20-kHz alternating current stimulation: effects on motor and somatosensory thresholds

Abstract

Background: High frequency alternating current (HFAC) stimulation have been shown to produce a peripheral nerve conduction block. Currently, all the studies applying HFAC stimulation in clinical studies, have employed frequencies below 10 kHz. The main aim of this work was to investigate the neuromodulatory effect of transcutaneous 20 kHz stimulation on somatosensory and pain thresholds, and maximal handgrip strength.

Methods: A randomized, crossover, single-blinded, placebo-controlled trial was conducted following recruitment of fourteen healthy volunteers. Transcutaneous stimulation at 20 kHz and sham stimulation were applied over the ulnar and median nerves of fourteen healthy volunteers for 20 min. Maximal handgrip strength (MHS), mechanical detection threshold (MDT) and pressure pain threshold (PPT) were registered prior to, during (15 min), immediately after the end (20 min), and 10 min following stimulation.

Results: The 20 kHz stimulation showed a lower MHS during the stimulation at the 15 min (30.1 kgs SE 2.8) and at 20 min (31.8 kgs, SE 2.8) when compared to sham stimulation (35.1 kgs, SE 3.4; p < 0.001 and 34.2 kgs, SE 3.4; p = 0.03, respectively). The 20 kHz stimulation resulted in a slight increase in MDT at 15 min (0.25 mN; 0.25-2.00) when compared to the sham stimulation (0.25 mN; 0.25-0.25; p = 0.02), and no effects were showed for PPT.

Conclusions: High-frequency stimulation at 20 kHz suggests a partial block of nerve activity. Studies in subjects with neurological disorders characterized by nerve hyperactivity are needed to confirm the clinical impact of this non-invasive electrical stimulation technique.

Trial registration: NCT, NCT02837458. Registered on 12 April 2017.

Keywords: High-frequency; Nerve block; Peripheral nerve; Transcutaneous electric stimulation.

Fig. 1

Stimulus intervention, electrode placement and outcome measure assessment. a Maximal handgrip strength. b Mechanical detection threshold. c Pressure pain threshold

Fig. 2

HFAC stimulation effect on maximal handgrip strength. Sham stimulation (grey) and 20 kHz (black). Data are represented as mean and standard error values. * Indicates value significantly different compared to sham stimulation (***p < 0.001; * p < 0.05). # Indicates significant difference from baseline and 30 min (### p < 0.001)