Effects of TENS on Pain Threshold and Brain Activities in Healthy Adults

Study Overview
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Brief Summary
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The purpose of this study was to understand the effects of conventional versus acupuncture-like TENS on pain threshold, brain activities, and their relationships.

Detailed Description
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Transcutaneous electrical nerve stimulation (TENS) is a pain modulation tool which is commonly used clinically. TENS has 2 major modes: conventional TENS'' and acupuncture like TENS. Conventional TENS induces a local pain modulation, whereas acupuncture like TENS induces central pain modulation mechanism. The pain threshold at treatment area and outside of area is regarded as local pain modulation and central pain modulation respectively. However, the effect of acupuncture like TENS on pain threshold was remained unclear. TENS also induces cortical activities changed in the central nervous system. Recent Electroencephalography (EEG) studies suggested that TENS induces event-related potential and power spectrum changes, however, the time and frequency bands of EEG changes and its relationship with pain threshold were still unclear. Therefore, the purpose of this study was to understand the effects of conventional versus acupuncture-like TENS on pain threshold, brain activities, and their relationships.

Official Title
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Effects of Conventional Versus Acupuncture-like TENS on Pain Threshold and Brain Activities in Healthy Adults

Conditions
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Transcutaneous Electrical Nerve Stimulation, Electroencephalography, Pressure Pain Threshold

Intervention / Treatment
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* Device: Acupuncture like TENS
* Device: Conventional TENS
* Device: Sham TENS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 20 65 y adults No cognitive function problem Without taking any type of pain medication or substances that could affect the cognitive functions Exclusion Criteria: Peripheral or central nervous system disease Sensory lose TENS application is contraindication Cardiac pacemaker Any type of pain

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acupuncture like TENS<br>The study would use acupuncture like TENS for 30 minutes | Device: Acupuncture like TENS<br>* Frequency: 4 Hz, pulse duration: 200 μs, intensity: 3/10 painful sensation with muscle contraction , time: 30 minutes<br>|
| Experimental: Conventional TENS<br>The study would use conventional TENS for 30 minutes | Device: Conventional TENS<br>* Frequency: 100 Hz, pulse duration: 200 μs, intensity: strong but comfortable tingling sensation , time: 30 minutes<br>|
| Experimental: Sham TENS<br>The study would use sham TENS for 30 minutes | Device: Sham TENS<br>* Frequency: 4 Hz, pulse duration: 200 μs, intensity: tingling sensation, time: turn on the electricity for 15 seconds, then turn off the machine for 30 minutes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure pain threshold after the intervention | Use a pressure algometer to press on the first dorsal interosseous muscle and the pressure would stop until the feeling changes from non-painful feeling to painful feeling. | The change between baseline and the time after 30 minutes intervention | 
| Pressure pain tolerance after the intervention | Use a pressure algometer to press on the first dorsal interosseous muscle and the pressure would stop until the feeling reach the pain intensity at 5/10. | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in delta band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in theta band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in alpha band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in beta band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in low-gamma band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in high-gamma band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 
| EEG power spectrum change in total gamma band after the intervention | Evaluate brain activity after the intervention | The change between baseline and the time after 30 minutes intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure pain tolerance after the 30 minutes break | Use a pressure algometer to press on the first dorsal interosseous muscle and the pressure would stop until the feeling reach the pain intensity at 5/10. | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| Pressure pain threshold after the 30 minutes break | Use a pressure algometer to press on the first dorsal interosseous muscle and the pressure would stop until the feeling changes from non-painful feeling to painful feeling. | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in delta band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in theta band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in alpha band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in beta band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in low-gamma band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in high-gamma band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 
| EEG power spectrum change in total gamma band after the 30 minutes break | Evaluate brain activity after the 30 minutes break | The change between 30 minutes intervention and 30 minutes break after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Electroencephalography, Pressure pain threshold, Transcutaneous electrical nerve stimulation, Pressure pain tolerance