WIRELESS NEUROSTIMULATORS

• US 20150018728A1
• Filed: 01/24/2013
• Published: 01/15/2015
• Est. Priority Date: 01/26/2012
• Status: Abandoned Application

• Current Assignee: BlueWind Medical Ltd.
• Original Assignee: BlueWind Medical Ltd.
• Inventors: Gross, Yossi, Oron, Gur, Neeman, Dany, Ronen, Shlomo, Stern-Cohen, Ali
• Application Number:
  US14/374,375
• Publication Number:
  US 20150018728A1
• Time in Patent Office: Days
• US Class Current: 601/46
• CPC Class Codes: A61H 23/00 Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms apparatus for passive exercising A61H1/00; generating or transmitting mechanical vibrations in general B06B
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• 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 1/36167 Timing, e.g. stimulation onset
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source
• CPC Class Codes: A61N 5/022 Apparatus adapted for a specific treatment
• CPC Class Codes: A61N 5/04 Radiators for near-field treatment

Abstract

Apparatus for applying a treatment (216) to at least one tissue of a subject is described, the apparatus comprising a transmitting unit (210) configured to transmit a wireless power signal (214), a first implant (202a), and a second implant (202b), each of the implants being configured to receive the power signal and to apply the treatment asynchronously to each other, in response to the power signal. Other embodiments are also described.

Claims

1. Apparatus for applying a treatment to at least one tissue of a subject, the apparatus comprising:

a transmitting unit, configured to transmit a wireless power signal; and

a first implant and a second implant, each of the implants being configured to receive the power signal and to apply the treatment asynchronously to each other, in response to the power signal.

2. The apparatus according to claim 1, wherein the first implant comprises a plurality of first implants, the first implants being configured to apply the treatment synchronously with respect to each other, in response to the power signal.

3. The apparatus according to claim 1, wherein at least one of the implants comprises a subcutaneously-implantable implant.

4. The apparatus according to claim 1, wherein the implants are configured to receive power from the power signal.

5. The apparatus according to any one of claims 1-4, wherein the first implant does not comprise a power supply that is able to continuously power the first implant for a period greater than one minute.

6. The apparatus according to claim 5, wherein the second implant does not comprise a power supply that is able to continuously power the second implant for a period greater than one minute.

7. The apparatus according to any one of claims 1-4, wherein:

the first implant is configured to receive the power signal, and to apply the treatment after a first duration following receiving the power signal, and

the second implant is configured to receive the power signal, and to apply the treatment after a second duration following receiving the power signal, the second duration being longer than the first duration.

8. The apparatus according to any one of claims 1-4, wherein:

the transmitting unit is configured to transmit a plurality of wireless power signals, comprising at least first and second wireless power signals,

the first implant is configured to receive power from the first power signal, and

the second implant is configured to receive power from the second power signal.

9. The apparatus according to claim 8, wherein the transmitting unit is configured to transmit the first and second power signals asynchronously.

10. The apparatus according to claim 8, wherein the first implant is configured to apply the treatment in response to the first power signal, and the second implant is configured to apply the treatment in response to the second power signal.

11. The apparatus according to claim 8, wherein:

the transmitting unit is configured to configure the first and second power signals to have respective first and second characteristics that differ from one another,

the first implant is configured to receive power from the first power signal, in response to an effect of the first characteristic on the first implant, and

the second implant is configured to receive power from the second power signal, in response to an effect of the second characteristic on the second implant.

12. The apparatus according to claim 11, wherein:

the first and second characteristics include respective first and second frequencies, and

the transmitting unit is configured to configure the first and second power signals to have the respective first and second frequencies.

13. The apparatus according to claim 11, wherein:

the first and second characteristics include respective first and second codes, and

the transmitting unit is configured to configure the first and second power signals to have the respective first and second codes.

14. The apparatus according to any one of claims 1-4, wherein the transmitting unit is configured to transmit a control signal, and each implant is configured to apply the treatment in response to the control signal.

15. The apparatus according to claim 14, wherein the transmitting unit is configured to modulate the control signal onto the power signal.

16. The apparatus according to claim 14, wherein:

the first implant is configured to receive the control signal, and to apply the treatment after a first duration following receiving the control signal, and

the second implant is configured to receive the control signal, and to apply the treatment after a second duration following receiving the control signal, the second duration being longer than the first duration.

17. The apparatus according to claim 16, wherein the transmitting unit is configured to configure the power signal to be at least as long as the second duration.

18. The apparatus according to claim 14, wherein:

the transmitting unit is configured to transmit a plurality of control signals, including at least first and second control signals,

the first implant is configured to apply the treatment in response to the first control signal, and

the second implant is configured to apply the treatment in response to the second control signal.

19. The apparatus according to claim 18, wherein the transmitting unit is configured to transmit the power signal at least during the transmission of both the first and the second control signals.

20. The apparatus according to claim 18, wherein the first and second implants are each configured to apply the treatment while receiving the first and second control signals, respectively.

21. The apparatus according to any one of claims 1-4, wherein the apparatus comprises a plurality of implants that comprise at least the first and second implants, and wherein the apparatus is configured such that each implant is implantable at a pre-selected distance from another one of the implants.

22. The apparatus according to claim 21, further comprising a support to which at least two of the implants are couplable, at the pre-selected distance from one another.

23. The apparatus according to claim 22, wherein the support comprises a stent, configured to be implanted in a tubular structure of the subject.

24. The apparatus according to claim 22, wherein the support comprises a cuff, configured to be disposed around a tubular structure of the subject.

25. The apparatus according to claim 22, wherein the support comprises a delivery device, configured to facilitate the implantation at the pre-selected distance.

26. The apparatus according to claim 25, wherein:

the delivery device has a distal portion and a proximal portion,

the delivery device comprises a release member at the proximal portion, and

the at least two of the implants are decouplable from the distal portion of the delivery device, by activation of the release member at the proximal portion.

27. Apparatus for applying a treatment to a tissue of a subject,

the apparatus comprising a medical implant,

the implant comprising a plurality of components,

at least one of the components comprising a circuitry unit, which is injectably implantable into the subject, and

at least one of the components comprising an effector element, which is not injectably implantable into the subject, and which is flexibly coupled to the circuitry unit.

28. The apparatus according to claim 27, wherein the implant does not comprise a power supply that is able to continuously power the implant for a period greater than one minute.

29. The apparatus according to any one of claims 27-28, wherein the effector element comprises an electrode.

30. The apparatus according to claim 29, further comprising a nerve cuff, the nerve cuff comprising the electrode.

31. Apparatus for treating a condition of a subject, the apparatus comprising an implant, the implant:

having a skin-facing side on which at least one effector element is disposed,

having an opposing side on which no effector element is disposed,

being configured to be implanted at an implantation site that is deeper than a surface of skin of the subject, such that the skin-facing side faces superficially, and

comprising a circuitry unit, configured to drive the effector element to apply a treatment that stimulates sensory fibers of the skin of the subject.

32. The apparatus according to claim 31, wherein the implant is configured to be implanted subcutaneously.

33. The apparatus according to claim 31, wherein the implant is configured to be implanted intradermally.

34. The apparatus according to claim 31, wherein the implant does not comprise a power supply that is able to continuously power the implant for a period greater than one minute.

35. The apparatus according to claim 31, wherein the effector element comprises a vibrating element, and wherein the circuitry unit is configured to drive the vibrating element to stimulate the sensory fibers, by driving the vibrating element to vibrate.

36. The apparatus according to claim 31, wherein the implant is configured not to induce contraction of a muscle of the subject.

37. The apparatus according to any one of claims 31-36, wherein the effector element is disposed farther than 1 mm from any lateral edge of the implant.

38. The apparatus according to claim 37, wherein the effector element is disposed farther than 2 mm from any lateral edge of the implant.

39. The apparatus according to claim 38, wherein the effector element is disposed farther than 5 mm from any lateral edge of the implant.

40. The apparatus according to any one of claims 31-36, further comprising a transmitting unit, configured to transmit wireless power, and wherein the implant is configured to receive the wireless power.

41. The apparatus according to claim 40, wherein the implant is configured to apply the treatment in response to receiving the wireless power.

42. The apparatus according to claim 41, wherein the implant is configured to apply the treatment only when the implant receives the wireless power.

43. The apparatus according to any one of claims 31-36, wherein the implant has a height, from the skin-facing side to the opposing side of the implant, that is smaller than both a longest length and a width of the implant.

44. The apparatus according to claim 43, wherein the implant is generally flat.

45. The apparatus according to claim 43, wherein the implant is generally shaped to define a prism that has a transverse cross-sectional shape that is generally semicircular.

46. The apparatus according to claim 43, wherein the implant is generally shaped to define a prism that has a transverse cross-sectional shape that is generally elliptical.

47. The apparatus according to any one of claims 31-36, wherein the implant is configured not to directly initiate action potentials in a nerve of the subject.

48. The apparatus according to claim 47, wherein the implant is configured not to directly initiate the action potentials in the nerve of the subject, by being configured to apply the treatment that stimulates sensory fibers of the skin of the subject from an implantation site that is farther than 1 cm from the nerve of the subject.

49. The apparatus according to claim 48, wherein the implant is configured not to directly initiate the action potentials in the nerve of the subject, by being configured to apply the treatment that stimulates sensory fibers of the skin of the subject from an implantation site that is farther than 2 cm from the nerve of the subject.

50. The apparatus according to claim 49, wherein the implant is configured not to directly initiate the action potentials in the nerve of the subject, by being configured to apply the treatment that stimulates sensory fibers of the skin of the subject from an implantation site that is farther than 3 cm from the nerve of the subject.

51. The apparatus according to claim 47, wherein the effector element comprises an electrode, and wherein the circuitry unit is configured to drive the electrode to stimulate the sensory fibers, by driving a current through the electrode.

52. The apparatus according to claim 51, wherein the implant is configured not to directly initiate the actions potentials in the nerve of the subject, by the circuitry unit being configured to configure the current not to directly initiate the action potentials in the nerve of the subject.

53. The apparatus according to claim 47, wherein the implant is configured not to directly initiate action potentials in the nerve of the subject, by being configured to direct the treatment superficially from the implant.

54. The apparatus according to claim 53, wherein the implant is configured to direct the treatment superficially, by the effector element being disposed on the skin-facing superficial side of the implant.

55. The apparatus according to claim 53, wherein the implant is configured to direct the treatment superficially, by the implant comprising an insulating member, disposed on the opposing side of the implant.

56. The apparatus according to any one of claims 31-36, wherein the implant is configured to induce a sensation in the skin of the subject.

57. The apparatus according to any one of claims 31-36, wherein the effector element comprises an electrode, and wherein the circuitry unit is configured to drive the electrode to stimulate the sensory fibers, by driving a current through the electrode.

58. The apparatus according to claim 57, wherein the implant is configured, when implanted at the implantation site, to drive the current superficially to the implant.

59. The apparatus according to any one of claims 31-36, wherein the implant further comprises an accelerometer, configured to detect movement of at least the implant.

60. The apparatus according to claim 59, wherein the implant is configured to be implanted in a limb of the subject, and wherein the accelerometer is configured to detect movement of the limb of the subject.

61. The apparatus according to claim 60, wherein the implant is configured to be implanted in a limb of the subject that is affected by tremor, and wherein the accelerometer is configured to detect the tremor of the limb of the subject.

62. The apparatus according to claim 59, wherein the circuitry unit is configured to configure the treatment at least in part responsively to the detection of the movement.

63. The apparatus according to claim 62, wherein the movement has a phase, and wherein the circuitry unit is configured to configure the treatment by applying the treatment in phase with the phase of the movement.

64. The apparatus according to claim 63, wherein the circuitry unit is configured to configure the treatment by altering an angle of phase of the treatment with respect to the phase of the movement.

65. The apparatus according to claim 62, wherein the treatment includes application of an electrical current, and wherein the circuitry unit is configured to configure the treatment by configuring one or more parameters of the current selected from the group consisting of:

an amplitude of the current, a frequency of the current, a pulse-width of the current, and an on-off pattern of the current.

66. Apparatus for applying a treatment to a tissue of a subject, the apparatus comprising a medical implant, the implant comprising:

an injectable circuitry unit;

at least one effector element, coupled to the circuitry unit, and configured to be driven by the circuitry unit to apply the treatment;

at least one anchor, coupled to the circuitry unit, and having a delivery configuration, and an anchoring configuration in which, when the implant is implanted in the tissue of the subject, the anchor inhibits movement of the implant along a longitudinal axis thereof.

67. The apparatus according to claim 66, wherein the implant does not comprise a power supply that is able to continuously power the implant for a period greater than one minute.

68. The apparatus according to any one of claims 66-67, further comprising a delivery device, shaped to define a lumen, and wherein:

the implant is disposable in, slidable through, and slidable out of the lumen of the delivery device, and is deliverable to the tissue of the subject by sliding the device out of the lumen of the delivery device, and

the anchors are configured;

when the implant is disposed in the lumen of the delivery device, to be constrained by the delivery device in the delivery configuration, and

when the implant is slid out of the lumen of the delivery device, to automatically move toward the anchoring configuration.

69. Apparatus for applying at least one treatment to a subject, the apparatus comprising:

a first transmitting unit, configured to transmit a first wireless signal;

a second transmitting unit, configured to transmit a second wireless signal;

a first implant, configured to be implanted at a first implantation site of the subject, and to apply the at least one treatment to the subject in response to the first wireless signal; and

a second implant, configured to be implanted at a second implantation site of the subject, to apply the at least one treatment to the subject in response to the second wireless signal, and not to apply the at least one treatment to the subject in response to the first wireless signal.

70. The apparatus according to claim 69, wherein each implant does not comprise a power supply that is able to continuously power the implant for a period greater than one minute.

71. The apparatus according to claim 69, wherein the first transmitting unit is configured to configure the first wireless signal to have a first frequency, and the second transmitting unit is configured to configure the second wireless signal to have a second frequency that is different from the first frequency.

72. The apparatus according to claim 69, wherein:

the first and second wireless signals comprise first and second wireless power signals,

the first implant is configured to receive power from the first power signal, and

the second implant is configured to receive power from the second power signal, and not to receive power from the first power signal.

73. The apparatus according to claim 69, wherein the transmitting units are configured to be coupled to the subject.

74. The apparatus according to claim 69, wherein the implants are configured to be implanted such that the implants are disposed, at least part of the time, within 30 cm of each other.

75. The apparatus according to any one of claims 69-74, wherein the first implant is configured to be implanted in a first leg of the subject and the second implant is configured to be implanted in a second leg of the subject.

76. The apparatus according to claim 75, wherein the first transmitting unit is configured to be coupled to the first leg of the subject, and the second transmitting unit is configured to be coupled to the second leg of the subject.

77. A method for use with a medical implant for implanting at a tissue of a subject, the method comprising:

percutaneously delivering at least part of at least one temporary electrode to the tissue of the subject;

electrically stimulating the tissue of the subject for between 1 and 120 minutes, using the temporary electrode;

receiving information indicative of a desired change in a sensation experienced by the subject between a time before a start of the electrical stimulation and a time after a start of the electrical stimulation; and

at least in part responsively to the received information, implanting the medical implant at the tissue of the subject.

78. The method according to claim 77, wherein electrically stimulating comprises electrically stimulating the tissue for between 10 and 30 minutes.

79. The method according to claim 77, wherein receiving the information indicative of the desired change in the sensation comprises receiving information indicative of a desired change in a pain experienced by the subject.

80. The method according to claim 77, wherein receiving the information indicative of the desired change in the sensation comprises receiving information indicative of paresthesia induced by the electrical stimulation of the tissue of the subject.

81. The method according to claim 77, further comprising:

receiving a first value indicative of the factor before the electrical stimulation; and

receiving a second value indicative of the factor after the electrical stimulation,

wherein receiving the information indicative of the change in the factor comprises receiving a value indicative of a difference between the first value and the second value.

82. The method according to claim 77, wherein receiving the information indicative of the change in the factor, comprises receiving information indicative of a change in pain experienced by the subject.

83. The method according to any one of claims 77-82, wherein the tissue of the subject includes a tibial nerve of the subject, and wherein stimulating the tissue of the subject comprises stimulating the tibial nerve of the subject.

84. A method for applying a treatment to at least one tissue of a subject, the method comprising:

transmitting a wireless power signal;

receiving the power signal using a first implant and a second implant, each of the implants being implanted at the tissue of the subject; and

in response to receiving the power signal, asynchronously applying the treatment using the first implant and using the second implant.

85. The method according to claim 84, wherein transmitting comprises extracorporeally transmitting the wireless power signal.

86. The method according to claim 84, wherein receiving the power signal comprises subcutaneously receiving the power signal using the first and second implants.

87. The method according to claim 84, wherein receiving the power signal comprises receiving the power signal using the first and second implants, after they have been transluminally implanted.

88. The method according to claim 84, wherein asynchronously applying the treatment comprises:

receiving the power signal using the first implant, and applying the treatment using the first implant after a first duration following receiving the power signal; and

receiving the power signal using the second implant, and applying the treatment using the second implant after a second duration following receiving the power signal, the second duration being longer than the first duration.

89. The method according to any one of claims 84-88, wherein:

transmitting the power signal comprises transmitting a plurality of wireless power signals, including at least first and second wireless power signals, and

receiving the power signal comprises receiving the first power signal using the first implant, and receiving the second power signal using the second implant.

90. The method according to claim 89, wherein transmitting comprises transmitting the first and second power signals asynchronously.

91. The method according to claim 89, wherein applying the treatment comprises:

applying the treatment using the first implant in response to the first power signal and not in response to the second power signal; and

applying the treatment using the second implant in response to the second power signal and not in response to the first power signal.

92. The method according to claim 91, wherein applying the treatment comprises:

applying the treatment using the first implant while receiving the first power signal; and

applying the treatment using the second implant while receiving the second power signal.

93. The method according to claim 89, wherein:

transmitting the first and second power signals comprises transmitting first and second power signals that have respective first and second characteristics that differ from one another,

receiving power from the first power signal, using the first implant, in response to an effect of the first characteristic on the first implant, and

receiving power from the second power signal, using the second implant, in response to an effect of the second characteristic on the second implant.

94. The method according to claim 93, wherein:

the first and second characteristics include respective first and second frequencies, and

transmitting comprises transmitting first and second power signals that have the respective first and second frequencies.

95. The method according to claim 93, wherein:

the first and second characteristics include respective first and second codes, and

transmitting comprises transmitting first and second power signals that have the respective first and second codes.

96. The method according to any one of claims 84-88, further comprising:

transmitting a control signal; and

receiving the control signal using the first and second implants,

wherein asynchronously applying the treatment comprises, in response to the control signal, asynchronously applying the treatment using the first implant and using the second implant.

97. The method according to claim 96, wherein transmitting the control signal comprises modulating the control signal onto the power signal.

98. The method according to claim 96, wherein asynchronously applying the treatment comprises:

receiving the control signal using the first implant, and applying the treatment using the first implant after a first duration following receiving the control signal; and

receiving the control signal using the second implant, and applying the treatment using the second implant after a second duration following receiving the control signal, the second duration being longer than the first duration.

99. The method according to claim 98, wherein transmitting the power signal comprises transmitting the power signal for a duration that is at least as long as the second duration.

100. The method according to claim 96, wherein:

transmitting the control signal comprises transmitting a plurality of control signals, comprising at least first and second control signals, and

asynchronously applying the treatment comprises;

applying the treatment using the first implant in response to the first control signal; and

applying the treatment using the second implant in response to the second control signal.

101. The method according to claim 100, wherein transmitting the power signal comprises transmitting the power signal at least during the transmission of both the first and the second control signals.

102. The method according to claim 100, wherein applying the treatment using the first implant comprises applying the treatment using the first implant while receiving the first control signal, and wherein applying the treatment using the second implant comprises applying the treatment using the second implant while receiving the second control signal.

103. The method according to any one of claims 84-88, wherein receiving the power signal comprises receiving the power signal using the first and second implants, after each of the implants has been implanted at a pre-selected distance from the other one of the implants.

104. The method according to claim 103, wherein the implants are couplable to a support at the pre-selected distance from one another, and wherein receiving the power signal comprises receiving the power signal using the first and second implants, after the support has been implanted in a tubular structure of the subject.

105. The method according to claim 104, wherein the support includes a stent, and wherein receiving the power signal comprises receiving the power signal using the first and second implants, after the stent has been implanted in the tubular structure of the subject.

106. The method according to claim 104, wherein the support includes a cuff, and wherein receiving the power signal comprises receiving the power signal using the first and second implants, after the cuff has been implanted in the tubular structure of the subject.

107. The method according to claim 104, wherein the support includes a delivery device, and wherein receiving the power signal comprises receiving the power signal using the first and second implants, after the stent has been implanted using the delivery device.

108. The method according to claim 107, wherein receiving the power signal comprises receiving the power signal using the first and second implants, after the stent has been decoupled from the delivery device.

109. A method for treating a condition of a subject, the method comprising:

driving a subcutaneously-implanted effector element to apply a treatment that stimulates sensory fibers of skin of the subject; and

using an inhibiting element, inhibiting direct stimulation of a nerve of the subject that is closest to the effector element, during the application of the treatment by the effector element.

110. The method according to claim 109, wherein inhibiting the direct stimulation of the nerve comprises preventing direct initiation of action potentials in the nerve.

111. The method according to claim 109, wherein inhibiting the direct stimulation of the nerve comprises preventing direct initiation of action potentials in an ulnar nerve of the subject.

112. The method according to claim 109, wherein inhibiting the direct stimulation of the nerve comprises preventing direct initiation of action potentials in a median nerve of the subject.

113. The method according to claim 109, wherein inhibiting the direct stimulation of the nerve comprises preventing direct initiation of action potentials in a nerve of the subject that is disposed deeper than the inhibiting element.

114. The method according to claim 109, wherein driving the effector element to apply the treatment comprises driving the effector element to vibrate.

115. The method according to claim 109, wherein inhibiting further comprises inhibiting direct induction of contraction of a muscle of the subject.

116. The method according to claim 109, wherein driving the effector element comprises driving the effector element using an implanted circuitry unit.

117. The method according to claim 109, wherein driving the effector element comprises wirelessly driving the effector element.

118. The method according to any one of claims 109-117, wherein inhibiting the direct stimulation of the nerve comprises directing the treatment away from the nerve.

119. The method according to claim 118, wherein directing the treatment comprises directing the treatment superficially.

120. The method according to any one of claims 109-117, wherein driving the effector element comprises driving the effector element after an implant that includes the effector element has been subcutaneously implanted in the subject.

121. The method according to claim 120, wherein the effector element is disposed only on a skin-facing side of the implant, and wherein inhibiting the direct stimulation of the nerve comprises driving the effector element that is disposed on the skin-facing side of the implant.

122. The method according to claim 120, wherein inhibiting the direct stimulation of the nerve comprises insulating the nerve from the treatment using the inhibiting element.

123. The method according to claim 122, wherein insulating comprises electrically insulating the nerve from the treatment.

124. The method according to claim 122, wherein insulating comprises mechanically insulating the nerve from the treatment.

129. The method according to any one of claims 109-117, wherein inhibiting the direct stimulation of the nerve comprises inhibiting the direct stimulation of the nerve by driving the effector element after an implant that includes the effector element has been implanted at an implantation site that is farther than 1 cm from the nerve of the subject.

130. The method according to claim 129, wherein inhibiting the direct stimulation of the nerve comprises inhibiting the direct stimulation of the nerve by driving the effector element after an implant that includes the effector element has been implanted at an implantation site that is farther than 2 cm from the nerve of the subject.

131. The method according to claim 130, wherein inhibiting the direct stimulation of the nerve comprises inhibiting the direct stimulation of the nerve by driving the effector element after an implant that includes the effector element has been implanted at an implantation site that is farther than 3 cm from the nerve of the subject.

132. The method according to any one of claims 109-117, wherein the effector element includes an electrode, and wherein driving the effector element to apply the treatment comprises driving a current through the electrode.

133. The method according to claim 132, wherein inhibiting the direct stimulation of the nerve comprises configuring the current not to directly stimulate the nerve of the subject.

134. The method according to claim 132, wherein inhibiting the direct stimulation comprises directing the current superficially.

135. The method according to any one of claims 109-117, further comprising detecting movement of a limb of the subject in which the effector element has been implanted, and wherein driving the effector element comprises driving the effector element at least in part responsively to the detected movement.

136. The method according to claim 135, wherein detecting the movement comprises detecting movement of the limb of the subject by detecting movement of an accelerometer that is coupled to the effector element.

137. The method according to claim 135, wherein detecting the movement of the limb of the subject comprises detecting tremor of the limb of the subject.

138. The method according to claim 135, wherein driving the effector element at least in part responsively to the detected movement comprises configuring the treatment at least in part responsively to the detected movement.

139. The method according to claim 138, wherein the movement of the limb has a frequency, and wherein configuring the treatment comprises configuring the treatment to have the frequency of the movement of the limb.

140. The method according to claim 139, wherein configuring the treatment comprises configuring the treatment to be in phase with a phase of the movement of the limb.

141. The method according to claim 139, wherein configuring the treatment comprises configuring the treatment to be out of phase with a phase of the movement of the limb.

125. The method according to claim 125, wherein driving the effector element comprises driving the effector element after an implant that (1) has a height from a lower portion to an upper portion of the implant that is smaller than both a longest length and a width of the implant, and (2) includes the effector element, has been subcutaneously implanted in the subject.

126. The method according to claim 125, wherein driving the effector element comprises driving the effector element after an implant that (1) is generally shaped to define a prism that has a transverse cross-sectional shape that is generally semicircular, and (2) includes the effector element, has been subcutaneously implanted in the subject.

127. The method according to claim 125, wherein driving the effector element comprises driving the effector element after an implant that (1) is generally shaped to define a prism that has a transverse cross-sectional shape that is generally elliptical, and (2) includes the effector element, has been subcutaneously implanted in the subject.

128. The method according to claim 125, wherein driving the effector element comprises driving the effector element after an implant that (1) is generally flat, and (2), includes the effector element, has been subcutaneously implanted in the subject.

142. An implant, comprising:

a circuitry unit, configured to receive power wirelessly;

a lead, having a proximal end and a distal end, the proximal end configured to be coupled to the circuitry unit; and

an array of microelectrodes, configured to be coupled to the circuitry unit by the lead, and configured to be coupled to a carotid sinus of a patient.

143. The implant according to claim 142, wherein the microelectrodes are configured to contact one or more baroreceptors in the carotid sinus.

144. The implant according to claim 142, wherein the circuitry unit is configured to drive the microelectrodes to deliver a current between 1 and 100 microamps.

145. The implant according to any one of claims 142-144, wherein the circuitry unit is configured to separately drive each microelectrode to apply a respective voltage.

146. An implant, comprising:

a circuitry unit, configured to receive power wirelessly; and

an array of microelectrodes, disposed on an outer surface of the circuitry unit.