title: High frequency transcutaneous electrical nerve stimulation with diphenidol administration results in an additive antiallodynic effect in rats following chronic constriction injury.
abstract: The impact of coadministration of transcutaneous electrical nerve stimulation (TENS) and diphenidol is not well established. Here we estimated the effects of diphenidol in combination with TENS on mechanical allodynia and tumor necrosis factor-α (TNF-α) expression. Using an animal chronic constriction injury (CCI) model, the rat was estimated for evidence of mechanical sensitivity via von Frey hair stimulation and TNF-α expression in the sciatic nerve using the ELISA assay. High frequency (100Hz) TENS or intraperitoneal injection of diphenidol (2.0μmol/kg) was applied daily, starting on postoperative day 1 (POD1) and lasting for the next 13 days. We demonstrated that both high frequency TENS and diphenidol groups had an increase in mechanical withdrawal thresholds of 60%. Coadministration of high frequency TENS and diphenidol gives better results of paw withdrawal thresholds in comparison with high frequency TENS alone or diphenidol alone. Both diphenidol and coadministration of high frequency TENS with diphenidol groups showed a significant reduction of the TNF-α level compared with the CCI or HFS group (P<0.05) in the sciatic nerve on POD7, whereas the CCI or high frequency TENS group exhibited a higher TNF-α level than the sham group (P<0.05). Our resulting data revealed that diphenidol alone, high frequency TENS alone, and the combination produced a reduction of neuropathic allodynia. Both diphenidol and the combination of diphenidol with high frequency TENS inhibited TNF-α expression. A moderately effective dose of diphenidol appeared to have an additive effect with high frequency TENS. Therefore, multidisciplinary treatments could be considered for this kind of mechanical allodynia.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Madou Sin-Lau Hospital, Tainan, Taiwan; Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.
authors.forename: Heng-Teng
authors.initials: HT
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Chi Mei Medical Center, Tainan and Liouying, Taiwan; Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Chong-Chi
authors.initials: CC
authors.lastname: Chiu
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Physical Therapy, National Cheng Kung University, No.1 Ta-Hsueh Road, Tainan, Taiwan. Electronic address: chhung@mail.ncku.edu.tw.
authors.forename: Ching-Hsia
authors.initials: CH
authors.lastname: Hung
authors.affiliation: Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Physical Therapy, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Chen
mesh_terms: D000700:Analgesics / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic / Q000150:complications; D006930:Hyperalgesia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D017288:Pain Threshold; D010812:Physical Stimulation; D010880:Piperidines / Q000494:pharmacology* / Q000627:therapeutic use; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000293:injuries*; D014110:Touch; D004561:Transcutaneous Electric Nerve Stimulation
chemical_list: D000700:Analgesics; D010880:Piperidines; C004858:diphenidol
keywords: Combination; Diphenidol; High frequency; Mechanical allodynia; Transcutaneous electrical nerve stimulation; Tumor necrosis factor-α