METHODS FOR STIMULATING A DORSAL ROOT GANGLION

• US 20120283697A1
• Filed: 07/16/2012
• Published: 11/08/2012
• Est. Priority Date: 09/08/2004
• Status: Active Grant

• Current Assignee: TC1 LLC (Abbott Laboratories Incorporated), Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: St. Jude Medical Luxembourg Holdings SMI S.A.R.L.
• Inventors: Kim, Daniel H., Imran, Mir A.
• Granted Patent: US 9,205,260 B2
• Time in Patent Office: Days
• US Class Current: 604/506
• CPC Class Codes: A61M 2210/1003 Spinal column
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/0568 with drug delivery
• 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 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36171 Frequency

Abstract

Some embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia. Some other embodiments of the present invention provide methods for selective neurostimulation of one or more dorsal root ganglia as well as techniques for applying neurostimulation to the spinal cord. Still other embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia in combination with a pharmacological agent.

Claims

1. A method of modulating a dorsal root ganglion comprising:

positioning an elongate body into an epidural space, wherein the elongate body has a conduit for delivery of a pharmacological agent;

advancing the elongate body along a nerve root and positioning an outlet of the conduit near the dorsal root ganglion associated with the nerve root; and

delivering a pharmacological agent through the conduit so that the pharmacological agent pharmacologically modulates the dorsal root ganglion without pharmacologically modulating an associated ventral root.

2. A method as in claim 1, wherein the pharmacological agent modulates the dorsal root ganglion by acting upon at least one cell body within the dorsal root ganglion.

3. A method as in claim 1, wherein the pharmacological agent modifies electrophysiological excitability of the dorsal root ganglion.

4. A method as in claim 3, wherein the electrophysiological excitability of the dorsal root ganglion is decreased at least in part by reducing the extent of membrane depolarization.

5. A method as in claim 1, wherein the pharmacological agent comprises a pharmacological blocker.

6. A method as in claim 1, wherein the pharmacological blocker comprises an Na+ channel blocker, a Ca++ channel blocker, an NMDA receptor blocker and/or an opioid analgesic.

7. A method as in claim 1, wherein the pharmacological agent reduces an activation potential of a nerve fiber.

8. A method as in claim 1, wherein the pharmacological agent affects at least one Na+ channel and/or at least one Ca++ channel.

9. A method as in claim 1, wherein the elongate body has at least one electrode disposed thereon, further comprising delivering electrical energy through the at least one electrode so that the energy electrically modulates the dorsal root ganglion.

10. A method as in claim 9, wherein the pharmacological modulation and electrical modulation act synergistically.

11. A method as in claim 9, wherein the electrical energy is delivered at least partially during delivery of the pharmacological agent.

12. A method as in claim 9, wherein the electrical energy is delivered at a time interval after the delivery of the pharmacological agent.

13. A method of modulating a dorsal root ganglion comprising:

positioning at least one electrode near the dorsal root ganglion, wherein the at least one electrode is capable of delivering an amount of electrical energy which achieves a desired level of electrical modulation of the dorsal root ganglion;

delivering a pharmacological agent to the dorsal root ganglion, wherein the pharmacological agent influences the dorsal root ganglion in such a way that the amount of stimulation energy which achieves the desired level of electrical modulation is reduced; and

delivering a reduced amount of stimulation energy from the at least one electrode so as to achieve the desired level of electrical modulation of the dorsal root ganglion.

14. A method as in claim 13, wherein the electrical energy is delivered in the presence of the pharmacological agent.

15. A method as in claim 13, wherein the electrical energy is delivered at a time interval after the delivery of the pharmacological agent.

16. A method as in claim 13, wherein the pharmacological agent is delivered by a pharmacological agent coating.

17. A method as in claim 13, wherein the pharmacological agent is delivered through a conduit.

18. A method as in claim 17, wherein the pharmacological agent is delivered through a perfusion port in at least one of the at least one electrode.

19. A method as in claim 13, wherein the pharmacological agent is comprised of an Na+ channel blocker, a Ca++ channel blocker, an NMDA receptor blocker and/or an opoid analgesic.

20. A method of modulating a dorsal root ganglion comprising:

advancing a distal end of an elongate body along a portion of a peripheral nerve toward the dorsal root ganglion and a midline of a spinal column;

implanting the distal end near the dorsal root ganglion; and

delivering a pharmacological agent from the distal end of the elongate body so that the pharmacological agent pharmacologically modulates the dorsal root ganglion.

21. A method as in claim 20, wherein the pharmacological agent modulates the dorsal root ganglion by acting upon at least one cell body within the dorsal root ganglion.

22. A method as in claim 20, wherein the pharmacological agent modifies electrophysiological excitability of the dorsal root ganglion.

23. A method as in claim 20, wherein the pharmacological agent comprises a pharmacological blocker.

24. A method as in claim 20, wherein the pharmacological agent reduces an activation potential of a nerve fiber.

25. A method as in claim 20, wherein the pharmacological agent affects at least one Na+ channel and/or at least one Ca++ channel.

26. A method as in claim 20, wherein the elongate body has at least one electrode disposed thereon, further comprising delivering electrical energy through the at least one electrode so that the energy electrically modulates the dorsal root ganglion.

27. A method as in claim 26, wherein the pharmacological modulation and electrical modulation act synergistically.

28. A method as in claim 26, wherein the electrical energy is delivered in the presence of the pharmacological agent.

29. A method as in claim 26, wherein the electrical energy is delivered at a time interval after the delivery of the pharmacological agent.

30. A method of modulating a dorsal root ganglion comprising:

positioning at least one electrode near the dorsal root ganglion, wherein the at least one electrode is capable of delivering an amount of electrical energy;

delivering a pharmacological agent to the dorsal root ganglion, wherein the pharmacological agent influences the dorsal root ganglion in such a way that the stimulation energy has an increased efficacy; and

delivering the amount of electrical energy to the dorsal root ganglion.