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Surface electrical stimulation to evoke referred sensation

Surface electrical stimulation to evoke referred sensation. Johanna C. Forst; Derek C. Blok; Julia P. Slopsema; John M. Boss; Lane A. Heyboer; Carson M. Tobias; Katharine H. Polasek, PhD. Aim Develop a noninvasive method to elicit natural, referred sensation. Relevance

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Surface electrical stimulation to evoke referred sensation

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  1. Surface electrical stimulation to evoke referred sensation Johanna C. Forst; Derek C. Blok; Julia P. Slopsema; John M. Boss; Lane A. Heyboer; Carson M. Tobias; Katharine H. Polasek, PhD

  2. Aim • Develop a noninvasive method to elicit natural, referred sensation. • Relevance • Improvement in surface electrical stimulation (SES) technique to produce natural sensations such as touch may improve treatment for phantom limb pain as well as provide noninvasive method to deliver sensory feedback.

  3. Methods • Median and ulnar nerve stimulation applied via voltage-controlled, charge-balanced, biphasic, nonsymmetric pulses. • Protocol 1: Parameter Estimation by Sequential Testing (PEST) was used to determine threshold at 3 pulse durations (100, 500, and 1,000 μs) and 4 pulse amplitudes, with 4 responses at each point. • Protocol 2: Durations increased to 5 (50, 100, 300, 500, and 1,000 μs) for 9 threshold points, with 4 responses at each point. • Strength-duration threshold curve along with its rheobase and chronaxie values was constructed from threshold points.

  4. Results • Distinguishable hand sensation was obtained from SES in all test sessions. Actual sensations varied from tingling to itchiness to pressing. • Strength-Duration Curve: rheobase voltage ranged from 6.8 to 26.7 V for median nerve and from 14.8 to 32.7 V for ulnar nerve. Chronaxie time ranged from 5.8 to 112.5 μs for median nerve and from 4.1 to 63.1 μs for ulnar nerve. • No significant differences between two protocols were found; significant differences were found between two nerves for both rheobase voltage (p < 0.001) and chronaxie time (p < 0.05). Rheobase and chronaxie values were observed to be lower for females, but differences were not significant (p > 0.05).

  5. Conclusion • SES at the elbow evokes referred sensation in the hand with use of both current-controlled and voltage-controlled stimulation. • Subject-specific strength-duration curves can be generated in a timely manner and used to define the lower boundary of the effective parameter space. • These curves will be used in future studies to investigate the location and type of sensation that can be evoked with the goal of obtaining a stable location and decreasing paresthesia-like sensations.

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