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

      research-article
      1 , 2 , 3 , 4 , 5 , 6
      Acupuncture in Medicine
      BMJ Publishing Group
      CLINICAL PHYSIOLOGY

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          Abstract

          Background

          The effects of transcutaneous electric nerve stimulation (TENS) and electroacupuncture (EA) on the cerebral cortex are largely unclear. The purpose of the present study was to investigate the effect of TENS and EA on the cerebral cortex by examining their effect on the median nerve-somatosensory evoked potentials (MN-SEPs).

          Methods

          Twenty volunteers were studied. The cortical and cervical spinal potentials were recorded by median nerve stimulation at the left wrist. Sham TENS, 2 Hz TENS and 2 Hz EA were applied to both ST36 and ST37. MN-SEPs were recorded during sham TENS, 2 Hz TENS and 2 Hz EA, with at least 1 week interval for each subject. One-way analysis of variance was used to determine the differences in latency and amplitude of the MN-SEPs observed in the stimulation and post-stimulation periods compared with baseline. Scheffe's post hoc correction was employed to identify pairwise differences.

          Results

          No differences in mean latency were found between the stimulation procedures during the stimulation and post-stimulation periods. 2 Hz EA but not sham TENS or 2 Hz TENS caused higher mean amplitudes in N20 and N30 during the stimulation and post-stimulation periods.

          Conclusions

          EA, but not TENS, induces changes in certain components of the signal.

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          Most cited references31

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          The ten twenty electrode system of The International Federation

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            Theories of pain: from specificity to gate control.

            Several theoretical frameworks have been proposed to explain the physiological basis of pain, although none yet completely accounts for all aspects of pain perception. Here, we provide a historical overview of the major contributions, ideas, and competing theories of pain from ancient civilizations to Melzack and Wall's Gate Control Theory of Pain.
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              Potentials evoked in human and monkey cerebral cortex by stimulation of the median nerve. A review of scalp and intracranial recordings.

              Somatosensory evoked potentials (SEPs) are generated in afferent pathways, subcortical structures and various regions of cerebellar and cerebral cortex by stimulation of somatic receptors or electrical stimulation of peripheral nerves. This review summarizes current knowledge of SEPs generated in cerebral cortex by stimulation of the median nerve, the most common form of stimulation for human research and clinical investigations. Major sources of data for the review are intracranial recordings obtained from patients during diagnostic or neurosurgical procedures, and similar recordings in monkeys. Short-latency cortical SEPs in the 20-40 ms latency range consist of P20 and N30, recorded from motor cortex and frontal scalp; P25 and N35, recorded from cortex near the central sulcus and central scalp; and N20 and P30, recorded from somatosensory cortex and parietal scalp. Several lines of evidence including cortical surface and intracerebral recordings, neuromagnetic recordings and lesion studies in humans and monkeys, strongly support the conclusion that these potentials are generated in contralateral somatosensory cortex in areas 3b and 1, in contrast to the conclusion of many previous studies that SEPs recorded from the frontal scalp are generated in motor cortex and other frontal lobe areas. These potentials are primarily mediated by cutaneous afferents of the dorsal column-medial lemniscal system; the contribution of muscle afferents has not been completely resolved but appears to be small. There is currently no evidence that short-latency SEPs are generated in cortex other than primary somatosensory cortex. Recordings from the vicinity of the second somatosensory area, from the supplementary motor and sensory areas and from surface cortex other than sensorimotor cortex have not detected reliable short-latency activity, although some of these regions generate long-latency potentials. Consequently, short-latency SEPs recorded from the scalp are similar to those recorded from the surface of sensorimotor cortex. Old World monkeys such as Macaca mulatta and M. fascicularis provide an excellent model for human short-latency SEPs. All the potentials described above in humans have corresponding monkey analogues, with similar distributions over the cortical surface. The squirrel monkey, a New World species, exhibits the same potentials, but due to the different morphology of sensorimotor cortex, the surface distribution of SEPs is quite different.
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                Author and article information

                Journal
                Acupunct Med
                Acupunct Med
                acupmed
                aim
                Acupuncture in Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0964-5284
                1759-9873
                February 2015
                28 November 2014
                : 33
                : 1
                : 36-41
                Affiliations
                [1 ]Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University , Taichung, Taiwan
                [2 ]Department of Traditional Chinese Medicine, Taichung Veterans General Hospital , Taichung, Taiwan
                [3 ]Department of Neurology, Taichung Hospital, Ministry of Health and Welfare , Taichung, Taiwan
                [4 ]Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University , Taichung, Taiwan
                [5 ]Department of Chinese Medicine, China Medical University Hospital , Taichung, Taiwan
                [6 ]Research Center for Chinese Medicine and Acupuncture, China Medical University , Taichung, Taiwan
                Author notes
                [Correspondence to ] Professor Ching-Liang Hsieh, Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, No 91, Hsueh-Shih Road, Taichung 40402, Taiwan; clhsieh@ 123456mail.cmuh.org.tw
                Author information
                http://orcid.org/0000-0002-8187-4716
                Article
                acupmed-2014-010650
                10.1136/acupmed-2014-010650
                4345985
                25432425
                fd673f32-5075-4971-9608-1bd1df2fa026
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 21 August 2014
                : 10 November 2014
                : 14 November 2014
                Categories
                1506
                Original Paper
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                Complementary & Alternative medicine
                clinical physiology
                Complementary & Alternative medicine
                clinical physiology

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