Gate Mechanism and Parameter Analysis of Anodal-First Waveforms for Improving Selectivity of C-Fiber Nerves

J Pain Res. 2021 Jun 15:14:1785-1807. doi: 10.2147/JPR.S311559. eCollection 2021.

Abstract

Purpose: Few investigations have been conducted on the selective stimulation of small-radius unmyelinated C nerves (C), which are critical to both the recovery of damaged nerves and pain suppression. The purpose of this study is to understand how an anodal pulse in an anodal-first stimulation could improve C-selectivity over myelinated nociceptive Aδ nerves () and to further clarify the landscape of the solution space.

Materials and methods: An adapted Hodgkin-Huxley (HH) model and the McIntyre-Richardson-Grill (MRG) model were used for modeling C and , respectively, to analyze the underlying ion dynamics and the influence of relevant stimulation waveforms, including monopolar, polarity-symmetric, and asymmetric pulses.

Results: The results showed that polarity asymmetric waveforms with preceding anodal stimulations benefit C-selectivity the most, underlain by the decrease in the potassium ion current of C.

Conclusion: The optimal parameters for C-selectivity have been identified in the low-frequency band, remarkably benefiting the design of selective stimulation waveforms for the recovery of damaged nerves and pain management.

Keywords: C-selectivity; anodal-first stimulation; ion dynamics; polarity-asymmetric waveforms.