title: Effect of nerve cuff electrode geometry on onset response firing in high-frequency nerve conduction block.
abstract: The delivery of high-frequency alternating currents has been shown to produce a focal and reversible conduction block in whole nerve and is a potential therapeutic option for various diseases and disorders involving pathological or undesired neurological activity. However, delivery of high-frequency alternating current to a nerve produces a finite burst of neuronal firing, called the onset response, before the nerve is blocked. Reduction or elimination of the onset response is very important to moving this type of nerve block into clinical applications since the onset response is likely to result in undesired muscle contraction and pain. This paper describes a study of the effect of nerve cuff electrode geometry (specifically, bipolar contact separation distance), and waveform amplitude on the magnitude and duration of the onset response. Electrode geometry and waveform amplitude were both found to affect these measures. The magnitude and duration of the onset response showed a monotonic relationship with bipolar separation distance and amplitude. The duration of the onset response varied by as much as 820% on average for combinations of different electrode geometries and waveform amplitudes. Bipolar electrodes with a contact separation distance of 0.5 mm resulted in the briefest onset response on average. Furthermore, the data presented in this study provide some insight into a biophysical explanation for the onset response. These data suggest that the onset response consists of two different phases: one phase which is responsive to experimental variables such as electrode geometry and waveform amplitude, and one which is not and appears to be inherent to the transition to the blocked state. This study has implications for nerve block electrode and stimulation parameter selection for clinical therapy systems and basic neurophysiology studies.
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA. dma18@case.edu
authors.forename: D Michael
authors.initials: DM
authors.lastname: Ackermann
authors.forename: Niloy
authors.initials: N
authors.lastname: Bhadra
authors.forename: Emily L
authors.initials: EL
authors.lastname: Foldes
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Wang
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kilgore
mesh_terms: D000818:Animals; D003627:Data Interpretation, Statistical; D004558:Electric Stimulation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D008959:Models, Neurological; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D009407:Nerve Block / Q000295:instrumentation*; D009431:Neural Conduction; D051381:Rats; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000502:physiology
references.citation: IEEE Trans Biomed Eng. 1995 Aug;42(8):809-17
references.pmid: 7642195
references.citation: Neurorehabil Neural Repair. 2009 Jul-Aug;23(6):615-26
references.pmid: 19109445
references.citation: Med Biol Eng Comput. 2011 Feb;49(2):241-51
references.pmid: 20890673
references.citation: Appl Neurophysiol. 1986;49(3):121-38
references.pmid: 3827239
references.citation: IEEE Trans Biomed Eng. 1986 Jun;33(6):541-9
references.pmid: 3013759
references.citation: Muscle Nerve. 2005 Dec;32(6):782-90
references.pmid: 16124008
references.citation: Anat Rec. 1986 May;215(1):71-81
references.pmid: 3706794
references.citation: J Neurosci Methods. 2010 Oct 30;193(1):72-6
references.pmid: 20705099
references.citation: Annu Rev Biomed Eng. 2005;7:327-60
references.pmid: 16004574
references.citation: J Neurosci Methods. 2005 Feb 15;141(2):171-98
references.pmid: 15661300
references.citation: Brain Res. 1991 Jun 21;552(1):106-12
references.pmid: 1913170
references.citation: J Neural Eng. 2008 Sep;5(3):263-74
references.pmid: 18566505
references.citation: Med Biol Eng Comput. 2004 May;42(3):394-406
references.pmid: 15191086
references.citation: Exp Brain Res. 1998 Aug;121(4):379-90
references.pmid: 9746144
references.citation: Neurourol Urodyn. 2008;27(5):435-9
references.pmid: 18041769
references.citation: IEEE Trans Neural Syst Rehabil Eng. 2005 Sep;13(3):415-22
references.pmid: 16200764
references.citation: J Comput Neurosci. 2007 Jun;22(3):313-26
references.pmid: 17200886
references.citation: IEEE Trans Neural Syst Rehabil Eng. 2009 Oct;17(5):469-77
references.pmid: 19840914
references.citation: Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:654-7
references.pmid: 19963721
references.citation: J Urol. 2004 Nov;172(5 Pt 1):2069-72
references.pmid: 15540791
references.citation: J Physiol. 1956 Feb 28;131(2):341-76
references.pmid: 13320339
references.citation: Exp Neurol. 2009 Nov;220(1):57-70
references.pmid: 19660453
references.citation: Annu Int Conf IEEE Eng Med Biol Soc. 2007;2007:1719-22
references.pmid: 18002307
references.citation: J Neural Eng. 2007 Dec;4(4):390-8
references.pmid: 18057506
references.citation: J Neural Eng. 2006 Jun;3(2):180-7
references.pmid: 16705274
references.citation: IEEE Trans Biomed Eng. 2005 Mar;52(3):362-70
references.pmid: 15759566
references.citation: Bull Los Angel Neuro Soc. 1964 Jun;29:87-94
references.pmid: 14169956
references.citation: Muscle Nerve. 2010 Jan;41(1):117-9
references.pmid: 19813186
references.citation: Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:614-7
references.pmid: 19963719