A session of transcutaneous electrical nerve stimulation changes the input-output function of motoneurons and alters the sense of force

Transcutaneous electrical nerve stimulation (TENS) is commonly used in research and clinical settings for pain management and augmenting somatosensory inputs for motor recovery. Besides its functional effect, TENS acutely alters kinesthesia and force steadiness. However, the short-term impact following a session of TENS on proprioception and motor unit behavior is unknown. We evaluated the effect of a session of TENS on the senses of force, joint position, touch, and discharge activity of motor units. Fifteen healthy participants underwent two experiments, each with two visits randomly administering TENS or sham-TENS. The sense of force (<i>experiment 1</i>) and position (<i>experiment 2</i>) were evaluated through matching trials by pinching a dial and rotating their wrist (ulnar deviation). Isometric pinch contractions were performed before and after the session of TENS or sham-TENS, in which electromyographic (EMG) signals were recorded from the first dorsal interosseus (FDI) and abductor pollicis brevis (APB). Results showed that TENS acutely altered the senses of force, position, and touch, but only the sense of force remained altered following TENS. Motor unit discharge rates increased in both FDI and APB muscles for the same force output following TENS. A positive correlation was also observed between changes in motor unit discharge rates and changes in errors in force perception. These findings suggest that a session of TENS may have short-term effects on the input/output function of motoneurons (5-10 min in this study), which in turn may alter the sense of force. However, the precise timeline for these short-term aftereffects is unknown.<b>NEW & NOTEWORTHY</b> It is often assumed that transcutaneous electrical nerve stimulation (TENS) has a transient effect on proprioception and motor control. We found that position, force, and touch perception were altered during TENS. However, the sense of force remained altered following TENS. As the discharge rate of motor units also increased in first dorsal interosseus (FDI) and abductor pollicis brevis (APB) muscles for the same force output following TENS, we suggest that their input-output function was altered, potentially causing a sustained decrease in performance in force-matching tasks.