Treatment of conditions through modulation of the autonomic nervous system

• US 20050240241A1
• Filed: 02/16/2005
• Published: 10/27/2005
• Est. Priority Date: 06/09/2003
• Status: Active Grant

• Current Assignee: Palo Alto Investors
• Original Assignee: Palo Alto Investors
• Inventors: Lee, Patrick Yuarn-Bor, Yun, Anthony Joonkyoo
• Granted Patent: US 7,738,952 B2
• Time in Patent Office: Days
• US Class Current: 607/42
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• 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 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

Methods are provided for treating a subject for a condition by modulating at least a portion of the subject'"'"'s autonomic nervous system. In accordance with certain embodiments of the subject methods, at least a portion of a subject'"'"'s autonomic nervous system is electrically or pharmacologically modulated in a manner that is effective to treat the subject for the condition. The subject methods find use in the treatment of a variety of different conditions, where such conditions include various disease conditions. Also provided are systems and kits for use in practicing the subject methods.

Claims

1. A method of treating a subject for a condition comprising electrically modulating at least a portion of said subject'"'"'s autonomic nervous system to increase the parasympathetic activity/sympathetic activity ratio in a manner effective to treat said subject for a condition chosen from the group of:

cardiovascular conditions;

neurodegenerative conditions;

neuroinflammatory;

orthopedic inflammatory conditions;

lymphoproliferative conditions;

autoimmune conditions;

inflammatory conditions;

infectious diseases;

pulmonary conditions;

transplant-related conditions;

gastrointestinal conditions;

endocrine;

genitourinary conditions;

skin conditions;

aging associated conditions;

neurologic conditions;

pediatric conditions;

Th-2 dominant conditions;

conditions, including diseases, that cause hypoxia, hypercarbia, hypercapnia, acidosis, acidemia;

OB-GYN conditions;

sudden death syndromes, menstrual related disorders;

peripartum and pregnancy related conditions;

fibrosis;

post-operative recovery conditions;

post-procedural recovery conditions;

chronic pain;

trauma;

hospitalization;

glaucoma;

male infertility;

disorders of thermoregulation;

respiratory sinus arrhythmia;

VQ mismatch; and

fibromyalgia.

2. The method of claim 1, wherein said condition is a cardiovascular condition chosen from the group of atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, eclampsia, pre-eclampsia, cardiomyopathy, volume retention, congestive heart failure, QT interval prolongation, aortic dissection, aortic aneurysm, arterial aneurysm, arterial vasospasm, myocardial infarction, reperfusion syndrome, ischemia, sudden adult death syndrome, arrhythmia, fatal arrythmias, coronary syndromes, coronary vasospasm, sick sinus syndrome, bradycardia, tachycardia, thromboembolic disease, deep vein thrombosis, coagulopathy, disseminated intravascular coagulation (“

DIC”

), mesenteric ischemia, syncope, venous thrombosis, arterial thrombosis, malignant hypertension, secondary hypertension, primary pulmonary hypertension, secondary pulmonary hypertension, raynaud'"'"'s, and paroxysmal supraventricular tachycardia.

3. The method of claim 1, wherein said condition is a neurodegenerative condition chosen from the group of Alzheimer'"'"'s Disease, Pick'"'"'s Disease, Parkinson'"'"'s Disease, dementia, delirium, and amyotrophic lateral sclerosis.

4. The method of claim 1, wherein said condition is a neuroinflammatory condition chosen from the group of:

viral meningitis, viral encephalitis, fungal meningitis, fungal encephalitis, multiple sclerosis, charcot joint, schizophrenia, and myasthenia gravis.

5. The method of claim 1, wherein said condition is an orthopedic inflammatory condition chosen from the group of:

osteoarthritis, inflammatory arthritis, regional idiopathic osteoporosis, reflex sympathetic dystrophy, Paget'"'"'s disease, osteoporosis, antigen-induced arthritis, and juvenile chronic arthritis.

6. The method of claim 1, wherein said condition is a lymphoproliferative condition including chosen from the group of:

lymphoma, lymphoproliferative disease, Hodgkin'"'"'s disease, and inflammatory pseudomotor of the liver.

7. The method of claim 1, wherein said condition is an autoimmune condition chosen from the group of:

Graves disease, raynaud'"'"'s, hashimoto'"'"'s, takayasu'"'"'s disease, kawasaki'"'"'s diseases, arteritis, scleroderma, CREST syndrome, allergies, dermatitis, Henoch-schlonlein purpura, goodpasture syndrome, autoimmune thyroiditis, myasthenia gravis, Reiter'"'"'s disease, and lupus.

8. The method of claim 1, wherein said condition is an inflammatory condition chosen from the group of:

acute respiratory distress syndrome (“

ARDS”

), multiple sclerosis, rheumatoid arthritis, juvenile rheumatoid arthritis, juvenile chronic arthritis, migraines, and chronic headaches.

9. The method of claim 1, wherein said condition is an infectious disease chosen from the group of:

sepsis, viral and fungal infections, diseases of wound healing, wound healing, tuberculosis, infection, AIDS, and human immunodeficiency virus.

10. The method of claim 1, wherein said condition is a pulmonary condition chosen from the group of:

tachypnea;

fibrotic lung diseases such as cystic fibrosis, interstitial lung disease, desquamative interstitial pneumonitis, intrapulmonary shunts;

non-specific interstitial pneumonitis, lymphocytic interstitial pneumonitis, usual interstitial pneumonitis, idiopathic pulmonary fibrosis, pulmonary edema, aspiration, asphyxiation, pneumothorax, right-to-left shunts, left-to-right shunts, and respiratory failure.

11. The method of claim 1, wherein said condition is a transplant-related condition chosen from the group of:

transplant related side effects such as transplant rejection, transplant-related tachycardia, transplant related renal failure, transplant related bowel dysmotility, and transplant-related hyperreninemia.

12. The method of claim 1, wherein said condition is a gastrointestinal condition chosne from the group of:

hepatitis, xerostomia, bowel mobility, peptic ulcer disease, constipation, ileus, irritable bowel syndrome, post-operative bowel dysmotility, inflammatory bowel disease, typhilitis, cholelethiasis, cholestasis, fecal incontinence, and cyclic vomiting syndrome.

13. The method of claim 1, wherein said condition is an endocrine condition chosen from the group of:

hypothyroidism, hyperglycemia, diabetes, obesity, syndrome X, insulin resistance, and polycystic ovarian syndrome (“

PCOS”

).

14. The method of claim 1, wherein said condition is a genitourinary condition chosen from the group of:

bladder dysfunction, renal failure, erectile dysfunction, hyperreninemia, hepatorenal syndrome, pulmonary renal syndrome, incontinence, arousal disorder, menopausal mood disorder, premenstrual mood disorder, renal tubular acidosis, and pulmonary renal syndrome.

15. The method of claim 1, wherein said condition is a skin condition chosen from the group of:

wrinkles, cutaneous vasculitis, rash; and

psoriasis.

16. The method of claim 1, wherein said condition is an aging associated condition chosen from the group of:

shy dragers, multi-system atrophy, age related inflammation conditions, cancer, and aging.

17. The method of claim 1, wherein said condition is a neurologic condition chosen from the group of:

epilepsy, depression, schizophrenia, seizures, stroke, insomnia, cerebral vascular accident, transient ischemic attacks, stress, bipolar disorder, concussions, post-concussive syndrome, cerebral vascular vasospasm, central sleep apnea, obstructive sleep apnea, sleep disorders, headaches incuding chronic headaches, migraines, and acute disseminated encephalomyelitis (“

ADEM”

).

18. The method of claim 1, wherein said condition is a pediatric condition chosen from the group of:

respiratory distress syndrome, sudden infant death syndrome, hirschsprung disease, bronchopulmonary dysplasia, congenital megacolon, ananglionosis, juvenile rheumatoid arthritis, and juvenile chronic arthritis.

19. The method of claim 1, wherein said condition is a Th-2 dominant condition chosen from the group of:

typhilitis, osteoporosis, lymphoma, myasthenia gravis, and lupus.

20. The method of claim 1, wherein said condition is a condition that cause hypoxia, hypercarbia, hypercapnia, acidosis, or academia chosen from the group of:

Chronic Obstructive Pulmonary Disease (“

COPD”

), emphysema, any chronic lung disease that causes acidosis, acute pulmonary embolism, sudden adult death syndrome (“

SADS”

), chronic pulmonary embolism, pleural effusion, cardiogenic pulmonary edema, non-cardiogenic pulmonary edema, acute respiratory distress syndrome (ARDS), neurogenic edema, hypercapnia, acidemia, asthma, renal tubular, asthma, acidosis, and chronic lung diseases that cause hypoxia, hypercarbia or hypercapnia.

113. A kit comprising:

(a) at least one of;

an electrical energy applying device and at least one pharmacological agent; and

(b) instructions for using said at least one of an electrical energy applying device and at least one pharmacological agent in a method according to claim 1.

21-51. -51. (canceled)

52. A method of treating a subject for a condition comprising pharmacologically modulating at least a portion of said subject'"'"'s autonomic nervous system to increase the parasympathetic activity/sympathetic activity ratio in a manner effective to treat said subject for a condition chosen from the group of:

cardiovascular conditions;

neurodegenerative conditions;

neuroinflammatory;

orthopedic inflammatory conditions;

lymphoproliferative conditions;

autoimmune conditions;

inflammatory conditions;

infectious diseases;

pulmonary conditions;

transplant-related conditions;

gastrointestinal conditions;

endocrine;

genitourinary conditions;

skin conditions;

aging associated conditions;

neurologic conditions;

pediatric conditions;

Th-2 dominant conditions;

conditions, including diseases, that cause hypoxia, hypercarbia, hypercapnia, acidosis, acidemia;

OB-GYN conditions;

sudden death syndromes, menstrual related disorders;

peripartum and pregnancy related conditions;

fibrosis;

post-operative recovery conditions;

post-procedural recovery conditions;

chronic pain;

trauma;

hospitalization;

glaucoma;

male infertility;

disorders of thermoregulation;

respiratory sinus arrhythmia;

VQ mismatch; and

fibromyalgia.

53-112. -112. (canceled)

114-116. -116. (canceled)