Nerve Block by Electrical Pulses at Sub-Threshold Intensity

Abstract

Provided herein is a method of blocking a nerve or neuron by applying an electrical stimulation to the nerve or neuron, wherein the electrical stimulation is of an intensity below the excitation threshold of the nerve or neuron for a length of time sufficient to produce a block of nerve conduction or neuron excitation.

What is claimed is: 
     
         1 . A device comprising:
 a controller;   a pulse generator in communication with the controller; and   an electrode configured to encircle or be placed in proximity to a nerve or neuron, the electrode in electrical communication with the pulse generator, wherein   the device is configured to apply an electrical stimulation to the nerve or neuron, wherein the electrical stimulation is of an intensity below an initial excitation threshold of the nerve or neuron, optionally wherein the intensity of the electrical stimulation is below a pain threshold of the patient, for a length of time sufficient to produce a block of nerve conduction or neuron excitation.   
     
     
         2 . The device of  claim 1 , wherein the pulse generator is configured to deliver electrical stimulation through the electrode at an intensity of 0.01 mA to 10 mA and/or 1 mV to 10,000 mV. 
     
     
         3 . The device of  claim 1 , wherein the pulse generator is configured to deliver electrical stimulation through the electrode at a frequency of 1 Hz to 50 kHz. 
     
     
         4 . The device of  claim 1 , wherein the pulse generator is configured to deliver electrical stimulation through the electrode for a duration of from 100 milliseconds to 14 days. 
     
     
         5 . The device of  claim 1 , wherein the pulse generator delivers electrical stimulation comprising biphasic, symmetric, charge-balanced electrical pulses. 
     
     
         6 . The device of  claim 1 , wherein the controller is programmed or configured to instruct the pulse generator to apply electrical stimulation at an intensity below the initial excitation threshold of the nerve or neuron for a length of time sufficient to cause an increase of the initial excitation threshold of the nerve or neuron to a first increased excitation threshold. 
     
     
         7 . The device of  claim 6 , wherein the controller is further programmed or configured to instruct the pulse generator to increase the intensity of the electrical stimulation to a first increased intensity electrical stimulation above the initial excitation threshold of the nerve or neuron and below the first increased excitation threshold of the nerve or neuron for a length of time sufficient to cause an increase of the first increased excitation threshold of the nerve or neuron to a second increased excitation threshold. 
     
     
         8 . The device of  claim 7 , wherein the controller is further programmed or configured to instruct the pulse generator to increase the intensity of the first increased intensity electrical stimulation to a second increased intensity electrical stimulation above the first increased excitation threshold of the nerve or neuron and below the second increased excitation threshold of the nerve or neuron for a length of time sufficient to cause an increase of the second excitation threshold of the nerve or neuron to a third increased excitation threshold. 
     
     
         9 . The device of  claim 8 , wherein the controller is further programmed or configured to increase the intensity of the second increased intensity electrical stimulation one or more additional times for a length of time sufficient to further increase the excitation threshold of the nerve or neuron. 
     
     
         10 . The device of  claim 1 , wherein the controller is programmed or configured to, once block of nerve conduction or neuron excitation is achieved, instruct the pulse generator to stop application of the electrical stimulation for a period of at least 1 minute, wherein the block of nerve conduction or neuron excitation is maintained during the period and, after the period has concluded, the controller is programmed or configured to resume electrical stimulation of the nerve or neuron at the same or a lower intensity to continue or prolong the block of nerve conduction or neuron excitation. 
     
     
         11 . The device of  claim 1 , wherein the controller is programmed or configured to, once block of nerve conduction or neuron excitation is achieved, instruct the pulse generator to change the intensity and/or frequency of the electrical stimulation, optionally by reducing the intensity of the electrical stimulation or increasing the frequency of the electrical stimulation. 
     
     
         12 . A method of blocking a nerve or neuron, comprising:
 applying, through an electrode configured to encircle or be placed in proximity to a nerve or neuron, the electrode in electrical communication with a pulse generator, an electrical stimulation to the nerve or neuron, wherein the electrical stimulation is of an intensity that does not cause nerve or neuron excitation for a length of time sufficient to produce a block of nerve conduction or neuron excitation.   
     
     
         13 . The method of  claim 12 , wherein the intensity of the electrical stimulation is below an initial excitation threshold of the nerve or neuron. 
     
     
         14 . The method of  claim 12 , wherein the electrical stimulation is delivered at an intensity of 0.01 mA to 10 mA and/or 1 mV to 10,000 mV. 
     
     
         15 . The method of  claim 12 , wherein the electrical stimulation is delivered at a frequency of 1 Hz to 50 kHz. 
     
     
         16 . The method of  claim 12 , wherein the electrical stimulation is delivered for a period of from 1 minute to 14 days. 
     
     
         17 . The method of  claim 12 , wherein the electrical stimulation comprises biphasic symmetric electrical pulses. 
     
     
         18 . The method of  claim 12 , wherein the electrical stimulation comprises electrical pulses that are charge-balanced. 
     
     
         19 . The method of  claim 12 , wherein the stimulation is applied at an intensity below the initial excitation threshold of the nerve or neuron for a length of time sufficient to cause an increase of the initial excitation threshold of the nerve or neuron to a first increased excitation threshold. 
     
     
         20 . The method of  claim 19 , further comprising increasing the intensity of the electrical stimulation to a first increased intensity electrical stimulation above the initial excitation threshold of the nerve or neuron and below the first increased excitation threshold of the nerve or neuron for a length of time sufficient to cause an increase of the first increased excitation threshold of the nerve or neuron to a second increased excitation threshold.