Onset-mitigating high-frequency nerve block

• US 8,983,614 B2
• Filed: 10/28/2008
• Issued: 03/17/2015
• Est. Priority Date: 10/29/2007
• Status: Active Grant

• Current Assignee: Case Western Reserve University
• Original Assignee: Boston Scientific Corporation
• Inventors: Kilgore, Kevin L., Bhadra, Niloy
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/739,413
• Publication Number:
  US 20100241190A1
• Time in Patent Office: 2,331 Days
• Field of Search: 607/45, 607/46, 607/48
• US Class Current: 607/48
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/20 continuous direct currents
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/36057 adapted for stimulating afferent nerves
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/3615 Intensity
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset
• CPC Class Codes: A61N 1/36171 Frequency

Abstract

A method of blocking signal transmission through a nerve with reduced onset activity includes applying an HFAC to an axon of a nerve to block the transmission of signals through the axon. The method may also include applying a direct current (DC) to the axon, increasing the amplitude of the DC over time to a predetermined amplitude, applying the HFAC, and then decreasing the DC. The method may also include temporarily reducing the amplitude of the HFAC to permit the transmission of signals through the axon and subsequently increasing the amplitude to block transmission without triggering an onset response. The method may also include temporarily applying an unbalanced charge to the nerve and then balancing the charge over time.

Claims

1. A method, comprising:

providing a DC ramp to a nerve;

providing a first alternating waveform having a first offset to the nerve after providing the DC ramp;

providing a second alternating waveform having a second offset different than the first offset to the nerve after providing the first alternating waveform; and

providing at least one steady-state waveform to the nerve after providing the second alternating waveform, wherein said method blocks nerve signal transmission in the nerve and mitigates onset activity in the nerve.

2. The method of claim 1, wherein the at least one steady-state waveform delivers a zero net charge.

3. The method of claim 1, wherein the DC ramp, the first alternating waveform, the second alternating waveform and the steady state waveform are delivered through a single electrode.

4. The method of claim 1, wherein the DC ramp, the first alternating waveform, the second alternating waveform and the steady-state waveform deliver electrical charge in an amount that does not produce an action potential in the nerve.

5. The method of claim 1, where one or more of the DC ramp, the first alternating waveform, or the second alternating waveform is imbalanced, and where the method includes recovering at least a portion of an imbalanced charge over a period of time.

6. The method of claim 1, where the at least one steady-state waveform is imbalanced, and where the method includes recovering at least a portion of an imbalanced charge over a period of time.

7. The method of claim 1, where the method comprises altering the first and second alternating waveforms to obtain a charge-balanced waveform.

8. The method of claim 1, wherein the first offset is a cathodic offset and the second offset is an anodic offset.

9. The method of claim 1, wherein the first offset is an anodic offset and the second offset is a cathodic offset.

10. The method of claim 1, wherein the first offset is one of a cathodic offset and an anodic offset and the second offset is one of a cathodic offset that ramps to zero and an anodic offset that ramps to zero.

11. An apparatus, comprising:

an electrode;

a waveform generator connected to the electrode; and

a controller configured to;

first control the waveform generator to generate a DC ramp and to apply the DC ramp to a nerve through the electrode;

then control the waveform generator to generate a first alternating waveform and to

apply the first alternating waveform to the nerve through the electrode, wherein the first alternating waveform has an increasing amplitude, and where the first alternating waveform has a first offset;

then control the waveform generator to generate a second alternating waveform and to apply the second alternating waveform to the nerve through the electrode, where the second alternating waveform has a second offset different than the first offset; and

then control the waveform generator to generate a steady-state, HFAC waveform and to apply the steady state HFAC waveform to the nerve through the electrode to produce a nerve conduction block.

12. The apparatus of claim 11, where the nerve conduction block is one of, a motor nerve block, a sensing nerve block, an autonomic block, a sternocleidomastoid block, a median nerve block, a phrenic nerve block, a celiac plexus nerve block, and a modulated spasticity block, and where the nerve conduction block is applied to treat symptoms of one or more of, torticollis, neuroma pain, hiccups, muscular dystrophy, cancer pain, post-operative pain, chronic pain, pain, and stroke.

13. The apparatus of claim 11, wherein the first offset is a cathodic offset and the second offset is an anodic offset.

14. The apparatus of claim 11, wherein the first offset is an anodic offset and the second offset is a cathodic offset.

15. The apparatus of claim 11, wherein the first offset is one of a cathodic offset and an anodic offset and the second offset is one of a cathodic offset that ramps to zero and an anodic offset that ramps to zero.