NESA® Neuromodulation
Scientific Evidence, Clinical Applications and Mechanisms of Action
What is NESA® Neuromodulation?
NESA® Non-Invasive Neuromodulation is a medical therapy that delivers ultra-low intensity biphasic microcurrents through surface electrodes placed on the wrists and ankles. These microcurrents stimulate peripheral nerve endings and afferent autonomic pathways, promoting regulation of the autonomic nervous system (ANS), particularly by increasing parasympathetic (vagal) tone and reducing excessive sympathetic activation.
NESA® is painless, non-invasive, and drug-free. It does not involve implants, needles, or surgery, and is currently used in integrative, functional, neurological, and sports medicine settings to support conditions related to sleep dysregulation, chronic pain, fatigue, autonomic imbalance, and stress-related disorders.
Sleep Disorders, Insomnia, Anxiety, Irritability and Depression
Institutionalized Older Adults – Sleep and Mental Well-Being
A prospective clinical study conducted in institutionalized older adults with poor sleep quality evaluated the effects of a course of NESA® non-invasive neuromodulation. Participants demonstrated significant improvements in Pittsburgh Sleep Quality Index (PSQI) scores, global sleep quality, and health-related quality of life, including mental health domains.
Conclusion: NESA® neuromodulation appears to improve sleep quality and overall well-being in frail elderly populations, supporting its clinical relevance in insomnia and neuropsychiatric symptoms.
Reference: Báez-Suárez et al., 2025 – Geriatrics (Basel).
General Sleep Disorders – Chronic Insomnia Case Series
A prospective observational case series evaluated patients with chronic sleep disturbances treated with 10 NESA® sessions over five weeks. The study reported marked reductions in PSQI scores, reflecting improved subjective sleep quality, reduced sleep latency, and fewer nighttime awakenings.
Clinical implication: These findings support NESA® as a non-pharmacological intervention for insomnia across mixed sleep-disorder populations.
Reference: Vega-Delgado et al., 2024 – International Journal of Research and Scientific Innovation.
Autism Spectrum Disorder – Sleep, Behavior and Irritability
A prospective study in children with autism spectrum disorder (ASD) assessed the effects of NESA® neuromodulation on sleep and behavior. Results demonstrated improvements in sleep parameters, including reduced bedtime resistance and fewer night awakenings, as well as reductions in hyperactivity, sensory hyper-reactivity, and aberrant behavior profiles that include irritability.
Relevance: These findings support a role for NESA® in addressing sleep dysregulation, anxiety-like behavior, and autonomic imbalance in neurodevelopmental conditions.
Reference: Molina-Cedrés et al., 2024 – Children (MDPI).
Multiple Sclerosis – Sleep and Pain
A randomized clinical study in patients with multiple sclerosis (MS) evaluated two NESA® neuromodulation protocols. Both groups demonstrated improvements in sleep quality, pain perception, and urinary symptoms following 15 treatment sessions.
Reference: Contreras-Polo et al., 2023 – CPQ Medicine.
A complementary MS case series involving eight patients reported statistically significant improvements in sleep quality (PSQI, p = 0.020), with clinically meaningful—though not statistically significant—improvements in fatigue, heart rate variability (HRV), and urinary incontinence.
Reference: Báez-Suárez et al., 2025 – International Journal of Research and Innovation in Social Science.
Dementia – Sleep, Daytime Sleepiness and Cognition
A multicenter clinical trial combining therapeutic exercise with NESA® neuromodulation in patients with dementia demonstrated improvements in sleep quality, reduced daytime sleepiness, and enhanced cognitive function compared to baseline.
Reference: Teruel-Hernández et al., 2023 – International Journal of Environmental Research and Public Health.
Chronic Fatigue, Chronic Pain and Fibromyalgia
Autonomic Nervous System and Pain Framework
A narrative review on pain and the autonomic nervous system positions NESA® neuromodulation as a therapeutic tool for chronic centralized and neuropathic pain. The authors describe its effects as mediated through autonomic modulation and reorganization of bioelectrical nerve signaling patterns.
Reference: Azevedo & Medina-Ramírez, 2025 – Frontiers in Pain Research.
Post-Traumatic Cervicalgia (Whiplash Injury)
A clinical study of patients with grade I–II post-traumatic cervicalgia (whiplash) evaluated the effects of NESA® neuromodulation combined with active exercise. After treatment, patients demonstrated reduced cervical pain, decreased disability scores, and increased cervical range of motion across all planes.
Clinical relevance: This study supports the use of NESA® in post-traumatic and mixed neuropathic–musculoskeletal pain conditions.
Reference: Bonilla-Eizaguirre et al., 2024 – International Journal of Research and Scientific Innovation.
Fibromyalgia – Randomized Controlled Trial (Completed)
A randomized, triple-blind clinical trial evaluating the efficacy of NESA® neuromodulation in fibromyalgia (ClinicalTrials.gov Identifier: NCT05648695) has been completed. According to expert review and preliminary reports, the trial demonstrated improvements in pain, fatigue, and sleep compared to placebo. Full peer-reviewed publication is currently emerging.
Position statement: NESA® shows promising high-quality clinical evidence for fibromyalgia, with randomized controlled data supporting its benefit as an adjunctive therapy.
Reference: ClinicalTrials.gov NCT05648695; Azevedo & Medina-Ramírez, 2025.
Dysautonomia, Heart Rate Variability and Cardiovascular Regulation
Post-COVID Dysautonomia
A triple-blind randomized pilot trial in women with post-COVID-19 condition and dysautonomia evaluated the effects of NESA® neuromodulation over 15 sessions. The NESA® group demonstrated significant increases in heart rate variability (SDNN) compared to placebo, along with improved pain thresholds. Fatigue and sleep improved in both groups.
Conclusion: This study provides direct evidence that NESA® modulates cardiac autonomic function in dysautonomia.
Reference: Melián-Ortiz et al., 2025 – Brain Sciences.
Urinary Incontinence, Overactive Bladder and Pelvic Autonomic Function
Clinical trials and case series in patients with multiple sclerosis report improvements in neurogenic urinary incontinence and bladder symptoms following NESA® neuromodulation. Pediatric and urogynecological studies further suggest benefits in bowel and bladder regulation, nocturia, and quality of life, interpreted as effects of autonomic nervous system modulation.
References:
- Contreras-Polo et al., 2023 – CPQ Medicine
- Báez-Suárez et al., 2025 – IJRISS
- Báez-Suárez et al., 2023 – BMC Pediatrics
Sports Performance, Recovery and Stress Regulation
Professional and Elite Athletes
Randomized clinical trials in professional and youth basketball players demonstrate that NESA® neuromodulation improves physiological recovery markers, heart rate variability, perceived fatigue, sleep duration, REM sleep, and cortisol normalization during high-stress competitive periods.
References:
- García et al., 2022 – Frontiers in Physiology
- Medina-Ramírez et al., 2024 – Stresses
Mechanism of Action – Why NESA® Influences Multiple Systems
Across clinical trials and reviews, NESA® neuromodulation demonstrates consistent physiological effects:
- Delivery of ultra-low biphasic microcurrents (0.1–0.9 mA; 1.1–14.3 Hz)
- Stimulation of distal peripheral nerve endings
- Modulation of autonomic balance (increased vagal tone, reduced sympathetic overactivity)
- Improvements in heart rate variability, sleep architecture, pain sensitization, stress hormone regulation, and bladder function
These findings support NESA® as a systemic autonomic neuromodulation therapy with downstream effects across multiple organ systems.
Clinical Summary
Current peer-reviewed evidence supports NESA® neuromodulation as a safe, non-invasive adjunctive therapy for:
- Insomnia and sleep disorders
- Anxiety, irritability, and stress-related symptoms
- Chronic pain, fibromyalgia, and fatigue syndromes
- Dysautonomia and autonomic imbalance
- Athletic recovery and stress adaptation
While some indications are supported by randomized controlled trials and others by observational or emerging data, the overall clinical signal is consistent: regulation of the autonomic nervous system is associated with meaningful improvements in sleep, pain, recovery, and quality of life.
Scientific References
Azevedo, Nelson, and Raquel Medina-Ramírez. “Pain and the Autonomic Nervous System: The Role of Non-Invasive Neuromodulation with NESA Microcurrents.” Frontiers in Pain Research, vol. 6, 2025, Article 1410808. DOI: 10.3389/fpain.2025.1410808.
Báez-Suárez, Aníbal, et al. “Improving Sleep Quality and Well-Being in Institutionalized Older Adults: The Potential of NESA Non-Invasive Neuromodulation Treatment.” Geriatrics, vol. 10, no. 1, 2025, Article 4. DOI: 10.3390/geriatrics10010004.
Vega-Delgado, Nayara, et al. “New Frontier in Sleep Disorders: The Rising of an Innovative Non-Invasive Neuromodulation Treatment.” International Journal of Research and Scientific Innovation, vol. 11, no. 15, 2024, pp. 689–697. DOI: 10.51244/IJRSI.2024.11150049P.
Contreras-Polo, Marina, et al. “Rehabilitation in Sleep, Pain, and Bladder Symptoms of NESA Neuromodulation Application in Multiple Sclerosis Patients: An Innovative Treatment.” CPQ Medicine, vol. 15, no. 1, 2023, pp. 1–11.
Báez-Suárez, Aníbal, et al. “Effectiveness of Non-Invasive NESA Neuromodulation in Patients with Multiple Sclerosis: A Case Series Study.” International Journal of Research and Innovation in Social Science, vol. 9, no. 6, 2025, pp. 3239–3249. DOI: 10.47772/IJRISS.2025.906000238.
Medina-Ramírez, Raquel, et al. “Effects in Sleep and Recovery Processes of NESA Neuromodulation Technique Application in Young Professional Basketball Players: A Preliminary Study.” Stresses, vol. 4, no. 2, 2024, pp. 238–250. DOI: 10.3390/stresses4020014.
García, Franc, et al. “Restoration of Physiological Status in Professional Basketball Players via NESA Neuromodulation Treatment during Various In-Season Microcycles: A Preliminary Randomized Clinical Trial.” Frontiers in Physiology, vol. 13, 2022, Article 1032020. DOI: 10.3389/fphys.2022.1032020.
Melián-Ortíz, Alberto, et al. “Superficial Neuromodulation in Dysautonomia in Women with Post-COVID-19 Condition: A Pilot Study.” Brain Sciences, vol. 15, no. 5, 2025, Article 510. DOI: 10.3390/brainsci15050510.
Molina-Cedrés, Fabiola, et al. “Impact of NESA Non-Invasive Neuromodulation on Sleep, Behavior, and Sensory Profile in Children with Autism Spectrum Disorder.” Children, vol. 12, no. 12, 2024, Article 1599. DOI: 10.3390/children12121599.
Báez-Suárez, Aníbal, et al. “The Utilization of Noninvasive Neuromodulation in Pediatric Patients with Neurodevelopmental Disorders to Improve Sleep Quality and Relieve Constipation.” BMC Pediatrics, vol. 23, 2023, Article 465. DOI: 10.1186/s12887-023-04307-
Teruel-Hernández, Esther, et al. “Enhancing Sleep Quality, Reducing Daytime Sleepiness, and Improving Cognitive Function in Patients with Dementia by Therapeutic Exercise and NESA Neuromodulation: A Multicenter Clinical Trial.” International Journal of Environmental Research and Public Health, vol. 20, no. 21, 2023, Article 7027. DOI: 10.3390/ijerph20217027.
Bonilla-Eizaguirre, Mónica, et al. “Efficacy of NESA Non-Invasive Neuromodulation in Patients with Post-Traumatic Cervicalgia.” International Journal of Research and Scientific Innovation, vol. 11, no. 10, 2024, pp. 474–482. DOI: 10.51244/IJRSI.2024.1110038.
Medical Disclaimer
NESA® neuromodulation is an integrative medical therapy and is not intended to replace conventional medical diagnosis or treatment. Individual responses may vary. All treatments should be supervised by a qualified healthcare professional.