Noninvasive Peripheral Nerve Stimulation

  • Sergio Canavero
  • Vincenzo Bonicalzi


Transcutaneous electrical nerve stimulation (TENS) is applied at high frequency (80–100 Hz) (also known as conventional TENS) aimed at activation of myelinated cutaneous sensory fibers or low-frequency stimulation (short trains of impulses at 1–4 Hz, known as acupuncture-like TENS) and aimed at activation of small-diameter nonnoxious muscle afferents and Aδ fibers. Stimulation must be directed over the most painful region, with dual-channel stimulators to cover a large body area with pain. A related technique, called Scrambler therapy, delivers self-learning algorithm-generated non-pain information to the painful area via standard silver gel electrodes. Its average charge is similar to TENS, at a frequency of 43–52 Hz. The protocol consists of 5 days of stimulation followed or not by a 2-day break and then another 5 days of stimulation, 45 min daily. It does not produce paresthesias, and analgesia occurs quickly with a sustained relief for days or months [1]. No experience has been published for CP nor for external noninvasive peripheral nerve stimulation (EN-PNS) ([2]; however, see [3], Table).


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Sergio Canavero
    • 1
  • Vincenzo Bonicalzi
    • 2
  1. 1.HEAVEN/GEMINI International Collaborative GroupTurinItaly
  2. 2.AOUCittà della Salute e della Scienza di Torino, Department of Neurosciences, Rita Levi MontalciniUniversità di TorinoTurinItaly

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