Electric modulation of sympathetic nervous sytem

• US 20070219596A1
• Filed: 05/17/2007
• Published: 09/20/2007
• Est. Priority Date: 03/22/2002
• Status: Active Grant

• Current Assignee: Leptos Biomedical, Inc. (Abbott Laboratories)
• Original Assignee: Leptos Biomedical, Inc. (Abbott Laboratories)
• Inventors: Dobak, John
• Granted Patent: US 7,937,144 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• 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 1/36071 Pain
• CPC Class Codes: A61N 1/36085 Eating disorders or obesity

Abstract

A method is described for the treatment of obesity or other disorders, by electrical activation or inhibition of the sympathetic nervous system. This activation or inhibition can be accomplished by electrically stimulating the greater splanchnic nerve or other portion of the sympathetic nervous system using an implantable pulse generator. This nerve activation can result in reduced food intake and increased energy expenditure. Reduced food intake may occur through a variety of mechanisms that reduce appetite and cause satiety. Increased adrenal gland hormone levels will result in increased energy expenditure. Fat and carbohydrate metabolism, which are also increased by sympathetic nerve activation, will accompany the increased energy expenditure.

Claims

1. A method for treating obesity, comprising:

monitoring a patient parameter; and

electrically activating the sympathetic nervous system of said patient so as to achieve a desired change in said monitored parameter;

wherein said monitored parameter is a plasma ghrelin level; and

wherein said electrically activating comprises activating the sympathetic nervous system to achieve a decreased plasma ghrelin level.

2. A method for implanting an electrode at the splanchnic nerve, the method comprising:

providing an introducer;

inserting said introducer into a patient;

applying an electrical pulse to said introducer;

monitoring for a change in at least one vital sign indicative of proximity of said introducer to the splanchnic nerve, said at least one vital sign change being selected from the group consisting of a rise in blood pressure and a decrease in heart rate; and

inserting an electrode through said introducer to place said electrode proximity to the splanchnic nerve.

3. A method for activating the splanchnic nerve to treat obesity, said method comprising:

applying a current pulse to a splanchnic nerve in a patient; and

selecting a duration of said current pulse to be no greater than the chronaxie of the splanchnic nerve.

4. The method recited in claim 3, further comprising selecting said duration of said pulse to be between 100 microseconds and 400 microseconds.

5. A method for activating a splanchnic nerve in a patient to treat obesity, said method comprising:

implanting a pulse generator within the patient, said pulse generator having programmable signal-on and signal-off times;

applying a current pulse to the splanchnic nerve with said pulse generator; and

programming said signal-on and signal-off times to maintain plasma epinephrine levels between 50 pg/ml and 1000 pg/ml.

6. A method for activating the splanchnic nerve to treat obesity, said method comprising:

implanting a pulse generator within a patient, said pulse generator having programmable treatment parameters;

applying a current pulse to a splanchnic nerve in the patient with said pulse generator; and

programming said treatment parameters to maintain plasma ghrelin levels below 250 pg/ml.

7. A method for treating a medical condition, comprising:

providing a pulse generator having programmable stimulation parameters;

programming said parameters to stimulate type B neurons; and

activating the sympathetic nervous system in a patient with said pulse generator.

8. The method recited in claim 7, wherein said stimulation parameters comprise current amplitude and pulse width, said method further comprising programming said pulse generator to produce a pulse having a current amplitude and a pulse width adapted to activate type B neurons.

9. A method for treating obesity, comprising administering unipolar electrical stimulation to a splanchnic nerve in a patient.

10. The method recited in claim 9, further comprising:

placing a first electrode in general proximity to the splanchnic nerve; and

generating a sufficiently large energy field with said first electrode to electrically couple with a second electrode, said energy field being sufficiently large to stimulate the splanchnic nerve.

11. The method recited in claim 10, further comprising:

implanting a pulse generator within a patient, said pulse generator having a portion adapted to function as said second electrode; and

applying a current pulse to said first electrode with said pulse generator, said current pulse being sufficiently large to electrically couple said first electrode with said portion of said pulse generator.

12. The method recited in claim 11, wherein said portion of said pulse generator comprises a housing.

13. A method for treating obesity of a patient, comprising:

monitoring electrical activity of a splanchnic nerve of the patient; and

electrically activating the sympathetic nervous system of the patient.

14. The method recited in claim 13, further comprising monitoring afferent activity of the splanchnic nerve.

15. The method recited in claim 13, further comprising monitoring efferent activity of the splanchnic nerve.

16. The method recited in claim 13, further comprising sensing activity of the splanchnic nerve that occurs upon feeding of the patient.

17. The method recited in claim 13, further comprising activating the sympathetic nervous system of the patient so as to limit food intake by the patient.

18. The method recited in claim 13, further comprising activating the sympathetic nervous system of the patient so as to reduce appetite of the patient.

19. The method recited in claim 13, further comprising activating the sympathetic nervous system of the patient so as to reduce a plasma ghrelin hormone level of the patient.

20. The method recited in claim 13, further comprising activating the sympathetic nervous system of the patient so as to increase a plasma glucose level of the patient.

21. A method for treating obesity of a patient, comprising:

sensing afferent activity of the splanchnic nerve in the patient resulting from feeding of the patient; and

electrically activating the sympathetic nervous system of the patient to limit food intake by the patient.

22. The method recited in claim 21, wherein the electrically activating the sympathetic nervous system reduces the appetite of the patient.

23. The method recited in claim 22, wherein the electrically activating the sympathetic nervous system reduces a plasma ghrelin hormone level of the patient.

24. The method recited in claim 22, wherein the electrically activating the sympathetic nervous system increases a plasma glucose level of the patient.

25. The method of claim 21, wherein the monitoring of said afferent activity of the splanchnic nerve comprises detecting a signal indicative of a commencement of feeding, and further comprising:

using said signal to begin stimulation of an efferent neuron of the splanchnic nerve.

26. A method for treating a medical condition in a patient, the method comprising electrically modulating the sympathetic nervous system of the patient, wherein said modulating comprises inhibiting the sympathetic nervous system of the patient.

27. The method of claim 26, wherein said inhibiting comprises electrically inhibiting the splanchnic nerve of the patient.

28. The method recited in claim 26, wherein said modulating comprises modulating the celiac ganglia of the patient.

29. The method recited in claim 26, wherein said modulating comprises modulating the sympathetic chain ganglia of the patient.

30. A method of treating anorexia nervosa, the method comprising:

selecting a patient with anorexia nervosa; and

electrically modulating the splanchnic nerve in the patient with anorexia nervosa.

31. A method of treating irritable bowel syndrome, the method comprising:

selecting a patient with irritable bowel syndrome; and

electrically modulating the splanchnic nerve in the patient with irritable bowel syndrome.

32. A method of treating pain, the method comprising:

selecting a patient with pain; and

electrically modulating the splanchnic nerve in the patient with pain.

33. A method of treating a medical condition, the method comprising:

producing electrical activation of a splanchnic nerve in a patient, said electrical activation having a signal-on time and a signal-off time;

wherein the signal-off time is equal to or longer than the signal-on time.

34. A method for treating a medical condition, the method comprising:

providing a pulse generator having programmable stimulation parameters;

programming said parameters to stimulate type B neurons; and

activating type B neurons in a splanchnic nerve in a patient with said pulse generator.

35. A method for treating a medical condition of a patient, the method comprising:

sensing electrical activity of a splanchnic nerve in the patient; and

electrically activating the splanchnic nerve.

36. The method of claim 35, wherein the electrically activating comprises performing unipolar stimulation of the splanchnic nerve.