Differential regulatory effects of electroacupuncture waveforms and electrode polarity reversal on sciatic nerve repair

Background The therapeutic efficacy of electroacupuncture, which enjoys high international recognition, has been extensively validated. However, there is a lack of visual characterization of electroacupuncture waveform features, as well as a clear set of guidelines or systematic research on the impact of different waveforms, such as sparse-dense wave (SDW), continuous wave (CW), and intermittent wave (IW), and the different electrode connection configurations on treatment outcomes. Methods In this study, we investigated the therapeutic potential of various electroacupuncture waveforms on sciatic nerve injury (SNI) both in vivo and in vitro, and further explored the effects of different electrode connection configurations using the optimal SDW. Results The oscilloscope captured the waveform characteristics from the electroacupuncture device. Therapeutic evaluation demonstrated that three waveforms facilitated recovery after SNI, with SDW exhibiting the most pronounced effect in behavioral assessments. Among them, SDW and IW were more effective in improving sciatic nerve blood perfusion, while SDW demonstrated stronger anti-inflammatory effects, and CW excelled in enhancing Schwann cell proliferation and migration. In experiments with different electrode connection configurations under the SDW waveform, the GB30(+)/GB34(−) configuration promoted better functional recovery in injured mice compared to the GB30(−)/GB34(+) group. Conclusions All three electroacupuncture waveforms enhanced the repair capacity of SNI, with SDW best for behavioral recovery, CW for Schwann cell proliferation and migration in vitro, and IW for blood perfusion. Each waveform offers distinct functional advantages, providing practical guidance for optimizing electroacupuncture parameters and device design. These findings support refined stimulation strategies, though the underlying mechanisms require further investigation.