Effects of ramped amplitude waveforms on the onset response of high-frequency mammalian nerve block

Abstract

Though high-frequency alternating current (HFAC) can block nerve conduction, the block is invariably preceded by an onset response which is a period of repetitive nerve firing. We tested the hypothesis that slowly ramping up the amplitude of the HFAC waveform could produce block without this initial onset response. Computer simulations were performed, using the McIntyre–Richardson–Grill (MRG) model of myelinated mammalian axon. A ramped-amplitude HFAC was applied to axons of diameters ranging from 7.3 µm to 16 µm and at frequencies ranging from 3125 Hz to 40 kHz. The ramped-amplitude HFAC was also investigated in vivo in preparations of rat sciatic nerve. Sinusoidal voltage-regulated waveforms, at frequencies between 10 kHz and 30 kHz, were applied with initial amplitudes of 0 V, linearly increasing with time to 10 V. Ramp durations ranged from 0 s to 60 s. In both the MRG model simulations and the experiments, ramping the HFAC waveform did not eliminate the onset response. In the rat experiments, the peak amplitude of the onset response was lessened by ramping the amplitude, but both the onset response duration and the amount of onset activity as measured by the force-time integral were increased.