Current perception threshold and reaction time in the assessment of sensory peripheral nerve fibers through sinusoidal electrical stimulation at different frequencies

✓ The Melzack-Wall gate control theory has been invoked to explain the peripheral analgesia resulting from repetitive electrical stimulation of peripheral nerve. This model emphasizes presynaptic inhibitory interactions among afferent fiber terminals in the spinal cord. An alternative explanation, that of velocity change in peripheral nerve fiber conduction, has been suggested by compound action potential studies from our laboratory. The present study was designed to extend this work, and to investigate the single fiber changes subsequent to brief (5- to 20-minute) periods of repetitive, high frequency (180 to 200/sec) electrical stimulation through an implantable peripheral nerve cuff device of the type used clinically for pain relief. Most fibers, regardless of their diameter (estimated from conduction velocity), show one or more of the following characteristics: a transient slowing of conduction velocity, an increase in electrical threshold and/or a decrease in response probability following a period of repetitive electrical stimulation. This supports the hypothesis that there are changes in direct peripheral nerve fiber excitability occurring under conditions simulating clinical electroanalgesia.

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A test-retest reliability study of assessing small cutaneous fibers by measuring current perception threshold with pin electrodes

PLoS ONE ◽

10.1371/journal.pone.0242490 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242490

Author(s):

Weiwei Xia ◽

Han Fu ◽

Haiying Liu ◽

Fanqi Meng ◽

Kaifeng Wang

Keyword(s):

Blood Flow ◽

Quantitative Measurement ◽

Nerve Fibers ◽

Reliability Study ◽

Perception Threshold ◽

Intra Class Correlation ◽

Retest Reliability ◽

Current Perception Threshold ◽

Test Retest Reliability ◽

Intra Class Correlation Coefficient

Background The quantitative measurement of current perception threshold (CPT) has been used as a method to assess the function of nerve fibers in neuropathy diseases. The aim of this study was to assess the test-retest reliability measuring CPT using the circular pin electrodes for assessing the function of cutaneous thin nerve fibers. Methods CPT measurement was repeated on two separate days with at least one-week interval in 55 volunteers. Superficial blood flow (SBF) and skin temperature (ST) were measured on the skin in an around area concentric to the circular pin electrodes after the process of finding CPTs. The coefficient of variation (CV) and intra-class correlation coefficient (ICC) were calculated. The correlation between each two of CPT, SBF increment and ST increment was analyzed. Results No significant differences were found for CPT, SBF and ST between two sessions. SBF was found to be significantly increased after the process of finding CPT. CPT values of males were found to be higher than females. SBF increment was found to be positively correlated with ST increment. The ICC values for CPT, SBF and ST were 0.595, 0.852 and 0.728, respectively. The CV values for CPT, SBF and ST were 25.53%, 12.59% and 1.94%, respectively. Conclusions The reliability of CPT measurement using circular pin electrodes is fair, and need consistence of measurements in longitudinal studies.

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Diameter-dependent excitation of peripheral nerve fibers by multipolar electrodes during electrical stimulation

Expert Review of Medical Devices ◽

10.1586/17434440.2.2.149 ◽

2005 ◽

Vol 2 (2) ◽

pp. 149-152 ◽

Cited By ~ 12

Author(s):

Thomas Stieglitz

Keyword(s):

Electrical Stimulation ◽

Peripheral Nerve ◽

Nerve Fibers

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Current perception threshold through sinusoidal electrical stimulation at different frequencies in a comparative assessment for subjects affected and non-affected by diabetes mellitus

2015 7th International IEEE/EMBS Conference on Neural Engineering (NER) ◽

10.1109/ner.2015.7146772 ◽

2015 ◽

Author(s):

Franassis B. Oliveira ◽

Emerson Fachin-Martins ◽

Clarissa C.S. Couto-Paz ◽

Henrique R. Martins ◽

Carlos Julio Tierra-Criollo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Electrical Stimulation ◽

Comparative Assessment ◽

Perception Threshold ◽

Current Perception Threshold

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Reproducibility of current perception threshold with the Neurometer® vs the Stimpod NMS450 peripheral nerve stimulator in healthy volunteers: an observational study

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-013-9965-z ◽

2013 ◽

Vol 60 (8) ◽

pp. 753-760 ◽

Cited By ~ 6

Author(s):

Ban C. H. Tsui ◽

Timothy J. Shakespeare ◽

Danika H. Leung ◽

Jeremy H. Tsui ◽

Gareth N. Corry

Keyword(s):

Observational Study ◽

Peripheral Nerve ◽

Healthy Volunteers ◽

Nerve Stimulator ◽

Perception Threshold ◽

Peripheral Nerve Stimulator ◽

Current Perception Threshold

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Investigating stimulation parameters for preferential small-fiber activation using exponentially rising electrical currents

Journal of Neurophysiology ◽

10.1152/jn.00390.2019 ◽

2019 ◽

Vol 122 (4) ◽

pp. 1745-1752

Author(s):

Rosa Hugosdottir ◽

Carsten Dahl Mørch ◽

Ole Kæseler Andersen ◽

Lars Arendt-Nielsen

Keyword(s):

Electrical Stimulation ◽

Small Diameter ◽

Nerve Fibers ◽

Perception Threshold ◽

Pain Mechanisms ◽

Pulse Trains ◽

Stimulus Response ◽

Stimulation Parameters ◽

Small Fiber ◽

Large Fiber

Electrical stimulation is widely used in pain research and profiling, but current technologies lack selectivity toward small sensory fibers. Pin electrodes deliver high current density in upper skin layers, and it has been proposed that slowly rising exponential pulses can elevate large-fiber activation threshold and thereby increase preferential small-fiber activation. Optimal stimulation parameters for the combined pin electrode and exponential pulse stimulation have so far not been established, which is the aim of this study. Perception thresholds were compared between pin and patch electrodes using single 1- to 100-ms exponential and rectangular pulses. Stimulus-response functions were evaluated for both pulse shapes delivered as single pulses and pulse trains of 10 Hz using intensities from 0.1 to 20 times perception threshold. Perception thresholds (mA) decreased when duration was increased for both electrodes with rectangular pulses and the pin electrode with exponential pulses. For the patch electrode, perception thresholds for exponential pulses decreased for durations ≤10 ms but increased for durations ≥15 ms, indicating accommodation of large fibers. Stimulus-response curves for single pulses were similar for the two pulse shapes. For pulse trains, the slope of the curve was higher for rectangular pulses. Maximal large-fiber accommodation to exponential pulses was observed for 100-ms pulses, indicating that 100-ms exponential pulses should be applied for preferential small-fiber activation. Intensity of 10 times perception threshold was sufficient to cause maximal pain ratings. The developed methodology may open new opportunities for using electrical stimulation paradigms for small-fiber stimulation and diagnostics. NEW & NOTEWORTHY Selective activation of small cutaneous nerve fibers is pivotal for investigations of the pain system. The present study demonstrated that patch electrode perception thresholds increase with increased duration of exponential currents from 20 to 100 ms. This is likely caused by large-fiber accommodation, which can be utilized to activate small fibers preferentially through small-diameter pin electrodes. This finding may be utilized in studies of fundamental pain mechanisms and, for example, in small-fiber neuropathy.

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