RESUMO
PURPOSE: Both repetitive peripheral magnetic stimulation (rPMS) and transcutaneous electrical current stimulation (TES) could elicit the limb movements; it is still unclear how subjective sensation is changed according to the amount of limb movements. We investigated the pain and discomfort induced by newly developed rPMS and TES of peripheral nerves in the dorsal forearm. METHODS: The subjects were 12 healthy adults. The stimulus site was the right dorsal forearm; thus, when stimulated, wrist dorsiflexion was induced. The rPMS was delivered by the new stimulator, Pathleader at 10 stimulus intensity levels, and TES intensity was in 1-mA increments. The duration of each stimulation was 2 s. The analysis parameters were subjective pain and discomfort, measured by a numerical rating scale. The rating scale at corresponding levels of integrated range of movement (iROM) induced by rPMS or TES was compared. The subjective values were analyzed by two-way repeated measures ANOVA with the stimulus conditions (rPMS, TES) and the seven levels of iROM (20-140 ºs). RESULTS: In the rPMS experiments, stimuli were administered to all subjects at all stimulus intensities. In the TES experiments, none of the subjects dropped out between 1 and 16 mA, but there were dropouts at each of the intensities as follows: 1 subject at 17 mA, 20 mA, 22 mA, 23 mA, 27 mA, 29 mA and 2 subjects at 21 mA, 24 mA, 26 mA. The main effects of the stimulus conditions and iROM were significant for pain and discomfort. Post hoc analysis demonstrated that pain and discomfort in rPMS were significantly lower compared to TES when the iROM was above 60 ºs and 80 ºs, respectively. CONCLUSION: New rPMS stimulator, Pathleader, caused less pain and discomfort than TES, but this was only evident when comparatively large joint movements occurred.
RESUMO
To promote the functional restoration of the nervous system following injury, it is necessary to provide optimal extracellular signals that can induce neuronal regenerative activities, particularly neurite formation. This study aimed to examine the regulation of neuritogenesis by temperature-controlled repeated thermal stimulation (TRTS) in rat PC12 pheochromocytoma cells, which can be induced by neurotrophic factors to differentiate into neuron-like cells with elongated neurites. A heating plate was used to apply thermal stimulation, and the correlation of culture medium temperature with varying surface temperature of the heating plate was monitored. Plated PC12 cells were exposed to TRTS at two different temperatures via heating plate (preset surface temperature of the heating plate, 39.5°C or 42°C) in growth or differentiating medium for up to 18 h per day. We then measured the extent of growth, neuritogenesis, or acetylcholine esterase (AChE) activity (a neuronal marker). To analyze the mechanisms underlying the effects of TRTS on these cells, we examined changes in intracellular signaling using the following: tropomyosin-related kinase A inhibitor GW441756; p38 mitogen-activated protein kinase (MAPK) inhibitor SB203580; and MAPK/extracellular signal-regulated kinase (ERK) kinase (MEK) inhibitor U0126 with its inactive analog, U0124, as a control. While a TRTS of 39.5°C did not decrease the growth rate of cells in the cell growth assay, it did increase the number of neurite-bearing PC12 cells and AChE activity without the addition of other neuritogenesis inducers. Furthermore, U0126, and SB203580, but not U0124 and GW441756, considerably inhibited TRTS-induced neuritogenesis. These results suggest that TRTS can induce neuritogenesis and that participation of both the ERK1/2 and p38 MAPK signaling pathways is required for TRTS-dependent neuritogenesis in PC12 cells. Thus, TRTS may be an effective technique for regenerative neuromedicine.