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. 2023 Dec 12;21(4):e14511. doi: 10.1111/iwj.14511

Mapping the hotspots and future trends of electrical stimulation for peripheral nerve injury: A bibliometric analysis from 2002 to 2023

Sheng Yang 1, Sen Zhong 2, Xuehan Jin 3, Guoxin Fan 4, Xiang Liao 4,✉, Xun Yang 5,✉, Shisheng He 1,✉
PMCID: PMC10958100  PMID: 38084069

Abstract

Peripheral nerve injuries often result in severe personal and social burden, and even with surgical treatment, patients continue to have poor clinical outcomes. Over the past two decades, electrical stimulation has been shown to promote axonal regeneration and alleviate refractory neuropathic pain. The aim of this study was to analyse this field using a bibliometric approach. Literature was searched through Web of Science Core Collection (WOSCC) for the years 2002–2023. Literature analysis included: (1) Describing publication trends in the field. (2) Exploring collaborative network relationships. (3) Finding research advances and research hotspots in the field. (4) Summarizing research trends in the field. With the number of studies in this field still increasing, a total of 693 publications were included in the analysis. This field of research is interdisciplinary in nature. Research hotspots include peripheral nerve regeneration, the treatment of neuropathic pain, materials for nerve injury repair, and the restoration of sensory function in patients with peripheral nerve injury. Correspondingly, the development of nerve conduits and systems for peripheral nerve electrical stimulation, clinical trials of peripheral nerve electrical stimulation, and tactile recovery and movement for amputees have shown significant promise as future research trends in this field.

Keywords: bibliometric, neuropathic pain, peripheral nerve injury, peripheral nerve regeneration, peripheral nerve stimulation

Abbreviations

BDNF

brain‐derived neurotrophic factor

cAMP

cyclic adenosine monophosphate

CMCS

carboxymethyl chitosan

GAP‐43

growth associated protein‐43

MAP kinase

mitogen‐activated protein kinase

NGF

nerve growth factor

P‐CREB

phospho‐ CAMP‐response element‐binding

PKC‐γ

protein kinase C‐γ

PVDF/PCL

polyvinylidene difluoride/Polycaprolactone

SA

sodium alginate

TrkB

tropomyosin receptor kinase B

WoSCC

web of science core collections

1. INTRODUCTION

Peripheral nerve injury is a critical and problematic clinical issue. An epidemiological study conducted in the United Kingdom revealed that the incidence of peripheral nerve injury was 11.2 per 100 000 people, which is comparable to the incidence of gastric or ovarian cancer. 1 Peripheral nerve injuries usually result in varying degrees of disability and pain, drastically lowering the quality of life of patients. 2 , 3 , 4 In a study of patients with upper limb nerve injuries which followed for an extended period of time, it was shown that hospitalization, rehabilitation, and socio‐economic burden exceeded 40 526 euros per person, and that 30% of those with severe injuries had an additional annual cost of living of 16 872 euros. 5

Currently, surgical intervention stands as the preferred approach for peripheral nerve injury treatment; however, surgical treatment alone has a limited effect on the cellular and molecular levels of peripheral nerve regeneration, resulting in a typically poor clinical outcome. 6 , 7 In contrast, it has been discovered that peripheral nerve electrical stimulation alleviates peripheral neuropathy‐related pain, 8 Furthermore, the perioperative electrical stimulation of damaged nerves has been demonstrated to accelerate axonal growth and facilitate axonal anatomy and neurological recovery. 9 In recent years, research in the field of electrical stimulation of peripheral nerves and peripheral nerve injury has become increasingly enthusiastic, and many positive outcomes have been achieved.

Bibliometric analysis is an interdisciplinary research method that employs mathematical and statistical principles, combined with visualization techniques, to scientifically analyse the knowledge structure and development trends of research in the field. 10 , 11 Accordingly, it has been widely used in a variety of research areas. However, systematic summaries of the research on peripheral nerve injuries and peripheral nerve electrical stimulation, as well as reviews relating to the evolutionary history of this field have been largely limited. Thus, in the current study, we employed bibliometric techniques with the purpose of analysing the evolution of this field, describing the key scientific insights relating to this field, and scientifically predicting its research hotspots and future trends.

2. MATERIALS AND METHODS

2.1. Data collection

The primary data were obtained from the Web of Science platform [Web of Science Core Collection (WoSCC)] using the search formula TS = (“electrical stimulation” OR “electrical nerve stimulation” OR “peripheral stimulation” OR “peripheral nerve stimulation” OR “dorsal root ganglion stimulation”) and TS = (“peripheral nerve” OR “brachial plexus” OR “axillary nerve” OR “cutaneous nerve” OR “median nerve” OR “radial nerve” OR “ulnar nerve” OR “femoral nerve” OR “sciatic nerve” OR “common peroneal nerve”). In addition, a timeline of 2002–2023, with a search period ending June 29, 2023, was ensured and the inclusion criteria comprised Articles for English language literature as the publication type. In order to exclude other types of literature from interfering with the analysis, two authors independently reviewed all the literature to screen studies related to peripheral nerve injury and peripheral nerve electrical stimulation for inclusion in the analysis, and a third person reviewed the same literature to decide whether or not to include it in the analysis if there was a difference of opinion. Figure 1 depicts the data collection and screening process. IRB approval was obtained.

FIGURE 1.

FIGURE 1

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The screening process of selected literature in this study.

2.2. Analysis methods

This study was conducted utilizing CiteSpace and the Bibliometrix R Package. CiteSpace was utilized primarily for clustering analysis of literature and keywords, as well as citation burst analysis. On the other hand, Bibliometrix R Package was used to analyse publication and citation trends, collaborative networks of countries, institutions, and authors, core journals, and theme maps of keywords, trending topics, etc. This study focused on the following aspects, while providing information about the relevant sciences:

  1. Determining the development trend of the field by investigating the publication trend and citation trend of the field.

  2. Finding the cooperation network, analysing the cooperation network between countries, institutions, and authors in the field, and locating the leading countries, institutions, and authors in the field, along with their research directions.

  3. Providing a summary of the current state of peripheral nerve electrical stimulation and peripheral nerve injury research. Analysing the clustering of relevant literature and keywords.

  4. Determining the research hotspots and research trends in the field by analysing the literature and keywords with a strong citation burst and a recent high number of citations.

3. RESULTS

3.1. Publication and citation trends

A total of 693 papers were included in the analysis, and they yielded a total of 18 829 citations, with an average of about 27.17 citations per paper; the main information of the papers included in the analysis is compiled in Table 1. The annual growth rate of publications in this field was 7.7%, and there were four significant growth time periods: 2002–2004, 2005–2011, 2013–2015, and 2017–2019 (Figure 2A). Figure 2B illustrates the trend of the average number of citations per year, which indicates that 2005, 2010, 2016, 2018, and 2020 have a higher average annual number of citations to the literature.

TABLE 1.

Main information of data for bibliometric analysis.

Main information about data
Timespan 2002:2023
Sources (Journals, Books, etc) 315
Documents 693
Annual growth rate % 7.7
Document average age 7.95
Average citations per document 27.17
References 20 003
Authors 2980
Authors of single‐authored docs 15
Authors collaboration
Single‐authored docs 17
Co‐authors per doc 5.6
International co‐authorships % 20.63
Document types
Article 693
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FIGURE 2.

FIGURE 2

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(A) Annual trends of publications. (B) Average citations per year.

3.2. Distribution of countries and institutions

The cooperation network relationship between countries is depicted in Figure 3A; the darker the colour, the greater the number of articles published. In addition, the connecting line represents the existence of a cooperation relationship. A cooperative relationship between the United States and many countries was discernible, with the most cooperation comprising those with European nations. Furthermore, the cooperation relationship between the European countries was also observed to be closer in nature. Figure 3B depicts the network of collaboration between institutions, where the width of the arc is more or less positively correlated with the number of collaborations and the connecting line represents a collaborative relationship; Herein, the University of Alberta had the most collaborative relationships with other institutions.

FIGURE 3.

FIGURE 3

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The analysis of countries and institutions. (A) Network map of collaborations among different countries. (B) Network of collaborations among different institutions. (C) The three‐field plot of countries, institutions, and keywords. [Correction added on 10 January 2024 after first online publication: In figure 3 have been corrected in this version.]

We collected the information of the top 20 countries in terms of the number of publications; the results are displayed in Table 2. The United States has the highest number of publications, totalling 224, followed by China (133) and Canada (48). With 8126 citations, the United States is also the most cited country, followed by Canada (2728) and China (2681). On the other hand, Canada has the highest average number of citations per paper. Additionally, we found that most of the countries with more research in the field comprised developed countries, with the United States accounting for nearly one‐third of the world's publications. The top 10 institutions with the highest number of publications are listed in Table 3, and the institution with the highest number of publications is Northwestern University (69) in the United States, followed by University of Alberta (58) and Johns Hopkins University (53). The United States is home to six of the top 10 institutions in terms of the number of publications, while China has three. Figure 3C depicts the principal research themes for countries and institutions, with the research theme in the middle column, the country on the left, and the institution on the right; the thickness of the lines is positively correlated with the number of studies conducted by each country/institution on that theme.

TABLE 2.

The TOP 20 countries with the most publications and citations.

Ranking Country/Region Papers Developed Country/Region Total citations Average article citations Developed
1 USA 224 YES USA 8126 36.30 YES
2 CHINA 133 NO CANADA 2728 56.80 YES
3 CANADA 48 YES CHINA 2681 20.20 NO
4 JAPAN 34 YES UNITED KINGDOM 711 21.50 YES
5 UNITED KINGDOM 33 YES ITALY 694 30.20 YES
6 KOREA 27 YES GERMANY 619 25.80 YES
7 GERMANY 24 YES SPAIN 457 35.20 YES
8 ITALY 23 YES KOREA 429 15.90 YES
9 TURKEY 17 NO JAPAN 402 11.80 YES
10 BRAZIL 16 NO BRAZIL 274 17.10 NO
11 SPAIN 13 YES FRANCE 269 29.90 YES
12 SWITZERLAND 10 YES SINGAPORE 212 42.40 YES
13 FRANCE 9 YES AUSTRALIA 191 31.80 YES
14 DENMARK 7 YES DENMARK 183 26.10 YES
15 AUSTRALIA 6 YES SWEDEN 137 22.80 YES
16 BELGIUM 6 YES TURKEY 132 7.80 NO
17 IRAN 6 NO SWITZERLAND 129 12.90 YES
18 SWEDEN 6 YES ISRAEL 109 21.80 NO
19 INDIA 5 NO IRAN 89 14.80 NO
20 ISRAEL 5 NO BELGIUM 77 12.80 YES
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TABLE 3.

The TOP 10 institutions with the most publications.

Rank Affiliation Papers Country/Region
1 Northwestern University 69 USA
2 University of Alberta 58 CANADA
3 Johns Hopkins University 53 USA
4 Shanghai Jiao Tong University 50 CHINA
5 Washington University 43 USA
6 China Medical University 38 CHINA
7 Case Western Reserve University 34 USA
8 Mayo Clinic 31 USA
9 Seoul National University 31 SOUTH KOREA
10 The Fourth Military Medical University 28 CHINA
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3.3. Analysis of authors

The collaborative network relationship between authors is shown in Figure 4A. There was a collaborative relationship between authors in each circle; the connecting line between the nodes represents this collaborative relationship. Hu XY, Huang JH, and Luo ZJ comprised the authors with the most collaborations. The information of the authors with the leading 10 publications and citations in the field is compiled in Table 4. Gordon T. comprised the author with the highest number of publications (11). It is interesting to note that the last nine authors have made the same number of contributions to the literature among the literature analysed. In addition, the authors of the top 10 publications were equally distributed between China and developed nations such as the United States, Canada, and Europe. The author most frequently cited is Gordon T (218), followed by Brushart TM (134) and Al‐Majed AA (72). It was also evident that the majority of authors with a high number of citations were from the United States, whereas authors from China performed poorly. Figure 4B depicts the network of citation relationships among authors, with Gordon T in the centre as the most cited author and the connecting lines between the nodes representing the citation relationships. The timeline graph of the top 10 authors by number of publications is shown in Figure 4C, where the horizontal axis represents the year of publication, the number of publications is positively correlated with the size of the node, and the average number of citations per year is positively correlated with the node's colour. For example, Gordon T had a substantial number of publications and received a large number of citations in 2016.

FIGURE 4.

FIGURE 4

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The analysis of authors. (A) The co‐authorship network. (B) The co‐citation network of authors. (C) The authors' production over time that with the most publications.

TABLE 4.

The TOP 10 authors with the most publications and local‐citations.

Authors Papers Country/Region Author Local citations Country/Region
Gordon, Tessa 11 CANADA Gordon, Tessa 218 CANADA
Chan, K Ming 8 CANADA Brushart, Thomas 134 USA
Chen, Yueh‐Sheng 8 CHINA TAIWAN Al‐Majed, Abdulhakeem A. 72 SAUDI ARABIA
English, Arthur 8 USA Hoffman, Paul N. 71 ENGLAND
Hu, XueYu 8 CHINA Hogans, Beth B. 71 USA
Huang, Jinghui 8 CHINA Royall, RM 71 USA
Luo, Zhuojing 8 CHINA Witzel, Christian 71 GERMANY
Navarro, Xavier 8 SPAIN Tam, Sabrina Lue 56 CANADA
Raspopovic, Stanisa 8 SWITZERLAND Rinta‐Aho, Jari 47 USA
Yao, Chun‐Hsu 8 CHINA TAIWAN Rohde, C. 47 GERMANY
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3.4. Analysis of journals

The literature that was analysed was published in a total of 315 journals. Table 5 lists the top 10 journals publishing articles in the field, with the highest number of articles appearing in the journal Neuromodulation (41, Q3, IF2.8), followed by the Journal of Neural Engineering (28, Q2, IF4.0), and Experimental Neurology (17, Q1, IF5.3). The publication trend of the top five journals based on the number of articles published is shown in Figure 5A. The journals with the most citations were the Journal of Neuroscience (1011, Q1, IF5.3), Experimental Neurology (909, Q1, IF5.3), and Pain (732, Q1, IF7.4). Figure 5B depicts the core journals in the field as determined by the Law of Bradford; these journals are the core journals in the field, and the articles published in them are the most significant research results in this field.

TABLE 5.

The TOP 10 journals with the most publications and local citations.

Ranking Journal Frequency JCR category Category rank 2022 Category quartile 2022 IF 2022
1 NEUROMODULATION 41 CLINICAL NEUROLOGY;MEDICINE, RESEARCH & EXPERIMENTAL 121/212;91/136 Q3;Q3 2.8
2 JOURNAL OF NEURAL ENGINEERING 28 ENGINEERING, BIOMEDICAL;NEUROSCIENCES 42/96;105/272 Q2;Q2 4.0
3 EXPERIMENTAL NEUROLOGY 17 NEUROSCIENCES 62/272 Q1 5.3
4 NEURAL REGENERATION RESEARCH 13 CELL BIOLOGY;NEUROSCIENCES 58/191;42/272 Q2;Q1 6.1
5 PAIN PHYSICIAN 13 ANESTHESIOLOGY;CLINICAL NEUROLOGY 11/35;79/212 Q2;Q2 3.7
6 IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING 11 ENGINEERING, BIOMEDICAL;REHABILITATION 29/96;4/68 Q2;Q1 4.9
7 JOURNAL OF NEUROPHYSIOLOGY 10 NEUROSCIENCES;PHYSIOLOGY 198/272;46/79 Q3;Q3 2.5
8 PLOS ONE 10 MULTIDISCIPLINARY SCIENCES 26/73 Q2 3.7
9 FRONTIERS IN NEUROSCIENCE 9 NEUROSCIENCES 94/272 Q2 4.3
10 JOURNAL OF NEUROTRAFMA 8 CLINICAL NEUROLOGY;CRITICAL CARE MEDICINE;NEUROSCIENCES 60/212;12/35;96/272 Q2;Q2;Q2 4.2
(B)
1 JOURNAL OF NEUROSCIENCE 1011 NEUROSCIENCES 62/272 Q1 5.3
2 EXPERIMENTAL NEUROLOGY 909 NEUROSCIENCES 62/272 Q1 5.3
3 PAIN 732 ANESTHESIOLOGY;CLINICAL NEUROLOGY;NEUROSCIENCES 4/35;19/212;30/272 Q1;Q1;Q1 7.4
4 BRAIN RESEARCH 527 NEUROSCIENCES 174/272 Q3 2.9
5 NEUROMODULATION 502 CLINICAL NEUROLOGY;MEDICINE, RESEARCH & EXPERIMENTAL 121/212;91/136 Q3;Q3 2.8
6 JOURNAL OF NEUROPHYSIOLOGY 463 NEUROSCIENCES;PHYSIOLOGY 198/272;46/79 Q3;Q3 2.5
7 MUSCLE & NERVE 438 CLINICAL NEUROLOGY;NEUROSCIENCES 90/212;136/272 Q2;Q2 3.4
8 BIOMATERIALS 433 ENGINEERING, BIOMEDICAL;MATERIALS SCIENCE, BIOMATERIALS 4/96;2/45 Q1;Q1 14.0
9 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING 393 ENGINEERING, BIOMEDICAL 34/96 Q2 4.6
10 JOURNAL OF NEURAL ENGINEERING 374 ENGINEERING, BIOMEDICAL;NEUROSCIENCES 42/96;105/272 Q2;Q2 4.0
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FIGURE 5.

FIGURE 5

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The analysis of journals. (A) The journals' production over time that with the most publications. (B) The core journals based on Bradford's Law.

3.5. Analysis of literature

All of the literature in the field was clustered as shown in Figure 6A; there were 15 clusters in total. The Q value of 0.8252 indicated significant modularity, and the weighted mean silhouette value of 0.9492 indicated the high credibility of the clustering result. The primary clusters were peripheral nerve injury regeneration (#1peripheral nerve regeneration, #6legged locomotion, #13 muscle denervation), neuralgia (#5occipital neuralgia, #9low back pain), nerve repair materials (#3nerve guide conduits, #4 graphene, #8aerogel, #15chitosan), and sensory recovery (#2 sensory feedback, #27 cochlear spiral ganglion).

FIGURE 6.

FIGURE 6

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The analysis of reference. (A) The cluster of references in the field. (B) Top 25 references with the strongest citation bursts and their classifications.

The 25 papers with the strongest citation bursts are depicted in Figure 6B. Herein, the red boxes represent basic studies related to peripheral nerve injury and electrical stimulation of peripheral nerves, while the blue boxes represent clinical studies, which were less than basic studies.

The study on tactile recovery in amputees published by Tan et al., in Science Translational Medicine (2014) was the most‐cited piece of literature, as shown in Table 6. Additionally, the study on electrical stimulation to enhance nerve regeneration by Brushart TM, published in the Journal of Neuroscience (2002), comprised the most‐cited piece of literature in the local dataset; Table 7 lists the next 10 most‐cited pieces of literature in the local dataset.

TABLE 6.

The TOP 10 literature with the most global citations.

Ranking Literature Total citations TC per year First author (year) Journal Country
1 A neural interface provides long‐term stable natural touch perception 468 46.80 Tan, Daniel W. (2014) SCIENCE TRANSLATIONAL MEDICINE USA
2 Electrical stimulation promotes motoneuron regeneration without increasing its speed or conditioning the neuron 293 13.32 Brushart, TM (2002) JOURNAL OF NEUROSCIENCE USA
3 Electrical stimulation promotes sensory neuron regeneration and growth‐associated gene expression 288 16.94 Geremia, Nicole M. (2007) EXPERIMENTAL NEUROLOGY CANADA
4 Biocompatibility of biodegradable semiconducting melanin films for nerve tissue engineering 286 19.07 Bettinger, Christopher J. (2009) BIOMATERIALS USA
5 Implanted hair follicle stem cells form Schwann cells that support repair of severed peripheral nerves 265 13.95 Amoh, Y (2005) PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA JAPAN
6 Experimental strategies to promote functional recovery after peripheral nerve injuries 233 11.10 Gordon, T (2003) JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM CANADA
7 Wireless bioresorbable electronic system enables sustained nonpharmacological neuroregenerative therapy 228 38.00 Koo, Jahyun (2018) NATURE MEDICINE USA
8 Residual function in peripheral nerve stumps of amputees: Implications for neural control of artificial limbs 228 11.40 Dhillon, GS (2004) JOURNAL OF HAND SURGERY‐AMERICAN VOLUME USA
9 Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves 191 23.88 Davis, T. S. (2016) JOURNAL OF NEURAL ENGINEERING USA
10 Electrical stimulation accelerates and enhances expression of regeneration‐associated genes in regenerating rat femoral motoneurons 187 9.35 Al‐Majed, AA (2004) CELLULAR AND MOLECULAR NEUROBIOLOGY CANADA
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TABLE 7.

The TOP 10 literature with the most local citations.

Ranking Literature Local citations First author (year) Journal Country/Region
1 Electrical stimulation promotes motoneuron regeneration without increasing its speed or conditioning the neuron 71 Brushart, TM (2002) JOURNAL OF NEUROSCIENCE USA
2 Electrical stimulation accelerates and enhances expression of regeneration‐associated genes in regenerating rat femoral motoneurons 56 Al‐Majed, AA (2004) CELLULAR AND MOLECULAR NEUROBIOLOGY CANADA
3 Electrical stimulation restores the specificity of sensory axon regeneration 47 Brushart, TM (2005) EXPERIMENTAL NEUROLOGY USA
4 Experimental strategies to promote functional recovery after peripheral nerve injuries 28 Gordon, T (2003) JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM CANADA
5 Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and trigeminal posttraumatic neuropathic pain: A pilot study 20 Johnson, MD (2004) NEUROSURGERY USA
6 BDNF/TrkB signalling regulates HNK‐1 carbohydrate expression in regenerating motor nerves and promotes functional recovery after peripheral nerve repair 16 Eberhardt, KA (2006) EXPERIMENTAL NEUROLOGY GERMANY
7 Residual function in peripheral nerve stumps of amputees: Implications for neural control of artificial limbs 13 Dhillon, GS (2004) JOURNAL OF HAND SURGERY‐AMERICAN VOLUME USA
8 Peripheral neurostimulation for treatment of intractable occipital neuralgia 13 Slavin, KV (2006) NEUROSURGERY USA
9 Trigeminal branch stimulation for intractable neuropathic pain: Technical note 10 Slavin, KV (2005) NEUROMODULATION USA
10 Long‐term peripheral nerve stimulation for painful nerve injuries 9 Eisenberg, E (2004) CLINICAL JOURNAL OF PAIN ISRAEL
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3.6. Keyword analysis

Figure 7A illustrates the clustering of all the keywords, including primarily peripheral nerve regeneration, neuropathic pain, and sensory feedback, among others. Figure 7B illustrates the fluctuating number of studies within these clusters over time. Figure 7C shows the keywords and the years in which they appear more often, with the year corresponding to the orb in Figure 7C being located in the year in which the keyword appears the most frequently. The strategic coordinates of the keywords are depicted in Figure 7D, where the hot topics, such as neuropathic pain, are located in the first quadrant and the topics that require additional research, such as sensory feedback, nerve regeneration, etc., are located in the fourth quadrant.

FIGURE 7.

FIGURE 7

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The analysis of keywords. (A) The cluster of keywords. (B) Timeline view of cluster analysis of keywords. (C) Trend topics of Keywords. (D) The strategic coordinate map of keywords.

We analysed the evolution of research themes in this field over a five‐year period and plotted the results in Figure 8A. The top 25 keywords with the strongest citation bursts are displayed in Figure 8B, with the red bars indicating that the keyword has received a great deal of attention from researchers during the specified time frame. Neurotrophic factor comprised the keyword with the highest citation burst, while the keywords that have received a lot of attention recently were cell, peripheral nerve regeneration, growth, and conduit.

FIGURE 8.

FIGURE 8

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The analysis of research themes. (A) Evolution of research themes in the field from 2002 to 2023. (B) TOP 25 keywords with the most citation bursts.

4. DISCUSSION

The study of peripheral nerve stimulation and peripheral nerve injury has been of great interest to researchers from a variety of disciplines such as neuroscience, materials science, physics, and computer science, among others over the past two decades, and numerous advancements have been made. Using bibliometric methods, this study provides an overview of the development of research in this field, scientifically identifies the hot spots and research trends in this field, and provides researchers with scientific information about this field in the hopes of advancing the field.

There have been four significant increases in the number of articles published in this field, and although the number of articles published since 2019 has continued to decline, it is still at a high level. Additionally, the articles published in 2023 were not fully accounted for, and so the number of articles published in this field is expected to increase. Likewise, 2005, 2010, 2016, 2018, and 2020 have all produced higher‐quality articles that continue to stimulate research development in this field.

With a third of the number of articles published and far more total citations, the United States is undoubtedly the leader in this field. However, the country with the highest quality of published articles was Canada, with an average of 56.8 citations per article. Although China published more articles, fewer high‐quality articles were found to result from China, when compared to the other countries. In addition, the United States exhibited the most collaborative relationships with other nations, as well as the most frequent collaboration with European nations; there was also close cooperation between European nations. However, China, which had the second‐largest number of articles, lacks international cooperation and can make future efforts to promote international cooperation. Additionally, the institution with the most research in this field was Northwestern University, whereas the institution with the most collaboration with other institutions was the University of Alberta.

In addition to the above, Gordon T, one of the most influential researchers in the field, was the author with the highest number of publications and citations in this field. His studies, which confirm that brief electrical stimulation promotes axonal regeneration after peripheral nerve transection and nerve repair surgery, and which demonstrate that the promotion of axonal regeneration is associated with increased expression of GAP‐43(Growth associated protein‐43) and BDNF‐related genes, have been widely acknowledged by other researchers. 12 , 13 , 14 , 15 In addition, he has conducted numerous clinical studies confirming that median nerve stimulation at 20 hz (1 h) after surgical decompression accelerates axonal growth and promotes full muscular innervation in patients with carpal tunnel syndrome. 16 The more collaborative authors, Luo Zhuojing et al., worked on electrical stimulation‐related biomaterials, 17 , 18 , 19 and the molecular mechanisms by which electrical stimulation promotes peripheral nerve regeneration, including the increased release of BDNF(brain‐derived neurotrophic factor) and NGF(Nerve growth factor). 20 , 21 , 22 Chen Seu‐hwa et al., on the other hand, utilized electrical stimulation to injure peripheral nerves in order to investigate the molecular mechanisms that cause pain after injury, 23 , 24 and have investigated how to reduce neuropeptide Y and c‐Fos expression. 25 , 26 Accordingly, researchers can follow these pioneering authors to learn about the cutting edge of research in their respective fields.

Approximately, 80% of the top 10 journals publishing the most articles in this field were above the Q2 index, had high quality, and garnered a widespread researcher recognition. In this regard, Neuromodulation had the highest number of articles that were published in this field. Considering the journals with the highest number of publications and the journals with the highest number of citations, this field is observed to be interdisciplinary, attracting researchers from materials science, neuroscience, bioengineering, rehabilitation, etc. Notably, future important results in this field are more likely to be published in these journals with a high number of publications and citations, and researchers can direct their attention toward them.

Through the cluster analysis of literature and keywords, we summarize the following four hot topics of research:

4.1. Nerve injury regeneration

The promotion of peripheral nerve regeneration by electrical stimulation of peripheral nerves comprised the most‐researched topic in this field. The first report of the use of electrical stimulation for peripheral nerve regeneration was made in 1952. 27 Subsequently, Al‐Majed et al., demonstrated that short‐cycle, low‐frequency electrical stimulation was effective at accelerating peripheral nerve regeneration after injury using a rat model. 28 Over time, an increasing number of researchers have reported that electrical stimulation promotes nerve regeneration following a range of peripheral nerve injuries. 29 , 30 , 31 Regarding the mechanism by which electrical stimulation promotes nerve regeneration by increasing cellular cAMP (cyclic adenosine monophosphate) and up‐regulating the expression of the neurotrophic factor BDNF and the receptor TrkB(tropomyosin receptor kinase B), numerous studies have been conducted, the most well‐known of which is the study demonstrating that electrical stimulation promotes nerve regeneration by increasing cellular cAMP and up‐regulating the expression of these neurotrophic factors. 32 , 33 , 34 In terms of clinical studies, researchers have reported the efficacy of electrical stimulation in postoperative patients with carpal tunnel syndrome 16 and patients with ulnar nerve injury, 35 However, a clinical study conducted by Piccinini G et al., on patients with traumatic peripheral nerve injury failed to demonstrate its efficacy, although researchers are optimistic about electrical stimulation. 36 Thus, future clinical experiments will be required to determine the variables that affect the efficacy of electrical stimulation of peripheral nerves.

4.2. Neuropathic pain

Electrical stimulation of peripheral nerves has been used to treat neuropathic pain for over 50 years, and its efficacy in treating pain caused by peripheral nerve injury was first demonstrated in 1967. 37 In the last two decades, researchers have conducted numerous clinical trials demonstrating that peripheral nerve electrical stimulation is effective in relieving a variety of peripheral neuropathic pains, including occipital neuralgia, 38 trigeminal neuralgia, 39 migraines, 40 and post‐amputation pain, 41 etc., and has achieved satisfactory analgesic effects. The study of the mechanism of pain relief by electrical stimulation of peripheral nerves has also attracted many researchers. Accordingly, Mastuo H et al., have demonstrated that early electrical stimulation can inhibit glial activation, MAP kinase (mitogen‐activated protein kinase) activation, PKC‐γ (protein kinase C‐γ) and P‐CREB(phospho‐CAMP‐response element‐binding) expression, and proinflammatory cytokine expression, and maintain spinal opioid receptors in order to alleviate pain. 42 Meanwhile, techniques and new devices for electrical stimulation of peripheral nerves have been developed continuously. 43 , 44

4.3. Neural repair materials

The development of biomaterials related to peripheral nerve electrical stimulation is also a research hotspot, and the wireless bioresorbable electrical stimulation system developed by Koo J et al., has garnered the attention of many researchers due to its biocompatibility, which reduces the risk of post‐implantation complications such as infection. 45 Diverse neural scaffolds with electrical conductivity have also been continuously developed, including graphene materials, 46 PVDF/PCL(Polyvinylidene difluoride/Polycaprolactone) materials, 47 sodium alginate (SA) with carboxymethyl chitosan (CMCS), 48 etc. This comprises an important interdisciplinary research direction in this field.

4.4. Sensory recovery

Researchers have discovered that electrical stimulation of peripheral nerves can restore a stable sense of touch to amputees with peripheral nerve damage caused by amputation, thereby enhancing their quality of life. 49 , 50 Davis TS et al., discovered that electrical stimulation not only provides sensory feedback, but also regulates prosthetic limb activity, paving the way for the development of more advanced nerve stimulation‐based prostheses with bidirectional communication. 51 Electrical stimulation also promotes cochlear spiral ganglia survival in order to preserve hearing. 52 , 53

Literature, keyword citation burst analysis, keyword strategic coordinate charts, and topic evolution analysis can also be effectively utilized to determine the research trends in this field. The wireless, absorbable peripheral nerve electrical stimulation system developed by Koo J et al., which ensures stimulation effect while effectively reducing complications associated with implants, has received sustained attention in the published literature for the period 2020–2023. 45 Recent keyword trends that have received a great deal of focus include cell, peripheral nerve regeneration, growth, and conduit. In 2019, Wang Juan et al., developed a graphene nerve conduit with high electrical conductivity and biocompatibility that, when combined with electrical stimulation, promotes peripheral nerve regeneration with a biological effect similar to that of autologous nerve grafts. 46 The development of a nerve conduits and peripheral nerve electrical stimulation systems that cooperate with peripheral nerve electrical stimulation will be a future research direction, and we also note that the top 25 papers subject to citation emergence are dominated by basic research, with a relative lack of clinical research, and that on the basis of a large number of basic studies confirming the effectiveness of peripheral nerve electrical stimulation on peripheral nerves. In addition, based on the analysis of keyword topic trends (Figures 5C and 6D), sensory feedback and prosthetic are the most recent research directions. Peripheral nerve electrical stimulation can restore sensory and motor abilities of amputees or people with peripheral nerve injuries resulting in sensory or motor loss, and amputees can restore tactile and motor abilities via bidirectional interaction between peripheral nerve electrical stimulation and prosthetic limbs, 51 and future research in this direction is likely to have significant development.

To the best of our knowledge, this is the first study to use bibliometric methods to describe the evolution of the field of peripheral nerve electrical stimulation and peripheral nerve injury, as well as research hotspots and trends. However, this study also has some limitations; we only reviewed English‐language literature with publication type Article in the WoSCC database, and there are some studies that are not included in WoSCC that were not included in the analysis, along with some video materials and books.

5. CONCLUSIONS

In this study, bibliometric techniques were used to analyse research conducted over the past two decades on peripheral nerve electrical stimulation and peripheral nerve injury. The research in this field is expanding and has become an interdisciplinary field involving neuroscience, materials science, and computer science; it is, therefore, anticipated that more researchers will become involved in the future. According to the current analysis, the United States leads the world in research in this field and has the most international collaborations. Northwestern University is the most researched institution, while the University of Alberta collaborates with the most other institutions. In addition, Gordon T. is the most prolific author in the field and has made significant contributions to both basic and clinical research in peripheral nerve electrical stimulation for nerve regeneration. Moreover, the majority of articles published in this area of research are published in Q2 and higher journals, indicating that they are of high quality. On the basis of the relevant literature and keywords, the research hotspots in this field include peripheral nerve electrical stimulation for peripheral nerve regeneration, peripheral nerve electrical stimulation for neuropathic pain, neuroprosthetic materials for the treatment of peripheral nerve injuries, and peripheral nerve electrical stimulation for the sensory restoration of people with peripheral nerve injuries. Future trends in this area of research include the development of nerve conduits and peripheral nerve electrical stimulation systems that work in tandem with peripheral nerve electrical stimulation, clinical trials of peripheral nerve electrical stimulation, and the use of peripheral nerve electrical stimulation for tactile sensory restoration and movement in amputees. In conclusion, future research in this field will continue to evolve, and the integration of multiple disciplines will present more opportunities and challenges for the advancement of this field.

FUNDING INFORMATION

This work was funded by the Science and Technology Commission of Shanghai Municipality (Grant No. 22S31900100), Yunnan Academician Expert Workstation (Grant No. 202205AF150058), the National Natural Science Foundation of China (Grant No. 82102640), the Medical Scientific Research Foundation of Guangdong Province of China (Grant No. A2023195), the National Key Research and Development Program of China (Grant No. 2022YFC3602203), the Nanshan District Health Science and Technology Project (Grant No. NS2023044), the Nanshan District Health Science and Technology Major Project (Grant No. NSZD2023023), and the Nanshan District Health Science and Technology Project (Grant No. NS2023002). I, Shisheng He, attest on behalf of all authors, that we had full access to the data of the study, conducted all data analyses independently from the funding entity, and take complete responsibility for the integrity and accuracy of the data reported in the manuscript.

CONFLICT OF INTEREST STATEMENT

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All JTACS disclosure forms have been supplied and are provided as supplemental digital content.

ACKNOWLEDGEMENTS

The authors thank Tongji University, supervisors, and colleagues for giving the opportunity and guidance; thank Bullet Edits Limited for the linguistic editing and proofreading of the manuscript.

Yang S, Zhong S, Jin X, et al. Mapping the hotspots and future trends of electrical stimulation for peripheral nerve injury: A bibliometric analysis from 2002 to 2023. Int Wound J. 2024;21(4):e14511. doi: 10.1111/iwj.14511

Sheng Yang, Sen Zhong and Xuehan Jin are contributed equally to this work.

Contributor Information

Xiang Liao, Email: digitalxiang@163.com.

Xun Yang, Email: xunyangwork@yeah.net.

Shisheng He, Email: tjhss7418@tongji.edu.cn.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available in Web of Science Core Collections.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available in Web of Science Core Collections.

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