(Verbatim from application) The goal of this research is to develop a reversible method for chronically blocking the conduction of action potentials in human peripheral nerves. Unwanted or uncoordinated generation of nerve impulses is a major factor in many disabling conditions, such as peripheral pain, spinal cord injury, stroke, cerebral palsy and multiple sclerosis. For example, unregulated nerve impulses produce spasticity in stroke, cause spasms in spinal cord injury, and generate neuroma pain in amputation. If these impulses can be intercepted along the peripheral nerves over which they travel, then the disabling condition can be reduced or eliminated. Although there are a few existing methods for surgically or pharmacologically blocking nerve impulses, none of these methods are broadly applicable or successful, are non-specific with sometimes serious side-effects, and, in many cases, are destructive to the nerve. Therefore, there is a widespread clinical need for a safe, reliable and reversible nerve block. The use of electrical stimulation, delivered through electrodes surrounding the nerve, has previously been shown to block nerve impulses in a reversible and predictable manner in acute situations. However, the present methods of electrical nerve block are likely to be damaging to the nerve during chronic usage. A novel stimulus waveform has now been developed that is likely to be safe for chronic human applications, while still producing an effective and reversible nerve conduction block. In this project, the effectiveness of this waveform to block action potential propagation in whole nerves in acute in-vivo experiments will be measured. Specifically, it will be demonstrated that this new waveform is capable of a complete block of both motor and sensory activity, including A-delta and C-fiber activity, and that this new waveform can also be used to selectively block activity in large diameter axons. The effect of nerve diameter and nerve fiber size on block effectiveness will also be evaluated. At the completion of this project, it will have demonstrated that an electrical nerve block can be achieved, and that it is effective in blocking conduction in both motor and sensory nerve fibers. In the future, chronic in vivo studies will be performed to test the long-term safety of this technique prior to human use. The initial intended human application will be to alleviate pain in individuals with neuromas secondary to limb amputation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
8R01EB002091-03
Application #
6639699
Study Section
Geriatrics and Rehabilitation Medicine (GRM)
Program Officer
Peng, Grace
Project Start
2001-06-15
Project End
2004-05-31
Budget Start
2003-06-01
Budget End
2004-05-31
Support Year
3
Fiscal Year
2003
Total Cost
$266,146
Indirect Cost
Name
Case Western Reserve University
Department
Orthopedics
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Vrabec, Tina; Bhadra, Niloy; Wainright, Jesse et al. (2016) Characterization of high capacitance electrodes for the application of direct current electrical nerve block. Med Biol Eng Comput 54:191-203
Franke, Manfred; Bhadra, Niloy; Bhadra, Narendra et al. (2014) Direct current contamination of kilohertz frequency alternating current waveforms. J Neurosci Methods 232:74-83
Kilgore, Kevin L; Bhadra, Niloy (2014) Reversible nerve conduction block using kilohertz frequency alternating current. Neuromodulation 17:242-54; discussion 254-5
Peckham, P Hunter; Kilgore, Kevin L (2013) Challenges and opportunities in restoring function after paralysis. IEEE Trans Biomed Eng 60:602-9
Foutz, Thomas J; Ackermann Jr, D Michael; Kilgore, Kevin L et al. (2012) Energy efficient neural stimulation: coupling circuit design and membrane biophysics. PLoS One 7:e51901
Bryden, Anne M; Peljovich, Allan E; Hoyen, Harry A et al. (2012) Surgical restoration of arm and hand function in people with tetraplegia. Top Spinal Cord Inj Rehabil 18:43-9
Boger, Adam S; Bhadra, Narendra; Gustafson, Kenneth J (2012) High frequency sacral root nerve block allows bladder voiding. Neurourol Urodyn 31:677-82
Ackermann, D Michael; Bhadra, Niloy; Gerges, Meana et al. (2011) Dynamics and sensitivity analysis of high-frequency conduction block. J Neural Eng 8:065007
Foldes, Emily L; Ackermann, D Michael; Bhadra, Niloy et al. (2011) Design, fabrication and evaluation of a conforming circumpolar peripheral nerve cuff electrode for acute experimental use. J Neurosci Methods 196:31-7
Ackermann Jr, D Michael; Bhadra, Niloy; Foldes, Emily L et al. (2011) Conduction block of whole nerve without onset firing using combined high frequency and direct current. Med Biol Eng Comput 49:241-51

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