Combined No Onset Waveform for KiloHertz Frequency Alternating Current Nerve Block

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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.