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First-in-Human Demonstration of High-Frequency Electrical Motor Nerve Block: Case Report.

Jayme S Knutson1, Kyle J Chepla, Richard D Wilson

  • 1From the Department of Physical Medicine and Rehabilitation, The MetroHealth System, Cleveland, Ohio (JSK, RDW, MJF, JC, KLK, NB); Department of Orthopedic Surgery, The MetroHealth System, Cleveland, Ohio (KLK); Division of Plastic Surgery, The MetroHealth System, Cleveland, Ohio (KJC); Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio (JSK, RDW, MJF, JC, KLK, NB); Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, Ohio (KLK), Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, Ohio (MJF); Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio (MJF, SAB, JC, NB); Department of Surgery, Case Western Reserve University, Cleveland, Ohio (KJC); and Research Service, Cleveland Functional Electrical Stimulation Center, Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio (JSK, KJC, RDW, MJF, ECI, JC, KLK).

American Journal of Physical Medicine & Rehabilitation
|July 3, 2024
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Summary

High-frequency stimulation can block muscle contractions. This study demonstrated that 8 mA of high-frequency stimulation completely blocked electrically induced muscle contractions, offering a potential treatment for spasticity.

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Area of Science:

  • Neurology
  • Biomedical Engineering

Background:

  • Muscle spasticity is a debilitating condition often treated with medications that have systemic side effects.
  • Electrical nerve stimulation offers a potential localized treatment approach.

Purpose of the Study:

  • To assess the feasibility of using high-frequency stimulation to block nerve-induced muscle contractions.
  • To determine the effective amplitude of high-frequency stimulation for motor block.

Main Methods:

  • A feasibility study was conducted during forearm tendon lengthening surgery.
  • The anterior interosseous nerve was exposed, and a nerve cuff electrode was used.
  • High-frequency stimulation (20 kHz) was applied via the cuff electrode to block muscle contractions elicited by proximal nerve stimulation.

Main Results:

  • Complete block of pronator quadratus muscle contractions was achieved with 8 mA peak-to-peak high-frequency stimulation.
  • Partial block was observed at lower amplitudes.
  • Muscle contractions immediately resumed upon cessation of high-frequency stimulation.

Conclusions:

  • High-frequency electrical nerve stimulation can effectively block nerve-induced motor activity.
  • This technique represents a significant step towards clinical application for managing spasticity.