Effect of Different Frequencies of Transcutaneous Electrical Acupoint Stimulation (TEAS) on EEG Source Localization in Healthy Volunteers: A Semi-Randomized, Placebo-Controlled, Crossover Study.

Background/Objectives: Transcutaneous electrical acupoint stimulation (TEAS), also known as transcutaneous electroacupuncture stimulation, delivers electrical pulses to the skin over acupuncture points ("acupoints") via surface electrodes. Electroencephalography (EEG) is an important tool for assessing the changes in the central nervous system (CNS) that may result from applying different TEAS frequencies peripherally-i.e., acting via the peripheral nervous system (PNS)-and determining how these influence cerebral activity and neural plasticity. Methods: A total of 48 healthy volunteers were allocated in a semi-randomized crossover study to receive four different TEAS frequencies: 2.5 pulses per second (pps); 10 pps; 80 pps; and sham (160 pps at a low, clinically ineffective amplitude). TEAS was applied for 20 min to each hand at the acupuncture point Hegu (LI4). The EEG was recorded during an initial 5 min baseline recording, then during TEAS application, and after stimulation for a further 15 min, separated into three periods of 5 min (initial, intermediate, and final) in order to assess post-stimulation changes. Source localization analysis was conducted for the traditional five EEG frequency bands: delta (0.1-3.9 Hz), theta (4-7.9 Hz), alpha (8-13 Hz), beta (14-30 Hz), and gamma (30.1-45 Hz). Results: Within-group source localization analyses of EEG data showed that during the initial 5 min post-stimulation, theta oscillations in the 2.5 pps TEAS group increased over the parahippocampal gyrus (t = 4.42, p < 0.01). The 10 pps TEAS group exhibited decreased alpha rhythms over the inferior parietal gyrus (t = -4.20, p < 0.05), whereas the sham (160 pps) TEAS group showed decreased delta rhythms over the postcentral gyrus (t = -3.97, p < 0.05). During the intermediate 5 min post-stimulation, the increased theta activity over the left parahippocampal gyrus (BA27) remained in the 2.5 pps TEAS group (t = 3.97, p < 0.05). However, diminished alpha rhythms were observed in the 10 pps TEAS group over the postcentral gyrus (t = -4.20, p < 0.01), as well as in the delta rhythms in the sham (160 pps) TEAS group in the same area (t = -4.35, p < 0.01). In the final 5 min post-stimulation, reduced alpha rhythms were exhibited over the insula in the 10 pps TEAS group (t = -4.07, p < 0.05). Interaction effects of condition by group demonstrate decreased alpha rhythms in the 10 pps TEAS group over the supramarginal gyrus during the initial 5 min post-stimulation (t = -4.31, p < 0.05), and decreased delta rhythms over the insula in the sham TEAS group during the final 5 min post-stimulation (t = -4.42, p < 0.01). Conclusions: This study revealed that low TEAS frequencies of 2.5 pps and 10 pps modulate theta and alpha oscillations over the brain areas related to emotional and attentional processes driven by external stimuli, as well as neural synchronization of delta rhythms in the sham group in brain areas related to stimulus expectation at baseline. It is hoped that these findings will stimulate further research in order to evaluate such TEAS modulation effects in clinical patients.