Safety of long-term electrical peripheral nerve stimulation: review of the state of the art.
Clara Günter, Jean Delbeke, Max Ortiz-Catalan
PMID 30658656WHAT IT FOUND
Implanted electrodes outside nerves have remained usable and stable in humans for up to 18 years.
Evidence for electrodes inside nerves is limited, and long-term peripheral stimulation safety is supported only for frequencies below 30 Hz.
Key findings
01Extraneural electrodes have shown long-term human biostability and compatibility, including at least 12 years on the peroneal nerve and up to 18 years on the phrenic nerve.
02Intraneural electrodes have not been reported for chronic human use, although short-term human experiments have used them for less than a month.
03For long-term peripheral nerve stimulation, evidence supports frequencies below 30 Hz; in cats, 20 Hz was safe, while 50 Hz and 100 Hz caused neural damage.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative review, not a clinical trial or systematic review, so it does not provide patient outcomes or treatment effects. The authors state that available data do not cover the topic systematically and that current limits are at best extrapolations. Most recommendations have been established for brain stimulation, while peripheral nerve literature is scarce. Animal and central nervous system findings cannot always be transferred to human peripheral nerves. There is no report of chronic intraneural electrode use in humans. Stimulation parameters are inconsistently documented, limiting comparison across studies. Long-term frequency safety evidence is limited to below 30 Hz.
The easy way to misread this
Do not read this review as showing that long-term peripheral nerve stimulation is safe for all electrode types and settings. Long-term human safety is mainly shown for extraneural electrodes, chronic intraneural human use has not been reported, and long-term frequency safety evidence exists only below 30 Hz.