Pudendal Nerve Block by Low-Frequency (≤1 kHz) Biphasic Electrical Stimulation.
Pudendal Nerve Block by Low-Frequency (≤1 kHz) Biphasic Electrical Stimulation.
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DOI：
10.1111/ner.13241
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Tai C
中科院分区：
文献类型：
--
作者：
Shapiro K;Guo W;Armann K;Pace N;Shen B;Wang J;Beckel J;de Groat W;Tai C
验证低频（≤1 kHz）双相刺激（LFBS）可实现刺激后神经传导阻滞的假设。将三极袖带电极放置在猫的阴部神经周围以递送LFBS（1 kHz、500 Hz和100 Hz）。将两个钩状电极放置在袖带电极的中心和远端，以诱导外尿道括约肌（EUS）收缩。将导管插入尿道以记录EUS收缩压力。中央钩状电极刺激未能诱导EUS收缩，而远端钩状电极刺激仍诱导收缩，证实了LFBS的阴部神经阻滞。终止LFBS后，在不同频率（1 kHz，500 Hz和100 Hz）下用LFBS完全阻断阴部神经传导。对于三种频率，在最小刺激强度和持续时间下诱导的LFBS后阻滞在相同时间段内（平均10-15 min）完全可逆。然而，当频率从100 Hz增加到1 kHz时，诱导阻滞的刺激持续时间从23 ± 8秒显著增加到95 ± 14秒（p < 0.05）。本研究发现低频双相电刺激（LFBS）（≤1 kHz）与高频双相电刺激（HFBS）一样，可引起刺激后阻滞。这一结果为双相电刺激波形通过改变细胞内外离子浓度来阻断轴突传导的理论提供了支持。LFBS后阻滞提供了开发用于临床应用的新神经调节装置的机会，其中初始神经放电是可接受的。
To test the hypothesis that poststimulation block of nerve conduction can be achieved by low-frequency (≤1 kHz) biphasic stimulation (LFBS). A tripolar cuff electrode was placed around the pudendal nerve in cats to deliver LFBS (1 kHz, 500 Hz, and 100 Hz). Two hook electrodes were placed central and distal to the cuff electrode to induce external urethral sphincter (EUS) contractions. A catheter was inserted into the urethra to record EUS contraction pressure. Pudendal nerve block by LFBS was confirmed by the failure of the central hook electrode stimulation to induce EUS contractions, while the distal hook electrode stimulation still induced contractions. Pudendal nerve conduction was completely blocked by LFBS at different frequencies (1 kHz, 500 Hz, and 100 Hz) after terminating LFBS. The post-LFBS block induced at the minimal stimulation intensity and duration was fully reversible within the same time period (10–15 min on average) for the three frequencies. However, the stimulation duration to induce block significantly (p < 0.05) increased from 23 ± 8 sec to 95 ± 14 sec when frequency increased from 100 Hz to 1 kHz. This study discovered that LFBS (≤1 kHz), like high-frequency (≥5 kHz) biphasic stimulation (HFBS), can induce poststimulation block. The result provides support for the theory that biphasic stimulation waveforms block axonal conduction by changing intracellular and extracellular ion concentrations. The post-LFBS block provides the opportunity to develop new neuromodulation devices for clinical applications where initial nerve firing is acceptable.
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