Perception thresholds and qualitative perceptions for electrocutaneous stimulation

Our long-term goal is the development of a wearable warning system that uses electrocutaneous stimulation. To find appropriate stimulation parameters and electrode configurations, we investigate perception amplitude thresholds and qualitative perceptions of electrocutaneous stimulation for varying pulse widths, electrode sizes, and electrode positions. The upper right arm was stimulated in 81 healthy volunteers with biphasic rectangular current pulses varying between 20 and 2000 μs. We determined perception, attention, and intolerance thresholds and the corresponding qualitative perceptions for 8 electrode pairs distributed around the upper arm. For a pulse width of 150 μs, we find median values of 3.5, 6.9, and 13.8 mA for perception, attention, and intolerance thresholds, respectively. All thresholds decrease with increasing pulse width. Lateral electrode positions have higher intolerance thresholds than medial electrode positions, but perception and attention threshold are not significantly different across electrode positions. Electrode size between 15 × 15 mm2 and 40 × 40 mm2 has no significant influence on the thresholds. Knocking is the prevailing perception for perception and attention thresholds while mostly muscle twitching, pinching, and stinging are reported at the intolerance threshold. Biphasic stimulation pulse widths between 150 μs and 250 μs are suitable for electric warning wearables. Within the given practical limits at the upper arm, electrode size, inter-electrode distance, and electrode position are flexible parameters of electric warning wearables. Our investigations provide the basis for electric warning wearables.