Method and apparatus for selective control of nerve fibers

• US 20020099419A1
• Filed: 04/04/2001
• Published: 07/25/2002
• Est. Priority Date: 01/25/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: BioControl Medical (B.C.M) Ltd.
• Inventors: Cohen, Ehud, Ayal, Shai
• Granted Patent: US 6,600,954 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• CPC Class Codes: A61N 1/36071 Pain

Abstract

A method and apparatus particularly useful for pain control by selectively blocking the propagation of body-generated action potentials travelling through a nerve bundle by using a tripolar electrode device to generate unidirectional action potentials to serve as collision blocks with the body-generated action potentials representing pain sensations in the small-diameter sensory fibers. In the described preferred embodiments there are a plurality of electrode devices spaced along the length of the nerve bundle which are sequentially actuated with delays corresponding to the velocity of propagation of the body-generated action potentials through the large-diameter fibers to produce a “green wave” effect which minimizes undesired anodal blocking of the large-diameter fibers while maximizing the collision blocking of the small-diameter fibers.

Claims

1. A method of reducing pain sensations resulting from the propagation of body-generated action potentials towards the central nervous system through small-diameter sensory fibers in a nerve bundle, without unduly reducing other sensations resulting from the propagation of body-generated action potentials towards the central nervous system through large-diameter sensory fibers in said nerve bundle, comprising:

applying to said nerve bundle at least one electrode device capable, upon actuation, of generating unidirectional action potentials to be propagated through both the small-diameter and large-diameter sensory fibers in said nerve bundle away from said central nervous system; and

actuating said electrode device to generate said unidirectional action potentials to produce collision blocks with respect to said body-generated action potentials propagated through said small-diameter fibers.

2. The method according to claim 1, wherein said electrode device includes electrodes which:

(a) generate said electrode-generated action potentials by cathodic stimulation;

(b) produce a complete anodal block on one side of the cathode to make said electrode-generated action potentials unidirectional; and

(c) produce a selective anodal block on the opposite side of the cathode to cause the electrode-generated action potentials to produce collision blocks with respect to the body-generated action potentials propagated through the small-diameter sensory fibers.

3. The method according to claim 2, wherein said electrode device is a tripolar electrode device which includes a central cathode for producing said cathodic stimulation, a first anode on one side of the cathode for producing said complete anodal block, and a second anode on the opposite side of said cathode for producing said selective anodal block.

4. The method according to claim 1, wherein there are a plurality of said electrode devices spaced along the length of the nerve bundle;

and wherein said electrode devices are sequentially actuated with delays timed to the velocity of propagation of the body-generated action potentials through said large-diameter fibers to produce a “

green wave”

of electrode-generated anodal blocks, thereby increasing the number of EGAPs in the small diameter fibers producing collision blocks while minimizing anodal blocking of the BGAPs propagated through the large-diameter sensory fibers.

5. A method of selectively suppressing the propagation of body-generated action potentials propagated in a predetermined direction at a first velocity through a first group of nerve fibers in a nerve bundle without unduly suppressing the propagation of body-generated action potentials propagated in said predetermined direction at a different velocity through a second group of nerve fibers in said nerve bundle, comprising:

applying a plurality of electrode devices to, and spaced along the length of, the nerve bundle, each electrode device being capable of outputting, when actuated, unidirectional electrode-generated action potentials producing collision blocks with respect to the body-generated action potentials propagated through said second type of nerve fibers;

and sequentially actuating said electrode devices with delays timed to said first velocity to produce a “

green wave”

of anodal blocks minimizing undesired blocking of said body-generated action potentials propagated through said first group of nerve fibers, while maximizing the generation rate of said unidirectional electrode-generated action potentials producing collision blocks with respect to the body-generated action potentials propagated through said second type of nerve fibers.

6. The method according to claim 5, wherein said first group of nerve fibers are large-diameter nerve fibers;

and said second group of nerve fibers are small-diameter nerve fibers.

7. The method according to claim 6, wherein said nerve fibers are sensory nerve fibers, in which said predetermined direction of propagation of the body-generated action potentials to be collision blocked is towards the central nervous system, said method being effective for suppressing pain sensations propagated through the small-diameter sensory fibers without unduly suppressing other sensations propagated through the large-diameter sensory fibers.

8. The method according to claim 6, wherein said nerve fibers are motor nerve fibers in which said predetermined direction of propagation of the body-generated action potentials to be collision blocked is away from the central nervous system towards a muscle or gland, said method being effective for suppressing motor impulses propagated through the small-diameter motor nerve fibers without unduly suppressing the propagation of the motor impulses through the large-diameter motor nerve fibers.

9. The method according to claim 5, wherein each of said electrode devices is a tripolar electrode which includes a central cathode for producing said electrode-generated action potentials by cathodic stimulation, a first anode on one side of the cathode for making said electrode-generated action potentials unidirectional, and a second anode on the opposite side of said cathode for producing said selective anodal blocking of said electrode-generated action potentials.

10. A method of selectively controlling nerve fibers in a nerve bundle having fibers of different diameters propagating action potentials at velocities corresponding to their respective diameters, comprising:

applying a plurality of electrode devices to, and spaced along the length of, the nerve bundle, each electrode device being capable of producing, when actuated, unidirectional electrode-generated action potentials;

and sequentially actuating said electrode devices with delays timed to the velocity of propagation of action potentials through the fibers of one of said diameters.

11. The method according to claim 10, wherein said electrode devices are sequentially actuated to generate unidirectional action potentials producing collision blocks of the body-generated action potentials propagated through said nerve fibers of a another diameter.

12. The method according to claim 11, wherein said electrode devices are sequentially actuated with delays timed to the velocity of the larger-diameter nerve fibers to produce a “

green-wave”

of anodal blocks in order to minimize blocking the body-generated action potentials propagated through the larger-diameter fibers while maximizing the number of EGAPs collision blocking the body-generated action potentials propagated through the small diameter fibers.

13. The method according to claim 12, wherein said fibers include large-diameter sensory fibers propagating body-generated action potentials representing normal sensations from the peripheral nervous system to the sensor nervous system, and small-diameter sensory fibers propagating body-generated action potentials representing pain sensations from the peripheral nervous system to the central nervous system, which pain sensations in the small-diameter sensory fibers are suppressed by collision block and said “

green-wave”

of anodal blocks minimizes blocking of said normal sensations in said large-diameter sensory nerves.

14. The method according to claim 12, wherein said nerve fibers include large-diameter motor fibers propagating body-generated action potentials representing certain motor controls from the central nervous system to the peripheral nervous system, and small-diameter motor nerve fibers representing other motor controls from the central nervous system to the peripheral nervous system, the motor controls in said small-diameter motor fibers being suppressed by collision blocks and said green-wave of anodal blocks minimizes blocking of the motor controls in said large-diameter motor fibers.

15. The method according to claim 10, wherein said nerve fibers are motor fibers of different diameters for propagating body-generated action potentials from the central nervous system to the peripheral nervous system, said electrode devices being sequentially actuated to generate unidirectional action potentials to serve as motor action potentials to be propagated from the central nervous system to the peripheral nervous system to replace motor action potentials failed to be generated by the body.

16. The method according to claim 10, wherein each of said electrode devices is a tripolar electrode which includes a central cathode for producing said electrode-generated action potentials by cathodic stimulation, a first anode on one side of the cathode for making said electrode-generated action potentials unidirectional, and a second anode on the opposite side of said cathode for producing said selective anodal blocking of said electrode-generated action potentials.

18. The apparatus according to claim 10, wherein said electrode device includes electrodes which:

(a) generate said electrode-generated action potentials by cathodic stimulation;

(b) produce a complete anodal block on one side of the cathode to make said electrode-generated action potentials unidirectional; and

(c)produce a selective anodal block on the opposite side of the cathode to block the electrode-generated action potentials propagated through the large-diameter sensory fibers to a greater extent than those propagated through the small-diameter sensory fibers.

19. The apparatus according to claim 18, wherein said electrode device is a tripolar electrode which includes a central cathode for producing said cathodic stimulation, a first anode on one side of the cathode for producing said complete anodal block, and a second anode on the opposite side of said cathode for producing said selective anodal block.

20. The apparatus according to claim 19, wherein there are a plurality of said electrode devices spaced along the length of the nerve bundle;

and wherein said electrode devices are sequentially actuated with delays corresponding to the velocity of propagation of the body-generated action potentials through said large-diameter fibers to produce a “

green wave”

of electrode-generated action potentials collision blocking with the body-generated action potentials propagated through the small-diameter fibers while minimizing anodal blocking of action potentials propagating through the large-diameter fibers.

17. Apparatus for selectively blocking pain sensations resulting from the propagation of body-generated action potentials towards the central nervous system through small-diameter sensory fibers in a nerve bundle, without unduly reducing other sensations resulting from the propagation of body-generated action potentials towards the central nervous system through large-diameter sensory fibers in said nerve bundle, comprising:

an electrical device to be applied to said nerve bundle and having at least one electrode device capable, upon actuation, of generating unidirectional action potentials to be propagated through both the small-diameter and large-diameter sensory fibers in said nerve bundle away from said central nervous system;

and a stimulator for actuating said electrode device to generate said unidirectional action potentials to produce collision blocks of the body-generated action potentials in said small-diameter sensory fibers.

21. Apparatus for selectively suppressing the propagation of body-generated action potentials propagated at a first velocity through a first type of nerve fibers in a nerve bundle without unduly suppressing the propagation of body-generated action potentials propagated at a different velocity through a second type of nerve fibers in said nerve bundle, comprising:

spacing a plurality of electrodes to be spaced along the length of the nerve bundle, each capable of producing, when actuated, unidirectional electrode-generated action potentials and a selective anodal block of the latter action potentials propagated through said first type of nerve fibers to a greater extent than those propagated through said second type of nerve fibers;

and a stimulator for sequentially actuating said electrode devices with delays timed to said first velocity to produce a “

green wave”

of anodal blocks minimizing undesired blocking of said body-generated action potentials propagated through said first group of nerve fibers, while maximizing the generation rate of said unidirectional electrode-generated action potentials producing collision blocks with respect to the body-generated action potentials propagated through said second type of nerve fibers.

22. The apparatus according to claim 21, wherein each of said electrode devices is a tripolar electrode which includes a central cathode for producing said electrode-generated action potentials by cathodic stimulation, a first anode on one side of the cathode for making said electrode-generated action potentials unidirectional, and a second anode on the opposite side of said cathode for producing said selective anodal blocking of said electrode-generated action potentials.

23. The apparatus according to claim 22, wherein said plurality of electrode devices and said stimulator are constructed to be implanted into the subject'"'"'s body with the electrodes in contact with or closely adjacent to said nerve bundle.

24. The apparatus according to claim 22, wherein said stimulator is connected to said plurality of electrode devices by an asynchronous, serial four-wire bus.

25. The apparatus according to claim 22, wherein said stimulator communicates with said plurality of electrode devices via a wireless communication link.

26. The apparatus according to claim 22, wherein each of said tripolar electrode devices includes an insulating base carrying said cathode and two anodes on one face thereof, and control circuitry on the opposite face.

27. The apparatus according to claim 26, wherein said control circuitry includes a microprocessor communicating with said stimulator, and an L-C pulsing network controlled by said microprocessor.

29. The apparatus according to claim 28, wherein said stimulator sequentially actuates said electrode devices to generate unidirectional action potentials producing collision blocks of the body-generated action potentials propagated through said nerve fibers of another diameter.

30. The apparatus according to claim 29, wherein said stimulator sequentially actuates said electrode devices with delays timed to the propagation velocity of larger-diameter nerve fibers to produce a “

green-wave”

of anodal blocks minimizing undesired blocking of said body-generated action potentials propagated through the large-diameter nerve fibers, while maximizing the generation rate of said unidirectional electrode-generated action potentials producing collision blocks with respect to the body-generated action potentials propagated through the small diameter nerve fibers.

31. The apparatus according to claim 28, wherein said nerve fibers are motor fibers of different diameters for propagating body-generated action potentials from the central nervous system to the peripheral nervous system,

and said stimulator sequentially actuates said electrode devices to generate unidirectional action potentials to serve as motor action potentials to be propagated from the central nervous system to the peripheral nervous system to replace motor action potentials failed to be generated by the body.

28. Apparatus for selectively controlling nerve fibers in a nerve bundle having fibers of different diameters propagating action potentials at velocities corresponding to their respective diameters, comprising:

a plurality of electrode devices to be applied to, and spaced along the length of, the nerve bundle, each electrode device being capable of producing, when actuated, unidirectional electrode-generated action potentials;

and a stimulator for sequentially actuating said electrode devices with delays timed to the velocity of propagation of action potentials through the fibers of one of said diameters.