Combining direct current and kilohertz frequency alternating current to mitigate onset activity during electrical nerve block.
Combining direct current and kilohertz frequency alternating current to mitigate onset activity during electrical nerve block.
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DOI：
10.1088/1741-2552/abebed
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发表时间：
2021-03-22
影响因子：
4
通讯作者：
中科院分区：
文献类型：
--
作者：
电神经阻滞提供了立即和可逆地阻断周围神经传导的能力，并将在新兴的生物电子学领域有应用。研究了两种电神经阻滞方式--千赫交流电(KHFAC)和直流电(DC)。KHFAC可以用传统的电极安全地给药，但有一个缺点是有起效反应，这是在阻断建立之前的一段神经激活期，目前限制了临床翻译。长期以来，DC一直被认为可以阻断神经传导而不产生起效反应，但会产生破坏性的活性物质。典型的电极可以安全地输送直流不到一秒，但先进的大电容电极允许直流输送高达10 S而不会损坏。本工作的目的是将DC和KHFAC合并成一个单一的波形，称为组合减慢起效波形(Crow)，它可以在不引起起搏反应的情况下启动阻断，同时还可以长时间保持安全的阻断。该波形由启动KHFAC之前的短直流预脉冲组成。在轴突模拟环境神经元中对这种新的波形进行了模拟，以测试其可行性并深入了解其作用机制。然后在成年Spraogue-Dawley大鼠身上进行了两组急性实验，以确定波形在缓解发作反应方面的有效性。乌鸦降低了硅胶和体内的起效反应。在急性实验中，根据所测试的参数，起效面积减小了90%以上。直流脉冲的幅度对于有效的起搏缓解特别重要，需要的幅度是直流阻断阈值的6-8倍。这种波形可以可靠地降低KHFAC的起效反应，并可以在临床上更广泛地应用电神经阻滞。
Electrical nerve block offers the ability to immediately and reversibly block peripheral nerve conduction and would have applications in the emerging field of bioelectronics. Two modalities of electrical nerve block have been investigated—kilohertz frequency alternating current (KHFAC) and direct current (DC). KHFAC can be safely delivered with conventional electrodes, but has the disadvantage of having an onset response, which is a period of increased neural activation before block is established and currently limits clinical translation. DC has long been known to block neural conduction without an onset response but creates damaging reactive species. Typical electrodes can safely deliver DC for less than one second, but advances in high capacitance electrodes allow DC delivery up to 10 s without damage. The present work aimed to combine DC and KHFAC into a single waveform, named the combined reduced onset waveform (CROW), which can initiate block without an onset response while also maintaining safe block for long durations. This waveform consists of a short, DC pre-pulse before initiating KHFAC. Simulations of this novel waveform were carried out in the axonal simulation environment NEURON to test feasibility and gain insight into the mechanisms of action. Two sets of acute experiments were then conducted in adult Sprague–Dawley rats to determine the effectiveness of the waveform in mitigating the onset response. The CROW reduced the onset response both in silico and in vivo. The onset area was reduced by over 90% with the tested parameters in the acute experiments. The amplitude of the DC pulse was shown to be particularly important for effective onset mitigation, requiring amplitudes 6–8 times the DC block threshold. This waveform can reliably reduce the onset response due to KHFAC and could allow for wider clinical implementation of electrical nerve block.
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DOI：
10.1111/ner.12100
发表时间：
2014-04
期刊：
Neuromodulation : journal of the International Neuromodulation Society
影响因子：
--
作者：
Kilgore KL;Bhadra N
通讯作者：
Bhadra N
影响因子：
3
作者：
Foldes, Emily L.;Ackermann, D. Michael;Bhadra, Niloy;Kilgore, Kevin L.;Bhadra, Narendra
通讯作者：
Bhadra, Narendra
影响因子：
4
作者：
Ackermann DM;Bhadra N;Gerges M;Thomas PJ
通讯作者：
Thomas PJ
影响因子：
4.6
作者：
KARU, ZZ;DURFEE, WK;BARZILAI, AM
通讯作者：
BARZILAI, AM
影响因子：
3.4
作者：
Bhadra, N;Kilgore, KL
通讯作者：
Kilgore, KL