Effect of Modulated TENS on Corticospinal Excitability in Healthy Subjects

Armita Faghani Jadidi*, Andrew James Thomas Stevenson, Ali Asghar Zarei, Winnie Jensen, Romulus Lontis

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

7 Citations (Scopus)
62 Downloads (Pure)


Conventional transcutaneous electrical nerve stimulation (TENS) has been reported to effectively alleviate chronic pain, including phantom limb pain (PLP). Recently, literature has focused on modulated TENS patterns, such as pulse width modulation (PWM) and burst modulation (BM), as alternatives to conventional, non-modulated (NM) sensory neurostimulation to increase the efficiency of rehabilitation. However, there is still limited knowledge of how these modulated TENS patterns affect corticospinal (CS) and motor cortex activity. Therefore, our aim was to first investigate the effect of modulated TENS patterns on CS activity and corticomotor map in healthy subjects. Motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) were recorded from three muscles before and after the application of TENS interventions. Four different TENS patterns (PWM, BM, NM 40 Hz, and NM 100 Hz) were applied. The results revealed significant facilitation of CS excitability following the PWM intervention. We also found an increase in the volume of the motor cortical map following the application of the PWM and NM (40 Hz). Although PLP alleviation has been reported to be associated with an enhancement of corticospinal excitability, the efficiency of the PWM intervention to induce pain alleviation should be validated in a future clinical study in amputees with PLP.

Original languageEnglish
Pages (from-to)53-64
Number of pages12
Publication statusPublished - 1 Mar 2022

Bibliographical note

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement [754465] and the Center for Neuroplasticity and Pain (CNAP), which is supported by the Danish National Research Foundation [DNRF121].

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.


  • TMS
  • corticospinal excitability
  • modulated TENS pattern
  • motor cortical plasticity
  • motor evoked potentials
  • pain alleviation


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