Abstract <p>Transcutaneous spinal cord stimulation (tSCS) is used in physiologicalresearch and clinical rehabilitation. The objective assessment ofpain sensations when using different stimulation pulse waveforms remainsone of the relevant challenges. The aim of this study was (1) toexperimentally compare the pain sensations elicited by tSCS usingsingle pulses of different waveforms, and (2) to evaluate the feasibilityof using the galvanic skin response (GSR) as a pain marker in anexperimental setup conventionally employed in tSCS studies. Thestudy involved healthy male volunteers (<i>n</i> =13) who underwent tSCS at the T11–T12 vertebral level using single pulsesof four waveforms: monophasic non-modulated (MN), monophasic modulatedat 5 kHz (MM), biphasic non-modulated (BN), and biphasic modulated(BM). Pulses of increasing intensity were delivered at a frequencyof approximately 0.3 Hz up to the maximum tolerable intensity, butnot exceeding 250 mA and no longer than 6 min. The maximum stimulationintensity for all pulse waveforms was about 240 mA. Pain intensitylevel was assessed using a visual analog scale (VAS) after the endof stimulation and instrumentally by continuous GSR recording. Itwas found that at maximum tSCS intensities, GSR values significantlyincreased compared to baseline values for all pulse waveforms. The greatestincrease in GSR and the highest VAS scores were recorded duringthe stimulation with MN pulses. Self-reported VAS pain scores andthe GSR increase during the stimulation with modulated pulses (MMand BM) were significantly lower compared to non-modulated pulses(MN and BN). Changes in GSR magnitude were consistent with self-reportedpain scoring. These findings confirm that kilohertz-frequency pulsemodulation increases tSCS tolerance, while continuous GSR recording providesreliable pain monitoring during functional experimental tSCS studies.</p>