Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
First Claim
1. A method of treating a medical condition in a patient having a brain, a vagus nerve, a trigeminal nerve, a glossopharyngeal nerve, a cardiac cycle, and a respiratory cycle, the method comprising:
- detecting a first selected portion of at least one of the cardiac cycle of the patient and the respiratory cycle of the patient; and
applying a first pulsed electrical signal to at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the first selected portion of the at least one of the cardiac cycle and the respiratory cycle of the patient, the first pulsed electrical signal comprising a plurality of microbursts wherein each microburst is separated from an adjacent microburst by an interburst period of at least 100 milliseconds, and each microburst comprises;
2 pulses to 20 pulses;
an interpulse interval between adjacent pulses of the microburst of from about 1 millisecond to about 20 milliseconds; and
a microburst duration of not greater than 1 second,wherein the first pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a first enhanced evoked potential in the brain of the patient;
measuring the first enhanced evoked potential in the brain of the patient;
changing at least one of the interburst period, the number of pulses per microburst, the interpulse interval between adjacent pulses of the microburst, and the microburst duration to provide a second pulsed electrical signal;
detecting a second selected portion of the at least one of the cardiac cycle of the patient and the respiratory cycle of the patient;
applying the second pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the second selected portion of the at least one of the cardiac cycle and the respiratory cycle of the patient, wherein the second pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a second enhanced evoked potential in the brain of the patient;
measuring the second enhanced evoked potential in the brain of the patient;
comparing the first enhanced evoked potential to the second enhanced evoked potential;
selecting one of the first pulsed electrical signal and the second pulsed electrical signal for continued application to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve based upon the comparison between the first and second enhanced evoked potentials; and
applying the selected pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve of the patient.
1 Assignment
0 Petitions
Accused Products
Abstract
Disclosed herein are methods, systems, and apparatus for treating a medical condition of a patient, involving detecting a physiological cycle or cycles of the patient and applying an electrical signal to a portion of the patient'"'"'s vagus nerve through an electrode at a selected point in the physiological cycle(s). The physiological cycle can be the cardiac and/or respiratory cycle. The selected point can be a point in the cardiac cycle correlated with increased afferent conduction on the vagus nerve, such as a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG, optionally during inspiration by the patient. The selected point can be a point in the cardiac cycle when said applying increases heart rate variability, such as a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG, optionally during expiration by the patient.
793 Citations
16 Claims
-
1. A method of treating a medical condition in a patient having a brain, a vagus nerve, a trigeminal nerve, a glossopharyngeal nerve, a cardiac cycle, and a respiratory cycle, the method comprising:
-
detecting a first selected portion of at least one of the cardiac cycle of the patient and the respiratory cycle of the patient; and applying a first pulsed electrical signal to at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the first selected portion of the at least one of the cardiac cycle and the respiratory cycle of the patient, the first pulsed electrical signal comprising a plurality of microbursts wherein each microburst is separated from an adjacent microburst by an interburst period of at least 100 milliseconds, and each microburst comprises; 2 pulses to 20 pulses; an interpulse interval between adjacent pulses of the microburst of from about 1 millisecond to about 20 milliseconds; and a microburst duration of not greater than 1 second, wherein the first pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a first enhanced evoked potential in the brain of the patient; measuring the first enhanced evoked potential in the brain of the patient; changing at least one of the interburst period, the number of pulses per microburst, the interpulse interval between adjacent pulses of the microburst, and the microburst duration to provide a second pulsed electrical signal; detecting a second selected portion of the at least one of the cardiac cycle of the patient and the respiratory cycle of the patient; applying the second pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the second selected portion of the at least one of the cardiac cycle and the respiratory cycle of the patient, wherein the second pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a second enhanced evoked potential in the brain of the patient; measuring the second enhanced evoked potential in the brain of the patient; comparing the first enhanced evoked potential to the second enhanced evoked potential; selecting one of the first pulsed electrical signal and the second pulsed electrical signal for continued application to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve based upon the comparison between the first and second enhanced evoked potentials; and applying the selected pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve of the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
-
-
16. A method of treating a medical condition in a patient comprising a brain, a vagus nerve, a trigeminal nerve, a glossopharyngeal nerve, and a respiratory cycle, the method comprising:
-
detecting a first selected portion of the respiratory cycle of the patient; and applying a first pulsed electrical signal comprising a plurality of microbursts to at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the first selected portion of the respiratory cycle of the patient, the first pulsed electrical signal comprising a plurality of microbursts, wherein each microburst is separated from an adjacent microburst by an interburst period of at least 100 milliseconds and comprises; 2 pulses to 20 pulses; an interpulse interval between adjacent pulses of the microburst of from about 1 millisecond to about 20 milliseconds; and a microburst duration of not greater than 1 second, wherein the first pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a first enhanced evoked potential in the brain of the patient; measuring the first enhanced evoked potential in the brain of the patient; changing at least one of the interburst period, the number of pulses per microburst, the interpulse interval between adjacent pulses of the microburst, and the microburst duration to provide a second pulsed electrical signal; detecting a second selected portion of the at least one of the cardiac cycle of the patient and the respiratory cycle of the patient; applying the second pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve to modulate the brain of the patient in response to detecting the second selected portion of the at least one of the cardiac cycle and the respiratory cycle of the patient, wherein the second pulsed electrical signal is configured to generate afferent electrical activity on the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve that produces a second enhanced evoked potential in the brain of the patient; measuring the second enhanced evoked potential in the brain of the patient; comparing the first enhanced evoked potential to the second enhanced evoked potential; selecting one of the first pulsed electrical signal and the second pulsed electrical signal for continued application to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve based upon the comparison between the first and second enhanced evoked potentials; and applying the selected pulsed electrical signal to the at least one of the vagus nerve, the trigeminal nerve, and the glossopharyngeal nerve of the patient.
-
Specification