From pulse width modulated TENS to cortical modulation: based on EEG functional connectivity analysis

Armita Faghani Jadidi; Winnie Jensen; Ali Asghar Zarei; Eugen Romulus Lontis; S Farokh Atashzar

doi:10.3389/fnins.2023.1239068

From pulse width modulated TENS to cortical modulation: based on EEG functional connectivity analysis

Front Neurosci. 2023 Aug 2:17:1239068. doi: 10.3389/fnins.2023.1239068. eCollection 2023.

Authors

Armita Faghani Jadidi¹, Winnie Jensen¹, Ali Asghar Zarei¹, Eugen Romulus Lontis¹, S Farokh Atashzar^{2

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Affiliations

¹ Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark.
² Department of Electrical and Computer Engineering, New York University, New York, NY, United States.
³ Department of Mechanical and Aerospace Engineering, New York University, New York, NY, United States.
⁴ Department of Biomedical Engineering, New York University, New York, NY, United States.
⁵ NYU WIRELESS, New York University (NYU), New York, NY, United States.
⁶ NYU Center for Urban Science and Progress (CUSP), New York University (NYU), New York, NY, United States.

Abstract

Modulation in the temporal pattern of transcutaneous electrical nerve stimulation (TENS), such as Pulse width modulated (PWM), has been considered a new dimension in pain and neurorehabilitation therapy. Recently, the potentials of PWM TENS have been studied on sensory profiles and corticospinal activity. However, the underlying mechanism of PWM TENS on cortical network which might lead to pain alleviation is not yet investigated. Therefore, we recorded cortical activity using electroencephalography (EEG) from 12 healthy subjects and assessed the alternation of the functional connectivity at the cortex level up to an hour following the PWM TENS and compared that with the effect of conventional TENS. The connectivity between eight brain regions involved in sensory and pain processing was calculated based on phase lag index and spearman correlation. The alteration in segregation and integration of information in the network were investigated using graph theory. The proposed analysis discovered several statistically significant network changes between PWM TENS and conventional TENS, such as increased local strength and efficiency of the network in high gamma-band in primary and secondary somatosensory sources one hour following stimulation. Our findings regarding the long-lasting desired effects of PWM TENS support its potential as a therapeutic intervention in clinical research.

Keywords: functional brain connectivity; graph theory; modulated TENS; neurorehabilitation; pain.