Functional Magnetic Resonance Imaging of the Effects of Low-frequency Transcutaneous Electrical Nerve Stimulation on Central Pain Modulation: A Double-blind, Placebo-controlled Trial

  title={Functional Magnetic Resonance Imaging of the Effects of Low-frequency Transcutaneous Electrical Nerve Stimulation on Central Pain Modulation: A Double-blind, Placebo-controlled Trial},
  author={Figen Koçyiğit and Elif Akalın and Naciye Sinem Gezer and Ozge Orbay and Ali Koçyiğit and Emel Ada},
  journal={The Clinical Journal oF Pain},
Objectives: Transcutaneous electrical nerve stimulation (TENS) is an analgesic current that is used in many acute and chronic painful states. The aim of this study was to investigate central pain modulation by low-frequency TENS. Methods: Twenty patients diagnosed with subacromial impingement syndrome of the shoulder were enrolled in the study. Patients were randomized into 2 groups: low-frequency TENS and sham TENS. Painful stimuli were delivered during which functional magnetic resonance… 

Efficacy and Safety of Transcutaneous Electrical Nerve Stimulation (TENS) for Acute and Chronic Pain: A Systematic Review and Meta-Analysis (Meta-TENS)

There is moderate-certainty evidence that TENS reduces pain intensity during and immediately after stimulation compared with placebo and there were no serious adverse events.


TENS therapy is an efficient therapy for patients experiencing rotator cuff disease and Median post-intervention total SPADI, disability and pain scores of the intervention group were significantly less as compared to the control group.

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

There was moderate-certainty evidence that pain intensity is lower during or immediately after TENS compared with placebo and without serious adverse events.

Different effects of transcutaneous electric nerve stimulation and electroacupuncture at ST36–ST37 on the cerebral cortex

EA, but not TENS, induces changes in certain components of the signal that cause higher mean amplitudes in N20 and N30 during the stimulation and post-stimulation periods.

Characterising the Features of 381 Clinical Studies Evaluating Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief: A Secondary Analysis of the Meta-TENS Study to Improve Future Research

Clinical studies on TENS are dominated by small parallel group evaluations of high frequency TENS that are often contaminated by concurrent treatment(s) and study reports tended focus on physiological and clinical implications rather than the veracity of methodology and findings.

Noninvasive Peripheral Nerve Stimulation

No experience has been published for CP nor for external noninvasive peripheral nerve stimulation (EN-PNS) ([2]; however, see [3], Table).

Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia

There are significant differences between HF and LF TENS based on pain assessment using various pain scales, which reflects the distinctive effects of different TENS modalities on different aspects of neuropathic pain.

Transcutaneous electrical nerve stimulation and conditioned pain modulation influence the perception of pain in humans

Whether the simultaneous application of TENS and CPM will enhance the analgesic effect of that produced by either treatment alone is investigated.

Application of Low Frequency and Medium Frequency Currents in the Management of Acute and Chronic Pain-A Narrative Review

It is found that even though TENS and IFT are used in management of pain, there is limited amount of high quality research available in this area and most of the studies lack methodological quality and have a low sample size.

Comparing complementary alternative treatment for chronic shoulder pain of myofascial origin

CMT may be more effective in reducing chronic shoulder pain of myofascial origin than the LTARM treatment, where treatment with the former resulted in better functional recovery after 4 weeks than the latter.



Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement.

  • B. RakelR. Frantz
  • Medicine
    The journal of pain : official journal of the American Pain Society
  • 2003
TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia, and the hypothesis that TENS works through reducing hyperalgesia is supported.

Brain imaging of analgesic and antihyperalgesic effects of cyclooxygenase inhibition in an experimental human pain model: a functional MRI study

There is a difference in the brain areas modulated by analgesia and antihyperalgesia, and during acute mechanical pain there was a greater modulation of mainly bilateral S2; therefore, the results of the present study suggest that there is a Difference in theBrain activation patterns during acute impact pain and mechanical hyperalgesic conditions.

Modulation of cold pain in human brain by electric acupoint stimulation: evidence from fMRI

It is suggested that EAS may induce an analgesic effect via modulation of both the sensory and the emotional aspect of pain processing.

Electrical stimulation in the treatment of pain

  • D. Rushton
  • Medicine
    Disability and rehabilitation
  • 2002
TENS has proved to be remarkably safe, and provides significant analgesia in about half of patients experiencing moderate predictable pain, and is found to be of potential benefit in the management of a range of painful conditions.

Transcutaneous electrical nerve stimulation for knee osteoarthritis.

TENS and AL-TENS are shown to be effective in pain control over placebo in this review, and different modes of TENS setting demonstrated a significant benefit in pain relief of the knee OA over placebo.

High‐frequency, but not low‐frequency, transcutaneous electrical nerve stimulation reduces aspartate and glutamate release in the spinal cord dorsal horn

High‐frequency TENS activates delta‐opioid receptors consequently reducing the increased release of glutamate and aspartate in the spinal cord, which is concluded to be a non‐pharmacological treatment for pain.

Functional imaging of brain responses to pain. A review and meta-analysis (2000)

Cortical and subcortical localization of response to pain in man using positron emission tomography

A quantitative study of the regional cerebral responses to non-painful and painful thermal stimuli in six normal volunteers by monitoring serial measurements of regional blood flow measured by positron emission tomography found highly significant increases in blood flow in response to painful heat.