Continuous Direct Current Nerve Block Using Multi Contact High Capacitance Electrodes

Vrabec, Tina; Bhadra, Niloy; Acker, Gustaf Van; Kilgore, Kevin L.

doi:10.1109/tnsre.2016.2589541

Cited by 31 publications

(27 citation statements)

References 49 publications

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“…On the rat sciatic nerve, a four-contact electrode was tested to provide a long-term DC block. Block was applied for 22 min while maintaining nerve integrity, as shown in Figure 7 [63]. This same electrode configuration was tested on the paravertebral chain to blunt the sympathetic reflex to prevent cardiac arrhythmia induction [64].…”

Section: Cbpc Systemmentioning

confidence: 99%

Reversible Conduction Block in Peripheral Nerve Using Electrical Waveforms

et al. 2017

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Introduction Electrical nerve block uses electrical waveforms to block action potential propagation. Materials & Methods Two key features that distinguish electrical nerve block from other nonelectrical means of nerve block: block occurs instantly, typically within 1 s; and block is fully and rapidly reversible (within seconds). Results Approaches for achieving electrical nerve block are reviewed, including kilohertz frequency alternating current and charge-balanced polarizing current. We conclude with a discussion of the future directions of electrical nerve block. Conclusion Electrical nerve block is an emerging technique that has many significant advantages over other methods of nerve block. This field is still in its infancy, but a significant expansion in the clinical application of this technique is expected in the coming years.

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Section: Cbpc Systemmentioning

confidence: 99%

Reversible Conduction Block in Peripheral Nerve Using Electrical Waveforms

et al. 2017

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“…The other reason that DC neuromodulation has gained interest in recent years is that the field of neuromodulation has become refined sufficiently to be faced with new challenges that are more difficult to address using pulsatile waveforms. Because DC directly controls membrane potential, it can increase or decrease firing rate, altogether block neural activity, control AP propagation velocity, and modulate synaptic connectivity (Goldberg et al, 1984; Bikson et al, 2004; Vrabec et al, 2017; Strang et al, 2018; Yang et al, 2018). DC also appears to maintain the stochastic properties of AP inter-pulse intervals on each neuron (Goldberg et al, 1984), in contrast to conventional pulsatile stimulation for which an evoked AP in phase with the stimulation pulse is the intended effect.…”

Section: Introductionmentioning

confidence: 99%

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Aplin

Fridman

2019

Front. Neurosci.

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Implantable neuroprostheses such as cochlear implants, deep brain stimulators, spinal cord stimulators, and retinal implants use charge-balanced alternating current (AC) pulses to recover delivered charge and thus mitigate toxicity from electrochemical reactions occurring at the metal-tissue interface. At low pulse rates, these short duration pulses have the effect of evoking spikes in neural tissue in a phase-locked fashion. When the therapeutic goal is to suppress neural activity, implants typically work indirectly by delivering excitation to populations of neurons that then inhibit the target neurons, or by delivering very high pulse rates that suffer from a number of undesirable side effects. Direct current (DC) neural modulation is an alternative methodology that can directly modulate extracellular membrane potential. This neuromodulation paradigm can excite or inhibit neurons in a graded fashion while maintaining their stochastic firing patterns. DC can also sensitize or desensitize neurons to input. When applied to a population of neurons, DC can modulate synaptic connectivity. Because DC delivered to metal electrodes inherently violates safe charge injection criteria, its use has not been explored for practical applicability of DC-based neural implants. Recently, several new technologies and strategies have been proposed that address this safety criteria and deliver ionic-based direct current (iDC). This, along with the increased understanding of the mechanisms behind the transcutaneous DC-based modulation of neural targets, has caused a resurgence of interest in the interaction between iDC and neural tissue both in the central and the peripheral nervous system. In this review we assess the feasibility of in-vivo iDC delivery as a form of neural modulation. We present the current understanding of DC/neural interaction. We explore the different design methodologies and technologies that attempt to safely deliver iDC to neural tissue and assess the scope of application for direct current modulation as a form of neuroprosthetic treatment in disease. Finally, we examine the safety implications of long duration iDC delivery. We conclude that DC-based neural implants are a promising new modulation technology that could benefit from further chronic safety assessments and a better understanding of the basic biological and biophysical mechanisms that underpin DC-mediated neural modulation.

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“…• Transcutaneous electrical nerve stimulation (TENS) [142][143][144] • Bioelectronic block [145][146][147][148] • Spinal cord stimulation (SCS) [118,[149][150][151][152] • Vagal nerve stimulation (VNS) [78,153,154] • Renal nerve denervation [155][156][157] • Cardiac decentralization and carotid body ablation [158][159][160][161][162] • Cardiac conditioning (ischemia, exercise) [21,163,164] Table 1. Management strategies that target the autonomic nervous system.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Autonomic Nervous System and Neurocardiac Physiopathology

Kingma¹,

Simard²,

Rouleau³

2018

Autonomic Nervous System

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The autonomic nervous system regulates multiple physiological functions; how distinct neurons in peripheral autonomic and intrathoracic ganglia communicate remains to be established. Increasing focus is being paid to functionality of the neurocardiac axis and crosstalk between the intrinsic nervous system and diverse organ systems. Current findings indicate that progression of cardiovascular disease comprises peripheral and central aspects of the cardiac nervous system hierarchy. Indeed, autonomic neuronal dysfunction is known to participate in arrhythmogenesis and sudden cardiac death; diverse interventions (pharmacological, non-pharmacological) that affect neuronal remodeling in the heart following injury caused by cardiovascular disease (congestive heart failure, etc.) or acute myocardial infarction are being investigated. Herein we examine recent findings from clinical and animal studies on the role of the intrinsic cardiac nervous system on regulation of myocardial perfusion and the consequences of cardiac injury. We also discuss different interventions that target the autonomic nervous system, stimulate neuronal remodeling and adaptation, and thereby optimize patient outcomes.

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Continuous Direct Current Nerve Block Using Multi Contact High Capacitance Electrodes

Cited by 31 publications

References 49 publications

Reversible Conduction Block in Peripheral Nerve Using Electrical Waveforms

Reversible Conduction Block in Peripheral Nerve Using Electrical Waveforms

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Autonomic Nervous System and Neurocardiac Physiopathology

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