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A typical electrode gel consists of a mixture of water, a thickener such as polyvinyl alcohol or carboxymethyl cellulose, and an electrolyte to increase conductivity. [1] [2] Some electrode gels have been shown to pose a potential fire risk when high-energy pulses are used, as for example when defibrillators are used. [3]
In fact, firm application of the hands and feet against the electrodes blocks physiological sweating, and the active measure extracts electro-active ions (i. e., chloride near the anode, proton near the cathode) and pulls them towards the electrodes. The resulting conductance is then given for each foot and hand in μS (micro-Siemens).
The electrodes are normally placed about an inch apart, and the resistance recorded varies according to the emotional state of the subject. Galvanic skin potential (GSP) refers to the voltage measured between two electrodes without any externally applied current. It is measured by connecting the electrodes to a voltage amplifier.
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To perform the test, one set of electrodes are placed on viable tissue (e.g. the chest) as a control and a second set is placed around the tissue in question (e.g. legs or feet). The electrodes may mildly heat the skin to increase blood flow into the area. Oxygen may also be given to the patient to see if that increases oxygen levels in the tissue.
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A patient sits comfortably with the treatment leg elevated. A fine needle electrode is inserted into the lower, inner aspect of the leg, slightly cephalad/rostral to the medial malleolus. As the goal is to send stimulation through the tibial nerve, it is important to have the needle electrode near (but not on) the tibial nerve.
The two-electrode, e.g., foot-to-foot or hand-to-hand measurement, is generally found to be less accurate than 4-electrode methods (tetra-polar technique in which the current circuit is provided by a pair of distal electrodes with impedance measured, as the voltage drop between a separate pair of proximal electrodes).
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