Method for direct modulation of the dorsolateral funiculus

• US 8,923,975 B2
• Filed: 12/07/2012
• Issued: 12/30/2014
• 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
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US13/708,742
• Publication Number:
  US 20130150920A1
• Time in Patent Office: 753 Days
• Field of Search: 607/46, 607/117
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36164 Sub-threshold or non-excitatory signals non-excitatory signals to the heart A61N1/3628
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration

Abstract

A method for treating a patient suffering from chronic neuropathic pain, comprises epidurally applying electrical stimulation energy to a dorsolateral funiculus 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 dorsolateral funiculus of the patient, wherein the electrical stimulation energy is applied to the dorsolateral funiculus of the patient while the activation threshold of the neural structure relative to the dorsolateral funiculus is increased, thereby treating the chronic neuropathic pain without stimulating the neural structure.

Claims

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

implanting at least one stimulation lead in an epidural space of the patient, each stimulation lead comprising a plurality of electrodes disposed along a distal portion of the stimulation lead, wherein the at least one stimulation lead is implanted with at least three of the electrodes disposed lateral of a midline of a spinal cord of the patient in a selected single dorsal-lateral quadrant of the epidural space and adjacent a dorsolateral funiculus of the patient; and

applying electrical stimulation energy to the dorsolateral funiculus of the patient, while applying electrical suppression energy to nerve root fibers of the patient, using the at least three electrodes to treat, the chronic neuropathic pain.

2. The method of claim 1, wherein the electrical stimulation energy is applied to a region of the dorsolateral funiculus of the patient rostral to a spinal nerve that innervates a painful region of the patient.

3. The method of claim 1, wherein applying electrical stimulation energy comprises applying the electrical stimulation energy as a time-varying electrical energy having a frequency in a range of 2 to 30 kHz.

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

applying electrical stimulation energy to a dorsolateral funiculus of the patient, thereby treating the chronic neuropathic pain; and

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

5. The method of claim 4, wherein the neural structure is a dorsal root (DR) nerve fiber.

6. The method of claim 4, wherein neural structure is a cervical spinal nerve.

7. The method of claim 4, wherein the activation threshold of the neural structure relative to the activation threshold of the dorsolateral funiculus is increased by applying electrical suppression energy to the neural structure.

8. The method of claim 7, wherein the electrical stimulation energy is applied to dorsolateral funiculus by sinking electrical current at a first electrode adjacent the dorsolateral funiculus, thereby treating the chronic neuropathic 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 a another neural structure adjacent the dorsolateral funiculus 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 stimulation energy is applied to the dorsolateral funiculus of the patient while the activation threshold of the other neural structure is increased, thereby treating the chronic neuropathic pain without stimulating the other neural structure.

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

11. 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.

12. 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.

13. The method of claim 4, 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 stimulation energy is applied to the dorsolateral funiculus by applying a depolarizing stimulation pulse to the dorsolateral funiculus.

14. The method of claim 13, wherein the conditioning pre-pulse has a duration less than 200 μ

s.

15. The method of claim 4, 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.

16. The method of claim 15, 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.

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

18. The method of claim 4, 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.

19. The method of claim 18, wherein the electrical stimulation energy epidurally applied to the dorsolateral funiculus 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 stimulating the relatively dorsolateral funiculus.

20. The method of claim 4, wherein applying electrical stimulation energy comprises applying the electrical stimulation energy as a time-varying electrical energy having a frequency in a range of 2 to 30 kHz.