A simulation study on selective stimulation of C-fiber nerves for chronic pain relief

It has been reported that stimulating nociceptive unmyelinated C nerves (C) near the sarcolemma could induce the secretion of endogenous opioids that relieve chronic pain. However, a substantial concern remains: concomitant stimulation might cause acute pain to nociceptive myelinated Aδ nerves (Aδ), which generally have a lower activation threshold than the C. However, few studies have reported on C selectivity over Aδ (C-selectivity). In this study, the C and Aδ nerves were modeled using the Hodgkin-Huxley (HH) and McIntyre-Richardson-Grill (MRG) models, respectively. Two potential stimulation schemes, including bipolar square waves and burst modulated alternating current, together with a new stimulation scheme named inhibit-Aδ (i-Aδ) that inhibits the excitability of theAδ, were systematically investigated. Their stimuli were given to the C and Aδ nerves through point electrodes located near the nerve fibers. Simulation results revealed that i-Aδ presented the highest C-selectivity, which provides a basis for non-invasive effective chronic-pain relief.