Electrode assembly for nerve control

• US 7,346,398 B2
• Filed: 09/23/2004
• Issued: 03/18/2008
• Est. Priority Date: 08/31/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: BioControl Medical (B.C.M) Ltd.
• Inventors: Cohen, Ehud, Gross, Yossi, Ayal, Shai
• Primary Examiner(s): Sykes; Angela D.
• Assistant Examiner(s): STOKLOSA, JOSEPH A
• Application Number:
  US10/948,516
• Publication Number:
  US 20050038490A1
• Time in Patent Office: 1,272 Days
• Field of Search: 607/40, 607/41, 607/46, 607/117, 607/118
• US Class Current: 607/118
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

Apparatus is provided for applying current to a nerve. A cathode is adapted to be placed in a vicinity of a cathodic longitudinal site of the nerve and to apply a cathodic current to the nerve. A primary inhibiting anode is adapted to be placed in a vicinity of a primary anodal longitudinal site of the nerve and to apply a primary anodal current to the nerve. A secondary inhibiting anode is adapted to be placed in a vicinity of a secondary anodal longitudinal site of the nerve and to apply a secondary anodal current to the nerve, the secondary anodal longitudinal site being closer to the primary anodal longitudinal site than to the cathodic longitudinal site.

Claims

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

a housing;

a cathode, coupled to the housing such that the cathode is brought into a vicinity of a cathodic site of the nerve when the housing is applied to the nerve; and

a plurality of anodes, coupled to the housing such that the anodes are brought into vicinities of respective anodal longitudinal sites of the nerve when the housing is applied to the nerve, and configured to apply respective anodal currents to the nerve, that define, in combination, an anodal activation function having;

(a) a hyperpolarizing portion thereof having a maximum hyperpolarizing amplitude, and (b) a depolarizing portion thereof, having a maximum depolarizing amplitude corresponding to a depolarizing site on the nerve, wherein a site corresponding to the hyperpolarizing portion is between the depolarizing site and the cathodic site, and wherein the maximum hyperpolarizing amplitude is at least five times greater than the maximum depolarizing amplitude.

2. Apparatus according to claim 1, wherein a distance of a first one of the anodes to an axis of the nerve is less than a distance of a second one of the anodes to the axis, the first one of the anodes being coupled to the housing closer to the cathode than the second one of the anodes is to the cathode.

3. Apparatus according to claim 1, wherein a surface area of a first one of the anodes is less than a surface area of a second one of the anodes, the first one of the anodes being coupled to the housing closer to the cathode than the second one of the anodes is to the cathode.

4. Apparatus according to claim 1, wherein one of the anodes is positioned within the housing so as to reduce a virtual cathode effect induced by another one of the anodes.

5. Apparatus according to claim 1, wherein the cathode and anodes are disposed such that a first one of the anodal longitudinal sites is between the cathodic site and a second one of the anodal longitudinal sites.

6. Apparatus according to claim 5, wherein the anodes are disposed such that the second one of the anodal longitudinal sites is between the first one of the anodal longitudinal sites and a third one of the anodal longitudinal sites.

7. Apparatus according to claim 5, wherein the anodes are adapted such that a current density of the anodal current applied at the second one of the anodal longitudinal sites has a lower magnitude than a magnitude of a current density of the anodal current applied at the first one of the anodal longitudinal sites.

8. Apparatus according to claim 7, wherein the anodes are adapted such that a ratio of the current density of the anodal current applied at the first site to the current density of the anodal current applied at the second site is at least 2:

1.

9. Apparatus according to claim 7, wherein the anodes are adapted such that a ratio of the current density of the anodal current applied at the first site to the current density of the anodal current applied at the second site is at least 5:

1.

10. Apparatus according to claim 1, wherein the cathode and the plurality of anodes are coupled to the housing such that all of the anodal longitudinal sites are on a same side of the cathodic site.

11. Apparatus according to claim 1, further comprising a primary fiber-selection anode, coupled to the housing such that the cathode is between the primary fiber-selection anode and the plurality of anodes.

12. Apparatus according to claim 1, wherein the plurality of anodes comprises:

a primary inhibiting anode, coupled to the housing such that the primary inhibiting anode is brought into a vicinity of a primary anodal longitudinal site of the nerve when the housing is applied to the nerve; and

a secondary inhibiting anode, coupled to the housing such that the secondary inhibiting anode is brought into a vicinity of a secondary anodal longitudinal site of the nerve when the housing is applied to the nerve, the primary anodal longitudinal site between the cathodic site and the secondary anodal longitudinal site, and

wherein the apparatus further comprises a control unit, configured to;

drive the cathode to apply a cathodic current to the nerve, drive the primary inhibiting anode to apply a primary anodal current to the nerve, and drive the secondary inhibiting anode to apply a secondary anodal current to the nerve.

13. Apparatus according to claim 12, further comprising a first resistive element coupled between the control unit and the primary inhibiting anode, and a second resistive element coupled between the control unit and the secondary inhibiting anode, the second resistive element having a resistance higher than a resistance of the first resistive element.

14. Apparatus according to claim 12, further comprising exactly one lead that leaves the control unit for coupling the control unit to the primary and secondary inhibiting anodes.

15. Apparatus according to claim 12, further comprising respective leads that leave the control unit and couple the control unit to the primary and secondary inhibiting anodes.

16. Apparatus according to claim 12, wherein the control unit is adapted to configure a current density of the secondary anodal current to be of lower magnitude than a current density of the primary anodal current.

39. Apparatus according to claim 1, further comprising a control unit, configured to:

drive the cathode to apply a cathodic current to the nerve, and

drive the anodes to apply the respective anodal currents to the nerve that, in combination, define the anodal activation function.

40. Apparatus according to claim 1, wherein a longitudinal width of a first one of the anodes is less than a longitudinal width of a second one of the anodes, the first one of the anodes being coupled to the housing closer to the cathode than the second one of the anodes is to the cathode.

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

applying cathodic current in a vicinity of a cathodic site of the nerve; and

applying anodal currents in a vicinity of respective anodal longitudinal sites of the nerve, the currents defining, in combination, an anodal activation function having;

(a) a hyperpolarizing portion thereof having a maximum hyperpolarizing amplitude, and (b) a depolarizing portion thereof, having a maximum depolarizing amplitude corresponding to a depolarizing site on the nerve distal, wherein a site corresponding to the hyperpolarizing portion is between the depolarizing site and the cathodic site, and wherein the maximum hyperpolarizing amplitude is at least five times greater than the maximum depolarizing amplitude.

18. A method according to claim 17, wherein applying the anodal currents comprises applying first and second ones of the anodal currents from respective first and second ones of the anodal longitudinal sites, wherein a distance of the first one of the anodal longitudinal sites to an axis of the nerve is less than a distance of the second one of the anodal longitudinal sites to the axis, the first one of the anodal longitudinal sites being longitudinally closer to the cathodic site than the second one of the anodal longitudinal sites is to the cathodic site.

19. A method according to claim 17, wherein applying the anodal currents comprises applying a first one of the anodal currents from a first one of the anodal longitudinal sites positioned so as to reduce a virtual cathode effect induced by applying a second one of the anodal currents.

20. A method according to claim 17, wherein applying the anodal currents comprises applying a first one of the anodal currents from a first one of the anodal longitudinal sites, and a second one of the anodal currents from a second one of the anodal longitudinal sites, the first one of the anodal longitudinal sites between the cathodic site and the second one of the anodal longitudinal sites.

21. A method according to claim 20, wherein applying the anodal currents comprises applying a third one of the anodal currents from a third one of the anodal longitudinal sites, the second one of the anodal longitudinal sites between the first one of the anodal longitudinal sites and the third one of the anodal longitudinal sites.

22. A method according to claim 20, wherein applying the anodal currents comprises configuring a current density of the second one of the anodal currents to have a lower magnitude than a magnitude of a current density of the first one of the anodal currents.

23. A method according to claim 20, wherein applying the anodal currents comprises configuring the first and second ones of the anodal currents such that a ratio of the current density of the first one of the anodal currents to the current density of the second one of the anodal currents is at least 2:

1.

24. A method according to claim 22, wherein applying the anodal currents comprises configuring the first and second ones of the anodal currents such that a ratio of the current density of the first one of the anodal currents to the current density of the second one of the anodal currents is at least 5:

1.

25. A method according to claim 17, wherein applying the anodal currents comprises applying all of the anodal currents from a same side of the cathodic site.

26. A method according to claim 17, comprising applying a primary fiber-selection anodal current at a primary fiber-selection anodal site, wherein the cathodic site is between the primary fiber-selection anodal site and the anodal longitudinal sites.

27. A method according to claim 17, wherein applying the anodal currents comprises:

applying a primary inhibiting anodal current in a vicinity of a primary anodal longitudinal site of the nerve; and

applying a secondary inhibiting anodal current in a vicinity of a secondary anodal longitudinal site of the nerve, the primary anodal longitudinal site between the cathodic site and the secondary anodal longitudinal site.

28. A method according to claim 27, wherein applying the primary and secondary inhibiting anodal currents comprises applying the primary and secondary inhibiting anodal currents through respective first and second resistive elements, the second resistive element having a resistance higher than a resistance of the first resistive element.

29. A method according to claim 27, wherein applying the primary and secondary inhibiting anodal currents comprises configuring a current density of the secondary inhibiting anodal current to be of lower magnitude than a current density of the primary inhibiting anodal current.

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

a housing;

a cathode, coupled to the housing such that the cathode is brought into in a vicinity of a cathodic site of the nerve when the housing is applied to the nerve; and

first and second anodes, coupled to the housing such that the anodes are brought into vicinities of respective first and second anodal longitudinal sites of the nerve that are on a same side of the cathodic site when the housing is applied to the nerve, and configured to apply respective first and second anodal currents to the nerve, that define, in combination, an anodal activation function having;

(a) a hyperpolarizing portion thereof having a maximum hyperpolarizing amplitude, and (b) a depolarizing portion thereof, having a maximum depolarizing amplitude corresponding to a depolarizing site on the nerve,

wherein a site corresponding to the hyperpolarizing portion is between the depolarizing site and the cathodic site, and

wherein the maximum hyperpolarizing amplitude is at least five times greater than the maximum depolarizing amplitude.

31. Apparatus according to claim 30, wherein a distance of the first anode to an axis of the nerve is less than a distance of the second anode to the axis, the first anode being coupled to the housing closer to the cathode than the second anode is to the cathode.

32. Apparatus according to claim 30, wherein a surface area of the first anode is less than a surface area of the second anode, the first anode being coupled to the housing closer to the cathode than the second anode is to the cathode.

33. Apparatus according to claim 30, wherein one of the anodes is positioned within the housing so as to reduce a virtual cathode effect induced by the other one of the anodes.

34. Apparatus according to claim 30, and further comprising a third anode, coupled to the housing such that the cathode is between the first anode and the third anode.

41. Apparatus according to claim 30, further comprising a control unit, configured to:

drive the cathode to apply a cathodic current to the nerve, and

drive the anodes to apply the respective anodal currents to the nerve that, in combination, define the anodal activation function.

42. Apparatus according to claim 30, wherein a longitudinal width of the first anode is less than a longitudinal width of the second anode, the first anode being coupled to the housing closer to the cathode than the second anode is to the cathode.

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

applying cathodic current in a vicinity of a cathodic site of the nerve; and

applying first and second anodal currents in a vicinity of respective first and second anodal longitudinal sites of the nerve that are on a same side of the cathodic site, the currents defining, in combination, an anodal activation function having;

(a) a hyperpolarizing portion thereof having a maximum hyperpolarizing amplitude, and (b) a depolarizing portion thereof having a maximum depolarizing amplitude corresponding to a depolarizing site on the nerve,

wherein a site corresponding to the hyperpolarizing portion is between the depolarizing site and the cathodic site, and

wherein the maximum hyperpolarizing amplitude is at least five times greater than the maximum depolarizing amplitude.

36. A method according to claim 35, wherein a distance of the first anodal longitudinal site to an axis of the nerve is less than a distance of the second anodal longitudinal site to the axis, and wherein the first anodal longitudinal site is longitudinally closer to the cathodic site than the second anodal longitudinal site is to the cathodic site.

37. A method according to claim 35, wherein applying the first anodal current comprises selecting the first anodal longitudinal site so as to reduce a virtual cathode effect induced by applying the second anodal current.

38. A method according to claim 35, comprising applying a third anodal current in a vicinity of a third anodal longitudinal site of the nerve, and wherein applying the cathodic current comprises applying the cathodic current between the first anodal longitudinal site and the third anodal longitudinal site.