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

US 7,599,736 B2
Filed: 07/19/2002
Issued: 10/06/2009
Est. Priority Date: 07/23/2001
Status: Active Grant

First Claim

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1. A device for treating disease, comprising:

(A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic trunk to induce weight loss;

(B) a connecting cable attached to said implantable pulse generator; and

(C) a modulator, wherein said modulator comprises a sympathetic trunk neuromodulatory interface in communication with said implantable pulse generator via said connecting cable.

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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. The method and apparatus includes chronically implanted neural and neuromuscular modulators, used to modulate the afferent neurons of the sympathetic nervous system to induce satiety. Furthermore, the method and apparatus includes neuromuscular stimulation of the stomach to effect baseline and intermittent smooth muscle contraction to increase gastric intraluminal pressure, which induces satiety, and stimulates sympathetic afferent fibers, including those in the sympathetic trunk, splanchnic nerves, and greater curvature of the stomach, to augment the perception of satiety.

182 Citations

478 Claims

1. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic trunk to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a sympathetic trunk neuromodulatory interface in communication with said implantable pulse generator via said connecting cable.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
- - 2. A device as in claim 1, wherein said electrode reversibly modulates a component of the sympathetic nervous system.
  - 3. A device as in claim 1, wherein the disease being treated is obesity.
  - 4. A device as in claim 1, wherein the disease being treated is obesity.
  - 5. A device as in claim 1, wherein the disease being treated is elevated body mass index.
  - 6. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to treat obesity.
  - 7. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to treat metabolic disease.
  - 8. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to treat diabetes.
  - 9. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to influence satiety.
  - 10. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to influence food intake.
  - 11. A device as in claim 1, wherein said modulator modulates activity of the sympathetic nervous system to control metabolism.
  - 12. A device as in claim 1, wherein said modulator comprises at least one electrode.
  - 13. A device as in claim 1, wherein said modulator comprises at least one energy emitter.
  - 14. A device as in claim 1, wherein said modulator comprises a nerve cuff.
  - 15. A device as in claim 1, wherein said modulator comprises at least one pharmaceutical delivery means.
  - 16. A device as in claim 1, wherein neuromodulatory interface delivers a signal which increases sympathetic activity and causes body weight to be reduced.
  - 17. A device as in claim 1, wherein neuromodulatory interface delivers a signal which decreases sympathetic activity and causes body weight to be increased.
  - 18. A device as in claim 1, wherein neuromodulatory interface delivers a signal which modulates sympathetic activity and causes body weight to be controlled.

19. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a thoracic splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.
- View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
- - 20. A device as in claim 19, wherein said electrode modulates cells of the sympathetic nervous system.
  - 21. A device as in claim 19, whereby the disease being treated is obesity.
  - 22. A device as in claim 19, wherein the disease being treated is obesity.
  - 23. A device as in claim 19, wherein the disease being treated is elevated body mass index.
  - 24. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat obesity.
  - 25. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat metabolic disease.
  - 26. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat diabetes.
  - 27. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to influence satiety.
  - 28. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to influence food intake.
  - 29. A device as in claim 19, wherein said modulator is configured to modulate activity of the sympathetic nervous system to control metabolism.
  - 30. A device as in claim 19, wherein said modulator comprises at least one electrode.
  - 31. A device as in claim 19, wherein said modulator comprises at least one energy emitter.
  - 32. A device as in claim 19, wherein said modulator comprises a nerve cuff.
  - 33. A device as in claim 19, wherein said modulator comprises at least one pharmaceutical delivery means.
  - 34. A device as in claim 19, wherein neuromodulatory interface delivers a signal which increases sympathetic activity and causes body weight to be reduced.
  - 35. A device, as in claim 19, wherein neuromodulatory interface delivers a signal which decreases sympathetic activity and causes body weight to be increased.
  - 36. A device as in claim 19, wherein neuromodulatory interface delivers a signal which modulates sympathetic activity and causes body weight to be controlled.

37. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises an abdominal splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.
- View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54)
- - 38. A device as in claim 37, wherein said electrode modulates fibers of the sympathetic nervous system.
  - 39. A device as in claim 37, wherein the disease being treated is obesity.
  - 40. A device as in claim 37, wherein the disease being treated is obesity.
  - 41. A device as in claim 37, wherein the disease being treated is elevated body mass index.
  - 42. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat obesity.
  - 43. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat metabolic disease.
  - 44. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat diabetes.
  - 45. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to influence satiety.
  - 46. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to influence food intake.
  - 47. A device as in claim 37, wherein said modulator is configured to modulate activity of the sympathetic nervous system to control metabolism.
  - 48. A device as in claim 37, wherein said modulator comprises at least one electrode.
  - 49. A device as in claim 37, wherein said modulator comprises at least one energy emitter.
  - 50. A device as in claim 37, wherein said modulator comprises a nerve cuff.
  - 51. A device as in claim 37, wherein said modulator comprises at least one pharmaceutical delivery means.
  - 52. A device as in claim 37, wherein neuromodulatory interface delivers a signal which increases sympathetic activity and causes body weight to be reduced.
  - 53. A device as in claim 37, wherein neuromodulatory interface delivers a signal which decreases sympathetic activity and causes body weight to be increased.
  - 54. A device as in claim 37, wherein neuromodulatory interface delivers a signal which modulates sympathetic activity and causes body weight to be controlled.

55. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator, and(C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers said signal.
- View Dependent Claims (56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70)
- - 56. A device as in claim 55, wherein the disease being treated is obesity.
  - 57. A device as in claim 55, wherein the disease being treated is elevated body mass index.
  - 58. A device as in claim 55, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat obesity.
  - 59. A device as in claim 55, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat metabolic disease.
  - 60. A device as in claim 55, wherein said modulator is configured to modulate activity of the sympathetic nervous system to treat diabetes.
  - 61. A device as in claim 55, wherein by said modulator is configured to modulate activity of the sympathetic nervous system to influence satiety.
  - 62. A device as in claim 55, wherein by said modulator is configured to modulate activity of the sympathetic nervous system to influence food intake.
  - 63. A device as in claim 55, wherein by said modulator is configured to modulate activity of the sympathetic nervous system to control metabolism.
  - 64. A device as in claim 55, wherein said modulator comprises at least one electrode.
  - 65. A device as in claim 55, wherein said modulator comprises at least one energy emitter.
  - 66. A device as in claim 55, wherein said modulator comprises a nerve cuff.
  - 67. A device as in claim 55, wherein said modulator comprises at least one pharmaceutical delivery means.
  - 68. A device as in claim 55, wherein body weight is reduced.
  - 69. A device as in claim 55, wherein body weight is increased.
  - 70. A device as in claim 55, wherein body weight is controlled.

71. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic neurons to induce weight loss;
  
  (B) a conducting member attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said conducting member and which delivers reversible modulation to neurons of the sympathetic nervous system.
- View Dependent Claims (72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87)
- - 72. The device for treating disease as in claim 71 wherein said modulator is in communication with intermediolateral neurons.
  - 73. The device for treating disease as in claim 71 wherein said modulator is in communication with the intermediolateral nucleus.
  - 74. The device for treating disease as in claim 71 wherein said modulator is in communication with thoracic intermediolateral neurons.
  - 75. The device for treating disease as in claim 71 wherein said modulator is in communication with the abdominal intermediolateral neurons.
  - 76. The device for treating disease as in claim 71 wherein said modulator is configured to modulate neural activity for the treatment of obesity.
  - 77. The device for treating disease as in claim 71 wherein said modulator is configured to modulate neural activity for the control of metabolism.
  - 78. The device for treating disease as in claim 71 wherein said modulator is configured to modulate neural activity for the control of body weight.
  - 79. The device for treating disease as in claim 71 wherein said modulator delivers electrical energy.
  - 80. The device for treating disease as in claim 71 wherein said modulator comprises an anterior central spinal neuromodulatory interface.
  - 81. The device for treating disease as in claim 71 wherein said modulator comprises an anterior right lateral spinal neuromodulatory interface.
  - 82. The device for treating disease as in claim 71 wherein said modulator comprises an anterior left lateral spinal neuromodulatory interface.
  - 83. The device for treating disease as in claim 71 wherein said modulator comprises a posterior central spinal neuromodulatory interface.
  - 84. The device for treating disease as in claim 71 wherein said modulator comprises a posterior right lateral spinal neuromodulatory interface.
  - 85. The device for treating disease as in claim 71 wherein said modulator comprises a posterior left lateral spinal neuromodulatory interface.
  - 86. The device for treating disease as in claim 71 wherein said modulator comprises a right lateral spinal neuromodulatory interface.
  - 87. The device for treating disease as in claim 71 wherein said modulator comprises a left lateral spinal neuromodulatory interface.

88. A device for treating a condition in a user, comprising:
- (A) a pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss;
  
  (B) a signal transmitting member, configured to transmit said signal from said pulse generator to a modulator; and
  
  (C) the modulator, wherein said modulator delivers said signal to at least a component of the user'"'"'s sympathetic nervous system.
- View Dependent Claims (89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151)
- - 89. The device as in claim 88, wherein said condition is obesity.
  - 90. The device as in claim 88, wherein said condition is elevated body mass index.
  - 91. The device as in claim 88, wherein said condition is anorexia.
  - 92. The device as in claim 88, wherein body weight is controlled.
  - 93. The device as in claim 88, wherein body weight is reduced.
  - 94. The device as in claim 88, wherein body weight is increased.
  - 95. The device as in claim 88, wherein satiety is influenced.
  - 96. The device as in claim 88, wherein food intake is reduced.
  - 97. The device as in claim 88, wherein metabolic rate is increased.
  - 98. The device as in claim 88, wherein said modulator delivers a pharmaceutical agent.
  - 99. A device as in claim 88, wherein said modulator is configured to modulate fibers of the sympathetic nervous system.
  - 100. A device as in claim 88, wherein said modulator is configured to modulate cells of the sympathetic nervous system.
  - 101. A device as in claim 88, wherein said modulator is configured to modulate at least one ganglia of the sympathetic nervous system.
  - 102. A device as in claim 88, wherein said modulator is configured to modulate at least one portion of the sympathetic trunk.
  - 103. A device as in claim 88, wherein said modulator is configured to modulate at least one portion of the greater splanchnic nerve.
  - 104. A device as in claim 88, wherein said modulator is configured to modulate at least one portion of the lesser splanchnic nerve.
  - 105. A device as in claim 88, wherein said modulator is configured to modulate at least one portion of the spinal cord.
  - 106. A device as in claim 105, wherein said modulator is configured to modulate at least a portion of at least one level of the spinal cord.
  - 107. A device as in claim 106, wherein said modulator is configured to modulate at least one level of the spinal cord.
  - 108. A device as in claim 106, wherein said modulator is configured to modulate at least one region of the spinal cord.
  - 109. A device as in claim 106, wherein said modulator is configured to modulate at least two regions of the spinal cord.
  - 110. A device as in claim 106, wherein said modulator is configured to modulate at least two levels of the spinal cord.
  - 111. A device as in claim 106, wherein said modulator is configured to modulate at least three levels of the spinal cord.
  - 112. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T1 of the spinal cord.
  - 113. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T2 of the spinal cord.
  - 114. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T3 of the spinal cord.
  - 115. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T4 of the spinal cord.
  - 116. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T5 of the spinal cord.
  - 117. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T6 of the spinal cord.
  - 118. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T7 of the spinal cord.
  - 119. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T8 of the spinal cord.
  - 120. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T9 of the spinal cord.
  - 121. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T10 of the spinal cord.
  - 122. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T11 of the spinal cord.
  - 123. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of thoracic level T12 of the spinal cord.
  - 124. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of lumbar level L1 of the spinal cord.
  - 125. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of lumbar level L2 of the spinal cord.
  - 126. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of lumbar level L3 of the spinal cord.
  - 127. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of lumbar level L4 of the spinal cord.
  - 128. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of lumbar level L5 of the spinal cord.
  - 129. A device as in claim 106, wherein said modulator is configured to modulate at least a portion of a thoracic level and a lumbar level of the spinal cord.
  - 130. A device as in claim 106, wherein said modulator is configured to modulate at least one portion of a thoracic level of the spinal cord.
  - 131. A device as in claim 106, wherein said modulator is configured to modulate at least one portion of a lumbar level of the spinal cord.
  - 132. A device as in claim 106, wherein said modulator is configured to modulate afferent sympathetic fibers in at least one level of the spinal cord.
  - 133. A device as in claim 106, wherein said modulator is configured to modulate efferent sympathetic fibers in at least one level of the spinal cord.
  - 134. A device as in claim 106, wherein said modulator is configured to modulate afferent and efferent sympathetic fibers.
  - 135. A device as in claim 106, wherein said modulator comprises an array of at least one modulator.
  - 136. A device as in claim 106, wherein at least one modulator modulates afferent sympathetic fibers and at least one modulator modulates efferent sympathetic fibers.
  - 137. A device as in claim 106, wherein at least one modulator modulates afferent sympathetic neurons and at least one modulator modulates efferent sympathetic neurons.
  - 138. A device as in claim 106, wherein at least one modulator modulates afferent sympathetic pathways and at least one modulator modulates efferent sympathetic pathways.
  - 139. A device as in claim 88, wherein said modulator is configured to modulate at least one portion of the intermediolateral nucleus.
  - 140. A device as in claim 88, wherein said signal transmitting member comprises a connecting cable.
  - 141. A device as in claim 88, wherein said signal transmitting member comprises a conducting member.
  - 142. A device as in claim 88, wherein said signal transmitting member comprises a pulse transmitting member.
  - 143. The device in claim 88, wherein said modulator delivers an electrical signal with pulse frequency between approximately 0.1 Hertz and approximately 1000 Hertz.
  - 144. The device in claim 88, wherein said modulator delivers an electrical signal with pulse width between approximately 1 microsecond and approximately 1000 milliseconds.
  - 145. The device in claim 88, wherein said modulator delivers an electrical signal with approximately zero net direct current charge delivery.
  - 146. The device in claim 88, wherein said modulator delivers an electrical signal comprising a bipolar pulse pair.
  - 147. The device in claim 88, wherein said modulator delivers an electrical signal with an interpulse interval of approximately 1 microsecond to 1000 milliseconds.
  - 148. The device in claim 88, wherein said modulator delivers an electrical signal which is current regulated.
  - 149. The device in claim 88, wherein said modulator delivers an electrical signal which is between approximately 1 microamp and 1000 milliamps.
  - 150. The device in claim 88, wherein said modulator delivers an electrical signal which is voltage regulated.
  - 151. The device in claim 88, wherein said modulator delivers an electrical signal which is between approximately 1 microvolt and 1000 volts.

152. A device for treating a condition in a user, comprising:
- (A) a pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss;
  
  (B) a signal transmitting member, configured to transmit said signal from said pulse generator to a modulator; and
  
  (C) the modulator, wherein said modulator delivers at least one modality of energy to at least a component of the user'"'"'s sympathetic nervous system.
- View Dependent Claims (153, 154)
- - 153. The device as in claim 152, wherein said modulator delivers electrical energy.
  - 154. The device as in claim 152, wherein said modulator delivers a signal which reversibly alters neural activity.

155. A device for modulating a user'"'"'s nervous system, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a stimulating or modulating energy which modulates the sympathetic nervous system to induce weight loss;
  
  (B) a signal transmitting member attached to said implantable pulse generator and configured to transmit generated stimulating or modulating energy; and
  
  (C) a modulator which is configured to deliver stimulating or modulating energy from the signal transmitting member to communicate with at least one component of the user'"'"'s sympathetic nervous system.
- View Dependent Claims (156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187)
- - 156. The device of claim 155, wherein said modulator is configured to communicate with afferent fibers of the user'"'"'s sympathetic nervous system.
  - 157. The device of claim 155, wherein said modulator is configured to communicate with efferent fibers of the user'"'"'s sympathetic nervous system.
  - 158. The device of claim 155, wherein said modulator is configured to communicate with a portion of the sympathetic trunk of the user'"'"'s sympathetic nervous system.
  - 159. The device of claim 155, wherein said modulator is configured to communicate with a portion of the greater splanchnic nerve of the user'"'"'s sympathetic nervous system.
  - 160. The device of claim 155, wherein said modulator is configured to communicate with a portion of the lesser splanchnic nerve of the user'"'"'s sympathetic nervous system.
  - 161. The device of claim 155, wherein said modulator is configured to communicate with a portion of the sympathetic nervous system in the spinal cord of the user.
  - 162. The device of claim 155, wherein said modulator is configured to communicate with a portion of the intermediolateral nucleus of the user'"'"'s sympathetic nervous system.
  - 163. The device of claim 155, wherein said modulator is configured to communicate with a portion of the grey ramus communicantes.
  - 164. The device of claim 155, wherein said modulator is configured to communicate with a portion of the white ramus communicantes.
  - 165. The device of claim 155, wherein said modulator is configured to communicate with a portion of a spinal root.
  - 166. The device of claim 155, wherein said modulator is configured to communicate with a portion of a spinal ganglion.
  - 167. The device of claim 155, wherein said modulator is configured to communicate with a component of a spinal nerve.
  - 168. The device of claim 155, wherein said modulator comprises an intermediolateral nucleus neuromodulatory interface.
  - 169. The device of claim 155, wherein said modulator is configured to be positioned in the epidural space.
  - 170. The device of claim 155, wherein said modulator is configured to be positioned in the subdural space.
  - 171. The device of claim 155, wherein said modulator is configured to be positioned in the subarachnoid space.
  - 172. The device of claim 155, wherein said modulator is configured to be positioned in the intraparenchymal space.
  - 173. The device of claim 155, wherein said modulator is configured to be in communication with the intermediolateral nucleus.
  - 174. The device of claim 155, wherein said modulator is configured to be in communication with the sympathetic trunk.
  - 175. The device of claim 155, wherein said modulator is configured to be in communication with the greater splanchnic nerve.
  - 176. The device of claim 155, wherein said modulator is configured to be in communication with the lesser splanchnic nerve.
  - 177. The device of claim 155, wherein said modulator is configured to be in direct communication with a component of the sympathetic nervous system.
  - 178. The device of claim 155, wherein said modulator is configured to be in indirect communication with a component of the sympathetic nervous system.
  - 179. The device of claim 155, wherein afferent fibers of sympathetic nervous system are selectively stimulated.
  - 180. The device of claim 155, wherein efferent fibers of sympathetic nervous system are selectively stimulated.
  - 181. The device of claim 155, wherein said modulator interfaces with a transected nerve.
  - 182. The device of claim 155, wherein said modulator is a nerve cuff.
  - 183. The device of claim 155, comprising at least one modulator.
  - 184. The device of claim 183, wherein said at least one modulator delivers more than one modality of signal.
  - 185. The device of claim 155, wherein at least one modulator delivers multimodal stimulation.
  - 186. The device of claim 155, wherein at least one of said modulator delivers modulating signal to at least one of gastric muscle fibers, fibers of the sympathetic nerve branch, vagus nerve, other sympathetic nervous system structures, and other parasympathetic nervous system structures.
  - 187. The device of claim 155, wherein depression is also treated.

188. A device for modulating a patient'"'"'s nervous system for the control of body weight, comprising:
- (A) a pulse generator comprising a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss;
  
  (B) a signal transmission member attached to said pulse generator and configured to transmit said signal; and
  
  (C) a modulator which is adapted to receive said signal from the signal transmission member and which is configured to communicate with at least a portion of the patient'"'"'s spinal cord.
- View Dependent Claims (189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 215, 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 258)
- - 189. The device in claim 188, wherein said device delivers said modulating signal to a portion of the spinal cord for the treatment of obesity.
  - 190. The device in claim 188, wherein said device delivers said modulating signal to a portion of the spinal cord for the treatment of morbid obesity.
  - 191. The device in claim 188, wherein said device delivers said modulating signal to a portion of the spinal cord for the reduction of body weight.
  - 192. The device in claim 191, wherein said modulator delivers a signal which influences metabolism.
  - 193. The device in claim 191, wherein said modulator delivers a signal which influences lipolysis.
  - 194. The device in claim 191, wherein said modulator is configured to modulate the activity of efferent fibers of the sympathetic nervous system.
  - 195. The device in claim 191, wherein said modulator is configured to alter the activity of at least a portion of the sympathetic nervous system.
  - 196. The device in claim 188, wherein said modulator is in communication with at least a portion of the sympathetic nervous system.
  - 197. The device in claim 196, wherein said modulator is in communication with at least a portion of the intermediolateral nucleus.
  - 198. The device in claim 196, wherein said modulator is implanted.
  - 199. The device in claim 196, wherein said modulator is configured to modulate the activity of at least a portion of the sympathetic nervous system.
  - 200. The device in claim 188, wherein said device delivers said modulating signal to a portion of the spinal cord for the reduction of body fat.
  - 201. The device in claim 188, wherein said device is implanted.
  - 202. The device in claim 188, wherein said modulator is in communication with at least a portion of the intermediolateral nucleus.
  - 203. The device in claim 188, wherein said modulator delivers a signal which influences satiety.
  - 204. The device in claim 188, wherein said modulator delivers a signal which influences metabolism.
  - 205. The device in claim 188, wherein said modulator delivers a signal which influences body weight.
  - 206. The device in claim 188, wherein said modulator delivers a signal which influences body fat.
  - 207. The device in claim 188, wherein said modulator delivers a signal which influences food intake.
  - 208. The device in claim 188, wherein said modulator is configured to be positioned in the epidural space.
  - 209. The device in claim 188, wherein said modulator is configured to be positioned in the subdural space.
  - 210. The device in claim 188, wherein said modulator is configured to be positioned in the subarachnoid space.
  - 211. The device in claim 188, wherein said modulator is configured to be positioned in the intraparenchymal space.
  - 212. The device in claim 188, wherein said modulator delivers an electrical signal.
  - 213. The device in claim 188, wherein said modulator delivers a signal which comprises at least one pulse.
  - 214. The device in claim 188, wherein said modulator delivers an electrical signal with pulse frequency between approximately 0.1 Hertz and approximately 1000 Hertz.
  - 215. The device in claim 188, wherein said modulator delivers an electrical signal with pulse width between approximately 1 microsecond and approximately 1000 milliseconds.
  - 216. The device in claim 188, wherein said modulator delivers an electrical signal with approximately zero net direct current charge delivery.
  - 217. The device in claim 188, wherein said modulator delivers an electrical signal comprising a bipolar pulse pair.
  - 218. The device in claim 188, wherein said modulator delivers an electrical signal with an interpulse interval of approximately 1 microsecond to 1000 milliseconds.
  - 219. The device in claim 188, wherein said modulator delivers an electrical signal which is current regulated.
  - 220. The device in claim 188, wherein said modulator delivers an electrical signal which is between approximately 1 microamp and 1000 milliamps.
  - 221. The device in claim 188, wherein said modulator delivers an electrical signal which is voltage regulated.
  - 222. The device in claim 188, wherein said modulator delivers an electrical signal which is between approximately 1 microvolt and 1000 volts.
  - 223. The device in claim 188, wherein said modulator delivers a signal which influences metabolic rate.
  - 224. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of at least one level of the spinal cord.
  - 225. A device as in claim 188, wherein said modulator is configured to modulate at least one level of the spinal cord.
  - 226. A device as in claim 188, wherein said modulator is configured to modulate at least one region of the spinal cord.
  - 227. A device as in claim 188, wherein said modulator is configured to modulate at least two regions of the spinal cord.
  - 228. A device as in claim 188, wherein said modulator is configured to modulate at least two levels of the spinal cord.
  - 229. A device as in claim 188, wherein said modulator is configured to modulate at least three levels of the spinal cord.
  - 230. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T1 of the spinal cord.
  - 231. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T2 of the spinal cord.
  - 232. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T3 of the spinal cord.
  - 233. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T4 of the spinal cord.
  - 234. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T5 of the spinal cord.
  - 235. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T6 of the spinal cord.
  - 236. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T7 of the spinal cord.
  - 237. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T8 of the spinal cord.
  - 238. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T9 of the spinal cord.
  - 239. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T10 of the spinal cord.
  - 240. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T11 of the spinal cord.
  - 241. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of thoracic level T12 of the spinal cord.
  - 242. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of lumbar level L1 of the spinal cord.
  - 243. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of lumbar level L2 of the spinal cord.
  - 244. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of lumbar level L3 of the spinal cord.
  - 245. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of lumbar level L4 of the spinal cord.
  - 246. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of lumbar level L5 of the spinal cord.
  - 247. A device as in claim 188, wherein said modulator is configured to modulate at least a portion of a thoracic level and a lumbar level of the spinal cord.
  - 248. A device as in claim 188, wherein said modulator is configured to modulate at least one portion of a thoracic level of the spinal cord.
  - 249. A device as in claim 188, wherein said modulator is configured to modulate at least one portion of a lumbar level of the spinal cord.
  - 250. A device as in claim 188, wherein said modulator is configured to modulate afferent sympathetic fibers in at least one level of the spinal cord.
  - 251. A device as in claim 188, wherein said modulator is configured to modulate efferent sympathetic fibers in at least one level of the spinal cord.
  - 252. A device as in claim 188, wherein said modulator is configured to modulate afferent and efferent sympathetic fibers.
  - 253. A device as in claim 188, wherein said modulator comprises an array of at least one modulator.
  - 254. A device as in claim 188, wherein at least one modulator modulates afferent sympathetic fibers and at least one modulator modulates efferent sympathetic fibers.
  - 255. A device as in claim 188, wherein at least one modulator modulates afferent sympathetic neurons and at least one modulator modulates efferent sympathetic neurons.
  - 256. A device as in claim 188, wherein at least one modulator modulates afferent sympathetic pathways and at least one modulator modulates efferent sympathetic pathways.
  - 257. The device in claim 188, wherein said modulator delivers a signal which influences appetite.
  - 258. The device in claim 188, wherein said processor is configured to generate a signal which influences metabolic rate.

259. An Apparatus for reducing body weight in a user comprising:
- (A) a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss; and
  
  (B) a modulator configured to deliver said signal to sympathetic neurons.
- View Dependent Claims (260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 303, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 342)
- - 260. The apparatus of claim 259, wherein said processor is configured to reduce body weight for the treatment of obesity.
  - 261. The apparatus of claim 259, wherein said modulator is configured to modulate sympathetic efferent neurons.
  - 262. The apparatus of claim 259, wherein said modulator is configured to modulate sympathetic afferent neurons.
  - 263. The apparatus method of claim 259, wherein said modulator is configured to modulate neurons in the locus ceruleus.
  - 264. The apparatus of claim 259, wherein said modulator is configured to modulate intermediolateral nucleus neurons.
  - 265. The apparatus of claim 259, wherein said modulator is configured to modulate sympathetic trunk neurons.
  - 266. The apparatus of claim 259, wherein said modulator is configured to modulate splanchnic nerve neurons.
  - 267. The apparatus of claim 259, wherein said modulator is configured to modulate greater splanchnic nerve neurons.
  - 268. The apparatus of claim 259, wherein said modulator is configured to modulate lesser splanchnic nerve neurons.
  - 269. The apparatus of claim 259, wherein said modulator is configured to modulate thoracic splanchnic nerve neurons.
  - 270. The apparatus of claim 259, wherein said modulator is configured to modulate thoracic greater splanchnic nerve neurons.
  - 271. The apparatus of claim 259, wherein said modulator is configured to modulate thoracic lesser splanchnic nerve neurons.
  - 272. The apparatus of claim 259, wherein said modulator is configured to modulate abdominal splanchnic nerve neurons.
  - 273. The apparatus of claim 259, wherein said modulator is configured to modulate abdominal greater splanchnic nerve neurons.
  - 274. The apparatus of claim 259, wherein said modulator is configured to modulate abdominal lesser splanchnic nerve neurons.
  - 275. The apparatus of claim 259, wherein said modulator is configured to modulate a single or plurality of sympathetic neurons which further modulate activity of the locus ceruleus.
  - 276. The apparatus of claim 259, wherein said modulator is configured to selectively modulate sympathetic afferent neurons.
  - 277. The apparatus of claim 259, wherein said modulator is configured to selectively modulate sympathetic efferent neurons.
  - 278. The apparatus of claim 259, wherein said modulator comprises a single or plurality of modulators configured to modulate multiple modalities.
  - 279. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and sympathetic efferent neurons.
  - 280. The apparatus method of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastric muscle tissue.
  - 281. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastric pylorus muscle tissue.
  - 282. The apparatus method of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastrointestinal tissue.
  - 283. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord neurons.
  - 284. The apparatus of claim 283, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and spinal cord neurons.
  - 285. The apparatus of claim 283, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and spinal cord neurons.
  - 286. The apparatus of claim 283, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord afferent neurons.
  - 287. The apparatus of claim 283, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord efferent neurons.
  - 288. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and muscle tissue.
  - 289. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and muscle tissue.
  - 290. The apparatus of claim 289, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastric muscle tissue.
  - 291. The apparatus of claim 289, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastric pylorus muscle tissue.
  - 292. The apparatus of claim 289, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastrointestinal tissue.
  - 293. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic neurons.
  - 294. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and somatic afferent neurons.
  - 295. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and somatic efferent neurons.
  - 296. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic afferent neurons.
  - 297. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic efferent neurons.
  - 298. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and somatic neurons.
  - 299. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and somatic neurons.
  - 300. The apparatus of claim 278, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and spinal cord neurons.
  - 301. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates sympathetic efferent neurons.
  - 302. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates sympathetic afferent neurons.
  - 303. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates neurons in the locus ceruleus.
  - 304. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates intermediolateral nucleus neurons.
  - 305. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates sympathetic trunk neurons.
  - 306. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates splanchnic nerve neurons.
  - 307. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates greater splanchnic nerve neurons.
  - 308. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates lesser splanchnic nerve neurons.
  - 309. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates thoracic splanchnic nerve neurons.
  - 310. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates thoracic greater splanchnic nerve neurons.
  - 311. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates thoracic lesser splanchnic nerve neurons.
  - 312. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates abdominal splanchnic nerve neurons.
  - 313. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates abdominal greater splanchnic nerve neurons.
  - 314. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates abdominal lesser splanchnic nerve neurons.
  - 315. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates a single or plurality of sympathetic neurons which further modulate activity of the locus ceruleus.
  - 316. The apparatus of claim 259, wherein said processor is configured to generate a signal which selectively modulates sympathetic afferent neurons.
  - 317. The apparatus of claim 259, wherein said processor is configured to generate a signal which selectively modulates sympathetic efferent neurons.
  - 318. The apparatus of claim 259, wherein said modulator is configured to modulate sympathetic spinal neurons.
  - 319. The apparatus of claim 259, wherein said processor is configured to generate a signal which modulates sympathetic spinal neurons.
  - 320. The apparatus of claim 259, wherein said processor is configured to generate a single or plurality of signals which modulate multiple modalities.
  - 321. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and sympathetic efferent neurons.
  - 322. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastric muscle tissue.
  - 323. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastric pylorus muscle tissue.
  - 324. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastrointestinal tissue.
  - 325. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord neurons.
  - 326. The apparatus of claim 325, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and spinal cord neurons.
  - 327. The apparatus of claim 325, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and spinal cord neurons.
  - 328. The apparatus of claim 325, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord afferent neurons.
  - 329. The apparatus of claim 325, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord efferent neurons.
  - 330. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and muscle tissue.
  - 331. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and muscle tissue.
  - 332. The apparatus of claim 331, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastric muscle tissue.
  - 333. The apparatus of claim 331, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastric pylorus muscle tissue.
  - 334. The apparatus of claim 331, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastrointestinal tissue.
  - 335. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic neurons.
  - 336. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and somatic afferent neurons.
  - 337. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and somatic efferent neurons.
  - 338. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic afferent neurons.
  - 339. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic efferent neurons.
  - 340. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and somatic neurons.
  - 341. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and somatic neurons.
  - 342. The apparatus of claim 320, wherein said processor is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord neurons.

343. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) pulse generator, in communication with a modulator, wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss;
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system, wherein said modulator modulates afferent sympathetic neurons and a second modulator modulates efferent sympathetic neurons.

344. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) a pulse generator, in communication with a modulator;
  
  wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system, wherein said modulator is configured to interface with a portion of the intermediolateral nucleus.

345. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) pulse generator, in communication with a modulator, wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic nervous system to induce weight loss; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system, wherein said modulator is configured to control metabolism.

346. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) a pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic nervous system to control or influence appetite, in communication with a modulator; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system.

347. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) a pulse generator, comprising a processor configured to generate a signal which modulates the sympathetic nervous system to control or influence satiety, in communication with a modulator; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system.

348. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) pulse generator, in communication with a modulator, wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic nervous system to control body weight; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system.

349. An apparatus for use in treating disease wherein fibers of the autonomic nervous system are stimulated, comprising:
- (A) pulse generator, in communication with a modulator, wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic nervous system to reduce body weight; and
  
  (B) the modulator, in communication with a portion of the sympathetic nervous system.

350. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates the sympathetic trunk to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a sympathetic trunk neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

351. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a thoracic splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

352. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises an abdominal splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

353. A device for treating disease, comprising:
- (A) an implantable pulse generator, wherein pulse generator comprises a processor configured to generate a signal which modulates the sympathetic trunk to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a sympathetic trunk neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

354. A device for treating disease, comprising:
- (A) an implantable pulse generator, wherein pulse generator comprises a processor configured to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a thoracic splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

355. A device for treating disease, comprising:
- (A) an implantable pulse generator, wherein pulse generator comprises a processor configured to generate a signal which modulates the splanchnic nerve to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises an abdominal splanchnic neuromodulatory interface connected to said implantable pulse generator via said connecting cable.

356. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers modulating signal.

357. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates afferents to the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers modulating signal.

358. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates afferents to the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers modulating signal.

359. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates efferents from the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers modulating signal.

360. A device for treating disease, comprising:
- (A) an implantable pulse generator, comprising memory containing instructions to generate a signal which modulates efferents from the spinal cord to induce weight loss;
  
  (B) a connecting cable attached to said implantable pulse generator; and
  
  (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said connecting cable, and which delivers modulating signal.

361. An Apparatus for reducing body weight in a user comprising:
- (A) a controller configured to generate a signal which modulates the sympathetic nervous system to induce weight loss; and
  
  (B) a modulator configured to deliver said signal to sympathetic neurons.
- View Dependent Claims (362, 363, 364, 365, 366, 367, 368, 369, 370, 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 418, 419, 420, 421, 422, 423, 424, 425, 426, 427, 428, 429, 430, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444)
- - 362. The apparatus of claim 361, wherein said controller is configured to reduce body weight for the treatment of obesity.
  - 363. The apparatus of claim 361, wherein said modulator is configured to modulate sympathetic efferent neurons.
  - 364. The apparatus of claim 361, wherein said modulator is configured to modulate sympathetic afferent neurons.
  - 365. The apparatus of claim 361, wherein said modulator is configured to modulate neurons in the locus ceruleus.
  - 366. The apparatus of claim 361, wherein said modulator is configured to modulate intermediolateral nucleus neurons.
  - 367. The apparatus of claim 361, wherein said modulator is configured to modulate sympathetic trunk neurons.
  - 368. The apparatus of claim 361, wherein said modulator is configured to modulate splanchnic nerve neurons.
  - 369. The apparatus of claim 361, wherein said modulator is configured to modulate greater splanchnic nerve neurons.
  - 370. The apparatus of claim 361, wherein said modulator is configured to modulate lesser splanchnic nerve neurons.
  - 371. The apparatus of claim 361, wherein said modulator is configured to modulate thoracic splanchnic nerve neurons.
  - 372. The apparatus of claim 361, wherein said modulator is configured to modulate thoracic greater splanchnic nerve neurons.
  - 373. The apparatus of claim 361, wherein said modulator is configured to modulate thoracic lesser splanchnic nerve neurons.
  - 374. The apparatus of claim 361, wherein said modulator is configured to modulate abdominal splanchnic nerve neurons.
  - 375. The apparatus of claim 361, wherein said modulator is configured to modulate abdominal greater splanchnic nerve neurons.
  - 376. The apparatus of claim 361, wherein said modulator is configured to modulate abdominal lesser splanchnic nerve neurons.
  - 377. The apparatus of claim 361, wherein said modulator is configured to modulate a single or plurality of sympathetic neurons which further modulate activity of the locus ceruleus.
  - 378. The apparatus of claim 361, wherein said modulator is configured to selectively modulate sympathetic afferent neurons.
  - 379. The apparatus of claim 361, wherein said modulator is configured to selectively modulate sympathetic efferent neurons.
  - 380. The apparatus of claim 361, wherein said modulator comprises a single or plurality of modulators configured to modulate multiple modalities.
  - 381. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and sympathetic efferent neurons.
  - 382. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastric muscle tissue.
  - 383. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastric pylorus muscle tissue.
  - 384. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and gastrointestinal tissue.
  - 385. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord neurons.
  - 386. The apparatus of claim 385, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and spinal cord neurons.
  - 387. The apparatus of claim 385, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and spinal cord neurons.
  - 388. The apparatus of claim 385, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord afferent neurons.
  - 389. The apparatus of claim 385, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and spinal cord efferent neurons.
  - 390. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and muscle tissue.
  - 391. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and muscle tissue.
  - 392. The apparatus of claim 391, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastric muscle tissue.
  - 393. The apparatus of claim 391, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastric pylorus muscle tissue.
  - 394. The apparatus of claim 391, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and gastrointestinal tissue.
  - 395. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic neurons.
  - 396. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and somatic afferent neurons.
  - 397. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and somatic efferent neurons.
  - 398. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic afferent neurons.
  - 399. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic neurons and somatic efferent neurons.
  - 400. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic afferent neurons and somatic neurons.
  - 401. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and somatic neurons.
  - 402. The apparatus of claim 380, wherein said single or plurality of modulators are configured to modulate sympathetic efferent neurons and spinal cord neurons.
  - 403. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates sympathetic efferent neurons.
  - 404. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates sympathetic afferent neurons.
  - 405. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates neurons in the locus ceruleus.
  - 406. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates intermediolateral nucleus neurons.
  - 407. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates sympathetic trunk neurons.
  - 408. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates splanchnic nerve neurons.
  - 409. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates greater splanchnic nerve neurons.
  - 410. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates lesser splanchnic nerve neurons.
  - 411. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates thoracic splanchnic nerve neurons.
  - 412. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates thoracic greater splanchnic nerve neurons.
  - 413. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates thoracic lesser splanchnic nerve neurons.
  - 414. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates abdominal splanchnic nerve neurons.
  - 415. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates abdominal greater splanchnic nerve neurons.
  - 416. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates abdominal lesser splanchnic nerve neurons.
  - 417. The apparatus of claim 361, wherein said controller is configured to generate a signal which modulates a single or plurality of sympathetic neurons which further modulate activity of the locus ceruleus.
  - 418. The apparatus of claim 361, wherein said controller is configured to generate a signal which selectively modulates sympathetic afferent neurons.
  - 419. The apparatus of claim 361, wherein said controller is configured to generate a signal which selectively modulates sympathetic efferent neurons.
  - 420. The apparatus of claim 361, wherein said modulator is configured to modulate sympathetic spinal neurons.
  - 421. The apparatus of claim 361, wherein said processor is configured to generate a signal which modulates sympathetic spinal neurons.
  - 422. The apparatus of claim 361, wherein said controller is configured to generate a single or plurality of signals which modulate multiple modalities.
  - 423. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and sympathetic efferent neurons.
  - 424. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastric muscle tissue.
  - 425. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastric pylorus muscle tissue.
  - 426. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and gastrointestinal tissue.
  - 427. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord neurons.
  - 428. The apparatus of claim 427, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and spinal cord neurons.
  - 429. The apparatus of claim 427, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and spinal cord neurons.
  - 430. The apparatus of claim 427, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord afferent neurons.
  - 431. The apparatus of claim 427, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord efferent neurons.
  - 432. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and muscle tissue.
  - 433. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and muscle tissue.
  - 434. The apparatus of claim 433, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastric muscle tissue.
  - 435. The apparatus of claim 433, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastric pylorus muscle tissue.
  - 436. The apparatus of claim 433, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and gastrointestinal tissue.
  - 437. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic neurons.
  - 438. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and somatic afferent neurons.
  - 439. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and somatic efferent neurons.
  - 440. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic afferent neurons.
  - 441. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and somatic efferent neurons.
  - 442. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic afferent neurons and somatic neurons.
  - 443. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic efferent neurons and somatic neurons.
  - 444. The apparatus of claim 422, wherein said controller is configured to generate a single or plurality of signals which modulate sympathetic neurons and spinal cord neurons.

445. A device for treating disease, comprising:
- (A) a pulse generator, wherein pulse generator comprises a controller configured to generate a signal which modulates at least a portion of the sympathetic nervous system to induce weight loss;
  
  (B) a connecting cable attached to said pulse generator; and
  
  (C) a modulator, wherein said modulator is connected to said pulse generator via said connecting cable.
- View Dependent Claims (446, 447, 448, 449, 450, 451, 452, 453, 454, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 474, 475, 476, 477, 478)
- - 446. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises the sympathetic trunk.
  - 447. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a splanchnic nerve.
  - 448. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a greater splanchnic nerve.
  - 449. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a lesser splanchnic nerve.
  - 450. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a spinal cord.
  - 451. The, device as in claim 445, wherein said portion of the sympathetic nervous system comprises afferents to the spinal cord.
  - 452. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises efferents from the spinal cord.
  - 453. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises an intermediolateral nucleus.
  - 454. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises sympathetic neurons.
  - 455. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a sympathetic neuron.
  - 456. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a sympathetic axon.
  - 457. The device as in claim 445, wherein said portion of the sympathetic nervous system comprises a sympathetic cell body.
  - 458. The device as in claim 445, wherein said modulator is configured to interface with a portion of a sympathetic trunk.
  - 459. The device as in claim 445, wherein said modulator is configured to interface with a portion of a splanchnic nerve.
  - 460. The device as in claim 445, wherein said modulator is configured to interface with a portion of a greater splanchnic nerve.
  - 461. The device as in claim 445, wherein said modulator is configured to interface with a portion of a lesser splanchnic nerve.
  - 462. The device as in claim 445, wherein said modulator is configured to interface with a portion of a spinal cord.
  - 463. The device as in claim 445, wherein said modulator is configured to interface with a portion of afferents to the spinal cord.
  - 464. The device as in claim 445, wherein said modulator is configured to interface with a portion of efferents from the spinal cord.
  - 465. The device as in claim 445, wherein said modulator is configured to interface with a portion of an intermediolateral nucleus.
  - 466. The device as in claim 445, wherein said modulator is configured to interface with a portion of sympathetic neurons.
  - 467. The device as in claim 445, wherein said modulator is configured to interface with a portion of a sympathetic neuron.
  - 468. The device as in claim 445, wherein said modulator is configured to interface with a portion of a sympathetic axon.
  - 469. The device as in claim 445, wherein said modulator is configured to interface with a portion of a sympathetic cell body.
  - 470. The device as in claim 445, wherein said signal influences metabolic rate.
  - 471. The device as in claim 445, wherein said signal induces an increase in metabolic rate.
  - 472. The device as in claim 445, wherein said signal induces a decrease in metabolic rate.
  - 473. The device as in claim 445, wherein said signal influences appetite.
  - 474. The device as in claim 445, wherein said signal induces an increase in appetite.
  - 475. The device as in claim 445, wherein said signal induces a decrease in appetite.
  - 476. The device as in claim 445, wherein said signal influences satiety.
  - 477. The device as in claim 445, wherein said signal induces an increase in satiety.
  - 478. The device as in claim 445, wherein said signal induces a decrease in satiety.

Specification

Resources

Litigation Campaign Assessment

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 Haeng

Application Number

US10/198,871
Publication Number

US 20030018367A1
Time in Patent Office

2,636 Days
Field of Search

607/2, 607/3, 607/40, 607/45, 607/46, 607/96, 607117-118
US Class Current

607/2
CPC Class Codes

A61N 1/0551   Spinal or peripheral nerve ...

A61N 1/36007   of urogenital or gastrointe...

A61N 1/36114   Cardiac control, e.g. by va...

A61N 2/00   Magnetotherapy

A61N 5/00   Radiation therapy ultrasoun...

A61N 7/00   Ultrasound therapy lithotri...

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

First Claim

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Abstract

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478 Claims

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

First Claim

7 Assignments

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0 Petitions

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Accused Products

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Abstract

182 Citations

478 Claims

Specification

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Solutions

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