Eur J Pediatr Surg 2025; 35(01): 060-070
DOI: 10.1055/a-2482-5997
Original Article

Interferential Current Stimulation Enhances Rectal Motor Activity: Insights from an Isolated Perfused Porcine Model

1   Department of Pediatric Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
2   Department of Neurophysiology, Mannheim Center vor Translational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
,
Michael Boettcher
1   Department of Pediatric Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
3   Mannheim Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
,
Michaela Klinke Petrowsky
1   Department of Pediatric Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
,
Nicolas Andres Hoyos
1   Department of Pediatric Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
4   Department of Pediatric Surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Baden-Württemberg, Germany
,
Irmgard Herrmann
6   Deutsches Zentrum Immuntherapie DZI, Erlangen University Hospital, Erlangen, Bayern, Germany
,
Walter Magerl*
2   Department of Neurophysiology, Mannheim Center vor Translational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
,
Martin Herrmann*
1   Department of Pediatric Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
5   Department of Medicine 3 Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Bayern, Germany
6   Deutsches Zentrum Immuntherapie DZI, Erlangen University Hospital, Erlangen, Bayern, Germany
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Abstract

Introduction Interferential current (IFC) has been studied in several clinical trials for the treatment of bowel motility disorders, most often in children. However, only moderate effects are reported, and in contrast to IFC, the so-called placebo application is indiscernible. The mechanisms and neuroanatomic points of action remain elusive. Therefore, this therapy remains being questioned.

Methods To gain objective experimental data about IFC stimulation, we examined this method ex vivo in an isolated perfused porcine rectum including the mesorectum. To elucidate the role of plexus nerve fibers and enteric ganglia, we performed IFC stimulation also in the presence of tetrodotoxin (TTX) or hexamethonium (HXN). We applied the commonly used stimulation modes with a beat frequency sweeping between 5 and 25 Hz (IFCd5–25) and 80 and 150 Hz (IFCd80–150). We monitored intraluminal pressure and motility by online barometry and video recording, respectively. Motor activity, reflected by changes in the intraluminal pressure (cm H2O·s−1) and longitudinal movements (pixels·s−1), was quantified over time as root mean squares (RMSs).

Results After IFCd5–25, we observed a 30% increase in the rectal motility in the pressure changes which was sustained over 30 minutes post-stimulation (p < 0.02); only a minor effect was detected for IFCd80–150. Both TTX and HTX abolished the stimulation. This suggests neuronal modulation.

Conclusion IFCd5–25 stimulates rectal motor activity in the isolated perfused porcine rectum. Ganglia in the enteric nervous system are modulated to allow increased activity for at least 30 minutes. Therefore, the isolated porcine rectum is a suitable tool to study the effectiveness of various IFC settings in the rectum.

* These authors contributed equally to this work.




Publikationsverlauf

Eingereicht: 27. März 2024

Angenommen: 22. November 2024

Accepted Manuscript online:
25. November 2024

Artikel online veröffentlicht:
11. Dezember 2024

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