Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders

US 20030100933A1
Filed: 09/24/2002
Published: 05/29/2003
Est. Priority Date: 04/26/2001
Status: Active Grant

First Claim

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1. A method for treating spasticity of a subject, comprising:

driving a current into a nerve of the subject that includes one or more sensory fibers; and

configuring the current so as to inhibit propagation of action potentials in one or more of the sensory fibers, so as to treat the spasticity.

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Abstract

A method for treating spasticity of a subject is provided, including driving a current into a nerve of the subject that includes one or more sensory fibers, and configuring the current so as to inhibit propagation of action potentials in one or more of the sensory fibers, so as to treat the spasticity. In a preferred embodiment, the sensory fibers include one or more Ia sensory fibers, and configuring the current includes configuring the current so as to inhibit propagation of the action potentials in at least one of the Ia sensory fibers.

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250 Claims

1. A method for treating spasticity of a subject, comprising:
- driving a current into a nerve of the subject that includes one or more sensory fibers; and
  
  configuring the current so as to inhibit propagation of action potentials in one or more of the sensory fibers, so as to treat the spasticity.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
- - 2. A method according to claim 1, wherein the sensory fibers include one or more Ia sensory fibers, and wherein configuring the current comprises configuring the current so as to inhibit propagation of the action potentials in at least one of the Ia sensory fibers.
  - 3. A method according to claim 1, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the current comprises driving the current into the nerve.
  - 4. A method according to claim 1, comprising implanting a device in a body of the subject, wherein driving the current comprises driving the current at the device.
  - 5. A method according to claim 1, wherein driving the current comprises driving the current at a site in a limb of the subject.
  - 6. A method according to claim 1, wherein driving the current comprises driving the current in a vicinity of a spinal cord nerve root of the subject.
  - 7. A method according to claim 1, wherein driving the current comprises driving the current in a series of pulses.
  - 8. A method according to claim 1, wherein configuring the current comprises configuring the current to have a frequency greater than about 5 Hz, so as to inhibit propagation of the action potentials.
  - 9. A method according to claim 1, comprising determining a time of day, wherein driving the current comprises driving the current responsive to the time of day.
  - 10. A method according to claim 1, wherein driving the current comprises driving the current into a portion of the nerve proximal to a spinal cord of the subject.
  - 11. A method according to claim 10, wherein driving the current into the portion of the nerve proximal to the spinal cord of the subject comprises driving the current into the portion of the nerve at a site within about 5 cm from the spinal cord.
  - 12. A method according to claim 1, wherein configuring the current comprises configuring the current to apply collision blocking to the nerve so as to inhibit propagation of the action potentials.
  - 13. A method according to claim 12, wherein driving the current comprises sequentially driving the current at a plurality of locations on the nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 14. A method according to claim 1, wherein the current includes a first current, wherein the nerve includes a first nerve that includes one or more first sensory fibers, wherein configuring the current comprises configuring the first current so as to inhibit propagation of first action potentials in one or more of the first sensory fibers, the method comprising:
    - driving a second current into a second nerve of the subject that innervates a second muscle of the subject that is antagonistic to a first muscle innervated by at least one of the first sensory fibers, the second nerve including one or more second sensory fibers; and
      
      configuring the second current so as to inhibit propagation of second action potentials in at least one of the second sensory fibers.
  - 15. A method according to claim 14, wherein the first nerve includes the second nerve, and wherein driving the second current comprises driving the second current into the first nerve.
  - 16. A method according to claim 14, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 17. A method according to claim 1, wherein the current includes a first current, wherein the nerve includes a first nerve that includes one or more first sensory fibers, wherein configuring the current comprises configuring the first current so as to inhibit propagation of first action potentials in one or more of the first sensory fibers, the method comprising:
    - driving a second current into a second nerve of the subject that innervates a second muscle of the subject that is synergistic to a first muscle innervated by at least one of the first sensory fibers, the second nerve including one or more second sensory fibers; and
      
      configuring the second current so as to inhibit propagation of second action potentials in at least one of the second sensory fibers.
  - 18. A method according to claim 17, wherein the first nerve includes the second nerve, and driving the second current comprises driving the second current into the first nerve.
  - 19. A method according to claim 17, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 20. A method according to claim 1, wherein the current includes a first current, wherein the nerve includes a first nerve that includes one or more first sensory fibers, wherein configuring the current comprises configuring the first current so as to inhibit propagation of first action potentials in one or more of the first sensory fibers, the method comprising:
    - driving a second current into a second nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of the subject; and
      
      configuring the second current so as to inhibit propagation of second action potentials in at least one of the gamma motor fibers.
  - 21. A method according to claim 20, wherein the first nerve includes the second nerve, and driving the second current comprises driving the second current into the first nerve.
  - 22. A method according to claim 20, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 23. A method according to claim 1, comprising sensing at least one physiological parameter of the subject, wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 24. A method according to claim 23, wherein the at least one physiological parameter includes a measure selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject, and wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 25. A method according to claim 23, comprising analyzing the at least one physiological parameter to determine a measure of spasticity of the subject, wherein driving the current comprises driving the current responsive to the measure of spasticity so as to reduce the measure of spasticity.

26. A method for treating spasticity of a subject, comprising:
- driving a current into a nerve of the subject that includes one or more sensory fibers; and
  
  configuring the current so as to induce propagation of action potentials in one or more of the sensory fibers, so as to treat the spasticity.
- View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 226, 227)
- - 27. A method according to claim 26, wherein the sensory fibers include one or more Ib sensory fibers, and wherein configuring the current comprises configuring the current so as to induce propagation of the action potentials in at least one of the Ib sensory fibers.
  - 28. A method according to claim 26, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the current comprises driving the current into the nerve.
  - 29. A method according to claim 26, comprising determining a time of day, wherein driving the current comprises driving the current responsive to the time of day.
  - 30. A method according to claim 26, comprising sensing at least one physiological parameter of the subject, wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 31. A method according to claim 30, wherein the at least one physiological parameter is selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject, and wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 32. A method according to claim 30, comprising analyzing the at least one physiological parameter to determine a measure of spasticity of the subject, wherein driving the current comprises driving the current responsive to the measure of spasticity so as to reduce the measure of spasticity.
  - 33. A method according to claim 26, wherein the current includes a first current, wherein the nerve includes a first nerve that includes one or more first sensory fibers, wherein configuring the current comprises configuring the first current so as to induce propagation of first action potentials in one or more of the first sensory fibers, the method comprising:
    - driving a second current into a second nerve of the subject that includes one or more second sensory fibers; and
      
      configuring the second current so as to inhibit propagation of second action potentials in one or more of the second sensory fibers.
  - 34. A method according to claim 33, wherein the second sensory fibers include one or more Ia sensory fibers, and wherein configuring the second current comprises configuring the second current so as to inhibit propagation of the second action potentials in at least one of the Ia sensory fibers.
  - 35. A method according to claim 33, wherein the first nerve includes the second nerve, and driving the second current comprises driving the second current into the first nerve.
  - 36. A method according to claim 33, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 226. A method according to claim 26, comprising implanting a device in a body of the subject, wherein driving the current comprises driving the current at the device.
  - 227. A method according to claim 26, wherein driving the current into the nerve comprises driving a stimulating current into the nerve, wherein configuring the current comprises configuring the stimulating current so as to induce the propagation of the action potentials, and wherein the method comprises applying to the nerve a supplementary current, which is configured to inhibit action potentials that are traveling in an efferent direction and that are induced by the stimulating current.

37. A method for treating spasticity of a subject, comprising:
- driving a current into a nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of a muscle of the subject; and
  
  configuring the current so as to inhibit propagation of action potentials in at least one of the gamma motor fibers, so as to treat the spasticity.
- View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53)
- - 38. A method according to claim 37, wherein driving the current comprises driving the current into a portion of the nerve in a vicinity of the muscle.
  - 39. A method according to claim 37, wherein driving the current comprises driving the current into a portion of the nerve in a vicinity of a spinal cord of the subject.
  - 40. A method according to claim 37, wherein the nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the current comprises driving the current into the nerve.
  - 41. A method according to claim 37, comprising implanting a device in a body of the subject, wherein driving the current comprises driving the current at the device.
  - 42. A method according to claim 37, wherein driving the current comprises driving the current in a series of pulses.
  - 43. A method according to claim 37, wherein configuring the current comprises configuring the current to have a frequency greater than about 5 Hz, so as to inhibit propagation of the action potentials.
  - 44. A method according to claim 37, comprising determining a time of day, wherein driving the current comprises driving the current responsive to the time of day.
  - 45. A method according to claim 37, wherein configuring the current comprises configuring the current to apply collision blocking to the nerve so as to inhibit propagation of the action potentials.
  - 46. A method according to claim 45, wherein driving the current comprises sequentially driving the current at a plurality of locations on the nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 47. A method according to claim 37, comprising sensing at least one physiological parameter of the subject, wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 48. A method according to claim 47, wherein the at least one physiological parameter is selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject, and wherein driving the current comprises driving the current responsive to the at least one physiological parameter.
  - 49. A method according to claim 47, comprising analyzing the at least one physiological parameter to determine a measure of spasticity of the subject, wherein driving the current comprises driving the current responsive to the measure of spasticity so as to reduce the measure of spasticity.
  - 50. A method according to claim 37, wherein the current includes a first current, wherein the nerve includes a first nerve that includes the one or more gamma motor fibers innervating the muscle spindle of the muscle of the subject, wherein configuring the current comprises configuring the first current so as to inhibit propagation of first action potentials in at least one of the gamma motor fibers, the method comprising:
    - driving a second current into a second nerve of the subject that includes one or more sensory fibers; and
      
      configuring the second current so as to inhibit propagation of second action potentials in one or more of the sensory fibers.
  - 51. A method according to claim 50, wherein the sensory fibers include one or more Ia sensory fibers, and wherein configuring the second current comprises configuring the second current so as to inhibit propagation of the second action potentials in at least one of the Ia sensory fibers.
  - 52. A method according to claim 50, wherein the first nerve includes the second nerve, and driving the second current comprises driving the second current into the first nerve.
  - 53. A method according to claim 50, wherein the first and second nerves comprise two distinct nerves of the subject.

54. A method for treating a weakness of a skeletal muscle of a subject, comprising:
- driving an inhibiting current into a first nerve of the subject that includes one or more sensory fibers innervating the muscle, so as to inhibit propagation of afferent action potentials in the sensory fibers; and
  
  driving a stimulating current into a second nerve of the subject that includes one or more motor fibers innervating the muscle, so as to stimulate efferent action potentials in the motor fibers.
- View Dependent Claims (55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70)
- - 55. A method according to claim 54, wherein the sensory fibers include one or more Ia sensory fibers, and wherein driving the inhibiting current comprises driving the inhibiting current so as to inhibit propagation of action potentials in at least one of the Ia sensory fibers.
  - 56. A method according to claim 54, wherein the motor fibers include one or more alpha motor fibers, and wherein driving the stimulating current comprises driving the stimulating current so as to stimulate efferent action potentials in at least one of the alpha motor fibers.
  - 57. A method according to claim 54, wherein the motor fibers include one or more A-beta motor fibers, and wherein driving the stimulating current comprises driving the stimulating current so as to stimulate efferent action potentials in at least one of the A-beta motor fibers.
  - 58. A method according to claim 54, wherein the first nerve includes the second nerve, and driving the stimulating current comprises driving the stimulating current into the first nerve.
  - 59. A method according to claim 54, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 60. A method according to claim 54, wherein the first nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the inhibiting current comprises driving the inhibiting current into the first nerve.
  - 61. A method according to claim 54, wherein the second nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the stimulating current comprises driving the stimulating current into the second nerve.
  - 62. A method according to claim 54, wherein the second nerve includes a set of nerve fibers, and wherein driving the stimulating current into the second nerve comprises applying to the second nerve a secondary inhibiting current which is capable of inhibiting efferent action potentials in the set of nerve fibers that are induced by the stimulating current, the nerve fibers in the set having generally larger diameters than the motor fibers.
  - 63. A method according to claim 54, wherein driving the stimulating current into the second nerve comprises applying to the second nerve a supplementary inhibiting current, which is configured to inhibit action potentials traveling in an afferent direction in one or more nerve fibers in the second nerve that are induced by the stimulating current.
  - 64. A method according to claim 54, wherein configuring the inhibiting current comprises configuring the inhibiting current to have a frequency greater than about 5 Hz.
  - 65. A method according to claim 54, comprising determining a time of day, wherein driving the inhibiting and stimulating currents comprises driving the inhibiting and stimulating currents responsive to the time of day.
  - 66. A method according to claim 54, wherein driving the inhibiting current comprises applying collision blocking to the first nerve so as to inhibit propagation of the afferent action potentials.
  - 67. A method according to claim 66, wherein driving the inhibiting current comprises sequentially driving the inhibiting current at a plurality of locations on the first nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the first nerve, so as to inhibit propagation of the afferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 68. A method according to claim 54, comprising sensing at least one physiological parameter of the subject, wherein driving the inhibiting and stimulating currents comprises driving the inhibiting and stimulating currents responsive to the at least one physiological parameter.
  - 69. A method according to claim 68, wherein the at least one physiological parameter is selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject, and wherein driving the inhibiting and stimulating currents comprises driving the inhibiting and stimulating currents responsive to the at least one physiological parameter.
  - 70. A method according to claim 68, comprising analyzing the at least one physiological parameter to determine a measure of spasticity of the subject, wherein driving the inhibiting and stimulating currents comprises driving the inhibiting and stimulating currents responsive to the measure of spasticity so as to reduce the measure of spasticity.

71. A method for treating spasticity of a subject, comprising:
- driving a current into a nerve of the subject that includes one or more motor fibers; and
  
  configuring the current so as to inhibit propagation of efferent action potentials in one or more of the motor fibers, so as to treat the spasticity.
- View Dependent Claims (72, 73, 74, 75)
- - 72. A method according to claim 71, wherein the motor fibers include one or more alpha motor fibers, and wherein configuring the current comprises configuring the current so as to inhibit propagation of efferent action potentials in the alpha motor fibers.
  - 73. A method according to claim 71, wherein the nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the current comprises driving the current into the nerve.
  - 74. A method according to claim 71, wherein driving the current comprises applying collision blocking to the nerve so as to inhibit propagation of the efferent action potentials.
  - 75. A method according to claim 71, wherein driving the current comprises sequentially driving the current at a plurality of locations on the nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the efferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.

76. A method for treating a weakness of a skeletal muscle of a subject, comprising:
- driving an inhibiting current into a first nerve of the subject that includes one or more gamma motor fibers innervating the muscle, so as to inhibit propagation of efferent action potentials in the gamma motor fibers; and
  
  driving a stimulating current into a second nerve of the subject that includes one or more motor fibers innervating the muscle, so as to stimulate efferent action potentials in the motor fibers.
- View Dependent Claims (77, 78, 79, 80, 81, 82, 83, 84, 228, 229)
- - 77. A method according to claim 76, wherein the motor fibers include one or more alpha motor fibers, and wherein driving the stimulating current comprises driving the stimulating current so as to stimulate efferent action potentials in the alpha motor fibers.
  - 78. A method according to claim 76, wherein the motor fibers include one or more A-beta motor fibers, and wherein driving the stimulating current comprises driving the stimulating current so as to stimulate efferent action potentials in the A-beta motor fibers.
  - 79. A method according to claim 76, wherein the first nerve includes the second nerve, and driving the stimulating current comprises driving the stimulating current into the first nerve.
  - 80. A method according to claim 76, wherein the first and second nerves comprise two distinct nerves of the subject.
  - 81. A method according to claim 76, wherein the first nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the inhibiting current comprises driving the inhibiting current into the first nerve.
  - 82. A method according to claim 76, wherein the second nerve is selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein driving the stimulating current comprises driving the stimulating current into the second nerve.
  - 83. A method according to claim 76, wherein driving the inhibiting current comprises applying collision blocking to the first nerve so as to inhibit propagation of the efferent action potentials.
  - 84. A method according to claim 76, wherein driving the inhibiting current comprises sequentially driving the inhibiting current at a plurality of locations on the first nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the first nerve, so as to inhibit propagation of the efferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 228. A method according to claim 76, comprising implanting a device in a body of the subject, wherein driving the inhibiting current comprises driving the inhibiting current at the device.
  - 229. A method according to claim 76, comprising applying to the second nerve a supplementary current, which is configured to inhibit action potentials that are traveling in an afferent direction and that are induced by the stimulating current.

85. A method for treating a weakness of a skeletal muscle of a subject, comprising:
- driving an inhibiting current into a nerve of the subject that includes one or more sensory fibers innervating the muscle, so as to inhibit propagation of afferent action potentials in the sensory fibers; and
  
  driving a stimulating current into the muscle, so as to stimulate the muscle.
- View Dependent Claims (230, 231, 232, 233, 234, 235, 236)
- - 230. A method according to claim 85, comprising configuring the inhibiting current to have a frequency greater than about 5 Hz.
  - 231. A method according to claim 85, comprising determining a time of day, wherein driving the inhibiting current comprises driving the inhibiting current responsive to the time of day.
  - 232. A method according to claim 85, wherein driving the inhibiting current comprises applying collision blocking to the nerve so as to inhibit propagation of the afferent action potentials.
  - 233. A method according to claim 232, wherein driving the inhibiting current comprises sequentially driving the inhibiting current at a plurality of locations on the nerve with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the afferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 234. A method according to claim 85, comprising sensing at least one physiological parameter of the subject, wherein driving the inhibiting current comprises driving the inhibiting current responsive to the at least one physiological parameter.
  - 235. A method according to claim 234, wherein the at least one physiological parameter is selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject, and wherein driving the inhibiting current comprises driving the inhibiting current responsive to the at least one physiological parameter.
  - 236. A method according to claim 234, comprising analyzing the at least one physiological parameter to determine a measure of weakness of the subject, wherein driving the inhibiting current comprises driving the inhibiting current responsive to the measure of weakness so as to reduce the measure of weakness.

86. A method for treating a weakness of a skeletal muscle of a subject, comprising:
- driving an inhibiting current into a nerve of the subject that includes one or more gamma motor fibers innervating the muscle, so as to inhibit propagation of efferent action potentials in the gamma motor fibers; and
  
  driving a stimulating current into the muscle, so as to stimulate the muscle.

87. A method for treating spasticity of a subject, comprising:
- driving a current into a spinal cord of the subject; and
  
  configuring the current so as to stimulate a subset of fibers of the spinal cord that include one or more fibers descending from an upper motor neuron (UMN), so as to treat the spasticity.
- View Dependent Claims (88, 89, 90, 91, 92, 93, 94)
- - 88. A method according to claim 87, comprising implanting a device in a body of the subject, wherein driving the current comprises driving the current at the device.
  - 89. A method according to claim 87, wherein driving the current comprises driving the current in a series of pulses.
  - 90. A method according to claim 87, wherein driving the current comprises driving the current into a nerve tract of the spinal cord, which nerve tract includes the subset of fibers.
  - 91. A method according to claim 87, wherein driving the current comprises driving the current onto a surface of the spinal cord.
  - 92. A method according to claim 87, wherein the current includes a first current, wherein configuring the current comprises configuring the first current so as to stimulate the subset of fibers of the spinal cord, the method comprising:
    - driving a second current into a nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of the subject; and
      
      configuring the second current so as to inhibit propagation of action potentials in at least one of the gamma motor fibers.
  - 93. A method according to claim 87, wherein the current includes a first current, wherein configuring the current comprises configuring the first current so as to stimulate the subset of fibers of the spinal cord, the method comprising:
    - driving a second current into a nerve of the subject that includes one or more sensory fibers; and
      
      configuring the second current so as to inhibit propagation of action potentials in one or more of the sensory fibers.
  - 94. A method according to claim 93, wherein the sensory fibers include one or more Ia sensory fibers, and wherein configuring the second current comprises configuring the second current so as to inhibit propagation of the action potentials in at least one of the Ia sensory fibers.

95. Apparatus for treating spasticity of a subject, comprising:
- an electrode device, adapted to be coupled to a nerve of the subject that includes one or more sensory fibers; and
  
  a control unit, adapted to drive the electrode device to apply to the nerve a current that is capable of inhibiting propagation of action potentials in at least one of the sensory fibers, so as to treat the spasticity.
- View Dependent Claims (96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128)
- - 96. Apparatus according to claim 95, wherein the sensory fibers include one or more Ia sensory fibers, and wherein the control unit is adapted to drive the electrode device to apply the current so as to inhibit propagation of the action potentials in at least one of the Ia sensory fibers.
  - 97. Apparatus according to claim 95, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the electrode device is adapted to be coupled to the nerve.
  - 98. Apparatus according to claim 95, wherein the electrode device is adapted to be implanted in a body of the subject.
  - 99. Apparatus according to claim 95, wherein the control unit is adapted to be implanted in a body of the subject.
  - 100. Apparatus according to claim 95, wherein the electrode device is adapted to be coupled to the nerve at a site in a limb of the subject.
  - 101. Apparatus according to claim 95, wherein the electrode device is adapted to be coupled to the nerve in a vicinity of a spinal cord nerve root of the subject.
  - 102. Apparatus according to claim 95, wherein the control unit is adapted to drive the electrode device to apply the current in a series of pulses.
  - 103. Apparatus according to claim 95, wherein the control unit is adapted to drive the electrode device to configure the current to have a frequency greater than about 5 Hz, so as to inhibit propagation of the action potentials.
  - 104. Apparatus according to claim 95, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the electrode device to apply the current responsive to the time of day.
  - 105. Apparatus according to claim 95, wherein the electrode device is adapted to be coupled to a portion of the nerve proximal to a spinal cord of the subject.
  - 106. Apparatus according to claim 105, wherein the electrode device is adapted to be coupled to the portion of the nerve at a site within about 5 cm from the spinal cord.
  - 107. Apparatus according to claim 95, wherein the electrode device comprises a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more first sensory fibers, wherein the control unit is adapted to drive the first electrode device to apply to the first nerve a first current that is capable of inhibiting propagation of action potentials in at least one of the first sensory fibers, the apparatus comprising a second electrode device, adapted to be coupled to a second nerve of the subject that innervates a second muscle of the subject that is antagonistic to a first muscle innervated by at least one of the first sensory fibers, the second nerve including one or more second sensory fibers, wherein the control unit is adapted to drive the second electrode device to apply to the second nerve a second current that is capable of inhibiting propagation of action potentials in at least one of the second sensory fibers.
  - 108. Apparatus according to claim 107, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 109. Apparatus according to claim 107, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 110. Apparatus according to claim 107, wherein the first electrode device comprises a first set of one or more electrodes, wherein the second electrode device comprises a second set of one or more electrodes, and wherein the first and second sets share at least one electrode.
  - 111. Apparatus according to claim 95, wherein the electrode device comprises a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more first sensory fibers, wherein the control unit is adapted to drive the first electrode device to apply to the first nerve a first current that is capable of inhibiting propagation of first action potentials in at least one of the first sensory fibers, the apparatus comprising a second electrode device, adapted to be coupled to a second nerve of the subject that innervates a second muscle of the subject that is synergistic to a first muscle innervated by at least one of the first sensory fibers, the second nerve including one or more second sensory fibers, wherein the control unit is adapted to drive the second electrode device to apply to the second nerve a second current that is capable of inhibiting propagation of second action potentials in at least one of the second sensory fibers.
  - 112. Apparatus according to claim 111, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 113. Apparatus according to claim 111, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 114. Apparatus according to claim 111, wherein the first electrode device comprises a first set of one or more electrodes, wherein the second electrode device comprises a second set of one or more electrodes, and wherein the first and second sets share at least one electrode.
  - 115. Apparatus according to claim 95, wherein the electrode device comprises a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more first sensory fibers, wherein the control unit is adapted to drive the first electrode device to apply to the first nerve a first current that is capable of inhibiting propagation of action potentials in at least one of the first sensory fibers, the apparatus comprising a second electrode device, adapted to be coupled to a second nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of the subject, wherein the control unit is adapted to drive the second electrode device to apply to the second nerve a second current that is capable of inhibiting propagation of action potentials in at least one of the gamma motor fibers.
  - 116. Apparatus according to claim 115, wherein the first nerve includes the second nerve, and the second electrode device is adapted to be coupled to the first nerve.
  - 117. Apparatus according to claim 115, wherein the first and second nerves include two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 118. Apparatus according to claim 115, wherein the first electrode device comprises a first set of one or more electrodes, wherein the second electrode device comprises a second set of one or more electrodes, and wherein the first and second sets share at least one electrode.
  - 119. Apparatus according to claim 95, wherein the control unit is adapted to drive the electrode device to apply collision blocking to the nerve, so as to inhibit propagation of the action potentials.
  - 120. Apparatus according to claim 119, wherein the electrode device comprises:
    - a cathode, adapted to apply to the nerve a stimulating current that is capable of inducing action potentials in the nerve;
      
      a first set of one or more anodes, adapted to be disposed on one side of the cathode, and to apply to the nerve a first inhibiting current that is capable of inhibiting action potentials in the nerve so as to produce a selective anodal block of the nerve; and
      
      a second set of one or more anodes, adapted to be disposed on a second side of the cathode opposite the first set of anodes, and to apply to the nerve a second inhibiting current which is capable of inhibiting action potentials in the nerve so as to produce an essentially complete anodal block of the nerve.
  - 121. Apparatus according to claim 119, comprising a plurality of electrode devices coupled to a respective plurality of locations on the nerve, wherein the control unit is adapted to sequentially drive the electrode devices to apply respective currents with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 122. Apparatus according to claim 95, comprising a sensor unit, wherein the control unit is adapted to receive at least one sensed parameter from the sensor unit, and to drive the electrode device to apply the current responsive to the at least one sensed parameter.
  - 123. Apparatus according to claim 122, wherein the sensor unit comprises an electromyographic (EMG) monitor, wherein the at least one sensed parameter includes a measure of electrical activity of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the EMG monitor.
  - 124. Apparatus according to claim 122, wherein the sensor unit comprises a strain gauge, wherein the at least one sensed parameter includes a measure of mechanical strain of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the strain gauge.
  - 125. Apparatus according to claim 122, wherein the sensor unit comprises an accelerometer, wherein the at least one sensed parameter includes a measure of motion of one or more limbs of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the accelerometer.
  - 126. Apparatus according to claim 122, wherein the at least one sensed parameter includes an indication whether the subject is sleeping, and wherein the control unit is adapted to drive the electrode device to apply the current responsive to the indication.
  - 127. Apparatus according to claim 122, wherein the sensor unit comprises a set of one or more electrodes, wherein the at least one sensed parameter includes a measure of an action potential in one or more nerve fibers of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the set of electrodes.
  - 128. Apparatus according to claim 122, wherein the control unit is adapted to analyze the at least one sensed parameter to determine a measure of spasticity of the subject, and to drive the electrode device to apply the current responsive to the measure of spasticity so as to reduce the measure of spasticity.

129. Apparatus for treating spasticity of a subject, comprising:
- an electrode device, adapted to be coupled to a nerve of the subject that includes one or more sensory fibers; and
  
  a control unit, adapted to drive the electrode device to apply to the nerve a current that is capable of inducing propagation of action potentials in at least one of the sensory fibers, so as to treat the spasticity.
- View Dependent Claims (130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 237)
- - 130. Apparatus according to claim 129, wherein the sensory fibers include one or more Ib sensory fibers, and wherein the control unit is adapted to drive the electrode device to apply the current so as to induce propagation of the action potentials in at least one of the Ib sensory fibers.
  - 131. Apparatus according to claim 129, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the electrode device is adapted to be coupled to the nerve.
  - 132. Apparatus according to claim 129, wherein the electrode device is adapted to be implanted in a body of the subject.
  - 133. Apparatus according to claim 129, wherein the control unit is adapted to be implanted in a body of the subject.
  - 134. Apparatus according to claim 129, wherein the electrode device is adapted to be coupled to the nerve at a site in a limb of the subject.
  - 135. Apparatus according to claim 129, wherein the electrode device is adapted to be coupled to the nerve in a vicinity of a spinal cord nerve root of the subject.
  - 136. Apparatus according to claim 129, wherein the control unit is adapted to drive the electrode device to apply the current in a series of pulses.
  - 137. Apparatus according to claim 129, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the electrode device to apply the current responsive to the time of day.
  - 138. Apparatus according to claim 129, wherein the electrode device comprises a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more first sensory fibers, wherein the control unit is adapted to drive the first electrode device to apply to the first nerve a first current that is capable of inducing propagation of first action potentials in at least one of the first sensory fibers, the apparatus comprising a second electrode device, adapted to be coupled to a second nerve of the subject that includes one or more second sensory fibers, wherein the control unit is adapted to drive the second electrode device to apply to the second nerve a second current which is capable of inhibiting propagation of second action potentials in one or more of the second sensory fibers.
  - 139. Apparatus according to claim 138, wherein the second sensory fibers include one or more Ia sensory fibers, and wherein the control unit is adapted to drive the second electrode device to apply the second current so as to inhibit propagation of the second action potentials in at least one of the Ia sensory fibers.
  - 140. Apparatus according to claim 138, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 141. Apparatus according to claim 138, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 142. Apparatus according to claim 129, comprising a sensor unit, wherein the control unit is adapted to receive at least one sensed parameter from the sensor unit, and to drive the electrode device to apply the current responsive to the at least one sensed parameter.
  - 143. Apparatus according to claim 142, wherein the sensor unit comprises an electromyographic (EMG) monitor, wherein the at least one sensed parameter includes a measure of electrical activity of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the EMG monitor.
  - 144. Apparatus according to claim 142, wherein the sensor unit comprises a strain gauge, wherein the at least one sensed parameter includes a measure of mechanical strain of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the strain gauge.
  - 145. Apparatus according to claim 142, wherein the sensor unit comprises an accelerometer, wherein the at least one sensed parameter includes a measure of motion of one or more limbs of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the accelerometer.
  - 146. Apparatus according to claim 142, wherein the at least one sensed parameter includes an indication whether the subject is sleeping, and wherein the control unit is adapted to drive the electrode device to apply the current responsive to the indication.
  - 147. Apparatus according to claim 142, wherein the sensor unit comprises a set of one or more electrodes, wherein the at least one sensed parameter includes a measure of an action potential in one or more nerve fibers of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the set of electrodes.
  - 148. Apparatus according to claim 142, wherein the control unit is adapted to analyze the at least one sensed parameter to determine a measure of spasticity of the subject, and to drive the electrode device to apply the current responsive to the measure of spasticity so as to reduce the measure of spasticity.
  - 237. Apparatus according to claim 129, wherein the control unit is adapted to drive the electrode device to apply a supplementary current, which is configured to inhibit action potentials that are traveling in an efferent direction and that are induced by the application of the current that is capable of inducing propagation of action potentials.

149. Apparatus for treating spasticity of a subject, comprising:
- an electrode device, adapted to be coupled to a nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of a muscle of the subject; and
  
  a control unit, adapted to drive the electrode device to apply to the nerve a current that is capable of inhibiting propagation of action potentials in at least one of the gamma motor fibers, so as to treat the spasticity.
- View Dependent Claims (150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173)
- - 150. Apparatus according to claim 149, wherein the electrode device is adapted to be implanted in a body of the subject.
  - 151. Apparatus according to claim 149, wherein the control unit is adapted to be implanted in a body of the subject.
  - 152. Apparatus according to claim 149, wherein the electrode device is adapted to be coupled to the nerve at a site in a limb of the subject.
  - 153. Apparatus according to claim 149, wherein the electrode device is adapted to be coupled to the nerve in a vicinity of a spinal cord nerve root of the subject.
  - 154. Apparatus according to claim 149, wherein the control unit is adapted to drive the electrode device to apply the current in a series of pulses.
  - 155. Apparatus according to claim 149, wherein the control unit is adapted to drive the electrode device to configure the current to have a frequency greater than about 5 Hz, so as to inhibit propagation of the action potentials.
  - 156. Apparatus according to claim 149, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the electrode device is adapted to be coupled to the nerve.
  - 157. Apparatus according to claim 149, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the electrode device to apply the current responsive to the time of day.
  - 158. Apparatus according to claim 149, wherein the electrode device is adapted to be coupled to a portion of the nerve proximal to a spinal cord of the subject.
  - 159. Apparatus according to claim 158, wherein the electrode device is adapted to be coupled to the portion of the nerve at a site within about 5 cm from the spinal cord.
  - 160. Apparatus according to claim 149, wherein the electrode device comprises a first electrode device, adapted to be coupled to a first nerve of the subject that includes that includes the one or more gamma motor fibers, wherein the control unit is adapted to drive the first electrode device to apply to the first nerve a first current that is capable of inhibiting propagation of first action potentials in at least one of the gamma motor fibers, the apparatus comprising a second electrode device, adapted to be coupled to a second nerve of the subject that includes one or more second sensory fibers, wherein the control unit is adapted to drive the second electrode device to apply to the second nerve a second current that is capable of inhibiting propagation of second action potentials in one or more of the second sensory fibers.
  - 161. Apparatus according to claim 160, wherein the sensory fibers include one or more Ia sensory fibers, and wherein the control unit is adapted to drive the second electrode device to apply the second current so as to inhibit propagation of the second action potentials in at least one of the Ia sensory fibers.
  - 162. Apparatus according to claim 160, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 163. Apparatus according to claim 160, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 164. Apparatus according to claim 149, wherein the control unit is adapted to drive the electrode device to apply collision blocking to the nerve, so as to inhibit propagation of the action potentials.
  - 165. Apparatus according to claim 164, wherein the electrode device comprises:
    - a cathode, adapted to apply to the nerve a stimulating current that is capable of inducing action potentials in the nerve;
      
      a first set of one or more anodes, adapted to be disposed on one side of the cathode, and to apply to the nerve an inhibiting current that is capable of inhibiting action potentials in the nerve so as to produce a selective anodal block of the nerve; and
      
      a second set of one or more anodes, adapted to be disposed on a second side of the cathode opposite the first set of anodes, and to apply to the nerve an inhibiting current which is capable of inhibiting action potentials in the nerve so as to produce an essentially complete anodal block of the nerve.
  - 166. Apparatus according to claim 164, comprising a plurality of electrode devices coupled to a respective plurality of locations on the nerve, wherein the control unit is adapted to sequentially drive the electrode devices to apply respective currents with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 167. Apparatus according to claim 149, comprising a sensor unit, wherein the control unit is adapted to receive at least one sensed parameter from the sensor unit, and to drive the electrode device to apply the current responsive to the at least one sensed parameter.
  - 168. Apparatus according to claim 167, wherein the sensor unit comprises an electromyographic (EMG) monitor, wherein the at least one sensed parameter includes a measure of electrical activity of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the EMG monitor.
  - 169. Apparatus according to claim 167, wherein the sensor unit comprises a strain gauge, wherein the at least one sensed parameter includes a measure of mechanical strain of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the strain gauge.
  - 170. Apparatus according to claim 167, wherein the sensor unit comprises an accelerometer, wherein the at least one sensed parameter includes a measure of motion of one or more limbs of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the accelerometer.
  - 171. Apparatus according to claim 167, wherein the at least one sensed parameter includes an indication whether the subject is sleeping, and wherein the control unit is adapted to drive the electrode device to apply the current responsive to the indication.
  - 172. Apparatus according to claim 167, wherein the sensor unit comprises a set of one or more electrodes, wherein the at least one sensed parameter includes a measure of an action potential in one or more nerve fibers of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the set of electrodes.
  - 173. Apparatus according to claim 167, wherein the control unit is adapted to analyze the at least one sensed parameter to determine a measure of spasticity of the subject, and to drive the electrode device to apply the current responsive to the measure of spasticity so as to reduce the measure of spasticity.

174. Apparatus for treating a weakness of a skeletal muscle of a subject, comprising:
- a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more sensory fibers innervating the muscle;
  
  a second electrode device, adapted to be coupled to a second nerve of the subject that includes one or more motor fibers innervating the muscle; and
  
  a control unit, adapted to;
  
  drive the first electrode device to apply to the first nerve an inhibiting current, which is capable of inhibiting propagation of afferent action potentials in the sensory fibers, and drive the second electrode device to apply to the second nerve a stimulating current, which is capable of stimulating efferent action potentials in the motor fibers.
- View Dependent Claims (175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196)
- - 175. Apparatus according to claim 174, wherein the sensory fibers include one or more Ia sensory fibers, and wherein the control unit is adapted to drive the first electrode device to apply the inhibiting current so as to inhibit propagation of afferent action potentials in at least one of the Ia sensory fibers.
  - 176. Apparatus according to claim 174, wherein the motor fibers include one or more alpha motor fibers, and wherein the control unit is adapted to drive the second electrode device to apply the stimulating current so as to stimulate efferent action potentials in at least one of the alpha motor fibers.
  - 177. Apparatus according to claim 174, wherein the motor fibers include one or more A-beta motor fibers, and wherein the control unit is adapted to drive the second electrode device to apply the stimulating current so as to stimulate efferent action potentials in at least one of the A-beta motor fibers.
  - 178. Apparatus according to claim 174, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 179. Apparatus according to claim 174, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 180. Apparatus according to claim 174, wherein the first nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the first electrode device is adapted to be coupled to the first nerve.
  - 181. Apparatus according to claim 174, wherein the second nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the second electrode device is adapted to be coupled to the second nerve.
  - 182. Apparatus according to claim 174, wherein the second nerve includes a set of nerve fibers, and wherein the second electrode device comprises:
    - a cathode, adapted to apply to the second nerve a stimulating current which is capable of inducing efferent action potentials in the set of nerve fibers of the second nerve and in the one or more motor fibers; and
      
      an anode, adapted to apply to the second nerve a secondary inhibiting current which is capable of inhibiting the induced efferent action potentials in the set of nerve fibers, the nerve fibers in the set having generally larger diameters than the motor fibers.
  - 183. Apparatus according to claim 174, wherein the control unit is adapted to drive the first electrode device at a frequency greater than about 5 Hz, so as to inhibit propagation of the afferent action potentials.
  - 184. Apparatus according to claim 174, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the first and second electrode devices to apply the respective currents responsive to the time of day.
  - 185. Apparatus according to claim 174, wherein the control unit is adapted to drive the first electrode device to apply collision blocking to the first nerve, so as to inhibit propagation of the afferent action potentials.
  - 186. Apparatus according to claim 185, wherein the first electrode device comprises:
    - a cathode, adapted to apply to the first nerve a stimulating current that is capable of inducing action potentials in the first nerve;
      
      a first set of one or more anodes, adapted to be disposed on one side of the cathode, and to apply to the first nerve an inhibiting current that is capable of inhibiting action potentials in the nerve so as to produce a selective anodal block of the first nerve; and
      
      a second set of one or more anodes, adapted to be disposed on a second side of the cathode opposite the first set of anodes, and to apply to the first nerve an inhibiting current which is capable of inhibiting action potentials in the first nerve so as to produce an essentially complete anodal block of the nerve.
  - 187. Apparatus according to claim 185, comprising a plurality of first electrode devices coupled to a respective plurality of locations on the first nerve, wherein the control unit is adapted to sequentially drive the first electrode devices to apply respective currents with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the first nerve, so as to inhibit propagation of the afferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 188. Apparatus according to claim 174, comprising a sensor unit, wherein the control unit is adapted to receive at least one sensed parameter from the sensor unit, and to drive the first and second electrode devices to apply the respective currents responsive to the at least one sensed parameter.
  - 189. Apparatus according to claim 188, wherein the sensor unit comprises an electromyographic (EMG) monitor, wherein the at least one sensed parameter includes a measure of electrical activity of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the EMG monitor.
  - 190. Apparatus according to claim 188, wherein the sensor unit comprises a strain gauge, wherein the at least one sensed parameter includes a measure of mechanical strain of one or more muscles of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the strain gauge.
  - 191. Apparatus according to claim 188, wherein the sensor unit comprises an accelerometer, wherein the at least one sensed parameter includes a measure of motion of one or more limbs of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the accelerometer.
  - 192. Apparatus according to claim 188, wherein the at least one sensed parameter includes an indication whether the subject is sleeping, and wherein the control unit is adapted to drive the first and second electrode devices to apply the respective currents responsive to the indication.
  - 193. Apparatus according to claim 188, wherein the sensor unit comprises a set of one or more electrodes, wherein the at least one sensed parameter includes a measure of an action potential in one or more nerve fibers of the subject, and wherein the control unit is adapted to receive the at least one sensed parameter from the set of electrodes.
  - 194. Apparatus according to claim 188, wherein the control unit is adapted to analyze the at least one sensed parameter to determine a measure of spasticity of the subject, and to drive the first and second electrode devices to apply the respective currents responsive to the measure of spasticity so as to reduce the measure of spasticity.
  - 195. Apparatus according to claim 174, wherein the second electrode device comprises:
    - a cathode, adapted to apply to the second nerve a stimulating current which is capable of inducing action potentials in the second nerve; and
      
      a primary and a secondary anode, adapted to be disposed so that the primary anode is located between the secondary anode and the cathode, and adapted to apply to the second nerve respective primary and secondary inhibiting currents which are capable of inhibiting action potentials in the second nerve.
  - 196. Apparatus according to claim 195, comprising a set of one or more blocking anodes, adapted to be disposed such that the cathode is between the set of blocking anodes and the primary anode, and adapted to apply to the second nerve a current which is capable of inhibiting action potentials propagating in the second nerve in a direction from the cathode towards the set of blocking anodes.

197. Apparatus for treating spasticity of a subject, comprising:
- an electrode device, adapted to be coupled to a nerve of the subject that includes one or more motor fibers; and
  
  a control unit, adapted to drive the electrode device to apply to the nerve a current, which is capable of inhibiting propagation of efferent action potentials in one or more of the motor fibers, so as to treat the spasticity.
- View Dependent Claims (198, 199, 200, 201, 202)
- - 198. Apparatus according to claim 197 wherein the motor fibers include one or more alpha fibers, and wherein the control unit is adapted to drive the electrode device to apply the current so as to inhibit propagation of the efferent action potentials in at least one of the alpha motor fibers.
  - 199. Apparatus according to claim 197 wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the electrode device is adapted to be coupled to the nerve.
  - 200. Apparatus according to claim 197 wherein the electrode device is adapted to be implanted in a body of the subject.
  - 201. Apparatus according to claim 197 wherein the control unit is adapted to be implanted in a body of the subject.
  - 202. Apparatus according to claim 197 wherein the control unit is adapted to drive the electrode device to apply collision blocking to the nerve, so as to inhibit propagation of the efferent action potentials.

203. Apparatus for treating a weakness of a skeletal muscle of a subject, comprising:
- a first electrode device, adapted to be coupled to a first nerve of the subject that includes one or more gamma motor fibers innervating the muscle;
  
  a second electrode device, adapted to be coupled to a second nerve of the subject that includes one or more motor fibers innervating the muscle; and
  
  a control unit, adapted to;
  
  drive the first electrode device to apply to the first nerve an inhibiting current, which is capable of inhibiting propagation of efferent action potentials in the gamma motor fibers, and drive the second electrode device to apply to the second nerve a stimulating current, which is capable of stimulating efferent action potentials in the motor fibers.
- View Dependent Claims (204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 238, 239, 240, 241, 242, 243)
- - 204. Apparatus according to claim 203, wherein the motor fibers include one or more alpha motor fibers, and wherein the control unit is adapted to drive the second electrode device to apply the stimulating current so as to stimulate efferent action potentials in at least one of the alpha motor fibers.
  - 205. Apparatus according to claim 203, wherein the motor fibers include one or more A-beta motor fibers, and wherein the control unit is adapted to drive the second electrode device to apply the stimulating current so as to stimulate efferent action potentials in at least one of the A-beta motor fibers.
  - 206. Apparatus according to claim 203, wherein the first nerve includes the second nerve, and wherein the second electrode device is adapted to be coupled to the first nerve.
  - 207. Apparatus according to claim 203, wherein the first and second nerves comprise two distinct nerves of the subject, and wherein the first electrode device is adapted to be coupled to the first nerve, and the second electrode device is adapted to be coupled to the second nerve.
  - 208. Apparatus according to claim 203, wherein the first nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the first electrode device is adapted to be coupled to the nerve.
  - 209. Apparatus according to claim 203, wherein the second nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the second electrode device is adapted to be coupled to the nerve.
  - 210. Apparatus according to claim 203, wherein the second nerve includes a set of nerve fibers, and wherein the second electrode device comprises:
    - a cathode, adapted to apply to the second nerve a stimulating current which is capable of inducing efferent action potentials in the set of nerve fibers of the second nerve and in the one or more motor fibers; and
      
      an anode, adapted to apply to the second nerve a secondary inhibiting current that is capable of inhibiting the induced efferent action potentials in the set of nerve fibers, the nerve fibers in the set having generally larger diameters than the motor fibers.
  - 211. Apparatus according to claim 203, wherein the control unit is adapted to drive the first electrode device to configure the inhibiting current to have a frequency greater than about 5 Hz, so as to inhibit propagation of the afferent action potentials.
  - 212. Apparatus according to claim 203, wherein the control unit is adapted to drive the first electrode device to apply collision blocking to the first nerve, so as to inhibit propagation of the efferent action potentials.
  - 213. Apparatus according to claim 212, wherein the first electrode device comprises:
    - a cathode, adapted to apply to the first nerve a stimulating current that is capable of inducing action potentials in the first nerve;
      
      a first set of one or more anodes, adapted to be disposed on one side of the cathode, and to apply to the first nerve an inhibiting current that is capable of inhibiting action potentials in the nerve so as to produce a selective anodal block of the first nerve; and
      
      a second set of one or more anodes, adapted to be disposed on a second side of the cathode opposite the first set of anodes, and to apply to the first nerve an inhibiting current which is capable of inhibiting action potentials in the first nerve so as to produce an essentially complete anodal block of the nerve.
  - 214. Apparatus according to claim 212, comprising a plurality of first electrode devices coupled to a respective plurality of locations on the first nerve, wherein the control unit is adapted to sequentially drive the first electrode devices to apply respective currents with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the first nerve, so as to inhibit propagation of the afferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 238. Apparatus according to claim 203, wherein the first electrode device is adapted to be implanted in a body of the subject.
  - 239. Apparatus according to claim 203, wherein the control unit is adapted to drive the second electrode device to apply a supplementary current, which is configured to inhibit action potentials that are traveling in an afferent direction and that are induced by the application of the stimulating current.
  - 240. Apparatus according to claim 203, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the first electrode device to apply the inhibiting current responsive to the time of day.
  - 241. Apparatus according to claim 203, wherein the control unit is adapted to drive the first electrode device to apply the inhibiting current in sequence at a plurality of locations on the first nerve, with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the first nerve, so as to inhibit propagation of the efferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 242. Apparatus according to claim 203, comprising a sensor adapted to sense at least one physiological parameter of the subject, wherein the control unit is adapted to drive the first electrode device to apply the inhibiting current responsive to the at least one physiological parameter.
  - 243. Apparatus according to claim 242, wherein the sensor comprises a sensor adapted to sense a physiological parameter selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject.

215. Apparatus for treating a weakness of a skeletal muscle of a subject, comprising:
- a first electrode device, adapted to be coupled to a nerve of the subject that includes one or more sensory fibers innervating the muscle;
  
  a second electrode device, adapted to be coupled to the muscle; and
  
  a control unit, adapted to;
  
  drive the first electrode device to apply to the nerve an inhibiting current, which is capable of inhibiting propagation of afferent action potentials in the sensory fibers, and drive the second electrode device to apply a stimulating current to the muscle.
- View Dependent Claims (244, 245, 246, 247, 248, 249, 250)
- - 244. Apparatus according to claim 215, wherein the nerve includes a nerve selected from the list consisting of:
    - a tibial nerve, a sciatic nerve, a femoral nerve, a median nerve, a musculocutaneous nerve, an ulnar nerve, and a radial nerve, and wherein the first electrode device is adapted to be coupled to the nerve.
  - 245. Apparatus according to claim 215, wherein the control unit is adapted to drive the first electrode device at a frequency greater than about 5 Hz, so as to inhibit propagation of the afferent action potentials.
  - 246. Apparatus according to claim 215, comprising a clock, wherein the control unit is adapted to receive a time of day from the clock, and to drive the first electrode device to apply the inhibiting current responsive to the time of day.
  - 247. Apparatus according to claim 215, wherein the control unit is adapted to drive the first electrode device to apply collision blocking to the nerve, so as to inhibit propagation of the afferent action potentials.
  - 248. Apparatus according to claim 215, wherein the control unit is adapted to drive the first electrode device to apply the inhibiting current in sequence at a plurality of locations on the nerve, with delays timed responsive to a velocity of propagation of body-generated action potentials traveling in the nerve, so as to inhibit propagation of the afferent action potentials while minimizing inhibition of propagation of the body-generated action potentials.
  - 249. Apparatus according to claim 215, comprising a sensor adapted to sense at least one physiological parameter of the subject, wherein the control unit is adapted to drive the first electrode device to apply the inhibiting current responsive to the at least one physiological parameter.
  - 250. Apparatus according to claim 249, wherein the sensor comprises a sensor adapted to sense a physiological parameter selected from the list consisting of:
    - a measure of electrical activity of one or more muscles of the subject, a measure of mechanical strain of one or more muscles of the subject, a measure of motion of one or more limbs of the subject, a measure indicating that the subject is sleeping, and a measure of an action potential in one or more nerve fibers of the subject.

216. Apparatus for treating a weakness of a skeletal muscle of a subject, comprising:
- a first electrode device, adapted to be coupled to a nerve of the subject that includes one or more gamma motor fibers innervating the muscle;
  
  a second electrode device, adapted to be coupled to the muscle; and
  
  a control unit, adapted to;
  
  drive the first electrode device to apply to the nerve an inhibiting current, which is capable of inhibiting propagation of efferent action potentials in the gamma motor fibers, and drive the second electrode device to apply a stimulating current to the muscle.

217. Apparatus for treating spasticity of a subject, comprising:
- an electrode device, adapted to be coupled to a spinal cord of the subject; and
  
  a control unit, adapted to drive the electrode device to apply to the spinal cord a current, which is capable of stimulating a subset of fibers of the spinal cord that includes one or more fibers descending from an upper motor neuron (UMN), so as to treat the spasticity.
- View Dependent Claims (218, 219, 220, 221, 222, 223, 224, 225)
- - 218. Apparatus according to claim 217, wherein the electrode device is adapted to be implanted in a body of the subject.
  - 219. Apparatus according to claim 217, wherein the control unit is adapted to be implanted in a body of the subject.
  - 220. Apparatus according to claim 217, wherein the control unit is adapted to drive the electrode device to apply the current in a series of pulses.
  - 221. Apparatus according to claim 217, wherein the electrode device comprises a first electrode device, adapted to be coupled to a spinal cord of the subject, wherein the control unit is adapted to drive the first electrode device to apply to the spinal cord a first current, which is capable of stimulating the subset of fibers of the spinal cord that includes one or more fibers descending from the UMN, the apparatus comprising a second electrode device, adapted to be coupled to a nerve of the subject that includes one or more gamma motor fibers innervating a muscle spindle of the subject, wherein the control unit is adapted to drive the second electrode device to apply to the nerve a second current that is capable of inhibiting propagation of action potentials in at least one of the gamma motor fibers.
  - 222. Apparatus according to claim 217, wherein the electrode device comprises an array of microelectrodes adapted to be applied to a nerve tract of the spinal cord, which nerve tract includes the subset of fibers.
  - 223. Apparatus according to claim 217, wherein the electrode device is adapted to be applied to a surface of the spinal cord.
  - 224. Apparatus according to claim 217, wherein the electrode device comprises a first electrode device, adapted to be coupled to a spinal cord of the subject, wherein the control unit is adapted to drive the first electrode device to apply to the spinal cord a first current, which is capable of stimulating the subset of fibers of the spinal cord that includes one or more fibers descending from the UMN, the apparatus comprising a second electrode device, adapted to be coupled to a nerve of the subject that includes one or more sensory fibers, wherein the control unit is adapted to drive the second electrode device to apply to the nerve a second current, which is capable of inhibiting propagation of action potentials in one or more of the sensory fibers.
  - 225. Apparatus according to claim 224, wherein the sensory fibers include one or more Ia sensory fibers, and wherein the control unit is adapted to drive the second electrode device to apply the second current so as to inhibit propagation of the action potentials in at least one of the Ia sensory fibers.

Specification

Resources

Litigation Campaign Assessment

Current Assignee
BioControl Medical (B.C.M) Ltd.
Original Assignee
BioControl Medical (B.C.M) Ltd.
Inventors
Cohen, Ehud, Ayal, Shai, Darby, Ron

Granted Patent

US 6,892,098 B2
Time in Patent Office

Days
Field of Search
US Class Current

607/48
CPC Class Codes

A61N 1/36003   of motor muscles, e.g. for ...

A61N 1/36007   of urogenital or gastrointe...

A61N 1/36021   for treatment of pain

A61N 1/36067   Movement disorders, e.g. tr...

A61N 1/36071   Pain

A61N 1/37205   Microstimulators, e.g. impl...

Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders

First Claim

4 Assignments

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Accused Products

Abstract

137 Citations

250 Claims

Specification

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Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders

First Claim

4 Assignments

Subscription Required

Subscription Required

0 Petitions

Subscription Required

Accused Products

Subscription Required

Abstract

137 Citations

250 Claims

Specification

Subscription Required

Solutions

Use Cases

Quick Links