The goal of this research is to develop and clinically implement a new method of quickly and reversibly blocking the conduction of action potentials in peripheral nerve. In our currently funded project, we have demonstrated that high frequency alternating current (HFAC) waveforms produce a block of nerve activity that is completely effective and reversible. Specifically, through in-vivo experimentation and computer modeling we have demonstrated that nerve block can be produced by alternating current waveforms in the 5-30 KHz range when delivered through electrodes encircling the nerve. We have determined that the conduction block occurs locally and has no direct effect on the surrounding nerve or muscle. Although this technique has significant potential application in controlling muscle spasticity and pain, there remain two major impediments to human application. First, the HFAC waveform produces a transient activity in the nerve when it is first turned on. This transient activity can be quite large and last for several seconds. For most human applications it will be necessary to eliminate this activity. Second, it must be demonstrated that the HFAC waveform is safe to both the tissue and electrode when delivered chronically. Therefore we propose to address both of these issues in this project. Modified HFAC waveforms that do not produce the transient activity will be developed through computer simulation and then tested experimentally in-vivo to identify the most promising waveform. We will then develop the necessary technology to produce the modified HFAC waveform for chronic testing in animals. The chronic testing will be performed and analyzed and all other preparations for human application will be completed during this project. At the completion of the proposed project we will be ready to test HFAC nerve block in humans utilizing a percutaneous system. Targeted applications include the relief of muscle spasticity in dystonia, control of muscle spasticity in stroke and relief from neuroma pain after amputation. This research will provide a significant tool in our ongoing efforts to reduce disability and improve quality of life.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
3R01EB002091-09S2
Application #
7893978
Study Section
Special Emphasis Panel (ZRG1-BDCN-K (10))
Program Officer
Peng, Grace
Project Start
2001-06-15
Project End
2011-07-31
Budget Start
2009-08-15
Budget End
2011-07-31
Support Year
9
Fiscal Year
2009
Total Cost
$185,411
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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