Progress in basic research and clinical application of median nerve electrical stimulation_West China Medical Journal

Authors：

 SUN Weiming ^1,2,3,4 , GUO Shuyue ^1,2 , WANG Xiaoxiao ^1,2 , DONG Xiangli ^2,5 , YANG Yang ^3,4 , MA Chaolin ^3,4 , FENG Zhen ^1,2

1. Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P. R. China;
2. Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330031, P. R. China;
3. School of Life Science, Nanchang University, Nanchang, Jiangxi 330031, P. R. China;
4. Institute of Life Science, Nanchang University, Nanchang, Jiangxi 330031, P. R. China;
5. Department of Psychosomatic Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330036, P. R. China;

Corresponding author：

SUN Weiming, Email: sunweiming@email.ncu.edu.cn

Keywords：

Median nerve electrical stimulation; research progress; clinical application; animal research

DOI：

10.7507/1002-0179.202210155

Video：

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Median nerve electrical stimulation is a common peripheral nerve electrical stimulation treatment technology in clinic. With simple operation, it has been widely used in clinical to promote coma after craniocerebral trauma, relieve pain, improve cognition, Parkinson’s disease and so on. However, its mechanism has always been a hot topic and difficult part. At present, there are a large number of clinical efficacy studies and animal experiments of median nerve electrical stimulation at home and abroad. This article reviews the clinical application and animal experiments of median nerve electrical stimulation in recent years, and summarizes its mechanism, hoping to contribute to relevant clinical applications and research.

Citation： SUN Weiming, GUO Shuyue, WANG Xiaoxiao, DONG Xiangli, YANG Yang, MA Chaolin, FENG Zhen. Progress in basic research and clinical application of median nerve electrical stimulation. West China Medical Journal, 2023, 38(5): 753-757. doi: 10.7507/1002-0179.202210155 Copy

1.	任善红, 郭爱松. 正中神经电刺激的临床应用进展. 交通医学, 2019, 33(4): 378-381.
2.	陶敏, 马彦霖, 陈礼娜. 右侧正中神经电刺激对大面积脑梗死意识障碍患者促醒作用的临床观察. 中外医学研究, 2019, 17(4): 135-136.
3.	Strand NH, D’Souza R, Wie C, et al. Mechanism of action of peripheral nerve stimulation. Curr Pain Headache Rep, 2021, 25(7): 47.
4.	闻万顺, 赵元元, 叶祥明. 早期右正中神经刺激对颅脑外伤昏迷患者促醒作用的临床观察. 浙江创伤外科, 2017, 22(3): 420-423.
5.	游文栋, 唐琪临, 王磊, 等. 右正中神经电刺激对颅脑创伤昏迷患者脑电活动的影响. 中华创伤杂志, 2016, 32(2): 120-123.
6.	Peri CV, Shaffrey ME, Farace E, et al. Pilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome. Brain Inj, 2001, 15(10): 903-910.
7.	钟颖君, 冯珍. 正中神经电刺激对促醒相关神经递质影响的研究进展. 中国康复医学杂志, 2015, 30(3): 299-301.
8.	方圆, 许能贵. 开窍醒神针刺法配合电刺激对早期重型颅脑损伤昏迷患者的促醒作用观察. 中医药导报, 2019, 25(9): 116-118, 122.
9.	Lee MT, Chen YH, Mackie K, et al. Median nerve stimulation as a nonpharmacological approach to bypass analgesic tolerance to morphine: a proof-of-concept study in mice. J Pain, 2021, 22(3): 300-312.
10.	Moreno-Balandrán E, Garzón M, Bódalo C, et al. Sleep-wakefulness effects after microinjections of hypocretin 1 (orexin A) in cholinoceptive areas of the cat oral pontine tegmentum. Eur J Neurosci, 2008, 28(2): 331-341.
11.	Li SB, Damonte VM, Chen C, et al. Hyperexcitable arousal circuits drive sleep instability during aging. Science, 2022, 375(6583): eabh3021.
12.	钟颖君, 王亮, 魏天琪, 等. 正中神经电刺激对脑外伤后昏迷大鼠前额叶皮质及下丘脑 Orexin-A 及其受体 OX1R 表达变化的影响. 中国康复医学杂志, 2015, 30(7): 640-644.
13.	杜青, 冯珍. 正中神经电刺激脑外伤昏迷大鼠前额叶皮质 5-HT 2A 受体表达的实验研究. 中国康复医学杂志, 2017, 32(3): 253-257.
14.	魏天祺, 冯珍. 正中神经电刺激对脑外伤后昏迷大鼠γ-氨基丁酸 b 受体表达变化的影响. 中国康复医学杂志, 2016, 31(1): 9-13.
15.	李益欢, 钱春生, 张斌, 等. 神经电刺激对脑外伤昏迷大鼠前额叶皮质 5-羟色胺 2A 和γ-氨基丁酸 b 受体表达的影响. 中国老年学杂志, 2021, 41(6): 1309-1312.
16.	Wall PD, Sweet WH. Temporary abolition of pain in man. Science, 1967, 155(3758): 108-109.
17.	Chen YH, Lee HJ, Lee MT, et al. Median nerve stimulation induces analgesia via orexin-initiated endocannabinoid disinhibition in the periaqueductal gray. Proc Natl Acad Sci U S A, 2018, 115(45): E10720-E10729.
18.	Papazachariadis O, Dante V, Ferraina S. Median nerve stimulation modulates extracellular signals in the primary motor area of a macaque monkey. Neurosci Lett, 2013, 550: 184-188.
19.	Tsai ST, Chuang WY, Kuo CC, et al. Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia. J Neurosurg, 2015, 123(6): 1394-1400.
20.	Qiao PG, Han C, Qian T, et al. BOLD-fMRI with median nerve electrical stimulation predict hemodynamic improvement after revascularization in patients with moyamoya disease. J Magn Reson Imaging, 2017, 46(4): 1159-1166.
21.	Qiao PG, Cheng X, Zuo ZW, et al. Blood oxygen level-dependent response changes in the ipsilateral primary somatosensory cortex and thalamus of patients with moyamoya disease during median nerve electrical stimulation. J Comput Assist Tomogr, 2019, 43(4): 539-546.
22.	刘岩松, 刘子渤, 杨哲, 等. 正中神经电刺激治疗脑损伤所致意识障碍的研究进展. 脑与神经疾病杂志, 2022, 30(3): 190-193.
23.	Cooper JB, Jane JA, Alves WM, et al. Right median nerve electrical stimulation to hasten awakening from coma. Brain Inj, 1999, 13(4): 261-267.
24.	石艳红, 邵秀芹, 冯珍, 等. 正中神经电刺激与常规疗法治疗昏迷患者促醒疗效的 meta 分析. 中国康复医学杂志, 2017, 32(11): 1273-1277.
25.	杨虎银, 蒋坤, 方大钊, 等. 正中神经电刺激对脑损伤后昏迷患者血流动力学的影响. 华中科技大学学报(医学版), 2017, 46(4): 462-465.
26.	狄丽宏, 焦洋洋, 陈深, 等. sTBI 患者治疗前后脑氧代谢指标变化与颅内压及预后的关系. 创伤外科杂志, 2020, 22(10): 742-745.
27.	王丹丹, 庞猛, 王辉. 电针刺激对重型颅脑损伤迁延性昏迷患者昏迷程度的影响及其机制. 现代中西医结合杂志, 2020, 29(1): 51-54.
28.	李晓彦, 高敏, 王雪争, 等. 针刺联合吞咽电刺激对老年痴呆伴吞咽障碍患者舌骨喉复合体动度的影响. 上海针灸杂志, 2020, 39(10): 1253-1258.
29.	张霄琼, 张娟, 张丝丝, 等. 正中神经电刺激联合计算机辅助认知训练治疗脑卒中后认知功能障碍的效果. 中国医药导报, 2021, 18(26): 73-76.
30.	荆静, 马艳平, 刘万林, 等. 正中神经电刺激治疗脑卒中后认知障碍的康复疗效及机制探讨. 中华物理医学与康复杂志, 2020, 42(3): 215-220.
31.	何文. 近红外光谱技术在医学上应用进展. 生物技术世界, 2013(7): 77.
32.	昌凡, 李豪喆, 张盛宇, 等. 基于 fNIRS 技术检测脑外伤所致轻度认知功能障碍者工作记忆. 法医学杂志, 2020, 36(1): 52-60.
33.	王萍, 陈宜懿, 顾延庆, 等. 非侵入性脑刺激技术在卒中后认知障碍康复中的应用进展. 按摩与康复医学, 2022, 13(13): 52-54.
34.	Planitzer U, Steinke H, Meixensberger J, et al. Median nerve fascicular anatomy as a basis for distal neural prostheses. Ann Anat, 2014, 196(2/3): 144-149.
35.	Mirone G, Natale M, Rotondo M. Peripheral median nerve stimulation for the treatment of iatrogenic complex regional pain syndrome (CRPS) type II after carpal tunnel surgery. J Clin Neurosci, 2009, 16(6): 825-827.
36.	Webster M, Valle M, Blake J, et al. Median nerve modulation: a novel approach to resistant hypertension. J Am Soc Hypertens, 2016, 10(4): e6-e9.
37.	Bang SK, Ryu Y, Chang S, et al. Attenuation of hypertension by C-fiber stimulation of the human median nerve and the concept-based novel device. Sci Rep, 2018, 8(1): 14967.
38.	Li P, Pitsillides KF, Rendig SV, et al. Reversal of reflex-induced myocardial ischemia by median nerve stimulation: a feline model of electroacupuncture. Circulation, 1998, 97(12): 1186-1194.
39.	Zhou W, Ko Y, Benharash P, et al. Cardioprotection of electroacupuncture against myocardial ischemia-reperfusion injury by modulation of cardiac norepinephrine release. Am J Physiol Heart Circ Physiol, 2012, 302(9): H1818-H1825.
40.	Chen CC, Chuang YF, Yang HC, et al. Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia. J Electromyogr Kinesiol, 2015, 25(1): 143-150.

1. 任善红, 郭爱松. 正中神经电刺激的临床应用进展. 交通医学, 2019, 33(4): 378-381.
2. 陶敏, 马彦霖, 陈礼娜. 右侧正中神经电刺激对大面积脑梗死意识障碍患者促醒作用的临床观察. 中外医学研究, 2019, 17(4): 135-136.
3. Strand NH, D’Souza R, Wie C, et al. Mechanism of action of peripheral nerve stimulation. Curr Pain Headache Rep, 2021, 25(7): 47.
4. 闻万顺, 赵元元, 叶祥明. 早期右正中神经刺激对颅脑外伤昏迷患者促醒作用的临床观察. 浙江创伤外科, 2017, 22(3): 420-423.
5. 游文栋, 唐琪临, 王磊, 等. 右正中神经电刺激对颅脑创伤昏迷患者脑电活动的影响. 中华创伤杂志, 2016, 32(2): 120-123.
6. Peri CV, Shaffrey ME, Farace E, et al. Pilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome. Brain Inj, 2001, 15(10): 903-910.
7. 钟颖君, 冯珍. 正中神经电刺激对促醒相关神经递质影响的研究进展. 中国康复医学杂志, 2015, 30(3): 299-301.
8. 方圆, 许能贵. 开窍醒神针刺法配合电刺激对早期重型颅脑损伤昏迷患者的促醒作用观察. 中医药导报, 2019, 25(9): 116-118, 122.
9. Lee MT, Chen YH, Mackie K, et al. Median nerve stimulation as a nonpharmacological approach to bypass analgesic tolerance to morphine: a proof-of-concept study in mice. J Pain, 2021, 22(3): 300-312.
10. Moreno-Balandrán E, Garzón M, Bódalo C, et al. Sleep-wakefulness effects after microinjections of hypocretin 1 (orexin A) in cholinoceptive areas of the cat oral pontine tegmentum. Eur J Neurosci, 2008, 28(2): 331-341.
11. Li SB, Damonte VM, Chen C, et al. Hyperexcitable arousal circuits drive sleep instability during aging. Science, 2022, 375(6583): eabh3021.
12. 钟颖君, 王亮, 魏天琪, 等. 正中神经电刺激对脑外伤后昏迷大鼠前额叶皮质及下丘脑 Orexin-A 及其受体 OX1R 表达变化的影响. 中国康复医学杂志, 2015, 30(7): 640-644.
13. 杜青, 冯珍. 正中神经电刺激脑外伤昏迷大鼠前额叶皮质 5-HT 2A 受体表达的实验研究. 中国康复医学杂志, 2017, 32(3): 253-257.
14. 魏天祺, 冯珍. 正中神经电刺激对脑外伤后昏迷大鼠γ-氨基丁酸 b 受体表达变化的影响. 中国康复医学杂志, 2016, 31(1): 9-13.
15. 李益欢, 钱春生, 张斌, 等. 神经电刺激对脑外伤昏迷大鼠前额叶皮质 5-羟色胺 2A 和γ-氨基丁酸 b 受体表达的影响. 中国老年学杂志, 2021, 41(6): 1309-1312.
16. Wall PD, Sweet WH. Temporary abolition of pain in man. Science, 1967, 155(3758): 108-109.
17. Chen YH, Lee HJ, Lee MT, et al. Median nerve stimulation induces analgesia via orexin-initiated endocannabinoid disinhibition in the periaqueductal gray. Proc Natl Acad Sci U S A, 2018, 115(45): E10720-E10729.
18. Papazachariadis O, Dante V, Ferraina S. Median nerve stimulation modulates extracellular signals in the primary motor area of a macaque monkey. Neurosci Lett, 2013, 550: 184-188.
19. Tsai ST, Chuang WY, Kuo CC, et al. Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia. J Neurosurg, 2015, 123(6): 1394-1400.
20. Qiao PG, Han C, Qian T, et al. BOLD-fMRI with median nerve electrical stimulation predict hemodynamic improvement after revascularization in patients with moyamoya disease. J Magn Reson Imaging, 2017, 46(4): 1159-1166.
21. Qiao PG, Cheng X, Zuo ZW, et al. Blood oxygen level-dependent response changes in the ipsilateral primary somatosensory cortex and thalamus of patients with moyamoya disease during median nerve electrical stimulation. J Comput Assist Tomogr, 2019, 43(4): 539-546.
22. 刘岩松, 刘子渤, 杨哲, 等. 正中神经电刺激治疗脑损伤所致意识障碍的研究进展. 脑与神经疾病杂志, 2022, 30(3): 190-193.
23. Cooper JB, Jane JA, Alves WM, et al. Right median nerve electrical stimulation to hasten awakening from coma. Brain Inj, 1999, 13(4): 261-267.
24. 石艳红, 邵秀芹, 冯珍, 等. 正中神经电刺激与常规疗法治疗昏迷患者促醒疗效的 meta 分析. 中国康复医学杂志, 2017, 32(11): 1273-1277.
25. 杨虎银, 蒋坤, 方大钊, 等. 正中神经电刺激对脑损伤后昏迷患者血流动力学的影响. 华中科技大学学报(医学版), 2017, 46(4): 462-465.
26. 狄丽宏, 焦洋洋, 陈深, 等. sTBI 患者治疗前后脑氧代谢指标变化与颅内压及预后的关系. 创伤外科杂志, 2020, 22(10): 742-745.
27. 王丹丹, 庞猛, 王辉. 电针刺激对重型颅脑损伤迁延性昏迷患者昏迷程度的影响及其机制. 现代中西医结合杂志, 2020, 29(1): 51-54.
28. 李晓彦, 高敏, 王雪争, 等. 针刺联合吞咽电刺激对老年痴呆伴吞咽障碍患者舌骨喉复合体动度的影响. 上海针灸杂志, 2020, 39(10): 1253-1258.
29. 张霄琼, 张娟, 张丝丝, 等. 正中神经电刺激联合计算机辅助认知训练治疗脑卒中后认知功能障碍的效果. 中国医药导报, 2021, 18(26): 73-76.
30. 荆静, 马艳平, 刘万林, 等. 正中神经电刺激治疗脑卒中后认知障碍的康复疗效及机制探讨. 中华物理医学与康复杂志, 2020, 42(3): 215-220.
31. 何文. 近红外光谱技术在医学上应用进展. 生物技术世界, 2013(7): 77.
32. 昌凡, 李豪喆, 张盛宇, 等. 基于 fNIRS 技术检测脑外伤所致轻度认知功能障碍者工作记忆. 法医学杂志, 2020, 36(1): 52-60.
33. 王萍, 陈宜懿, 顾延庆, 等. 非侵入性脑刺激技术在卒中后认知障碍康复中的应用进展. 按摩与康复医学, 2022, 13(13): 52-54.
34. Planitzer U, Steinke H, Meixensberger J, et al. Median nerve fascicular anatomy as a basis for distal neural prostheses. Ann Anat, 2014, 196(2/3): 144-149.
35. Mirone G, Natale M, Rotondo M. Peripheral median nerve stimulation for the treatment of iatrogenic complex regional pain syndrome (CRPS) type II after carpal tunnel surgery. J Clin Neurosci, 2009, 16(6): 825-827.
36. Webster M, Valle M, Blake J, et al. Median nerve modulation: a novel approach to resistant hypertension. J Am Soc Hypertens, 2016, 10(4): e6-e9.
37. Bang SK, Ryu Y, Chang S, et al. Attenuation of hypertension by C-fiber stimulation of the human median nerve and the concept-based novel device. Sci Rep, 2018, 8(1): 14967.
38. Li P, Pitsillides KF, Rendig SV, et al. Reversal of reflex-induced myocardial ischemia by median nerve stimulation: a feline model of electroacupuncture. Circulation, 1998, 97(12): 1186-1194.
39. Zhou W, Ko Y, Benharash P, et al. Cardioprotection of electroacupuncture against myocardial ischemia-reperfusion injury by modulation of cardiac norepinephrine release. Am J Physiol Heart Circ Physiol, 2012, 302(9): H1818-H1825.
40. Chen CC, Chuang YF, Yang HC, et al. Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia. J Electromyogr Kinesiol, 2015, 25(1): 143-150.

West China Medical Journal

Progress in basic research and clinical application of median nerve electrical stimulation

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