Article

Response of plasma beta-endorphins to transcutaneous electrical nerve stimulation in healthy subjects

Physical Therapy (Impact Factor: 3.25). 08/1984; 64(7):1062-6.
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ABSTRACT A study of 31 healthy volunteers was done to test the hypothesis that analgesia produced by low frequency/high intensity (LoF/Hil) transcutaneous electrical nerve stimulation (TENS) is mediated by release of beta-endorphin (beta-E). After randomization, Group 1 (n = 10) received no stimulation (placebo); Group 2 (n = 9) received 30 minutes of high frequency/low intensity (HiF/Lol) TENS; and Group 3 (n = 12) received 30 minutes of low frequency/high density (LoF/Hil) TENS. Blood pressure, pulse, plasma beta-E levels, and evoked potential response were measured before and after treatment. Mean plasma beta-E increased with treatment in Groups 2 and 3 and fell in Group 1, but the difference between the groups was not statistically significant. Sixty-seven percent of Groups 2 and 3 showed an increase in plasma beta-E levels compared with 30 percent in Group 1 (two-sample test of proportions, p less than .05). Evoked potential response, a measure of pain threshold, varied directly with plasma beta-E level independent of the type of treatment applied. This study did not demonstrate a difference between the effects of HiF/Lol versus Lof/Hil TENS on plasma beta-E in healthy subjects.

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Available from: Peter R Lichstein, Jul 28, 2015
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    • "The rectangular waveform is claimed to be the typical delivery mode of electrical stimulation [60] [61] [62] while preserving " the essential features of Nemec's original design " [63]. The choice of 4 Hz as the treatment frequency was based on previous studies in TENS that demonstrated the low frequency stimulates BEND release [27] [35] [64] [65]. Also, the choice of 20 minutes as treatment time was based on previous research in TENS that demonstrated BEND was released following this application time [28] [38] [40]. "
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    ABSTRACT: Objectives: Interferential therapy (IFT) is a common electrophysical agent used by physiotherapists for pain man-agement. However, there is ongoing debate regarding the hypoalgesic and neurophysiologic mechanisms by which IFT reduces pain. This study aimed to investigate the effect of IFT on plasma beta-endorphin (BEND) levels in the rat model as a proposed analgesic mechanism of IFT. Methods: Twelve adult male Wistar rats received an intra-plantar injection of 0.15 ml of Freund's complete adjuvant (FCA) into the right hind paw under anaesthesia. Five days post FCA, the rats were anesthetized and were divided into two groups (n = 6). One group received IFT at 4 Hz for 20 minutes on the inflamed paw while the other group received sham IFT. One ml of blood was withdrawn from the tail vein of both groups before IFT application but after anaesthesia and then again at the end of the 20 minutes of IFT/sham IFT. Collected blood was centrifuged and plasma was removed for analysis of BEND. Concentrations of BEND were measured in the plasma using ELISA radioimmunoassay. Results: There was a slight increase in the BEND levels in the treatment group following 20 minutes of IFT. However, this increase was not statistically significant neither within (Z = −0.314, P = 0.753, Wilcoxon test) or between the treatment and sham groups (Z = −0.363, P = 0.79, Mann-Whitney U test). Conclusion: The findings suggested that the release of plasma BEND may not be the mechanism by which 4 Hz IFT have an analgesic effect.
    Physiotherapy Theory and Practice 01/2012; 33:97-104.
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    • "In animals, higher concentrations of systemic naloxone also prevent the effects of high frequency TENS analgesia [24] [64]. In parallel, opioid peptides are released in the cerebrospinal fluid and plasma in humans [22] [30] [46] in response to either low or high frequency TENS in a frequency-dependent manner. Previous studies from our laboratory extend those studies by showing the ability of opioid receptor antagonists administered directly to the rostroventromedial medulla (RVM) or the spinal cord prevents the anti-hyperalgesic effects of both high and low frequency TENS [1] [31]. "
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    ABSTRACT: Transcutaneous electrical nerve stimulation (TENS) is a treatment for pain that involves placement of electrical stimulation through the skin for pain relief. Previous work from our laboratory shows that repeated application of TENS produces analgesic tolerance by the fourth day and a concomitant cross-tolerance at spinal opioid receptors. Prior pharmacological studies show that blockade of cholecystokinin (CCK) receptors systemically and spinally prevents the development of analgesic tolerance to repeated doses of opioid agonists. We therefore hypothesized that systemic and intrathecal blockade of CCK receptors would prevent the development of analgesic tolerance to TENS, and cross-tolerance at spinal opioid receptors. In animals with knee joint inflammation (3% kaolin/carrageenan), high (100Hz) or low frequency (4Hz) TENS was applied daily and the mechanical withdrawal thresholds of the muscle and paw were examined. We tested thresholds before and after inflammation, and before and after TENS. Animals treated systemically, prior to TENS, with the CCK antagonist, proglumide, did not develop tolerance to repeated application of TENS on the fourth day. Spinal blockade of CCK-A or CCK-B receptors blocked the development of tolerance to high and low frequency TENS, respectively. In the same animals we show that spinal blockade of CCK-A receptors prevents cross-tolerance at spinal delta-opioid receptors that normally occurs with high frequency TENS; and blockade of CCK-B receptors prevents cross-tolerance at spinal mu-opioid receptors that normally occurs with low frequency TENS. Thus, we conclude that blockade of CCK receptors prevents the development of analgesic tolerance to repeated application of TENS in a frequency-dependent manner.
    Pain 11/2009; 148(1):84-93. DOI:10.1016/j.pain.2009.10.011 · 5.84 Impact Factor
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    • "Low frequency TENS activates μ-opioid receptors and high frequency TENS activates δ-opioid receptors in the spinal cord and rostral ventral medulla (Sluka et al., 1999; Kalra et al., 2001). Similarly, human studies show increased endogenous opioid concentrations in cerebrospinal fluid (CSF) following PES (Hughes et al., 1984; Almay et al., 1985). Further, in rats, repeated application of low or high frequency TENS can lead to development of tolerance of spinal μand δ-opioid receptors, respectively (Chandran and Sluka, 2003). "
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    ABSTRACT: Transcutaneous electrical nerve stimulation (TENS) is a form of non-pharmacological treatment for pain. Involvement of descending inhibitory systems is implicated in TENS-induced analgesia. In the present study, the roles of spinal 5-HT and alpha(2)-adrenoceptors in TENS analgesia were investigated in rats. Hyperalgesia was induced by inflaming the knee joint with 3% kaolin-carrageenan mixture and assessed by measuring paw withdrawal latency (PWL) to heat before and 4 h after injection. The (1). alpha(2)-adrenergic antagonist yohimbine (30 microg), (2). 5-HT antagonist methysergide (5-HT(1). and 5-HT(2). 30 microg), one of the 5-HT receptor subtype antagonists, (3). NAN-190 (5-HT(1A), 15 microg), (4). ketanserin (5-HT(2A), 30 microg), (5). MDL-72222 (5-HT(3), 12 microg), or (6). vehicle was administered intrathecally prior to TENS treatment. Low (4 Hz) or high (100 Hz) frequency TENS at sensory intensity was then applied to the inflamed knee for 20 min and PWL was determined. Selectivity of the antagonists used was confirmed using respective agonists administered intrathecally. Yohimbine had no effect on the antihyperalgesia produced by low or high frequency TENS. Methysergide and MDL-72222 prevented the antihyperalgesia produced by low, but not high, frequency TENS. Ketanserin attenuated the antihyperalgesic effects of low frequency TENS whereas NAN-190 had no effect. The results from the present study show that spinal 5-HT receptors mediate low, but not high, frequency TENS-induced antihyperalgesia through activation of 5-HT(2A) and 5-HT(3) receptors in rats. Furthermore, spinal noradrenergic receptors are not involved in either low or high frequency TENS antihyperalgesia.
    Pain 10/2003; 105(1-2):205-13. DOI:10.1016/S0304-3959(03)00207-0 · 5.84 Impact Factor
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