61. Dome-shaped electrodes for pain management in transcutaneous electrical nerve stimulation: a modelling study

Abstract

Background: Transcutaneous electrical nerve stimulation (TENS) is an established technique for pain management. There is evidence that stimulation delivered through a dome-shaped electrode is associated with improved clinical outcomes compared with conventional flat patch electrodes currently utilized in TENS, due to a greater depth and area of electrical stimulation. The aim was to investigate this using computational modelling analysis. Method(s): A 3D finite element model of cutaneous tissue coupled with an active model of nerve fibre was developed, for simulation of E-fields originating from various electrode geometries and stimulation configurations. Outputs from the tissue model were transferred into the nerve model to determine the minimum currents required to activate cutaneous fibres. The efficacy was based on the level of activation of Abeta, Adelta and C fibres. Result(s): Dome-shaped electrodes required significantly lower device current to activate nerve fibres compared with flat TENS electrodes. The depth of electrical stimulus was 4x greater and the area of field activation 40% greater. The maximum amplitude was 40x higher with the dome shaped electrode compared to TENS electrodes at depths of 2 cm. The dome-shaped electrode could activate large nerves at up to ~1 cm depth with current 30 mA, whilst TENS could only do so at 0.25 cm. Conclusion(s): A dome-shaped electrode appears to recruit more nerves at the same level of stimulating current due to its greater depth of penetration and activation field compared with conventional electrodes. This may equate with improved pain and functional outcomes for patients. Copyright © 2025