Uncoordinated or unwanted generation of nerve impulses is a major disabling factor in many medical conditions. These can affect motor, sensory, and autonomic nerves. Many of these pathological conditions could be ameliorated by interrupting these abnormal impulses in the periphery. The accepted methods of inhibiting neural activity are typically pharmacological (local anesthetics, channel blockers, etc.) or surgical (denervation). Electrical nerve block has been proposed and evaluated as a means of providing real-time rapidly acting and rapidly reversing nerve block and is a potential candidate for inducing a reliable, rapid, gradable and reversible nerve block. We have been investigating two types of electrical nerve block; KiloHertz Frequency Alternating Current (KHFAC) and Charge Balance Polarizing Current (CBPC) nerve block for clinical applications. KHFAC produces a rapid and reversible block. However, it has an important side effect. It produces an onset response when first initiated. This onset response is a brief rapid activation of the nerve and is a detriment to generalized clinical applications. CBPC block does not produce an onset response but can only be applied up to 10 seconds at a time with a low duty cycle. We have combined the positive aspects of the two methods of electrical nerve block into a single waveform (Combined No Onset Waveform or CNOW). We propose to investigate and optimize the design of the CNOW through computer simulations, hardware design and animal experiments to finalize a reliable method of applying KHFAC nerve block, without an onset response, in a variety of clinically relevant peripheral nerves.

Public Health Relevance

Uncoordinated or unwanted generation of nerve impulses is a major disabling factor in many medical conditions. These can affect motor, sensory, and autonomic nerves. Many of these pathological conditions could be ameliorated by interrupting these abnormal impulses in the periphery. Electrical nerve block is a potential candidate for inducing a reliable, rapid, gradable and reversible nerve block. KiloHertz Frequency Alternating Current (KHFAC) produces rapid and reversible block but has an onset response, when first initiated, which produces a brief period of nerve activation. This is a detriment to generalized clinical applications. We propose an innovative KHFAC waveform that can produce nerve block without the onset response. The future clinical impact would be in many diseases that are caused by pathologies of motor, sensory and autonomic function.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
5R01EB024860-03
Application #
9698939
Study Section
Bioengineering of Neuroscience, Vision and Low Vision Technologies Study Section (BNVT)
Program Officer
Wolfson, Michael
Project Start
2017-08-01
Project End
2021-04-30
Budget Start
2019-05-01
Budget End
2020-04-30
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106