Year: 2016
Type: article
Abstract: There are many diseases that could benefit from electrical nerve block.The properties of rapid block, rapid reversal and localization makes electrical nerve block an improved option over pharmaceutical options or surgery.Applications exist in many body systems.Motor block can provide relief from spasticity.Sensory block can provide pain relief without the possibility of prescription drug abuses.Autonomic block can modulate organ systems such as heart rate or blood pressure.These applications are all very complex and diverse.In order to provide solutions to these wide range of problems and over a varied group of patients, it is advantageous to have as many tools as possible available to choose from.Kilohertz-frequency alternating current (KHFAC) has been studied extensively and applied to many different applications.It fits all the requirements of electrical nerve block.It is also inherently safe, but at the initiation of KHFAC onset activity occurs which is undesirable in many applications.Direct current (DC) nerve block can be used without causing onset if the parameters are chosen correctly, but with conventional electrodes, damage to the nerve can occur in just a few seconds.The damage from DC can be mitigated with the correct waveform parameters and the correct electrodes.In order to prevent the formation of cytotoxic products at the electrode surface, high capacitance electrodes were developed to extend the amount of charge that could x be delivered before reactants were formed at the electrode interface.These electrodes, used with a charge balanced direct current (CBDC) waveform were able to extend the amount of time that DC could be applied.The ability to provide even a short burst of DC opened up several novel nerve block applications.Three different configurations were tested.1) A CBDC electrode was used with a KHFAC electrode to block the onset from the KHFAC using DC. 2) The CBDC waveform was combined with the KHFAC through one electrode to generate the combined no onset waveform.3) A DC only application was tested, using a 4 contact CBDC waveform.These applications provide more tools that can be applied to control of the nervous system.xi was reduced from 13.3±12.9Nsto 0.6±0.4Ns(p<0.01).No change in nerve conductivity was observed post application of the combined KHFAC+CBDC block relative to KHFAC waveforms. Conclusion:The distal application of CBDC can significantly reduce or even completely prevent the KHFAC onset response without a change in nerve conductivity.
Author: Tina Vrabec
Institution: Case Western Reserve University
Language: English
Subfield: Cellular and Molecular Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W2618474084