Neuromodulation最新文献

{"title":"Effects of Pulsed Radiofrequency Duration in Patients With Chronic Lumbosacral Radicular Pain: A Randomized Double-Blind Study","authors":"Chan-Sik Kim MD,&nbsp;Yujin Kim MD,&nbsp;Doo-Hwan Kim MD, PhD,&nbsp;Hyun-Jung Kwon MD,&nbsp;Jin-Woo Shin MD, PhD,&nbsp;Seong-Soo Choi MD, PhD","doi":"10.1016/j.neurom.2024.03.006","DOIUrl":"10.1016/j.neurom.2024.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div>We hypothesized that the duration of pulsed radiofrequency (PRF) application may affect the effectiveness of PRF in patients with chronic lumbosacral radicular pain (LRP).</div></div><div><h3>Materials and Methods</h3><div>In this prospective, double-blind, randomized study, 68 patients were randomly allocated to two groups: a 6-minute group, in which PRF was applied at 42 °C for 2 minutes followed by a 2-minute pause, repeated three times; and a 12-minute group, with a continuous application at 42 °C for 12 minutes. The total application time in each group was equal. After PRF, 2 to 3 mL of 1% lidocaine with 5 mg of dexamethasone was injected. The primary outcome was the intensity of leg pain measured using a numerical rating scale (NRS) three months after the procedure. The secondary outcomes were intensities of leg and back pain, the Oswestry Disability Index (ODI), the Medication Quantification Scale III (MQS), the Global Perceived Effect of Satisfaction (GPES), and the incidence of adverse events during follow-up. Primary and secondary outcomes were analyzed using a linear mixed-effect model in the modified intention-to-treat population.</div></div><div><h3>Results</h3><div>Each group comprised 34 patients. Three patients in each group did not receive the allocated intervention owing to alleviation of pain. The estimated NRS mean of leg pain at three months was 4.0 (95% CI, 3.2–4.9) and 4.5 (95% CI, 3.6–5.4) in the 6- and 12-minute groups, respectively, with no significant difference between groups (estimated mean difference, −0.5; 95% CI, −1.8 to 0.8; <em>p</em> = 0.436). Regarding the intensities of leg and back pain, ODI, MQS, and GPES, there was no significant difference between the two groups except for GPES at six months. No adverse events were observed in the groups.</div></div><div><h3>Conclusions</h3><div>Among patients with chronic LRP, a prolonged PRF application of 12 minutes, compared with 6 minutes, caused no significant difference in leg pain intensity.</div></div><div><h3>Clinical Trial Registration</h3><div>The <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> registration number under the Clinical Trial Registry of Korea for the study is KCT0003850; <span><span>https://cris.nih.go.kr</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Pages 256-262"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims","authors":"","doi":"10.1016/S1094-7159(24)01288-1","DOIUrl":"10.1016/S1094-7159(24)01288-1","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Page A3"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cylindrical vs Paddle Leads in Spinal Cord Stimulation for the Long-term Treatment of Chronic Pain: A Systematic Review and Meta-analysis","authors":"Salim El Hadwe MD ,&nbsp;Filip Wronowski ,&nbsp;Sara Rehman ,&nbsp;Yaw Ofosu Ansong Snr ,&nbsp;Damiano G. Barone MD, PhD","doi":"10.1016/j.neurom.2024.10.007","DOIUrl":"10.1016/j.neurom.2024.10.007","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review compares the long-term efficacy of cylindrical-lead spinal cord stimulation (CL-SCS) vs paddle-lead spinal cord stimulation (Paddle-SCS) for chronic pain management.</div></div><div><h3>Materials and Methods</h3><div>We included prospective and retrospective studies with at least ten patients reporting on the efficacy of either lead type. Primary outcomes were pain score reduction (measured by the visual analog scale [VAS] and numeric rating scale [NRS]) and 50% pain relief after at least 12 months. Secondary outcomes included functional disability and complications, such as lead migration and infection rates. Meta-analyses compared effect sizes, while meta-regression and subgroup analyses addressed heterogeneity.</div></div><div><h3>Results</h3><div>A total of 96 studies, comprising 7726 patients, met the inclusion criteria. Paddle-SCS demonstrated superior pain reduction, with a standardized mean difference (SMD) of 5.37 (95% CI [5.35, 5.38]) compared with CL-SCS, which had an SMD of 4.09 (95% CI [4.08, 4.10]) on the VAS. However, CL-SCS outperformed Paddle-SCS on the NRS, with SMDs of 4.39 vs 2.35, respectively. For 50% pain relief, Paddle-SCS had a success rate of 41.4%, as opposed to 35.4% for CL-SCS. Paddle-SCS showed a lower migration rate (4.3% vs 7.2% for CL-SCS) but higher infection rates (5.0% vs 3.3%).</div></div><div><h3>Conclusions</h3><div>Paddle-SCS offers superior pain reduction (as measured by the VAS) and a lower migration rate, but a higher infection risk compared with CL-SCS. CL-SCS showed better outcomes as measured by the NRS. The choice between Paddle-SCS and CL-SCS should be individualized according to patient-specific factors and treatment goals. Further research with rigorous study designs is needed to provide clearer comparisons between these interventions.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Pages 204-233"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Stimulation Implantation Combining Ultrasound With Microendoscopy for Management of Chronic Neuropathic Pain: A Case Series Study","authors":"Bénédicte Bouche MD ,&nbsp;Maxime Billot PhD ,&nbsp;Arthur Voratanouvong MD ,&nbsp;Amine Ounajim PhD ,&nbsp;Maarten Moens MD, PhD ,&nbsp;Lisa Goudman PT, PhD ,&nbsp;Sam Eldabe MD ,&nbsp;Denys Fontaine MD, PhD ,&nbsp;Manon Duraffourg MD ,&nbsp;Manuel Roulaud MSc ,&nbsp;Kévin Nivole MSc ,&nbsp;Mathilde Many MSc ,&nbsp;Sandrine Baron RN ,&nbsp;Bertille Lorgeoux MSc ,&nbsp;Lucie Lampert MSc ,&nbsp;Romain David MD ,&nbsp;Philippe Rigoard MD, PhD","doi":"10.1016/j.neurom.2024.10.013","DOIUrl":"10.1016/j.neurom.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral nerve stimulation (PNS) has emerged as a minimally invasive percutaneous procedure addressing neuropathic pain. However, the percutaneous cylindrical lead ultrasound-guided implantation procedure requires expertise that limits widespread PNS utilization. To overcome these challenges, a microinvasive endoscopy device has very recently been developed, enhancing the precision of PNS implantation by providing accurate visualization of the targeted nerve. We aimed to determine the feasibility, safety, clinical effectiveness, and energy consumption of PNS therapy by means of ultrasound guidance combined with microendoscopy.</div></div><div><h3>Materials and Methods</h3><div>This is a retrospective, single-center, single-arm study. Patient recruitment was performed in February and March 2023. Patients with &gt;12 months of upper or lower limb pain presenting with pain &gt;5 of 10 that was refractory to conventional treatments were eligible. Safety was assessed by collecting adverse events and complications related to the PNS implantation with microendoscopy. The Multidimensional Clinical Response Index (MCRI), pain intensity (visual analog scale [VAS]), pain surface (PRISMap Software, PRISMATICS lab, CHU de Poitiers, Poitiers, France), quality of life (EuroQoL 5 dimensions 5 levels [EQ5D-5L]), functional disability (Oswestry Disability Index [ODI]), anxiety and depression (Hospital Anxiety and Depression Scale), and energy consumption were assessed at baseline and at one and three months.</div></div><div><h3>Results</h3><div>Six patients received PNS, which was implanted through ultrasound guidance combined with microendoscopy. No adverse event was reported during the three-month follow-up. Clinical outcomes (MCRI, VAS, ODI, EQ5D-5L) significantly increased at one- and three-month follow-up. Energy consumption was, on average, 2.6 ± 1.1 μC.s⁻¹ at one-month and 3.3 ± 2.0 μC.s⁻¹ at three-month follow-up.</div></div><div><h3>Conclusions</h3><div>Implanted PNS by means of ultrasound combined with microendoscopy was safe and provided clinical benefits with very low energy consumption (15–440 times less than spinal cord stimulation) in patients with upper or lower limb neuropathic pain. Microendoscopy would offer extended PNS indications, overcoming limitations associated with ultrasound alone. Future research is nonetheless needed to provide stronger evidence through randomized controlled trial design.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Pages 274-282"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Calendar of Events - February","authors":"","doi":"10.1016/S1094-7159(24)01295-9","DOIUrl":"10.1016/S1094-7159(24)01295-9","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Page 369"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, and Association of Both in Patients With Refractory Chronic Back and/or Lower Limb Neuropathic Pain: A Prospective, Randomized, Double-Blind, Cross-Over Trial (BOOST-DRG Study)","authors":"Philippe Rigoard MD, PhD ,&nbsp;Amine Ounajim PhD ,&nbsp;Bénédicte Bouche MD ,&nbsp;Maarten Moens MD, PhD ,&nbsp;Lisa Goudman PT, PhD ,&nbsp;Sam Eldabe MD ,&nbsp;Manuel Roulaud MSc ,&nbsp;Bertille Lorgeoux MSc ,&nbsp;Sandrine Baron RN ,&nbsp;Kévin Nivole MSc ,&nbsp;Mathilde Many MSc ,&nbsp;Lucie Lampert MSc ,&nbsp;Romain David MD ,&nbsp;Maxime Billot PhD","doi":"10.1016/j.neurom.2024.10.003","DOIUrl":"10.1016/j.neurom.2024.10.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRGS) have individually shown efficacy in relieving pain in patients with persistent spinal pain syndrome after spinal surgery (PSPS-T2). Combining SCS and DRGS simultaneously, along with Burst stimulation programming, may enhance the responder rate of patients with PSPS-T2.</div></div><div><h3>Material and Methods</h3><div>This study aimed to compare the pain relief (≥50%) responder rates in SCS, DRGS, and SCS+DGRS (DUAL) through a three-month randomized cross-over trial in patients with PSPS-T2. After the cross-over period, stimulation programming was switched to Burst. Secondary objectives included evaluating the clinical efficacy at three-, four-, six-, and 12-month follow-ups, assessing pain intensity, area of pain, area of paresthesia coverage, quality of life, functional disability, psychologic distress, medication intake, and the Multidimensional Clinical Response Index (MCRI).</div></div><div><h3>Results</h3><div>The responder rate of pain relief was similar in SCS, DRGS, and DUAL (60%, <em>p</em> = 0.84) at the end of the cross-over period, increasing to 80% with the ability to switch between stimulation possibilities. Burst programming did not provide additional pain relief at the four-month follow-up (<em>p</em> = 0.99). Clinical outcomes significantly improved until 12-month follow-up compared with baseline. Considering a clinically significant increase of 1.05 of the MCRI, all patients were responders at three-, four-, and six- month follow-up, and 80% were responders at 12 months compared with baseline.</div></div><div><h3>Conclusions</h3><div>The full option to stimulate different neural structures, separately or simultaneously, led to improved responder rates, allowing patients to personalize treatment. A multidimensional assessment is essential to reveal the full potential benefits of neuromodulation in patients with chronic pain.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Pages 283-296"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Spinal Cord Stimulation as a Therapeutic Strategy for Postmastectomy Pain Syndrome: A Retrospective Observational Study","authors":"Yun Li MD,&nbsp;Yang Chen MD,&nbsp;Guangfu Wei MSc,&nbsp;Shengtao Wang MSc,&nbsp;Tao Sun MD,&nbsp;Xuli Zhao MD","doi":"10.1016/j.neurom.2024.10.008","DOIUrl":"10.1016/j.neurom.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Postmastectomy pain syndrome (PMPS) is a chronic condition that significantly impacts breast cancer survivors, marked by persistent neuropathic pain that is often unresponsive to conventional therapies. Spinal cord stimulation (SCS) has emerged as a promising intervention for managing this type of pain. This study aimed to assess the clinical efficacy of SCS in managing PMPS and identify patient-specific factors impacting treatment outcomes.</div></div><div><h3>Materials and Methods</h3><div>This retrospective observational study analyzed 78 female patients who underwent SCS implantation between January and October 2023. The efficacy of SCS was assessed by evaluating changes in visual analog scale (VAS) pain scores from baseline to six months after implantation. The influence of factors such as age, body mass index (BMI), prior treatments, and psychologic health on treatment success was explored using binary logistic regression.</div></div><div><h3>Results</h3><div>Six months after implantation, 61 patients (78.2%) reported significant pain relief, with a decrease in VAS scores by ≥4 points. Statistical analysis revealed several predictors of positive outcomes: younger age (hazard ratio [HR] = 0.882, 95% CI: 0.802–0.970, <em>p</em> = 0.009), lower BMI (HR = 0.659, 95% CI: 0.487–0.891, <em>p</em> = 0.007), and psychologic treatment (HR = 0.015, 95% CI: 0.001–0.377, <em>p</em> = 0.011). Conversely, prior radiotherapy was associated with less favorable outcomes (HR = 2.139, 95% CI: 1.219–5.808, <em>p</em> = 0.029). The receiver operating characteristic curve analysis confirmed the model’s accuracy (area under the curve = 0.927).</div></div><div><h3>Conclusions</h3><div>SCS is an effective treatment for PMPS, with age, BMI, psychologic treatments, and prior radiotherapy being significant predictors of outcomes. Tailoring treatment plans to these factors can potentially enhance pain management for patients with PMPS.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 2","pages":"Pages 341-347"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinical Care Pathway for Patients With Chronic Mechanical Low Back Pain Having Restorative Neurostimulation for Multifidus Muscle: Description, Patient Compliance, Clinical Outcomes, and Satisfaction in the First Two Years.","authors":"Allen J Huang, Derek Yull, Yun-Hom Yau, Mike Selby, Kyle Craig, Tim Bass, Sally Fish, Peter Murphy, Eleanor Clausen, Ian R Whittle","doi":"10.1016/j.neurom.2024.12.004","DOIUrl":"10.1016/j.neurom.2024.12.004","url":null,"abstract":"<p><strong>Objectives: </strong>Restorative neurostimulation for multifidus muscle is a novel therapy for chronic low back pain (CLBP). Optimal outcomes require interdisciplinary follow-up. We describe a clinical care pathway (CPW) for this therapy and report patient compliance, clinical outcomes, and patient satisfaction with the CPW.</p><p><strong>Materials and methods: </strong>This study aimed to develop, at a single center, a CPW with derivation, practical basis, description, and evolution. Included in the study were audits of 1) patient compliance with attendance over 24 months, 2) medical and paramedical attendance at the clinic, 3) clinical outcomes in terms of reductions in both patient and cohort disability (Oswestry Disability Index, ODI) and CLBP numeric rating score (NRS), and 4) adverse events; and a prospective cross-sectional survey of patient satisfaction with the CPW.</p><p><strong>Results: </strong>A CPW that involved both preoperative and postoperative education and integrated interdisciplinary care was developed and incorporated into the clinical service with a dedicated clinic. In the two years under study, 172 patients attended the education session, and 92 proceeded to restorative neurostimulation for multifidus muscle therapy; 15 patients who had this therapy before the CPW also were incorporated into the CPW. Patient compliance with the pathway was 88% (95% CI 79%-94%) at 12 months. Attendance at the dedicated CPW clinic by the various subspeciality clinicians ranged between 74% and 100%. There were serial reductions in both ODI (38.9 [95% CI 35.9-41.9] to 24.7 (95% CI 21.1-28.3) and CLBP NRS (6.3 [95% CI 6.0-6.7] to 3.3 (95% 2.7-3.9) after 12 months; 76 of the 99 patients assessable (77%: 95% CI 67%-85%) had a minimally important clinical difference reduction in either ODI or pain NRS, whereas eight were unassessable. Patient satisfaction with the CPW was very high (mean 26.9; median 27, maximum 28).</p><p><strong>Conclusions: </strong>The CPW facilitated clinical management and optimized outcomes in patients having restorative neurostimulation. Its design and delivery were very well accepted by patients.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking and Failure Analysis of Explanted Neuromodulation Devices.","authors":"Tess L Veuthey, Deborah Duricka, Dario J Englot, David A Provenzano, David M Dickerson, Sanket Dhruva, Christopher Miranda Loftus, Nina Meizu-Nwaba, David Prescott McMullen, Richard B North, Pierre D'Haese, Peter E Konrad, Lawrence Poree","doi":"10.1016/j.neurom.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.neurom.2024.11.008","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerative Effects of Transcutaneous Electrical Acustimulation on Postoperative Recovery After Thoracolumbar Vertebral Fracture Associated With Suppressed Sympathetic Activity and Interleukin-6.","authors":"Ying Kang, Feng Xu, Yang Wang, Xiangyue Gao, Weixin Dong, Liansong Lu, Fei Li, Lin Lin, Jiande D Z Chen","doi":"10.1016/j.neurom.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.neurom.2024.11.011","url":null,"abstract":"<p><strong>Objectives: </strong>Gastrointestinal (GI) disturbance is a frequent complication in patients with thoracolumbar vertebral fracture (TVF). Transcutaneous electrical acustimulation (TEA) has been reported to effectively accelerate postoperative GI function recovery after abdominal surgery. This study aimed to investigate the effects of TEA on postoperative recovery and the associated mechanisms.</p><p><strong>Materials and methods: </strong>A total of 81 patients with TVF who underwent elective posterior pedicle screw fixation surgery were randomized to receive TEA or sham-TEA. TEA at ST36 or sham-TEA at nonacupoints was performed for one hour twice daily, from 24 hours before surgery to postoperative day (POD) 3. The effects were then assessed in the form of a diary at different time points.</p><p><strong>Results: </strong>Compared with sham-TEA, TEA attenuated postoperative impairments associated with lower GI motility, including a reduction in time to defecation by 27.2% (p = 0.002 vs sham-TEA), time to first flatus by 17.2% (p = 0.027), an increase in the Bristol stool score (p = 0.014), and the number of spontaneous bowel movement (p = 0.009). TEA also relieved other GI symptoms including abdominal bloating on POD1 and POD4 (p < 0.001 and p = 0.001, respectively), straining during defecation (p < 0.001), and sensation of anorectal blockage during defecation (p = 0.02). Moreover, TEA reduced the visual analog scale wound pain score on POD1 (p = 0.026), POD2 (p < 0.001), and POD3 (p < 0.001), increased vagal activity, and decreased sympathetic activity (p < 0.001), in addition to suppressing the serum level of norepinephrine on both POD1 (p = 0.047) and POD4 (p = 0.036). TEA caused a higher decrease from POD1 to POD4 in serum interleukin-6 (p = 0.011, vs sham-TEA). The use of TEA was an independent predictor of shortened time to first defecation.</p><p><strong>Conclusion: </strong>Noninvasive TEA at ST36, in comparison with sham-TEA, is effective in promoting postoperative recovery in patients with TVF by enhancing vagal and suppressing sympathetic activities.</p><p><strong>Clinical trial registration: </strong>The study was retrospectively registered on www.chictr.org.cn (Chinese Clinical Trial Registry ChiCTR2300078195).</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}