Methods and systems for selective control of bladder function

• US 20040111126A1
• Filed: 12/06/2002
• Published: 06/10/2004
• Est. Priority Date: 12/06/2002
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Tanagho, Emil A., Gleason, Curtis A.
• Granted Patent: US 6,990,376 B2
• Time in Patent Office: Days
• US Class Current: 607/40
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36071 Pain

Abstract

A method and system for selective inhibition of somatic nerve fibers in a mixed nerve containing both somatic and autonomic nerve fibers where the method finds use in treatment of chronic pain, spastic muscles and for sensory for motor control of a bladder. The methods and systems utilize alternate phase rectangular electrical pulses. An electrical pulse generator is coupled to a nerve. An alternate phase high frequency, low amplitude pulse is first applied to selectively inhibit somatic nerves when present in a mixed nerve. An alternate phase low frequency, high amplitude phase pulse subsequently supplied to stimulate the autonomic nerve fibers and in the case of the sacral root will permit a controlled voiding of the bladder and bowel.

Claims

1. A method of selectively inhibiting neural transmission of a somatic fiber in a mixed nerve containing both somatic and autonomic nerve fibers where the method comprises applying alternate phase high frequency, low amplitude pulse pairs to the nerve in an amount sufficient to inhibit neural transmission of somatic fibers without substantially inhibiting autonomic fibers in said mixed nerve.

2. The method of claim 1, further comprising applying an alternate phase low frequency, high amplitude pulse pairs to the nerve to inhibit both somatic and autonomic nerve fibers.

3. A method of controlling a bladder or a bowel, said method comprising:

applying alternate phase high frequency, low amplitude pulse pairs to a nerve that innervates said bowel or bladder; and

applying alternate phase low frequency, high amplitude pulse pairs to said nerve to void the bladder or bowel, while continuing to apply the alternate phase high frequency, low amplitude pulse pairs.

4. The method of claim 3, wherein the high frequency pulse pairs are at least 50 pulse pairs per second

5. The method of claim 3, wherein the high frequency pulse pairs range from about 50 to about 200 pulse pairs per second.

6. The method of claim 5, wherein the high frequency pulse pairs range from about 80 to about 120 pulse pairs per second.

7. The method of claim 3, wherein the low frequency pulse pairs are in a range of up to about 40 pulse pairs per second.

8. The method of claim 7, wherein the low frequency pairs are in a range of about 15 to about 25 pulse pairs per second.

9. The method of claim 3, wherein the amplitude of high frequency pulse pairs ranges from about 0.1 milliamperes to about 1.5 milliamperes.

10. The method of claim 3, wherein the amplitude of high frequency pulse pairs ranges from about 0.3 milliamperes to about 0.8 milliamperes.

11. The method of claim 3, wherein the amplitude of low frequency pulse pairs ranges from about 1 milliamperes to about 3 milliamperes.

12. The method of claim 11, wherein the amplitude of low frequency pulse pairs ranges from about 1.3 milliamperes to about 1.7 milliamperes.

13. The method of claim 3, wherein the high frequency pulses have pulse widths in a range of about 0.01 ms to about 0.5 ms.

14. The method of claim 13, wherein the high frequency pulses have pulse widths in a range of about 0.08 ms to about 0.12 ms.

15. The method of claim 3, wherein the low frequency pulses have pulse widths in a range of about 0.1 ms to about 1.0 ms.

16. The method of claim 15, wherein the low frequency pulses have pulse widths of approximately 0.5 ms.

17. A system for controlling a bladder or bowel, said system comprising:

an electrical pulse generator configured to produce alternate phase high frequency, low amplitude pulses and an alternate phase low frequency, high amplitude pulses to a sacral nerve; and

at least one electrode that can be coupled to a nerve and transmit an electrical signal from said pulse generator to said nerve.

18. The system of claim 17, wherein said electrode is coupled to the sacral nerve and in electrical communication with the electrical pulse generator.

19. The system of claim 17, wherein the system comprises two electrodes coupled to the electrical pulse generator with four wires.

20. The system of claim 17, further comprising an external power source electromagnetically coupled to the electrical pulse generator.

21. The system of claim 17, further comprising a pressure sensitive switch on the electrical pulse generator.

22. A method of inhibiting neural transmission in a nerve by applying electrical impulses to the nerve where the electrical impulses have the following characteristics:

alternate phase and a frequency in of at least 60 pulse pairs per second at an amplitude sufficient to inhibit neural transmission.

23. The method of claim 22, where the frequency is at least 60 pulse pairs per second.

24. The method of claim 22, where the frequency is in a range of about 60 to about 500 pulse pairs per second.

25. The method claim 22, where the frequency is in a range of about 60 to about 300 pulse pairs per second.

26. A method of reducing chronic pain, said method comprising applying electrical impulses having the following characteristics:

alternate phase and a frequency of at least 60 pulse pairs per second to a nerve at an amplitude sufficient to inhibit neural transmission.

27. The method of claim 26, wherein the frequency is at least 60 pulse pairs per second.

28. The method of claim 26, wherein the frequency is in a range of about 60 to about 500 pulse pairs per second.

29. The method of claim 26, wherein the frequency is in a range of about 60 to about 300 pulse pairs per second.

30. A method of reducing muscle spasticity in muscles innervated with nerves, said method comprising applying electrical impulses having the following characteristics:

alternate phase and a frequency range of at least 60 pulse pairs per second to the nerve at an amplitude sufficient to inhibit neural transmission.

31. The method of claim 30, where the frequency is in a range of about 60 to about 500 pulse pairs per second.

32. The method of claim 30, where the frequency is in a range of about 60 to about 300 pulse pairs per second.

33. A method of inhibiting neural transmission in nerves by contacting the nerves with an electrode connected to an electrical pulse generator and applying electrical impulses having the following characteristics:

alternate phase and a frequency in a range of 60 pulse pairs per second at an amplitude sufficient to inhibit neural transmission.

34. The method of claim 33, wherein the electrode is a ribbon of conducting metal.

35. The method of claim 33, wherein the nerve is an intact extradural root.

36. The method of claim 33, wherein the nerve is a human nerve.

37. A method of controlling a bladder or a bowel, the method comprising:

providing an electrical pulse generator;

operatively linking the electrical pulse generator to at least one nerve;

applying alternate phase high frequency, low amplitude pulse pairs to the nerve; and

applying low frequency, high amplitude pulse pairs to the nerve to void the bladder while continuing to apply the alternate phase high frequency, low amplitude pulse pairs.

38. The method of claim 37, wherein the high frequency pulse pairs are at least 50 pulse pairs per second

39. The method of claim 37, wherein the high frequency pulse pairs range from about 50 to about 200 pulse pairs per second.

40. The method of claim 39, wherein the high frequency pulse pairs range from about 80 to about 120 pulse pairs per second.

41. The method of claim 37, wherein the low frequency pulse pairs are in a range of up to about 40 pulse pairs per second.

42. The method of claim 41, wherein the low frequency pairs are in a range of about 15 to about 25 pulse pairs per second.

43. The method of claim 37, wherein the amplitude of high frequency pulse pairs ranges from about 0.1 milliamperes to about 1.5 milliamperes.

44. The method of claim 43, wherein the amplitude of high frequency pulse pairs ranges from about 0.3 milliamperes to about 0.8 milliamperes.

45. The method of claim 37, wherein the amplitude of low frequency pulse pairs ranges from about 1 milliamperes to about 3 milliamperes.

46. The method of claim 45, wherein the amplitude of low frequency pulse pairs ranges from about 1.3 milliamperes to about 1.7 milliamperes.

47. The method of claim 37, wherein the high frequency pulses have pulse widths in a range of about 0.01 ms to about 0.5 ms.

49. The method of claim 37, wherein the low frequency pulses have pulse widths in a range of about 0.1 ms to about 1.0 ms.

50. The method of claim 49, wherein the low frequency pulses have pulse widths of approximately 0.5 ms.

48. The method of claim Error! Reference source not found., wherein the high frequency pulses have pulse widths in a range of about 0.08 ms to about 0.12 ms.

51. A method of stimulating nerve fibers by applying alternate phase pulse pairs.

52. A method of selectively inhibiting neural transmission of somatic nerve fibers while selectively stimulating neural transmission of autonomic nerve fibers in a mixed nerve containing both somatic and autonomic nerve fibers, the method comprising:

applying alternate phase high frequency, low amplitude pulse pairs to inhibit neural transmission of somatic nerve fibers without substantially inhibiting neural transmission of autonomic nerve fibers; and

applying alternate phase low frequency, high amplitude pulse pairs to the nerve in an amount sufficient to stimulate neural transmission of autonomic nerve fibers.

53. A method of controlling a bladder or a bowel, the method comprising:

(i) applying alternate phase high frequency, low amplitude pulse pairs to inhibit neural transmission of somatic nerve fibers without substantially inhibiting neural transmission of autonomic nerve fibers; and

(ii) applying alternate phase low frequency, high amplitude pulse pairs to the nerve in an amount sufficient to stimulate neural transmission of autonomic nerve fibers.

54. A system for controlling a bladder or a bowel, the system comprising:

at least one electrical pulse generator configured to produce alternate phase low frequency, high amplitude pulse pairs and/or alternate phase high frequency, low amplitude pulse pairs in communication with at least one mixed nerve containing both somatic and autonomic nerve fibers through at least one electrode.

55. A system for controlling a bladder or a bowel, the system comprising:

at least an electrical pulse generator configured to produce alternate phase low frequency, high amplitude pulse pairs and alternate phase high frequency, low amplitude pulse pairs in communication with a multitude of mixed nerves containing both somatic and autonomic nerve fibers through an array of electrodes.