细胞萤光素酶活性的变化 ,测定细胞内PKC活性的改变 .不同Ca2 + 振荡引起细胞内PKC活性升高幅度不同 ;电刺激C2C12细胞可导致nAChRγ基因表达活性降低 ,3种Ca2 + 振荡对nAChRγ基因启动子活性的影响无显著差异 .结果表明 ,电刺激可引起肌细胞产生不同形式Ca2 + 信号 ,但不同形式Ca2 + 信号对nAChRγ启动子活性的抑制无明显差异 ,提示Ca2 + 依赖的PKC途径可能不是nAChR基因表达下调的唯一途径     

Gastric Electrical‐Stimulation Effects on Canine Gastric Emptying,Food Intake,and Body Weight

Objective: It has been reported that electrical stimulation at the distal stomach can disrupt intrinsic gastric electrical activity and delay gastric emptying. Gastric dysrhythmia and impaired gastric emptying are associated with upper gastrointestinal symptoms and weight loss. The purpose of this study was to evaluate the effect of low‐frequency/long‐pulse gastric electrical stimulation (GES), at proximal and distal stomach, on canine gastric emptying, food intake, and body weight. Research Methods and Procedures: Eight dogs were surgically implanted with four pairs of electrodes along the greater curvature and a gastric tube at the dependent part of the stomach. Liquid gastric emptying at baseline, during proximal and distal GES at 6 cycles per minute, was assessed first by a dye dilution technique. Proximal and distal GES were then randomly delivered during feeding for 10 consecutive days, and food intake and body weight were recorded daily. Results: There was no significant difference in gastric emptying parameters among the various sessions. The mean daily food consumption was significantly reduced during both sessions of GES, resulting in significant immediate weight loss. Percentage weight loss was comparable between both sessions of GES. Discussion: Short‐term GES significantly reduced canine food intake and weight. This effect may not be related to changes in gastric emptying. GES may have a potential role in the treatment of obesity.     

电剌激及心肌缺血所致豚鼠心脏神经肽Y释放变化的研究

电剌激豚鼠心脏左星状交感神经节,可引起钙依赖性的神经肽Ｙ（ＮＰＹ）胞外释放,缺血１０ｍｉｎ后行电刺激（Ｓ２）,与对照期（Ｓ１）比较,ＮＰＹ释放无明显变化,缺血２０ｍｉｎ后行电剌激,ＮＰＹ释放受到一定程度的抑制,（Ｓ２／Ｓ１：０．７２,Ｐ＜０．０５）,而再灌注５ｍｉｎ后行电剌激ＮＰＹ释放抑制作用逐步消失,与Ｓ１比较,已无明显减少（Ｓ２／Ｓ１;１．０１,Ｐ＞０．０５）。仅缺血无电剌激几乎不引起ＮＰＹ释放。这些结果提示,电剌激交感神经节可致ＮＰＹ呈现一种钙依赖性出胞释放,缺血早期ＮＰＹ释放受到某些代谢产物抑制,恢复再灌注后,代谢产物逐步冲洗出,抑制作用也随之消失。     

电和L—谷氨酸钠刺激兔中缝隐核对膈神经放电的影响

实验在45只麻醉、自主呼吸、断双侧颈迷走神经的家兔上进行。电刺激或微量注射L-谷氨酸钠于中缝隐核(Nucleus raphe obscurus,NRO),观察到:(1)长串电脉冲刺激NRO(50—200μA,波宽0.3ms,100Hz,4—6s),出现膈神经放电被抑制的反应,被抑制的程度与刺激强度、刺激频率间存在相关性。(2)吸气期用短串电脉冲(100—200μA,波宽0.3ms,50—100Hz,5—20个脉冲)刺激NRO,可提前终止膈神经放电,产生吸气切断效应。吸气切断时间具有刺激落位和刺激强度依赖性。(3)NRO内微量注射细胞体兴奋剂谷氨酸钠(1mol/L,1μl),注药期间出现膈神经放电抑制,注药后为吸气时程(Ti)缩短和呼气时程(Te)延长。     

Playing the electric light orchestra—how electrical stimulation of visual cortex elucidates the neural basis of perception

Vision research has the potential to reveal fundamental mechanisms underlying sensory experience. Causal experimental approaches, such as electrical microstimulation, provide a unique opportunity to test the direct contributions of visual cortical neurons to perception and behaviour. But in spite of their importance, causal methods constitute a minority of the experiments used to investigate the visual cortex to date. We reconsider the function and organization of visual cortex according to results obtained from stimulation techniques, with a special emphasis on electrical stimulation of small groups of cells in awake subjects who can report their visual experience. We compare findings from humans and monkeys, striate and extrastriate cortex, and superficial versus deep cortical layers, and identify a number of revealing gaps in the ‘causal map′ of visual cortex. Integrating results from different methods and species, we provide a critical overview of the ways in which causal approaches have been used to further our understanding of circuitry, plasticity and information integration in visual cortex. Electrical stimulation not only elucidates the contributions of different visual areas to perception, but also contributes to our understanding of neuronal mechanisms underlying memory, attention and decision-making.     

电刺激兔脑干中缝背核引起呼吸易化效应的观察

本文在30只全麻、制动、断双侧迷走神经的家兔上,记录一侧膈神经放电,观察了电刺激脑干中缝背核(Nucleus Raphe Dorsalis,NRD)所诱发出的呼吸效应。1.施以6—10s 长串电脉冲刺激(波宽0.3ms,频率100Hz,波幅4—6V),诱发出了强的呼吸易化效应,使呼吸加深加快。2.吸气相给予0.4s 短串电脉冲刺激可以明显的延长吸气相,用0.15mA 强度刺激,落位在吸气相的2/3时效应最明显。3.呼气相短串电脉串刺激可规律地使呼气时程缩短,促进呼气向吸气的位相转换,诱发此效应出现的强度阈值在呼气相中逐渐降低。     

Effect of electrical stimulation of antagonist muscles for voluntary motor drive

Voluntary motor drive is an important central command that descends via the corticospinal tract to initiate muscle contraction. When electrical stimulation (ES) is applied to an antagonist or agonist muscle, it changes the agonist muscle’s representative motor cortex and thus its voluntary motor drive. In this study, we used a reaction time task to compare the effects of weak and strong ES of the antagonist or agonist muscle during the premotor period of a wrist extension. We recorded motor evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS) that was applied to the extensor carpi radialis (ECR; agonist) and flexor carpi radialis (FCR; antagonist). When stronger ES intensities were applied to the antagonist, the MEP control ratio in the ECR significantly increased during the premotor time. Furthermore, the MEP control ratio with stronger antagonist ES intensity was significantly larger than that in the agonist for the same ES intensity. In the FCR, the MEP control ratio was also significantly greater at the strong ES intensity than at the weak ES intensity. Furthermore, the MEP control ratio in the antagonist with a strong ES intensity was significantly larger than that in the agonist with the same ES intensity. These results suggest that agonist corticomotor excitability might be enhanced by ES of the antagonist, which in turn strongly activates the descending motor system in the preparation of agonist contraction.     

Ventilatory conditioning by self-stimulation in rats: A pilot study

This article describes an experimental attempt to condition breathing pattern in rats. In this experiment, a freely moving rat was first rewarded by an electrical stimulation of the medial forebrain bundle whenever inspiratory duration (TI) exceeded 300 ms. A bidirectional control was then used: TIs longer than 400 ms were rewarded, and then TIs shorter than 300 ms were rewarded. The frequency of TIs longer than 300 ms increased when this event was rewarded, further increased when TIs above 400 ms were rewarded, and decreased during reversal conditioning (TI < 300 ms). At the beginning of the experiment, stimulation caused increased arousal and motor activity, but after prolonged conditioning, the brain stimulation was associated with quiet wakefulness. Although the general procedure appears to be well-suited to the experimental study of voluntary breathing, some possible improvements are suggested for further, more extensive investigations.We are grateful to Professor Claude Gaultier and to Professor Vincent Bloch for their support, to Pascale Leblanc for her invaluable assistance, and to Gerard Dutrieux and Michel Vigouroux for their technical contribution. This work was supported by the Université de Paris-Sud (Grant AI-9023) and by the Institut National de la Sante et de la Recherche Médicale (CJF 89-09).     

Anatomic consequences of intrinsic tongue muscle activation.

We recently showed respiratory-related coactivation of both extrinsic and intrinsic tongue muscles in the rat. Here, we test the hypothesis that intrinsic tongue muscles contribute importantly to changes in velopharyngeal airway volume. Spontaneously breathing anesthetized rats were placed in a MRI scanner. A catheter was placed in the hypopharynx and connected to a pressure source. Axial and sagittal images of the velopharyngeal airway were obtained, and the volume of each image was computed at airway pressures ranging from +5.0 to -5.0 cm H2O. We obtained images in the hypoglossal intact animal (i.e., coactivation of intrinsic and extrinsic tongue muscles) and after selective denervation of the intrinsic tongue muscles, with and without electrical stimulation. Denervation of the intrinsic tongue muscles reduced velopharyngeal airway volume at atmospheric and positive airway pressures. Electrical stimulation of the intact hypoglossal nerve increased velopharyngeal airway volume; however, when stimulation was repeated after selective denervation of the intrinsic tongue muscles, the increase in velopharyngeal airway volume was significantly attenuated. These findings support our working hypothesis that intrinsic tongue muscles play a critical role in modulating upper airway patency.     

Post-tetanic potentiation of reciprocal Ia inhibition in human lower limb.

The purpose of this study was to investigate how reciprocal Ia inhibition is changed during muscle fatigue of lower limb muscle, induced with a voluntary contraction or height frequency electrical stimulation. Reciprocal Ia inhibition from ankle flexors to extensors has been investigated in 12 healthy subjects. Hoffmann reflex (H-reflex) in the soleus muscle was used to monitor changes in the amount of reciprocal Ia inhibition from common peroneal nerve as demonstrated during voluntary dorsi or planterflexion and 50 Hz electrical stimulation induced dorsi or planterflexion. The test soleus H-reflex was kept at 20-25% of maximum directly evoked motor response (M response) and the strength of the conditioning common peroneal nerve stimulation was kept at 1.0 x motor threshold. At rest, weak la inhibition was demonstrated in 12 subjects, maximal inhibition from the common peroneal nerve was 28.8%. During voluntary dorsiflexion and 50 Hz electrical stimulation induced dorsiflexion, there absolute amounts of inhibition increased as compared to at rest, and decreased or disappeared during voluntary planterflexion and 50 Hz electrical stimulation induced planterflexion as compared to at rest. During voluntary or electrical stimulation induced agonist muscle fatigue, the inhibition of the soleus H-reflex from the common peroneal nerve was greater during voluntary dorsiflexion (maximal, 11.1%) and 50 Hz (maximal, 6.7%) electrical stimulation induced dorsiflexion than at rest. The inhibition was decreased or disappeared during voluntary planterflexion 50 Hz electrical stimulation induced planterflexion. It was concluded that the results were considered to support the hypothesis that alpha-motoneurones and la inhibitory intemeurones link to antagonist motoneurones in reciprocal inhibition. The diminished reciprocal Ia inhibition of voluntary contraction during muscle fatigue as compared to electrical stimulation, is discussed in relation to its possible contribution to ankle stability.     

Probing neural circuitry and function with electrical microstimulation

Since the discovery of the nervous system's electrical excitability more than 200 years ago, neuroscientists have used electrical stimulation to manipulate brain activity in order to study its function. Microstimulation has been a valuable technique for probing neural circuitry and identifying networks of neurons that underlie perception, movement and cognition. In this review, we focus on the use of stimulation in behaving primates, an experimental system that permits causal inferences to be made about the effect of stimulation-induced activity on the resulting behaviour or neural signals elsewhere in the brain.