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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2012; 22(04): 189-194
DOI: 10.1055/s-0032-1314864
Wissenschaft und Forschung
© Georg Thieme Verlag KG Stuttgart · New York

Effect of Transcutaneous Electric Nerve Stimulation over the Stellate Ganglion: A Placebo-Controlled Double Blind Study in Healthy Subjects

Effekt der transkutanen elektrischen Nervenstimulation über dem Ganglion stellatum: eine placebokontrollierte Doppelblindstudie an gesunden Probanden
O. Schuhfried
1   Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
M. Herceg
1   Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
G. Vacariu
2   Department of Physical Medicine, Orthopaedic Hospital Speising, Vienna, Austria
› Author Affiliations
Further Information

Publication History

received 02 April 2012

accepted 14 May 2012

Publication Date:
22 August 2012 (online)

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Abstract

Abstract Purpose:

Does transcutaneous electric nerve stimulation (TENS) over the stellate ganglion influence the function of the autonomic nervous system?

Materials and Methods:

12 healthy subjects (6 female, 6 male) received according to a randomization list (cross-over design) either conventional TENS therapy (100 Hz biphasic) or a placebo application (device switched on, but current intensity zero) over the stellate ganglion of the non-dominant side for 20 min on 2 different days. Before and after the interventions the pain threshold was determined by pressure algometry on the forearm. Skin temperature was recorded by infrared thermography in the dorsum of the hand and the distal phalanx of the middle finger of the treated arm before and immediately after 20 min of intervention. After this, alterations of skin temperature were measured 1 min as well as 5 min after a Valsalva like manoeuvre. At the same time points the heart rate was measured using a pulse recorder.

Results:

After the intervention temperature assessment in the dorsum of the hand showed higher values (given as differences compared to baseline values before the intervention) with TENS treatment than with placebo treatment at all time points of measurement. For temperature values in the dorsum of the hand repeated-measures analysis of variance showed a significant effect both between the interventions (p=0.046) and over time (p<0.0001). For the temperature assessment in the distal phalanx of the middle finger no significant effect between the 2 interventions was found. Furthermore there were no statistically significant differences with regard to the measurement of the pain threshold and the heart rate data (given as differences compared to baseline values before the intervention).

Conclusions:

Conventional TENS application over the stellate ganglion leads to a significantly higher skin temperature in the dorsum of the hand as compared to placebo application in healthy humans. This suggests that this therapeutic application may inhibit sympathetic outflow from the stellate ganglion.

Zusammenfassung

Fragestellung:

Beeinflusst eine transkutane elektrische Nervenstimulation (TENS) über dem Ganglion stellatum die Funktionen des autonomen Nervensystems?

Material und Methode:

12 gesunde Probanden (6w, 6 m) erhielten entsprechend einer Randomisierungsliste an 2 unterschiedlichen Tagen für 20 min entweder konventionelle TENS (100 Hz biphasisch) oder eine Placebo-Anwendung (eingeschaltetes Gerät, aber Intensität auf 0) über dem Ganglion stellatum der nicht dominanten Seite. Vor und nach den Interventionen wurde die Schmerzschwelle mittels Druckalgometer am Unterarm bestimmt. Mittels Infrarotthermogra­fie erfolgte eine Aufzeichnung der Hauttempe­ratur im Bereich des Handrückens und der distalen Phalanx des Mittelfingers des behandelten Arms vor und unmittelbar nach 20 min Intervention. Danach wurde die Veränderung der Hauttemperatur nach 1 min und 5 min nach einem Valsalva-Manöver gemessen. Zu den selben Zeitpunkten wurde die Herzfrequenz mittels Pulsabnahmegerät gemessen.

Ergebnisse:

Es konnte zu allen postinterventionellen Messzeitpunkten eine höhere Hauttemperatur am Handrücken (dargestellt als Differenz zur Ausgangsmessung vor der Intervention) im Vergleich zu Placebo gemessen werden. Für die Temperaturmessungen am Handrücken zeigte sich in der Varianzanalyse mit Messwiederholungen ein signifikanter Unterschied sowohl zwischen den Interventionen (p=0,046) als auch im zeitlichen Verlauf (p<0,0001). Die Temperaturmessungen der distalen Phalanx des Mittelfingers zeigten keine signifikanten Unterschiede zwischen den Interventionen. Für die Schmerzschwellenmessung und Pulswerte (dargestellt als Differenz zur Ausgangsmessung vor der Intervention) zeigten sich keine signifikanten Unterschiede.

Schlussfolgerung:

Die konventionelle TENS-Applikation über dem Ganglion stellatum führt bei gesunden Probanden im Bereich des Handrückens im Vergleich zur Plazebo-Anwendung zu einer signifikant höheren Hauttemperatur. Das gibt Hinweis auf einen hemmenden Effekt dieser Therapieform auf die sympathische Aktivität des Ganglion stellatum.

Key words

skin temperature - stellate ganglion - sympathetic nervous ­system - thermography - transcutaneous electrical nerve stimulation

Schlüsselwörter

Hauttemperatur - Ganglion stellatum - sympathisches Nerven­system - Thermografie - transcutane elektrische Nervenstimulation
 

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