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      Application of facial neuromuscular electrical stimulation (fNMES) in psychophysiological research: Practical recommendations based on a systematic review of the literature

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          Abstract

          Facial neuromuscular electrical stimulation (fNMES), which allows for the non-invasive and physiologically sound activation of facial muscles, has great potential for investigating fundamental questions in psychology and neuroscience, such as the role of proprioceptive facial feedback in emotion induction and emotion recognition, and may serve for clinical applications, such as alleviating symptoms of depression. However, despite illustrious origins in the 19th-century work of Duchenne de Boulogne, the practical application of fNMES remains largely unknown to today’s researchers in psychology. In addition, published studies vary dramatically in the stimulation parameters used, such as stimulation frequency, amplitude, duration, and electrode size, and in the way they reported them. Because fNMES parameters impact the comfort and safety of volunteers, as well as its physiological (and psychological) effects, it is of paramount importance to establish recommendations of good practice and to ensure studies can be better compared and integrated. Here, we provide an introduction to fNMES, systematically review the existing literature focusing on the stimulation parameters used, and offer recommendations on how to safely and reliably deliver fNMES and on how to report the fNMES parameters to allow better cross-study comparison. In addition, we provide a free webpage, to easily visualise fNMES parameters and verify their safety based on current density. As an example of a potential application, we focus on the use of fNMES for the investigation of the facial feedback hypothesis.

          Supplementary Information

          The online version contains supplementary material available at 10.3758/s13428-023-02262-7.

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          Pain Mechanisms: A New Theory

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            Emotional Contagion

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              Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness.

              Transcutaneous electrical nerve stimulation (TENS) is used clinically by a variety of health care professionals for the reduction of pain. Clinical effectiveness of TENS is controversial, with some studies supporting whereas others refute its clinical use. Although used by health professionals for decades, the mechanisms by which TENS produces analgesia or reduces pain are only recently being elucidated. This article describes the basic science mechanisms behind different frequencies of TENS stimulation. Specifically, we describe the literature that supports the use of different frequencies and intensities of TENS. We further describe theories that support the use of TENS such as the gate control theory and the release of endogenous opioids. The literature that supports or refutes each of these theories is described. We also review the clinical literature on TENS effectiveness and elucidate the problems with clinical research studies to date. In conclusion, TENS is a noninvasive modality that is easy to apply with relatively few contraindications. However, the clinical efficacy of TENS will remain equivocal until the publication of sufficient numbers of high quality, randomized, controlled clinical trials.
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                Author and article information

                Contributors
                t.efthimiou@essex.ac.uk
                sebastian.korb@essex.ac.uk
                Journal
                Behav Res Methods
                Behav Res Methods
                Behavior Research Methods
                Springer US (New York )
                1554-351X
                1554-3528
                20 October 2023
                20 October 2023
                2024
                : 56
                : 4
                : 2941-2976
                Affiliations
                [1 ]Department of Psychology, University of Essex, ( https://ror.org/02nkf1q06) Colchester, UK
                [2 ]Nara Institute of Science and Technology, ( https://ror.org/05bhada84) Ikoma, Japan
                [3 ]GRID grid.498855.d, ISNI 0000 0004 0395 6518, ArtScience Interfaculty, Royal Academy of Art, , Royal Conservatory, ; The Hague, Netherlands
                [4 ]Department of Psychology, Webster Vienna Private University, ( https://ror.org/03nhjjj32) Vienna, Austria
                [5 ]Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, ( https://ror.org/03prydq77) Vienna, Austria
                Author information
                http://orcid.org/0000-0002-8458-5493
                Article
                2262
                10.3758/s13428-023-02262-7
                11133044
                37864116
                4e9e9d1e-c216-4a88-b0c6-47dc8ddbda50
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 29 September 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002428, Austrian Science Fund;
                Award ID: P 32637-B
                Categories
                Original Manuscript
                Custom metadata
                © The Psychonomic Society, Inc. 2024

                Clinical Psychology & Psychiatry
                nmes,facial muscles,emotion,facial feedback,electrical stimulation

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