Method for direct modulation of the spinothalamic tract

• US 8,706,240 B2
• Filed: 12/07/2012
• Issued: 04/22/2014
• Est. Priority Date: 12/09/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Bradley, Kerry, Makous, James C.
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US13/708,655
• Publication Number:
  US 20130150919A1
• Time in Patent Office: 501 Days
• Field of Search: 607/46
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36071 Pain

Abstract

A method for treating a patient suffering from chronic neuropathic pain, comprises epidurally applying electrical stimulation energy to a spinothalamic tract of the patient, thereby treating the chronic neuropathic pain. The method may further comprise increasing the activation threshold of a side-effect exhibiting neural structure relative to the activation threshold of the spinothalamic tract of the patient, wherein the electrical stimulation energy is applied to the spinothalamic tract of the patient while the activation threshold of the neural structure relative to the spinothalamic tract is increased, thereby treating the chronic neuropathic pain without stimulating the neural structure.

Claims

1. A method for treating a patient suffering from chronic pain, the method comprising:

epidurally applying electrical modulation energy to a spinothalamic tract of the patient, thereby treating the chronic pain, wherein the electrical modulation energy is applied to a region of the spinothalamic tract of the patient rostral to a spinal segment that receives neural information from a painful region of the patient.

2. The method of claim 1, wherein the electrical modulation energy is electrical stimulation energy.

3. A method for treating a patient suffering from chronic pain, the method comprising:

epidurally applying electrical modulation energy to a spinothalamic tract of the patient, thereby treating the chronic pain, wherein the electrical modulation energy is applied to the spinothalamic tract by at least one electrode implanted within the ventral-lateral quadrant of an epidural space of the patient.

4. The method of claim 3, wherein the electrical modulation energy is electrical stimulation energy.

5. A method for treating a patient suffering from chronic pain, the method comprising:

epidurally applying electrical modulation energy to a spinothalamic tract of the patient, thereby treating the chronic pain; and

increasing the activation threshold of a side-effect exhibiting neural structure relative to the activation threshold of the spinothalamic tract of the patient, wherein the electrical modulation energy is applied to the spinothalamic tract of the patient while the activation threshold of the neural structure relative to the activation threshold spinothalamic tract is increased, thereby treating the chronic pain without stimulating the neural structure.

6. The method of claim 5, wherein the neural structure is one of a dorsal root (DR) nerve fiber and a ventral root (VR) nerve fiber.

7. The method of claim 5, wherein the activation threshold of the neural structure relative to the activation threshold of the spinothalamic tract is increased by applying electrical suppression energy to the neural structure.

8. The method of claim 7, wherein the electrical modulation energy is applied to spinothalamic tract by sinking electrical current at a first electrode adjacent the spinothalamic tract, thereby treating the chronic pain, and the electrical suppression energy is applied to the neural structure by sourcing at least a portion of the electrical current from a second electrode adjacent the neural structure, thereby increasing the activation threshold of the neural structure.

9. The method of claim 8, wherein electrical suppression energy is applied to another neural structure adjacent the spinothalamic tract to increase the activation threshold of the other neural structure by sourcing at least another portion of the electrical current from a third electrode adjacent the other neural structure, wherein the electrical modulation energy is applied to the spinothalamic tract of the patient while the activation threshold of the other neural structure is increased, thereby treating the chronic pain without stimulating the other neural structure.

10. The method of claim 9, wherein the neural structure is a dorsal root (DR) nerve fiber and the other neural structure is a ventral root (VR) nerve fiber.

11. The method of claim 9, wherein neural structure is a first ventral root (VR) nerve fiber, and the other neural structure is a second ventral root (VR) nerve fiber.

12. The method of claim 9, wherein the first electrode is a center electrode, and the second and third electrodes are flanking electrodes of a tripole configuration located between the neural structures.

13. The method of claim 9, further comprising sinking at least a portion of the electrical current sourced at the second electrode adjacent the neural structure into a remote electrode.

14. The method of claim 5, wherein the activation threshold of the neural structure is increased by applying a sub-threshold, hyperpolarizing conditioning pre-pulse to the neural structure, and electrical modulation energy is applied to the spinothalamic tract by applying a depolarizing stimulation pulse to the spinothalamic tract.

15. The method of claim 14, wherein the conditioning pre-pulse has a duration less than 200 μ

s.

16. The method of claim 5, wherein the activation threshold of the neural structure is increased by applying electrical background energy to the neural structure in accordance with at least one stochastic parameter to the neural structure.

17. The method of claim 16, wherein the electrical background energy comprises pulses, and the at least one stochastic parameter comprises at least one of an interpulse interval, pulse amplitude, pulse shape, and pulse duration.

18. The method of claim 16, wherein the electrical background energy comprises white noise, and the at least one stochastic parameter comprises a frequency.

19. The method of claim 5, wherein the activation threshold of the neural structure is increased by applying time-varying electrical energy having a frequency and amplitude that increases the activation threshold of the neural structure.

20. The method of claim 19, wherein the electrical modulation energy epidurally applied to the spinothalamic tract is the time-varying electrical energy, and the time-varying electrical energy having a frequency and amplitude that increases the activation threshold of the neural structure, while modulating the spinothalamic tract.

21. The method of claim 5, wherein the electrical modulation energy is electrical stimulation energy.