Method and apparatus for neuromodulation and physiologic modulation for the treatment of metabolic and neuropsychiatric disease

• US 7,529,582 B1
• Filed: 06/21/2004
• Issued: 05/05/2009
• Est. Priority Date: 08/05/1998
• Status: Expired due to Term

• Current Assignee: Daniel J. Dilorenzo
• Original Assignee: DiLorenzo Biomedical, LLC
• Inventors: DiLorenzo, Daniel John
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US10/872,549
• Time in Patent Office: 1,779 Days
• Field of Search: None
• US Class Current: 607/2
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 2/00 Magnetotherapy
• CPC Class Codes: A61N 5/00 Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A method and apparatus for physiological modulation, including neural and gastrointestinal modulation, for the purposes of treating several disorders, including obesity, depression, epilepsy, and diabetes. This includes chronically implanted neural and neuromuscular modulators, used to modulate the afferent neurons of the sympathetic nervous system to induce satiety. Furthermore, this includes neuromuscular stimulation of the stomach to effect baseline and intermittent smooth muscle contraction to increase gastric intraluminal pressure, which induces satiety, and stimulate sympathetic afferent fibers, including those in the sympathetic trunk, splanchnic nerves, and greater curvature of the stomach, to augment the perception of satiety.

Claims

1. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal using a neuromodulator which activates the splanchnic nerve to induce weight loss.

2. The method recited in claim 1, wherein said activating the splanchnic nerve induces weight loss by reducing appetite.

3. The method recited in claim 2, wherein said activating the splanchnic nerve induces weight loss by increasing energy expenditure.

4. The method recited in claim 1 wherein said activating comprises activating the splanchnic nerve and inducing physiologic effects of splanchnic stimulation.

5. The method recited in claim 1 wherein said activating the splanchnic nerve induces weight loss by inducing satiety.

6. The method recited in claim 5 wherein said activating increases pyloric sphincter tone.

7. The method recited in claim 6 wherein said increased pyloric sphincter tone carries out the physiologic function of the pylorus, namely decreased gastric emptying.

8. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal using a neuromodulator to activate a splanchnic nerve, said splanchnic nerve comprising at least one of the superior splanchnic nerve, inferior splanchnic nerve, and other neural structure, said activating inducing physiological effects, and

wherein said physiologic effects include change in plasma glucose levels.

9. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal using a neuromodulator to activate a splanchnic nerve, said splanchnic nerve comprising at least one of the superior splanchnic nerve, inferior splanchnic nerve, and other neural structure, said activating inducing physiological effects, and

wherein said physiologic effects include change in plasma insulin levels.

10. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal using a neuromodulator to activate a splanchnic nerve, said splanchnic nerve comprising at least one of the superior splanchnic nerve, inferior splanchnic nerve, and other neural structure, said activating inducing physiological effects, and

wherein said physiologic effects include change in appetite.

11. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal to activate a splanchnic nerve, said splanchnic nerve comprising at least one of the superior splanchnic nerve, inferior splanchnic nerve, and other neural structure, and

wherein said activating the splanchnic nerve comprises;

activating the splanchnic nerve to increase plasma glucose levels, thereby reducing appetite; and

activating the splanchnic nerve to increase plasma catecholamine levels, thereby increasing energy expenditure.

12. A method for treating a medical condition comprising:

modulating the sympathetic nervous system, said modulating comprising delivering a signal using a neuromodulator to activate a splanchnic nerve to reduce insulin secretion.

13. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, and

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

14. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, and

selecting the duration of said current pulse to be within the range of 1 microsecond and 500 milliseconds.

15. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, wherein said current pulse is biphasic.

16. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, and

selecting the amplitude of said current pulse to be within the range of 1 microamp and 1000 milliamps.

17. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, and

selecting the interpulse interval to be within the range of 1 microsecond and 1000 milliseconds.

18. A method for activating the splanchnic nerve to treat obesity comprising:

applying a current pulse to the splanchnic nerve, and

selecting the duration of said current pulse to be between 100 microseconds and 400 microseconds.

19. A method for activating the splanchnic nerve to treat obesity comprising:

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

programming said treatment parameters to induce satiety, and

applying a current pulse to the splanchnic nerve with said pulse generator.

20. A method for treating a medical condition comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of a splanchnic nerve.

21. The method recited in claim 20, further comprising:

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

applying a sufficiently large energy field to stimulate the splanchnic nerve in general proximity to said first electrode.

22. The method recited in claim 20, further comprising:

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

applying a sufficiently large energy field with said first electrode to electrically couple with a second electrode remote from said first electrode, said energy field being sufficiently large to stimulate the splanchnic nerve in general proximity to said first electrode.

23. The method as recited in claim 22, further comprising implanting a pulse generator within a patient.

24. The method as recited in claim 22, further comprising:

implanting a pulse generator within a patient, remote from said splanchnic nerve, said pulse generator having an external portion adapted to function as said remote 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 external portion of said pulse generator.

25. The method recited in claim 24, further comprising providing a housing on said pulse generator adapted to function as said second electrode.

26. A method for treating a medical condition comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using bipolar stimulation of a splanchnic nerve.

27. A method for treating a user comprising delivering energy using a neuromodulator in communication with at least a portion of the intermediolateral nucleus at levels T1-T9.

28. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T6-T9.

29. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T1.

30. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T2.

31. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T3.

32. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T4.

33. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T5.

34. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T6.

35. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T7.

36. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T8.

37. The method of claim 27 wherein said neuromodulator is in communication with at least a portion of the intermediolateral nucleus at levels T9.

162. The method as in claim 27, wherein said energy is an electrical signal.

190. The method as in any one of claims 27, 38, or 49, wherein said energy is activating.

192. The method as in any one of claims 27, 38, or 49, wherein said energy is applied to control activity of intermediolateral nucleus.

194. The method as in any one of claims 27, 38, or 49, wherein said energy is applied to control body weight.

196. The method as in any one of claims 27, 38, or 49, wherein said energy is applied to control metabolic rate.

198. The method as in any one of claims 27, 38, or 49, wherein said energy is applied to control appetite.

200. The method as in any one of claims 27, 38, or 49, wherein said energy is applied to control satiety.

202. The method as in any one of claims 27, 38, 49, 81, 84, wherein said treating a user comprises the treatment of obesity.

204. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy modulates activity of sympathetic neurons.

206. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy increases metabolic rate.

208. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy decreases appetite.

210. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy influences body mass index.

212. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy causes a reduction in body fat composition.

231. The method as in any one of claims 27, 38, or 49, wherein delivery of said energy is performed using a spinal cord stimulation electrode.

233. The method as in any one of claims 27, 38, or 49, wherein said energy parameters are selected to cause weight reduction.

38. A method for treating a user comprising delivering energy using a neuromodulator in communication with projections from the intermediolateral nucleus at levels T1-T9.

39. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T6-T9.

40. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T1.

41. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T2.

42. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T3.

43. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T4.

44. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T5.

45. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T6.

46. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T7.

47. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T8.

48. The method of claim 38 wherein said neuromodulator is in communication with projections from the intermediolateral nucleus at levels T9.

140. The method recited in any one of claims 41-53, further comprising implanting at least one electrode such that it is in communication with projections to the intermediolateral nucleus.

156. The method recited in claim 140, wherein said projection comprises a splanchnic nerve.

157. The method recited in claim 140, wherein said projections arise from abdominal organs.

163. The method as in claim 38, wherein said energy is an electrical signal.

49. A method for treating a user comprising delivering energy using a neuromodulator in communication with projections to the intermediolateral nucleus.

50. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T6-T9.

51. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T1.

52. The method of claim 49 wherein said neuromodulator is in communication wit projections to the intermediolateral nucleus at levels T2.

53. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T3.

54. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T4.

55. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T5.

56. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T6.

57. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T7.

58. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T8.

59. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T9.

60. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T10.

61. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T11.

62. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels T12.

63. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C1.

64. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C2.

65. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C3.

66. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C4.

67. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C5.

68. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C6.

69. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C7.

70. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels C8.

71. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels L1.

72. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels L2.

73. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels L3.

74. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels L4.

75. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels L5.

76. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels S1.

77. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels S2.

78. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels S3.

79. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels S4.

80. The method of claim 49 wherein said neuromodulator is in communication with projections to the intermediolateral nucleus at levels S5.

164. The method as in claim 49, wherein said energy is an electrical signal.

81. A method for treating a user comprising applying an electrical signal to the intermediolateral nucleus, wherein duration of said signal is greater than 10 seconds per day.

82. The method of claim 81, wherein duration of said signal is greater than 20 seconds per day.

83. The method of claim 81, wherein duration of said signal is greater than 30 seconds per day.

84. The method of claim 81, wherein duration of said signal is greater than 1 minute per day.

85. The method of claim 81, wherein duration of said signal is greater than 2 minutes per day.

86. The method of claim 81, wherein duration of said signal is greater than 5 minutes per day.

87. The method of claim 81, wherein duration of said signal is greater than 7 minutes per day.

88. The method of claim 81, wherein duration of said signal is greater than 10 minutes per day.

89. The method of claim 81, wherein duration of said signal is greater than 12 minutes per day.

90. The method of claim 81, wherein duration of said signal is greater than 15 minutes per day.

91. The method of claim 81, wherein duration of said signal is greater than 20 minute per day.

92. The method of claim 81, wherein duration of said signal is greater than 30 minutes per day.

93. The method of claim 81, wherein duration of said signal is greater than 45 minutes per day.

94. The method of claim 81, wherein duration of said signal is greater than 1 hour per day.

95. The method of claim 81, wherein duration of said signal is greater than 2 hours per day.

96. The method of claim 81, wherein duration of said signal is greater than 4 hour per day.

97. The method of claim 81, wherein duration of said signal is greater than 8 hour per day.

98. The method of claim 81, wherein duration of said signal is greater than 12 hour per day.

99. The method of claim 81, wherein said signal is continuous.

100. The method of claim 81, wherein said signal is intermittent.

101. The method of claim 81, wherein said signal is applied at regular intervals.

102. A method for activating the intermediolateral nucleus to treat a user comprising:

applying an electrical signal to the intermediolateral nucleus; and

selecting stimulation parameters which cause weight reduction.

113. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

applying an electrical signal to the intermediolateral nucleus, and

selecting the duration of said electrical signal to be no greater than the chronaxie of the intermediolateral nucleus.

114. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

applying an electrical signal to the intermediolateral nucleus, and

selecting the duration of said electrical signal to be within the range of 1 microsecond and 1000 milliseconds.

115. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

Applying an electrical signal to the intermediolateral nucleus, wherein said electrical signal is biphasic.

116. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

applying an electrical signal to the intermediolateral nucleus, and

selecting the amplitude of said electrical signal to be within the range of 1 microamp and 1000 milliamps.

117. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

applying an electrical signal to the intermediolateral nucleus, and

selecting the interpulse interval to be within the range of 1 microsecond and 1000 milliseconds.

118. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

applying an electrical signal to the intermediolateral nucleus, and

selecting the duration of said electrical signal to be between 100 microseconds and 400 microseconds.

119. A method for activating the intermediolateral nucleus to treat obesity as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

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

programming said treatment parameters to induce satiety, and

applying an electrical signal to the intermediolateral nucleus with said pulse generator.

120. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus.

121. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using bipolar stimulation of an intermediolateral nucleus.

122. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus.

123. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus;

placing a first electrode in general proximity to the intermediolateral nucleus; and

applying a sufficiently large energy field to stimulate the intermediolateral nucleus in general proximity to said first electrode.

124. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus;

placing a first electrode in general proximity to the intermediolateral nucleus; and

applying a sufficiently large energy field with said first electrode to electrically couple with a second electrode remote from said first electrode, said energy field being sufficiently large to stimulate the intermediolateral nucleus in general proximity to said first electrode.

125. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus;

placing a first electrode in general proximity to the intermediolateral nucleus;

applying a sufficiently large energy field with said first electrode to electrically couple with a second electrode remote from said first electrode, said energy field being sufficiently large to stimulate the intermediolateral nucleus in general proximity to said first electrode; and

implanting a pulse generator within a patient.

126. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus;

placing a first electrode in general proximity to the intermediolateral nucleus; and

applying a sufficiently large energy field with said first electrode to electrically couple with a second electrode remote from said first electrode, said energy field being sufficiently large to stimulate the intermediolateral nucleus in general proximity to said first electrode; and

implanting a pulse generator within a patient, remote from said intermediolateral nucleus, said pulse generator having an external portion adapted to function as said remote second electrode; and

applying an electrical signal to said first electrode with said pulse generator, said electrical signal being sufficiently large to electrically couple said first electrode with said external portion of said pulse generator.

127. A method for treating a medical condition as in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111 further comprising:

modulating the sympathetic nervous system to treat obesity, wherein obesity is treated using unipolar stimulation of an intermediolateral nucleus;

placing a first electrode in general proximity to the intermediolateral nucleus; and

applying a sufficiently large energy field with said first electrode to electrically couple with a second electrode remote from said first electrode, said energy field being sufficiently large to stimulate the intermediolateral nucleus in general proximity to said first electrode; and

implanting a pulse generator within a patient, remote from said intermediolateral nucleus, said pulse generator having an external portion adapted to function as said remote second electrode; and

applying an electrical signal to said first electrode with said pulse generator, said electrical signal being sufficiently large to electrically couple said first electrode with said external portion of said pulse generator; and

providing a housing on said pulse generator adapted to function as said second electrode.

128. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode adjacent to the spinal cord.

129. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode within the spinal canal.

130. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode adjacent to the lateral surface of the spinal cord.

131. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode along the lateral surface of the spinal cord.

132. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode adjacent to the dorsolateral surface of the spinal cord.

133. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode adjacent to the ventrolateral surface of the spinal cord.

134. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with the spinal cord.

135. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with the lateral portion of the spinal grey matter.

136. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with the dorsolateral portion of the spinal grey matter.

137. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with the ventrolateral portion of the spinal greay matter.

138. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with the intermediolateral nucleus.

139. The method recited in claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising implanting at least one electrode such that it is in communication with projections from the intermediolateral nucleus.

141. The method recited in claim 139, wherein said projection comprises a splanchnic nerve.

142. The method recited in claim 139, wherein said projections project to abdominal organs.

143. The method recited in claim 139, wherein said projections modulate metabolism.

144. The method recited in claim 139, wherein said projections project to abdominal organisms to modulate metabolism.

145. The method recited in claim 139, wherein said projections arise from thoracic spinal segments.

146. The method recited in claim 142, wherein said projections arise from spinal segments T6-T9.

147. The method recited in claim 142, wherein said projections arise from spinal segment T6.

148. The method recited in claim 142, wherein said projections arise from spinal segment T7.

149. The method recited in claim 142, wherein said projections arise from spinal segment T8.

150. The method recited in claim 142, wherein said projections arise from spinal segment T9.

151. The method recited in claim 143, wherein said projections arise from spinal segments T6-T9.

152. The method recited in claim 143, wherein said projections arise from spinal segment T6.

153. The method recited in claim 143, wherein said projections arise from spinal segment T7.

154. The method recited in claim 143, wherein said projections arise from spinal segment T8.

155. The method recited in claim 143, wherein said projections arise from spinal segment T9.

158. The method recited in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising:

A. implanting at least one electrode such that it is in communication with projections to the intermediolateral nucleus; and

B. implanting at least one electrode such that it is in communication with projections from the intermediolateral nucleus.

159. The method recited in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising:

A. implanting at least one electrode such that it is in communication with afferent pathways comprising the intermediolateral nucleus; and

B. implanting at least one electrode such that is it in communication with efferent pathways comprising the intermediolateral nucleus.

160. The method recited in any one of claims 27, 38, 49, 81, 84, 102, 103, 104, 105, 106, 109, or 111, further comprising:

A. implanting at least one electrode such that it is in communication with afferent pathways comprising the spinal cord; and

B. implanting at least one electrode such that it is in communication with efferent pathways comprising the intermediolateral nucleus.

165. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is monopolar.

166. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is bipolar.

167. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is bipolar pulse pair.

168. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is bipolar pulse pair with an interpulse interval.

169. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is charge balanced.

170. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is single channel.

171. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is multichannel.

172. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency within the range of 0.1 Hertz to 1000 Hertz.

173. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency greater than 100 Hertz.

174. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency within the range of 50 to 100 Hertz.

175. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency within the range of 10 to 50 Hertz.

176. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency within the range of 0.1 to 10 Hertz.

177. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a frequency less than 5 Hertz.

178. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises a pulse width within the range of 1 microsecond to 500 milliseconds.

179. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal comprises an interpulse interval within the range of 1 microseconds to 1000 milliseconds.

180. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is a pulse pair.

181. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is biphasic.

182. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is a current pulse.

183. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is current regulated.

184. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal comprises a current amplitude within the range of 1 microamp to 1000 milliamps.

185. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal comprises a current amplitude within the range of 0.1 milliamp to 50 milliamps.

186. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is a voltage pulse.

187. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal is voltage regulated.

188. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal comprises a voltage amplitude within the range of 1 microvolt to 1000 volts.

189. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said electrical signal comprises a voltage amplitude within the range of 1 volt to 10 volts.

191. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is activating.

193. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is applied to control activity of intermediolateral nucleus.

195. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is applied to control body weight.

197. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is applied to control metabolic rate.

199. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is applied to control appetite.

201. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal is applied to control satiety.

203. The method as in any one of claims 102, 103, 104, 105, 106, 109, or 111, wherein the method to treat as user comprises the treatment of obesity.

205. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal modulates activity of sympathetic neurons.

207. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal increases metabolic rate.

209. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal decreases appetite.

211. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal influences body mass index.

213. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal causes a reduction in body fact composition.

232. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein delivery of said signal is performed using a spinal cord stimulation electrode.

234. The method as in any one of claims 81, 84, 102, 103, 104, 105, 106, 109, or 111, 162, 163, 164, wherein said signal parameters are selected to cause weight reduction.

103. A method for activating the intermediolateral nucleus to treat a user comprising:

applying an electrical signal to the intermediolateral nucleus; and

selecting stimulation parameters which cause appetite reduction.

104. A method for activating the intermediolateral nucleus to treat a user comprising:

applying an electrical signal to the intermediolateral nucleus; and

selecting stimulation parameters which induce satiety.

105. A method for activating the intermediolateral nucleus to treat a user comprising:

applying an electrical signal to the intermediolateral nucleus; and

selecting stimulation parameters which cause increase in metabolism.

106. A method for activating the intermediolateral nucleus to treat a user comprising:

selecting a user in whom body weight is to be reduced; and

applying an electrical signal to the intermediolateral nucleus.

107. The method of claim 106 wherein said body weight is above a desired weight.

108. The method of claim 106 wherein said user has a body weight which is in the obese range.

109. A method for activating the intermediolateral nucleus to treat a user comprising:

selecting a user with a body weight above normal; and

applying an electrical signal to the intermediolateral nucleus.

110. The method of claim 109 wherein said body weight is substantially above normal.

111. The method of claim 109 wherein said user is obese.

112. The method of claim 109 wherein said user is morbidly obese.

161. The method recited in claims any one of 41-53, further comprising:

A. implanting at least one electrode such that it is in communication with afferent pathways comprising the intermediolateral nucleus; and

B. implanting at least one electrode such that it is in communication with efferent pathways comprising the spinal cord.

214. A method for reducing body weight in a user comprising:

(A) selecting a user of body weight control;

(B) positioning a neuromodulator in communication with at least a component of the intermediolateral nucleus; and

(C) modulating sympathetic activity for control of body weight.

215. The method as in claim 214, wherein positioning a neuromodulator comprises implanting at least one first spinal cord electrode.

216. The method as in claim 215, further comprising implanting at least one second spinal cord electrode.

217. The method as in claim 216, further comprising implanting at least one second pulse generator in communication with at least one second spinal cord electrode.

218. The method as in claim 216, wherein delivering an electrical signal using at least one second spinal cord electrode causes increase in metabolic rate.

219. The method as in claim 216, wherein delivering an electrical signal using at least one second spinal cord electrode causes reduction in appetite.

220. The method as in claim 216, wherein delivering an electrical signal using at least one second spinal cord electrode causes increase in satiety.

221. The method as in claim 216, wherein delivering an electrical signal using at least one second spinal cord electrode causes reduction in body weight.

222. The method as in claim 215, further comprising implanting at least one first pulse generator, in communication with at least one first spinal cord electrode.

223. The method as in claim 215, wherein delivering an electrical signal using at least one first spinal cord electrode causes increase in metabolic rate.

224. The method as in claim 215, wherein delivering an electrical signal using at least one first spinal cord electrode causes reduction in appetite.

225. The method as in claim 215, wherein delivering an electrical signal using at least one first spinal cord electrode causes increase in satiety.

226. The method as in claim 215, wherein delivering an electrical signal using at least one first spinal cord electrode causes reduction in body weight.

227. The method as in claim 214, wherein modulating sympathetic activity causes increase in metabolic rate.

228. The method as in claim 214, wherein modulating sympathetic activity causes reduction in appetite.

229. The method as in claim 214, wherein modulating sympathetic activity causes increase in satiety.

230. The method as in claim 214, wherein modulating sympathetic activity causes reduction in body weight.