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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Abstract Full text Figures/Tables Video References Cited by

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.	任善紅, 郭愛松. 正中神經電刺激的臨床應用進展. 交通醫學, 2019, 33(4): 378-381.
2.	陶敏, 馬彥霖, 陳禮娜. 右側正中神經電刺激對大面積腦梗死意識障礙患者促醒作用的臨床觀察. 中外醫學研究, 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.	聞萬順, 趙元元, 葉祥明. 早期右正中神經刺激對顱腦外傷昏迷患者促醒作用的臨床觀察. 浙江創傷外科, 2017, 22(3): 420-423.
5.	游文棟, 唐琪臨, 王磊, 等. 右正中神經電刺激對顱腦創傷昏迷患者腦電活動的影響. 中華創傷雜志, 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.	鐘穎君, 馮珍. 正中神經電刺激對促醒相關神經遞質影響的研究進展. 中國康復醫學雜志, 2015, 30(3): 299-301.
8.	方圓, 許能貴. 開竅醒神針刺法配合電刺激對早期重型顱腦損傷昏迷患者的促醒作用觀察. 中醫藥導報, 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.	鐘穎君, 王亮, 魏天琪, 等. 正中神經電刺激對腦外傷后昏迷大鼠前額葉皮質及下丘腦 Orexin-A 及其受體 OX1R 表達變化的影響. 中國康復醫學雜志, 2015, 30(7): 640-644.
13.	杜青, 馮珍. 正中神經電刺激腦外傷昏迷大鼠前額葉皮質 5-HT 2A 受體表達的實驗研究. 中國康復醫學雜志, 2017, 32(3): 253-257.
14.	魏天祺, 馮珍. 正中神經電刺激對腦外傷后昏迷大鼠γ-氨基丁酸 b 受體表達變化的影響. 中國康復醫學雜志, 2016, 31(1): 9-13.
15.	李益歡, 錢春生, 張斌, 等. 神經電刺激對腦外傷昏迷大鼠前額葉皮質 5-羥色胺 2A 和γ-氨基丁酸 b 受體表達的影響. 中國老年學雜志, 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.	劉巖松, 劉子渤, 楊哲, 等. 正中神經電刺激治療腦損傷所致意識障礙的研究進展. 腦與神經疾病雜志, 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.	石艷紅, 邵秀芹, 馮珍, 等. 正中神經電刺激與常規療法治療昏迷患者促醒療效的 meta 分析. 中國康復醫學雜志, 2017, 32(11): 1273-1277.
25.	楊虎銀, 蔣坤, 方大釗, 等. 正中神經電刺激對腦損傷后昏迷患者血流動力學的影響. 華中科技大學學報(醫學版), 2017, 46(4): 462-465.
26.	狄麗宏, 焦洋洋, 陳深, 等. sTBI 患者治療前后腦氧代謝指標變化與顱內壓及預后的關系. 創傷外科雜志, 2020, 22(10): 742-745.
27.	王丹丹, 龐猛, 王輝. 電針刺激對重型顱腦損傷遷延性昏迷患者昏迷程度的影響及其機制. 現代中西醫結合雜志, 2020, 29(1): 51-54.
28.	李曉彥, 高敏, 王雪爭, 等. 針刺聯合吞咽電刺激對老年癡呆伴吞咽障礙患者舌骨喉復合體動度的影響. 上海針灸雜志, 2020, 39(10): 1253-1258.
29.	張霄瓊, 張娟, 張絲絲, 等. 正中神經電刺激聯合計算機輔助認知訓練治療腦卒中后認知功能障礙的效果. 中國醫藥導報, 2021, 18(26): 73-76.
30.	荊靜, 馬艷平, 劉萬林, 等. 正中神經電刺激治療腦卒中后認知障礙的康復療效及機制探討. 中華物理醫學與康復雜志, 2020, 42(3): 215-220.
31.	何文. 近紅外光譜技術在醫學上應用進展. 生物技術世界, 2013(7): 77.
32.	昌凡, 李豪喆, 張盛宇, 等. 基于 fNIRS 技術檢測腦外傷所致輕度認知功能障礙者工作記憶. 法醫學雜志, 2020, 36(1): 52-60.
33.	王萍, 陳宜懿, 顧延慶, 等. 非侵入性腦刺激技術在卒中后認知障礙康復中的應用進展. 按摩與康復醫學, 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. 任善紅, 郭愛松. 正中神經電刺激的臨床應用進展. 交通醫學, 2019, 33(4): 378-381.
2. 陶敏, 馬彥霖, 陳禮娜. 右側正中神經電刺激對大面積腦梗死意識障礙患者促醒作用的臨床觀察. 中外醫學研究, 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. 聞萬順, 趙元元, 葉祥明. 早期右正中神經刺激對顱腦外傷昏迷患者促醒作用的臨床觀察. 浙江創傷外科, 2017, 22(3): 420-423.
5. 游文棟, 唐琪臨, 王磊, 等. 右正中神經電刺激對顱腦創傷昏迷患者腦電活動的影響. 中華創傷雜志, 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. 鐘穎君, 馮珍. 正中神經電刺激對促醒相關神經遞質影響的研究進展. 中國康復醫學雜志, 2015, 30(3): 299-301.
8. 方圓, 許能貴. 開竅醒神針刺法配合電刺激對早期重型顱腦損傷昏迷患者的促醒作用觀察. 中醫藥導報, 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. 鐘穎君, 王亮, 魏天琪, 等. 正中神經電刺激對腦外傷后昏迷大鼠前額葉皮質及下丘腦 Orexin-A 及其受體 OX1R 表達變化的影響. 中國康復醫學雜志, 2015, 30(7): 640-644.
13. 杜青, 馮珍. 正中神經電刺激腦外傷昏迷大鼠前額葉皮質 5-HT 2A 受體表達的實驗研究. 中國康復醫學雜志, 2017, 32(3): 253-257.
14. 魏天祺, 馮珍. 正中神經電刺激對腦外傷后昏迷大鼠γ-氨基丁酸 b 受體表達變化的影響. 中國康復醫學雜志, 2016, 31(1): 9-13.
15. 李益歡, 錢春生, 張斌, 等. 神經電刺激對腦外傷昏迷大鼠前額葉皮質 5-羥色胺 2A 和γ-氨基丁酸 b 受體表達的影響. 中國老年學雜志, 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. 劉巖松, 劉子渤, 楊哲, 等. 正中神經電刺激治療腦損傷所致意識障礙的研究進展. 腦與神經疾病雜志, 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. 石艷紅, 邵秀芹, 馮珍, 等. 正中神經電刺激與常規療法治療昏迷患者促醒療效的 meta 分析. 中國康復醫學雜志, 2017, 32(11): 1273-1277.
25. 楊虎銀, 蔣坤, 方大釗, 等. 正中神經電刺激對腦損傷后昏迷患者血流動力學的影響. 華中科技大學學報(醫學版), 2017, 46(4): 462-465.
26. 狄麗宏, 焦洋洋, 陳深, 等. sTBI 患者治療前后腦氧代謝指標變化與顱內壓及預后的關系. 創傷外科雜志, 2020, 22(10): 742-745.
27. 王丹丹, 龐猛, 王輝. 電針刺激對重型顱腦損傷遷延性昏迷患者昏迷程度的影響及其機制. 現代中西醫結合雜志, 2020, 29(1): 51-54.
28. 李曉彥, 高敏, 王雪爭, 等. 針刺聯合吞咽電刺激對老年癡呆伴吞咽障礙患者舌骨喉復合體動度的影響. 上海針灸雜志, 2020, 39(10): 1253-1258.
29. 張霄瓊, 張娟, 張絲絲, 等. 正中神經電刺激聯合計算機輔助認知訓練治療腦卒中后認知功能障礙的效果. 中國醫藥導報, 2021, 18(26): 73-76.
30. 荊靜, 馬艷平, 劉萬林, 等. 正中神經電刺激治療腦卒中后認知障礙的康復療效及機制探討. 中華物理醫學與康復雜志, 2020, 42(3): 215-220.
31. 何文. 近紅外光譜技術在醫學上應用進展. 生物技術世界, 2013(7): 77.
32. 昌凡, 李豪喆, 張盛宇, 等. 基于 fNIRS 技術檢測腦外傷所致輕度認知功能障礙者工作記憶. 法醫學雜志, 2020, 36(1): 52-60.
33. 王萍, 陳宜懿, 顧延慶, 等. 非侵入性腦刺激技術在卒中后認知障礙康復中的應用進展. 按摩與康復醫學, 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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