Systems and methods for respiratory-gated nerve stimulation

Patent metadata

Field	Value
Publication number	US-11794012-B2
Application number	US-201816629395-A
Country	US
Kind code	B2
Filing date	Jul 10, 2018
Priority date	Jul 11, 2017
Publication date	Oct 24, 2023
Grant date	Oct 24, 2023

Abstract

Systems and methods are provided for neurostimulation timed relative to respiratory activity. Neurostimulation may be delivered to the spinal cord, the vagus nerve, and/or branches of the vagus nerve to provide therapeutic outcomes by controlling or adjusting stimulation based on pulmonary activity. In particular, the systems and methods use a detecting device to detect respiratory activity over time. Specific points in the respiratory signal are identified where central autonomic nuclei may be more receptive to afferent input and a stimulator is instructed to provide neurostimulation to at least one auricular branch of a vagus nerve, or to a cervical branch of the vagus nerve, or to a spinal cord of the subject. In this regard, the neurostimulation is advantageously correlated to the detected respiratory activity providing improved therapeutic outcomes.

First claim

The invention claimed is:

1. An apparatus comprising:
an electrode configured to be electrically coupled to an afferent nerve fiber of a vagus nerve of a subject;
a stimulation circuit connected to the electrode to deliver a stimulation signal to the electrode, thereby stimulating the afferent nerve fiber;
at least one processor configured to:
determine one or more pulmonary characteristics of the subject, the one or more pulmonary characteristics including a concentration of carbon dioxide; and
deliver the stimulation signal to the stimulation circuit to effectuate electrical stimulation of the subject based on the concentration of carbon dioxide.

2. The apparatus of claim 1 wherein the one or more pulmonary characteristics include at least one of inspiration and expiration and wherein delivering the stimulation signal includes timing a delivery of stimulations to the subject at a beginning of expiration and extending through a portion of expiration.

3. The apparatus of claim 2 wherein the processor is configured to terminate delivery of stimulations to the subject prior to inspiration.

4. The apparatus of claim 1 wherein the processor is configured to utilize an adaptive window to determine a timing of the pulmonary characteristic.

5. The apparatus of claim 1 further comprising a detector configured to monitor pulmonary activity of the subject and communicate a pulmonary activity waveform to the processor.

6. The apparatus of claim 5 wherein the detector includes at least one of a pulse sensor configured to measure blood pressure, a nasal cannula configured to measure respiratory flow or the concentration of carbon dioxide, or a respiration belt configured to measure expansion and contraction of a thorax of the subject during respiration.

7. The apparatus of claim 1 wherein the electrical stimulation is configured to achieve a therapeutic function to treat at least one of hypertension, inflammatory disorders, or gastrointestinal disorders.

8. The apparatus of claim 1 wherein the electrical stimulation includes at least one of:
a constant-current pulse;
a burst of bi-phasic square wave pulses;
a frequency between 1-100 Hz;
current intensity between 0.25 mA to 20 mA; and
a pulse width between 100-1000 microseconds.

Assignees

• Massachusetts Gen Hospital

Inventors

• Napadow Vitaly
• Goldstein Jill M
• Garcia Ronald G
• Pless Benjamin

Classifications

• A61N1/36053 Primary

  adapted for vagal stimulation (A61N1/36114 takes precedence) · CPC title

• A61N1/0551

  Spinal or peripheral nerve electrodes · CPC title

• A61N1/36139

  with automatic adjustment · CPC title

• A61N1/0502

  Skin piercing electrodes · CPC title

• A61N1/36096

  Mood disorders, e.g. depression, anxiety or panic disorder · CPC title