| Autor: |
Al-Zamil M; Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples' Friendship University of Russia, 117198 Moscow, Russia., Kulikova NG; Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples' Friendship University of Russia, 117198 Moscow, Russia.; Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia., Minenko IA; Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia.; Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia., Shurygina IP; Department of Ophthalmology, Rostov State Medical University, 344022 Rostov, Russia., Petrova MM; Shared Core Facilities 'Molecular and Cell Technologies', Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia., Mansur N; Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples' Friendship University of Russia, 117198 Moscow, Russia.; Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia.; City Clinical Hospital Named after V. V. Vinogradov, 117292 Moscow, Russia., Kuliev RR; Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia., Blinova VV; Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples' Friendship University of Russia, 117198 Moscow, Russia.; Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia., Khripunova OV; Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia., Shnayder NA; Shared Core Facilities 'Molecular and Cell Technologies', Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia.; Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia. |
| Abstrakt: |
Background/Objectives : The anxiolytic effect of transcutaneous electrical nerve stimulation (TENS) is associated with the activation of endogenous inhibitory mechanisms in the central nervous system. Both low-frequency, high-amplitude TENS (LF-TENS) and high-frequency, low-amplitude TENS (HF-TENS) are capable of activating opioid, GABA, serotonin, muscarinic, and cannabinoid receptors. However, there has been no comparative analysis of the effectiveness of HF-TENS and LF-TENS in the treatment of GAD. The purpose of our research was to study the effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of patients with GAD compared with sham TENS. Methods: The effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of GAD was studied using Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hamilton Anxiety Rating Scale (HAM-A). 40 patients underwent sham TENS, 40 patients passed HF-TENS (50 Hz-50 μs-sensory response) and 41 patients completed LF -TENS (1 Hz-200 μs-motor response) for 30 days daily. After completion of treatment, half of the patients received weekly maintenance therapy for 6 months. Electroencephalography was performed before and after treatment. Results: Our study showed that a significant reduction in the clinical symptoms of GAD as assessed by GAD-7 and HAM-A was observed after HF-TENS and LF-TENS by an average of 42.4%, and after sham stimulation only by 13.5% for at least 2 months after the end of treatment. However, LF-TENS turned out to be superior in effectiveness to HF-TENS by 51% and only on electroencephalography leads to an increase in PSD for the alpha rhythm in the occipital regions by 24% and a decrease in PSD for the beta I rhythm in the temporal and frontal regions by 28%. The prolonged effect of HF-TENS and LF-TENS was maintained without negative dynamics when TENS treatment was continued weekly throughout the entire six-month observation period. Conclusions: A prolonged anxiolytic effect of direct TENS of the right median nerve has been proven with greater regression of clinical and neurophysiological manifestations of GAD after LF-TENS compared to HF-TENS. Minimal side effects, low cost, safety, and simplicity of TENS procedures are appropriate as a home treatment modality. |
