Autonomic nervous system control via high frequency spinal cord modulation, and associated systems and methods

• US 9,833,614 B1
• Filed: 06/20/2013
• Issued: 12/05/2017
• Est. Priority Date: 06/22/2012
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Gliner, Bradford Evan
• Primary Examiner(s): Mahmood, Nadia A
• Application Number:
  US13/922,765
• Time in Patent Office: 1,629 Days
• Field of Search: 607117, 607 46
• CPC Class Codes: A61N 1/36062 Spinal stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36121 Production of neurotransmitters; Modulation of genes expression
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36171 Frequency

Abstract

Autonomic nervous system control via high frequency spinal cord modulation, and associated systems and methods. A method for treating a patient in accordance with a particular embodiment includes selecting a neural modulation site to include a neural population of the patient'"'"'s spinal cord, and selecting parameters of a neural modulation signal to at least reduce an autonomic system deficit in the patient.

Claims

1. A method for treating a patient, comprising:

reducing or modifying an organ dysfunction of an identified organ in the patient by applying or directing application of an electrical signal to a spinal cord of the patient via an implanted signal delivery device, at a vertebral level associated with the identified organ, the electrical signal having a frequency of from about 1.5 kHz to about 100 kHz, wherein reducing or modifying the organ dysfunction includes modifying an imbalance in the patient'"'"'s autonomic system by normalizing a combined effect of the patient'"'"'s sympathetic and parasympathetic systems.

2. The method of claim 1 wherein the autonomic system imbalance affects a target organ of the patient'"'"'s cardiovascular system.

3. The method of claim 1 wherein the autonomic system imbalance affects a target organ of the patient'"'"'s gastrointestinal system.

13. The method of claim 1 wherein the organ is an organ in the patient'"'"'s cardiovascular system or the patient'"'"'s gastrointestinal system.

16. The method of claim 1 wherein the organ dysfunction is reduced or modified indirectly by altering gene expression.

19. The method of claim 13 wherein the vertebral level of the patient'"'"'s spinal cord is an upper thoracic vertebral level.

22. The method of claim 1 wherein the vertebral level of the patient'"'"'s spinal cord is a cervical level of the spinal cord.

4. A method for treating a patient, comprising:

implanting a signal delivery device at a location proximate to a vertebral level of the patient'"'"'s spinal cord associated with an organ in the patient identified as having an organ dysfunction; and

directing an electrical signal to the patient'"'"'s spinal cord at the vertebral level and at a frequency in a range of from about 1.5 kHz to about 100 kHz to reduce or modify the organ dysfunction by normalizing a combined effect of the patient'"'"'s sympathetic and parasympathetic systems.

5. The method of claim 4 wherein directing the electrical signal includes directing the electrical signal to wide dynamic range (WDR) neurons of the patient'"'"'s spinal cord.

6. The method of claim 4 wherein directing the electrical signal includes directing the electrical signal to the dorsal horn of the patient'"'"'s spinal cord.

7. The method of claim 4, further comprising:

monitoring the organ dysfunction of the patient; and

in response to results obtained from monitoring the patient'"'"'s organ dysfunction, adjusting at least one signal delivery parameter in accordance with which the electrical signal is applied to the patient'"'"'s spinal cord.

8. The method of claim 7 wherein monitoring includes observing a function of the patient controlled by the organ.

9. The method of claim 7 wherein monitoring includes monitoring with a medical device.

10. The method of claim 4 wherein the location is an epidural location.

14. The method of claim 4 wherein the organ is an organ in the patient'"'"'s cardiovascular system or the patient'"'"'s gastrointestinal system.

17. The method of claim 4 wherein the organ dysfunction is reduced or modified indirectly by altering gene expression.

20. The method of claim 14 wherein the vertebral level of the patient'"'"'s spinal cord is an upper thoracic vertebral level.

23. The method of claim 4 wherein the vertebral level of the patient'"'"'s spinal cord is a cervical level of the spinal cord.

25. The method of claim 4 wherein the organ dysfunction is modified by eliminating the organ dysfunction.

11. A method for evaluating a patient'"'"'s pain, comprising:

directing an electrical therapy signal to the patient'"'"'s spinal cord via an implanted signal delivery device to reduce or inhibit pain in the patient, the electrical therapy signal having a frequency of from about 1.5 kHz to about 100 kHz;

receiving feedback corresponding to an autonomic system response by the patient to the electrical therapy signal, wherein the autonomic system response is a reduction or modification of an autonomic system deficit achieved by normalizing a combined effect of the patient'"'"'s sympathetic and parasympathetic systems; and

based at least in part on the feedback, identifying a characteristic of the patient'"'"'s pain response to the electrical therapy signal.

12. A method for treating a patient having an organ identified as having an organ dysfunction by reducing or modifying the patient'"'"'s organ dysfunction, the method comprising:

applying or directing application of an electrical signal to a spinal cord region of the patient via an implanted signal delivery device, the electrical signal having a frequency of from about 1.5 kHz to about 100 kHz, wherein reducing or modifying the patient'"'"'s organ dysfunction includes normalizing a combined effect of the patient'"'"'s sympathetic and parasympathetic systems.

15. The method of claim 12 wherein the organ is an organ in the patient'"'"'s cardiovascular system or the patient'"'"'s gastrointestinal system.

18. The method of claim 12 wherein the organ dysfunction is reduced or modified indirectly by altering gene expression.

21. The method of claim 15 wherein the vertebral level of the patient'"'"'s spinal cord is an upper thoracic vertebral level.

24. The method of claim 12 wherein the vertebral level of the patient'"'"'s spinal cord is a cervical level of the spinal cord.