Techniques for nerve stimulation

• US 20060106441A1
• Filed: 11/15/2005
• Published: 05/18/2006
• Est. Priority Date: 11/15/2004
• 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 7,627,384 B2
• Time in Patent Office: Days
• US Class Current: 607/118
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system

Abstract

Apparatus is provided for applying current to a nerve, including a housing, adapted to be placed in a vicinity of the nerve, and at least one cathode and at least one anode, fixed to the housing. The apparatus further includes two or more passive electrodes, fixed to the housing, and a conducting element, which electrically couples the passive electrodes to one another. Other embodiments are also described.

Claims

1. Apparatus for applying current to a nerve, comprising:

a housing, adapted to be placed in a vicinity of the nerve;

at least one cathode and at least one anode, fixed to the housing;

two or more passive electrodes, fixed to the housing; and

a conducting element, which electrically couples the passive electrodes to one another.

2. The apparatus according to claim 1, wherein the two or more passive electrodes comprise exactly two passive electrodes.

3. The apparatus according to claim 1, wherein the at least one cathode and the at least one anode are fixed longitudinally between the two or more passive electrodes.

4. The apparatus according to claim 1, wherein at least one of the passive electrodes is fixed longitudinally between the at least one cathode and the at least one anode.

5. The apparatus according to claim 1, wherein the at least one anode comprises one or more anodes which are configured to apply to the nerve an inhibiting current capable of inhibiting cathode-induced action potentials traveling in a non-therapeutic direction in the nerve.

6. The apparatus according to claim 1, wherein the at least one cathode comprises one or more cathodes which are configured to apply to the nerve a stimulating current, which is capable of inducing action potentials in a first set and a second set of nerve fibers of the nerve, and wherein the at least one anode comprises one or more anodes that are configured to apply to the nerve an inhibiting current, which is capable of inhibiting the induced action potentials in the second set of nerve fibers, the nerve fibers in the second set having generally larger diameters than the nerve fibers in the first set.

7. The apparatus according to claim 1, wherein the electrodes comprise ring electrodes.

8. The apparatus according to claim 1, wherein the conducting element comprises at least one passive element that impedes passage of current through the conducting element.

9. The apparatus according to claim 1, wherein the housing comprises one or more insulating elements that separate one or more of the at least one cathode, the at least one anode, and the passive electrodes, the insulating elements positioned closer to the nerve than are the at least one cathode, the at least one anode, and the passive electrodes.

10. Apparatus for applying current to a nerve of a subject, comprising:

a housing, adapted to be placed in a vicinity of the nerve;

at least one cathode and at least one anode, fixed to the housing;

a passive electrode, fixed to the housing; and

a conducting element, which is electrically coupled to the passive electrode and extends to a remote location in a body of the subject at a distance of at least 1 cm from the housing.

11. Apparatus for applying current to a nerve having a radius, comprising:

a housing, adapted to be placed in a vicinity of the nerve; and

two or more cathodes and one or more anodes, fixed to the housing such that no anodes are positioned longitudinally between the two or more cathodes.

12. The The apparatus according to claim 11, comprising:

two or more passive electrodes, fixed to the housing, such that the cathodes and the anodes are longitudinally between the passive electrodes; and

a conducting element, which electrically couples the passive electrodes to one another.

13. The apparatus according to claim 11, wherein the two or more cathodes and the one or more anodes comprise ring electrodes.

14. The apparatus according to claim 11, wherein the housing comprises one or more insulating elements that separate one or more of the cathodes and the anodes, the insulating elements positioned closer to the nerve than are the cathodes and the anodes.

15. The apparatus according to claim 11, wherein the cathodes and anodes are fixed to the housing such that no cathodes are positioned longitudinally between the one or more anodes.

16. The apparatus according to claim 11,

wherein the two or more cathodes are fixed to the housing at respective cathodic longitudinal locations, and are configured to apply to the nerve a stimulating current, which is capable of inducing action potentials in a first set and a second set of nerve fibers of the nerve,

wherein the one or more anodes are fixed to the housing at respective anodal locations, such that no cathodes are positioned longitudinally between the one or more anodes,

wherein the cathodes are configured to produce a virtual anode effect at a virtual anodal longitudinal site of the nerve, which is capable of inhibiting the induced action potentials in the second set of nerve fibers, the nerve fibers in the second set having generally larger diameters than the nerve fibers in the first set, and

wherein the cathodic locations are between (a) the anodal locations and (b) the virtual anodal site.

17. The apparatus according to claim 11,

wherein the two or more cathodes are fixed to the housing at respective cathodic locations,

wherein the one or more anodes comprise a single anode, fixed to the housing at an anodal location,

wherein the anode is configured to produce a virtual cathode effect at a virtual cathodic longitudinal site of the nerve, which is incapable of generating action potentials in the nerve, and

wherein the anodal location is between (a) the cathodic locations and (b) the virtual cathodic site.

18. The apparatus according to claim 11,

wherein the two or more cathodes are fixed to the housing at respective cathodic locations,

wherein the one or more anodes comprise a single anode, fixed to the housing at an anodal location,

wherein the anode is configured to produce a virtual cathode effect at a virtual cathodic longitudinal site of the nerve, which does not generate action potentials in more than 10% of axons in the nerve, and

wherein the anodal location is between (a) the cathodic locations and (b) the virtual cathodic site.

19. The apparatus according to claim 11, wherein the cathodes are positioned such that a closest distance between two of the two or more cathodes is equal to at least the radius of the nerve.

20. The apparatus according to claim 19, wherein the cathodes are positioned such that the closest distance between the two of the two or more cathodes is equal to at least 1.5 times the radius of the nerve.

21. The apparatus according to claim 11,

wherein the cathodes are configured to apply respective cathodic currents to the nerve,

wherein the anodes are configured to apply respective anodal currents to the nerve, and

wherein, for any given depth within the nerve, for a myelinated axon within the nerve of diameter less than 10 microns, the cathodic currents define, in combination, for the depth, a cathodic activation function having a maximum depolarizing amplitude, and the anodal currents define, in combination, for the depth, an anodal activation function having a maximum hyperpolarizing amplitude greater than the maximum depolarizing amplitude.

22. The apparatus according to claim 21, wherein, for a 1 micron diameter myelinated axon within the nerve, the maximum hyperpolarizing amplitude is greater than or equal to 110% of the maximum depolarizing amplitude.

23. Apparatus for applying current to a nerve, comprising:

a housing, adapted to be placed in a vicinity of the nerve;

one or more cathodes, fixed to the housing, and configured to apply respective cathodic currents to the nerve; and

one or more anodes, fixed to the housing, and configured to apply respective anodal currents to the nerve,

wherein, for any given depth within the nerve, for a myelinated axon within the nerve of diameter less than 10 microns, the cathodic currents define, in combination, for the depth, a cathodic activation function having a maximum depolarizing amplitude, and the anodal currents define, in combination, for the depth, an anodal activation function having a maximum hyperpolarizing amplitude greater than the maximum depolarizing amplitude.

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29. Apparatus for applying current to a nerve, comprising:

a housing, adapted to be placed in a vicinity of the nerve;

one or more electrodes, fixed to the housing; and

two elongated end insulating elements, fixed to the housing such that all of the electrodes are longitudinally between the insulating elements, and adapted to be disposed with respect to the nerve such that each of the end insulating elements has a length in a direction parallel with the nerve of at least 2 mm.

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35. A method for applying current to a nerve, comprising:

applying at least one cathodic current and at least one anodal current to the nerve; and

passively electrically coupling at least two longitudinal sites of the nerve to one another.

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43. A method for applying current to a nerve having a radius, comprising:

applying two or more cathodic currents to the nerve at respective cathodic longitudinal sites; and

applying one or more anodal currents to the nerve at respective anodal longitudinal sites,

without applying anodal current to the nerve at any site longitudinally between the two or more cathodic longitudinal sites.

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53. A method for applying current to a nerve, comprising:

applying one or more cathodic currents to the nerve; and

applying one or more anodal currents to the nerve,

wherein, for any given depth within the nerve, for a myelinated axon within the nerve of diameter less than 10 microns, the cathodic currents define, in combination, for the depth, a cathodic activation function having a maximum depolarizing amplitude, and the anodal currents define, in combination, for the depth, an anodal activation function having a maximum hyperpolarizing amplitude greater than the maximum depolarizing amplitude.

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