Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: report of twelve cases and discussion of mechanism of action

Microcurrent wave alleviates mouse intracranial arterial dolichoectasia development

Intracranial arterial dolichoectasia (IADE) is associated with the interaction of hypertension and inflammation, and microcurrent can be effective in hypertension. Therefore, this study aimed to investigate the therapeutic effect of microcurrent electrical stimulation in a mouse IADE model. This study randomly categorized 20 mice into five groups: group 1-C (healthy control), group 2-D (IADE model), group 3-M + D (microcurrent administration before nephrectomy and until brain surgery), group 4-D + M (microcurrent administration for 4 weeks following brain surgery), and group 5-M (microcurrent administration for 4 weeks). Cerebral artery diameter and thickness and cerebral arterial wall extracellular matrix components were assessed. Among the five groups, group 2-D showed significantly higher cerebral arterial wall diameter (117.79 ± 17.05 µm) and proportion of collagen (42.46 ± 14.12%) and significantly lower arterial wall thickness (9.31 ± 2.26 µm) and proportion of smooth muscle cell (SMC) and elastin in the cerebral arterial wall (SMC: 38.05 ± 10.32%, elastin: 11.11 ± 6.97%). Additionally, group 4-D + M exhibited a non-significantly lower diameter (100.28 ± 25.99 µm) and higher thickness (12.82 ± 5.17 µm). Group 5-M demonstrated no evidence of toxicity in the liver and brain. The pilot study revealed that microcurrent is effective in preventing IADE development, although these beneficial effects warrant further investigation.

Microcurrent and Gold Nanoparticles Combined with Hyaluronic Acid Accelerates Wound Healing

This study aimed to investigate the effects of iontophoresis and hyaluronic acid (HA) combined with a gold nanoparticle (GNP) solution in an excisional wound model. Fifty Wistar rats (n = 10/group) were randomly assigned to the following groups: excisional wound (EW); EW + MC; EW + MC + HA; EW + MC + GNPs; and EW + MC + HA + GNPs. The animals were induced to a circular excision, and treatment started 24 h after injury with microcurrents (300 µA) containing gel with HA (0.9%) and/or GNPs (30 mg/L) in the electrodes (1 mL) for 7 days. The animals were euthanized 12 h after the last treatment application. The results demonstrate a reduction in the levels of pro-inflammatory cytokines (IFNϒ, IL-1β, TNFα, and IL-6) in the group in which the therapies were combined, and they show increased levels of anti-inflammatory cytokines (IL-4 and IL-10) and growth factors (FGF and TGF-β) in the EW + MC + HA and EW + MC + HA + GNPs groups. As for the levels of dichlorofluorescein (DCF) and nitrite, as well as oxidative damage (carbonyl and sulfhydryl), they decreased in the combined therapy group when compared to the control group. Regarding antioxidant defense, there was an increase in glutathione (GSH) and a decrease in superoxide dismutase (SOD) in the combined therapy group. A histological analysis showed reduced inflammatory infiltrate in the MC-treated groups and in the combination therapy group. There was an increase in the wound contraction rate in all treated groups when compared to the control group, proving that the proposed therapies are effective in the epithelial healing process. The results of this study demonstrate that the therapies in combination favor the tissue repair process more significantly than the therapies in isolation.

Effectiveness of Microcurrent Therapy for Treating Pressure Ulcers in Older People: A Double-Blind, Controlled, Randomized Clinical Trial

The aim of this study was to assess the effectiveness of microcurrent therapy for healing pressure ulcers in aged people. A multicentric, randomized clinical trial was designed with a sham stimulation control. The experimental group received an intervention following a standardized protocol for curing ulcers combined with 10 h of microcurrent therapy daily for 25 days. The sham group received the same curing protocol plus a sham microcurrent stimulation. The studied healing-related variables were the Pressure Ulcer Scale for Healing (PUSH) and the surface, depth, grade, and number of ulcers that healed completely. Three evaluations were conducted: pre-intervention (T1), 14 days following the start of the intervention (T2), and 1 day after the intervention was completed (T3). In total, 30 participants met the inclusion criteria (n = 15 in each group). The improvement in the PUSH at T2 and T3 was 16.8% (CI95% 0.5-33.1) and 25.3% (CI95% 7.6-43.0) greater in the experimental group versus the sham control, respectively. The reduction in the wound area at T2 and T3 was 20.1% (CI95% 5.2-35.0) and 28.6% (CI95% 11.9-45.3) greater in the experimental group versus the control, respectively. Microcurrent therapy improves the healing of pressure ulcers in older adults, both quantitatively and qualitatively.

Microcurrent stimulates cell proliferation and modulates cytokine release in fibroblast cells

AIMS

To analyse the effects of microcurrent on L929 fibroblast cell culture.

METHODS

Cells were cultivated in six-well plates at densities of 5×10⁴, 1×10⁵, 3×10⁵ and 5×10⁵ cells/well to determine the best plating density. Subsequently, two methods of current application were tested: with a paper cone coupled to the electrode (M1) and with the electrode directly inside the well (M2). Then, streams of 60µA (G60), 100µA (G100), 500µA (G500) and 900µA (G900) were applied to the cells (n=3) once a day for three minutes, for a period of one (T1), two (T2) and three days (T3). The MTT assay method was used to evaluate cell proliferation. For the quantification of the inflammatory markers by flow cytometry, the group and time that presented the best results were selected.

RESULTS

The ideal plating density was established as 1x10⁵ cells/well and M2 as the best application method. An increase in cell viability was observed at all intensities from T1 to T2, but with no significant differences. From T2 to T3, there was a decrease in viability in all groups, with a significant difference only in G500 (p<0.05). Flow cytometry was performed in the GC and G900 groups at T2. It was possible to observe an increase of 0.56pg/ml in Interleukin (IL)-17 and a decrease of 5.45pg/ml in IL-2.

CONCLUSION

This study showed that two applications of microcurrent increases cell proliferation and modulates the inflammatory response, aiding tissue regeneration and playing a key role in rehabilitation.

Effects of adding post-workout microcurrent in males cross country athletes

Post-exercise microcurrent based treatments have shown to optimise exercise-induced adaptations in athletes. We compared the effects of endurance training in combination with either, a microcurrent or a sham treatment, on endurance performance. Additionally, changes in body composition, post-exercise lactate kinetics and perceived delayed onset of muscle soreness (DOMS) were determined. Eighteen males (32.8 ± 6.3 years) completed an 8-week endurance training programme involving 5 to 6 workouts per week wearing a microcurrent (MIC, n=9) or a sham (SH, n=9) device for 3-h post-workout or in the morning during non-training days. Measurements were conducted at pre- and post-intervention. Compared to baseline, both groups increased (P < 0.01) maximal aerobic speed (MIC, pre = 17.6 ± 1.3 to post=18.3 ± 1.0; SH, pre=17.8 ± 1.5 to post = 18.3 ± 1.3 km^.h^-1) with no changes in V˙O_2peak. No interaction effect per group and time was observed (P=0.193). Although both groups increased (P < 0.05) trunk lean mass (MIC, pre=23.2 ± 2.7 to post=24.2 ± 2.0; SH, pre=23.4 ± 1.7 to post=24.3 ± 1.6 kg) only MIC decreased (pre=4.8 ± 1.5 to post=4.5 ± 1.5, p=0.029) lower body fat. At post-intervention, no main differences between groups were observed for lactate kinetics over the 5 min recovery period. Only MIC decreased (P<0.05) DOMS at 24-h and 48-h, showing a significant average lower DOMS score over 72-h after the completion of the exercise-induced muscle soreness protocol. In conclusion, a 3-h daily application of microcurrent over an 8-week endurance training programme produced no further benefits on performance in endurance-trained males. Nonetheless, the post-workout microcurrent application promoted more desirable changes in body composition and attenuated the perception of DOMS over 72-h post-exercise.

Efficacy of microcurrent therapy for treatment of acute knee pain: A randomized double-blinded controlled clinical trial

Objective:

We would like to determine whether electrotherapy, specifically microcurrent therapy, increases function and decreases pain in people who have acute knee pain.

Design:

Randomized, double-blinded, placebo-controlled clinical trial.

Setting:

University laboratory and patient home.

Subjects:

A total of 52 subjects (35 females and 17 males) with acute knee pain.

Intervention:

Treatment group (n = 26) wore the active microcurrent therapy device at home for 3 hours per day for 4 weeks and the control group (n = 26) wore the placebo for 3 hours per day for 4 weeks.

Main Measures:

Numeric Pain Rating Scale (NPRS) and Short Form 12 (SF-12) health scale were used to measure the pain level and the functionality of the participants. Secondary assessments included musculoskeletal ultrasound imaging (MSK US) and Lower Extremity Functional Scale (LEFS).

Results:

A total of 52 subjects completed the study; 26 in the treatment group and 26 in the control group. Microcurrent therapy significantly reduced pain over 4 weeks. Especially week three was significant (P < 0.01) after adjusting for the family-wise error rate. The analysis on SF-12 revealed those with microcurrent therapy showed an increasing trend in the improvement of physical function score until week three.

Conclusion:

An active microcurrent therapy device decreased knee pain and increased function. Microcurrent therapy may be an alternative or used with a pharmacological approach for people with acute knee pain.

Wound healing treatment by high frequency ultrasound, microcurrent, and combined therapy modifies the immune response in rats

BACKGROUND

Therapeutic high-frequency ultrasound, microcurrent, and a combination of the two have been used as potential interventions in the soft tissue healing process, but little is known about their effect on the immune system.

OBJECTIVE

To evaluate the effects of therapeutic high frequency ultrasound, microcurrent, and the combined therapy of the two on the size of the wound area, peritoneal macrophage function, CD4+ and CD8+, T lymphocyte populations, and plasma concentration of interleukins (ILs).

METHOD

Sixty-five Wistar rats were randomized into five groups, as follows: uninjured control (C, group 1), lesion and no treatment (L, group 2), lesion treated with ultrasound (LU, group 3), lesion treated with microcurrent (LM, group 4), and lesion treated with combined therapy (LUM, group 5). For groups 3, 4 and 5, treatment was initiated 24 hours after surgery under anesthesia and each group was allocated into three different subgroups (n=5) to allow for the use of the different therapy resources at on days 3, 7 and 14 Photoplanimetry was performed daily. After euthanasia, blood was collected for immune analysis.

RESULTS

Ultrasound increased the phagocytic capacity and the production of nitric oxide by macrophages and induced the reduction of CD4+ cells, the CD4+/CD8+ ratio, and the plasma concentration of IL-1β. Microcurrent and combined therapy decreased the production of superoxide anion, nitric oxide, CD4+-positive cells, the CD4+/CD8+ ratio, and IL-1β concentration.

CONCLUSIONS

Therapeutic high-frequency ultrasound, microcurrent, and combined therapy changed the activity of the innate and adaptive immune system during healing process but did not accelerate the closure of the wound.

Biophysical Approaches for Oral Wound Healing: Emphasis on Photobiomodulation

Significance: Oral wounds can lead to significant pain and discomfort as well as affect overall general health due to poor diet and inadequate nutrition. Besides many biological and pharmaceutical methods being investigated, there is growing interest in exploring various biophysical devices that utilize electric, magnetic, ultrasound, pressure, and light energy. Recent Advances: Significant insight into mechanisms of these biophysical devices could provide a clear rationale for their clinical use. Preclinical studies are essential precursors in determining physiological mechanisms and elucidation of causal pathways. This will lead to development of safe and effective therapeutic protocols for clinical wound management. Critical Issues: Identification of precise events initiated by biophysical devices, specifically photobiomodulation-the major focus of this review, offers promising avenues in improving oral wound management. The primary phase responses initiated by the interventions that distinctly contribute to the therapeutic response must be clearly delineated from secondary phase responses. The latter events are a consequence of the wound healing process and must not be confused with causal mechanisms. Future Direction: Clinical adoption of these biophysical devices needs robust and efficacious protocols that can be developed by well-designed preclinical and clinical studies. Elucidation of the precise molecular mechanisms of these biophysical approaches could determine optimization of their applications for predictive oral wound care.

Microcurrent stimulation at shenmen acupoint facilitates EEG associated with sleepiness and positive mood: a randomized controlled electrophysiological study

To examine the electrophysiological effects of microcurrent stimulation at the Shenmen acupoint, 40 healthy normal subjects were randomly assigned to a placebo group (sham stimulation) and an experimental group (bilateral electrocutaneous stimulation at the Shenmen). The following two electroencephalographic indicators were used to measure brain activity. (1) Arousal level was measured with reference to log-transformed absolute alpha power and power source and analyzed using low-resolution electromagnetic tomography and (2) frontal alpha asymmetry was used as an indicator of mood. After real stimulation for 10 minutes, absolute alpha power was globally reduced in the experimental group, particularly in the anterior and centrotemporal regions of the brain. This indicates a decline in the brain activity associated with arousal. Moreover, the reduction was more prominent in the left frontal region, as compared to the right frontal region, resulting in significant increase from negative to positive frontal alpha asymmetry scores and reflecting an increase in the brain activity associated with enhanced mood. However, the placebo group exhibited no significant changes in two indicators after sham stimulation. This study provides initial electrophysiological evidence of changes in brain activity associated with reduced arousal (and thus greater sleepiness) and enhanced mood after microcurrent stimulation at the Shenmen acupoint.

Possible local stem cells activation by microcurrent application in experimentally injured soleus muscle

BACKGROUND

Severe injuries in skeletal muscle result in muscle weakness that delays recovery and contribute to progressive decline in muscle function. Microcurrent therapy (MCT) is a novel treatment method used in soft tissue injury and tissue regeneration therapy. The regenerative capacity of skeletal muscle tissue resides in satellite cells, the quiescent adult stem cells.

AIM

The present work aimed at investigating the relation between microcurrent therapy and local stem cells in regeneration of induced skeletal muscle injury in albino rat.

MATERIALS AND METHODS

Twenty six adult male albino rats were divided into Sham group, Injury group (I): subjected to soleus muscle injury and subdivided into subgroups I1 & I2 sacrificed 2 and 4 weeks after injury respectively. Microcurrent group (M): subjected to muscle injury and micro-current was applied. The animals were subdivided into subgroups M1 and M2 sacrificed 2 and 4 weeks after injury. Histological, immunohistochemical and morphometric studies were performed.

RESULTS

Atypical fibers widely separated by infiltrating cells and strong acidophilic sarcoplasm with focal vacuolations were found in injury group. In M1 subgroup few atypical fibers were found. In M2 subgroup multiple typical fibers were detected. A significant decrease in the mean area of atypical fibers, a significant increase in the mean area% of alpha SMA+ve cells and that of CD34+ve cells were found in microcurrent group compared to injury group.

CONCLUSION

A definite therapeutic effect of the microcurrent was found on induced skeletal muscle injury. This effect was proved to be related to satellite cell activation.

Clinical Trials Involving Biphasic Pulsed Current, MicroCurrent, and/or Low-Intensity Direct Current

Significance: This invited critical review will summarize an expansive body of literature regarding electrical stimulation (ES) and wound healing. Several clinical reports have been published in which ES has been evaluated as a therapy to speed the closure of chronic wounds. Different forms of ES have been applied in varying ways and described using inconsistent terminology by researchers and clinicians around the world. It is important to compile this research and to critically appraise the findings so that clinicians who are not familiar with this field can interpret the research. Recent Advances: More recently, ES has been delivered at subsensory levels (termed microcurrent in this review) using very small electrical devices contained within wound dressing. While these newer technologies have obvious technical advances, what research has been published to date about these new devices has not produced findings that suggest this form of ES can accelerate wound closure. Critical Issues: Reviewing a collection of published reports on this subject reveals that not all forms of ES produce beneficial results. Rather, only certain ES protocols such as monophasic pulsed current applied to the wound and biphasic pulsed current current that is applied for 2 h daily to periulcer skin at intensities which produce motor responses have consistently demonstrated positive results. Future Directions: Optimal stimulus parameters and treatment schedule for ES used to treat chronic wounds need to be determined. Researchers publishing in this field should provide detailed information about their ES treatment protocol and use a similar terminology to describe the ES waveform and stimulus parameters.

Application of Jatropha curcas L. seed oil (Euphorbiaceae) and microcurrent on the healing of experimental wounds in Wistar rats

PURPOSE

To investigate the effects of Jatropha curcas L. seed oil and microcurrent stimulation on the healing of wounds experimentally induced in Wistar rats.

METHODS

Forty-eight animals were divided into four groups: (A) control; (B) treated with microcurrent (10 µA/2 min); (C) treated with J. curcas seed oil, and (D) treated with J. curcas seed oil plus microcurrent. Tissues samples were obtained two, six, ten and 14 days after injury and submitted to structural and morphometric analyses.

RESULTS

The animals of groups A and C showed similar responses in terms of repair area, total number of cells, number of newly formed blood vessels, epithelial thickness, and percentage of area occupied by mature collagen fibers. Significant differences in all parameters analyzed were observed between animals of groups B and D and the control 10 and 14 days after experimentally induced injury. The morphometric data confirmed the structural findings

CONCLUSIONS

The application of J. curcas seed oil alone was not effective on experimental wound healing when compared to control, but microcurrent application alone or combined with the oil exerted significant differences in the parameters studied. These findings suggest that the positive results were due to microcurrent stimulation.

Electrical Stimulation Therapy and Wound Healing: Where Are We Now?

BACKGROUND

Healing chronic wounds is an ongoing challenge for clinicians and poses a serious public health burden. Electrical stimulation (ES), broadly defined as the application of electrical current via electrodes placed on the skin adjacent to or directly within the wound, has been proposed as a therapeutic modality over a century ago, and recent advances in understanding the biology of electrical phenomena in the skin have rekindled an interest in this modality.

THE PROBLEM

Despite evidence that has shown ES to be effective for wound healing, it has been slow to gain acceptance in the United States. Also, there has been no consensus in terms of standardization of parameters to devise a systematic protocol for implementation of this technology.

BASIC/CLINICAL SCIENCE ADVANCES

The epidermis maintains a "skin battery" that generates an endogenous electric field and current flow when wounded. Experimental models have demonstrated that most of the cell types within the wound can sense an electric field in the range of that endogenously generated in the wound, and respond with a variety of biological and functional responses that can contribute to healing. Multiple animal wound models have demonstrated enhancement of a number of parameters of healing when ES is exogenously supplied.

CLINICAL CARE RELEVANCE

Clinical trials have investigated the efficacy of multiple forms of ES for improving healing in a wide variety of human chronic wounds. In 2002 the Centers for Medicare and Medicaid Services approved reimbursement for use of ES in a clinical setting for certain chronic wounds.

CONCLUSION

THERE REMAIN MANY VOIDS IN OUR KNOWLEDGE BASE: clinical evidence is limited by deficiencies in the design of many of the trials, a multiplicity of ES application modes and waveforms used in trials prevent selection of an optimal modality, and lack of uniformity in reporting ES dosages leave us not much advanced from our clinical knowledge base a decade ago.

Microcurrent application as analgesic treatment in venous ulcers: a pilot study

This study aimed to evaluate the effect of microcurrent electrical stimulation on pain and area of venous ulcers. In a pilot study for a single-blind controlled clinical trial, carried out at an outpatient clinic during four weeks, 14 subjects with venous ulcers (mean age 62±9 years) were divided in two groups: microcurrent (n=8) and control group (n=6). Pain (by Visual Analogue Scale) and the ulcer area were measured by planimetry. There was a significant difference between the two groups with respect to pain (microcurrent group from 8.5 (6.5-9.75) to 3.5 (1-4.75) and control group from 7.5 (5.75-10) to 8.5 (5.5-10), p<0.01). Non-significant changes were found with respect to ulcer area (planimetry by graph paper, p=0.41 and by Image J®, p=0.41). In conclusion, the application of microcurrent improves the pain of patients with venous ulcers (ClinicalTrials.gov: NCT01372020).

Effects of the Topical Application of Hydroalcoholic Leaf Extract of Oncidium flexuosum Sims. (Orchidaceae) and Microcurrent on the Healing of Wounds Surgically Induced in Wistar Rats

This study evaluated the wound healing activity of hydroalcoholic leaf extract of Oncidium flexuosum Sims. (Orchidaceae), an important native plant of Brazil, combined or not with microcurrent stimulation. Wistar rats were randomly divided into four groups of nine animals: control (C), topical application of the extract (OF), treated with a microcurrent (10 μA/2 min) (MC), and topical application of the extract plus microcurrent (OF + MC). Tissue samples were obtained 2, 6, and 10 days after injury and submitted to structural and morphometric analysis. The simultaneous application of OF + MC was found to be highly effective in terms of the parameters analyzed (P < .05), with positive effects on the area of newly formed tissue, number of fibroblasts, number of newly formed blood vessels, and epithelial thickness. Morphometric data confirmed the structural findings. The O. flexuosum leaf extract contains active compounds that speed the healing process, especially when applied simultaneously with microcurrent stimulation.