Transcutaneous electrical nerve stimulation (TENS) has been used to treat chronic pain. However, the potential efficacy and mechanism of the effect of applying TENS for a short time in chronic pain patients remains unclear. To identify the effect of short-term TENS on chronic pain patients and to clarify the mechanism of the effect, we investigated abnormalities of functional connectivity (FC) within the prefrontal cortex (PFC) using resting-state functional near-infrared spectroscopy (rs-fNIRS). Fifteen patients (56.8 ± 17.4 years, nine females) with chronic pain participated in this rs-fNIRS study. The fNIRS scans included two parts: a 5-minute resting-state scan followed by a 5-minute scan during TENS (150 Hz) application. The pain intensity was measured using a Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI). The spontaneous brain activity of the PFC and resting-state functional connectivity (rsFC) in the PFC were examined during TENS and compared to before TENS. The results showed that Pain intensity significantly decreased after TENS (p < 0.001). During TENS, fALFF values were significantly lower in BA46 (**p = 0.0025) and BA45 (**p = 0.0056). rsFC strength increased during TENS compared to before, with significant group-level increases in BA10, BA9, BA46, and BA44/45 (p < 0.05). Notably, the variation between BA10 and BA44/45 was highly significant (***p < 0.001). These findings suggest that FC between BA10 and BA44/45 was associated with analgesia of TENS in patients with chronic pain, indicating the potential role of FC as a novel objective parameter to predict the outcome of clinical use of TENS for pain relief in chronic pain patients.

Introduction: Music interventions have been proposed in recent years as a treatment for chronic pain. However, the mechanisms by which music relieves pain are unclear, and the effects of music intervention on physiological indicators in patients with chronic pain remain to be explored. This study aimed to explore whether a music intervention would have effects on subjective pain ratings, heart rate variability, and functional connectivity of the cerebral cortex in patients with chronic pain.Methods: A randomized controlled study was conducted on 37 pain patients aged 18–65 years, with the control group receiving usual care, and the intervention group receiving music intervention (8–150 Hz, 50–70 dB) for 30 min before bedtime for 7 days on top of usual care. Pain visual analog scale and heart rate variability were used as subjective and objective physiological indices before and after the music intervention, respectively. Changes in oxyhemoglobin and deoxyhemoglobin concentrations in the cerebral cortex were measured by functional near-infrared spectroscopy, and whole-brain correlation analysis was used to quantify the connectivity of prefrontal brain regions associated with the pain response.Results: Results showed that patients with chronic pain in the intervention group had significantly lower visual assessment scale scores, as well as significantly lower overall voluntary mobility during pain episodes, resulting in relatively higher vagal innervation compared to the control group. In addition, connections between the bilateral dorsolateral prefrontal cortex (BA9, BA46) and frontal areas (BA10) were significantly higher in the intervention group.Discussion: This study demonstrates the effectiveness of the combined application of music interventions with usual care in reducing pain levels in patients with chronic pain and provides insight into the pathological mechanisms of music interventions for analgesia, providing direction for new baseline indicators for quantitative clinical assessment of pain. The study was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100052993).Clinical trial registration: [https://www.chictr.org.cn/showproj.aspx?proj=136268], identifier [ChiCTR2100052993].

Introduction: Establishing an accurate way to quantify pain is one of the most formidable tasks in neuroscience and medical practice. Functional near-infrared spectroscopy (fNIRS) can be utilized to detect the brain’s reaction to pain. The study sought to assess the neural mechanisms of the wrist-ankle acupuncture transcutaneous electrical nerve stimulation analgesic bracelet (E-WAA) in providing pain relief and altering cerebral blood volume dynamics, and to ascertain the reliability of cortical activation patterns as a means of objectively measuring pain.Methods: The participants (mean age 36.6 ± 7.2 years) with the cervical-shoulder syndrome (CSS) underwent pain testing prior to, 1 min following, and 30 min after the left point Jianyu treatment. The E-WAA was used to administer an electrical stimulation therapy that lasted for 5 min. A 24-channel fNIRS system was utilized to monitor brain oxyhemoglobin (HbO) levels, and changes in HbO concentrations, cortical activation areas, and subjective pain assessment scales were documented.Results: We discovered that HbO concentrations in the prefrontal cortex significantly increased when CSS patients were exposed to painful stimuli at the cerebral cortex level. The second pain test saw a considerable decrease in the average HbO change amount in the prefrontal cortex when E-WAA was applied, which in turn led to a reduction in the amount of activation and the size of the activated area in the cortex.Discussion: This study revealed that the frontal polar (FP) and dorsolateral prefrontal cortex (DLPFC) were linked to the analgesic modulation activated by the E-WAA.

A flexible, multifunctional, intelligent analgesic bracelet was proposed to alleviate symptoms of pain. Based on the theory of wrist-ankle acupuncture in traditional Chinese medicine, transcutaneous nerve electrical stimulation is the technical basis of the method. A set of targeted circuit system capable of generating adjustable electrical stimulation signals to simulate filamentary acupuncture was designed. The system architecture includes a wireless communication module, a signal control module, a stimulus signal generation module, and a wearable, flexible bracelet. In addition, a pain assessment interface with a visual analog scale was designed to assess pain levels. Two comparative experiments were designed, involving a custom pain assessment scale and hand-held dolorimeter that were performed before and after wearing the bracelet to verify the analgesic effect of the bracelet. The results showed that the wrist-worn analgesic bracelet is significantly effective in alleviating pain in various parts of the human body.

Transcutaneous electrical nerve stimulation (TENS) based on wrist-ankle acupuncture has been shown to relieve pain levels in patients with myofascial pain syndrome (MPS). However, its efficacy is highly subjective. The purpose of this study was to evaluate the feasibility and effectiveness of TENS based on wrist-ankle acupuncture for pain management in patients with MPS from the perspective of cerebral cortex hemodynamics. We designed a double-blind, randomized, controlled clinical trial. Thirty-one male patients with MPS were randomly assigned to two parallel groups. The experimental group (n = 16) received TENS based on wrist-ankle acupuncture for analgesic treatment, while the control group (n = 15) did not. The pain was induced by mechanically pressurized at acupoint Jianjing. The multichannel functional near-infrared spectroscopy (fNIRS) equipment was utilized for measuring oxyhemoglobin (HbO) levels in the cerebral cortex during the tasks. After the intervention, visual analog scale (VAS), the activation degree and activation area of pain perception cortices were significantly reduced in the experimental group compared to the baseline values (P < .05). Particularly, Frontopolar Area (FPA), and Dorsolateral Prefrontal Cortex (DLPFC) are highly involved in the pain process and pain modulation. Compared to no intervention, TENS based on wrist-ankle acupuncture can be effective in relieving pain in patients with MPS in terms of cerebral cortical hemodynamics. However, further studies are necessary to quantify the analgesic effect in terms of cerebral hemodynamics and brain activation.