Systems and methods for direct suppression of nerve cells

Patent metadata

Field	Value
Publication number	US-11819693-B2
Application number	US-202117157888-A
Country	US
Kind code	B2
Filing date	Jan 25, 2021
Priority date	Jan 25, 2020
Publication date	Nov 21, 2023
Grant date	Nov 21, 2023

Abstract

The present technology provides systems and methods for directly suppressing nerve cells by delivering electrical stimulation having relatively long pulse widths and at amplitudes below an activation threshold of the nerve cells. For example, some embodiments include delivering a therapy signal having individual pulses with pulse widths of between about 5 ms and 100 ms. Directly suppressing the nerve cells is expected to reduce the transmission of pain signals.

First claim

We claim:

1. A patient treatment system, comprising:
a signal generator having a computer readable storage medium with instructions that, in operation, generate a therapy signal having a pulse width in a pulse width range from about 200 ms to about 2 seconds; and
a signal delivery element coupleable to the signal generator, wherein the signal delivery element is positionable proximate a spinal cord region, and, in operation, delivers the therapy signal to the spinal cord region to directly suppress at least a subset of neurons at or proximate the spinal cord region.

2. A patient treatment system, comprising:
a signal generator having a computer readable storage medium with instructions that, in operation, generate a therapy signal having (i) a pulse width in a pulse width range from about 200 ms to about 2 seconds, and (ii) an amplitude below an activation threshold of target neurons; and
a signal delivery element coupleable to the signal generator, wherein the signal delivery element is positionable proximate a spinal cord region, and, in operation, delivers the therapy signal to the spinal cord region to directly suppress at least a subset of the target neurons.

3. A method for treating a patient, comprising:
applying a therapy signal to the patient via a treatment system to directly suppress at least a subset of a target neural population, wherein the treatment system includes a signal delivery element positioned proximate a spinal cord region of the patient, and wherein the therapy signal includes pulses having a pulse width of from about 200 ms to about 2 seconds.

4. The method of claim 3 wherein the therapy signal has an amplitude below an activation threshold of the subset of neurons.

5. The method of claim 3 , further comprising determining a maximum amplitude of the therapy signal that does not evoke a clinically discernable response, wherein applying the therapy signal comprises applying the therapy signal at an amplitude less than or equal to the maximum amplitude.

6. The method of claim 3 wherein the signal delivery element includes an electrode, the method further comprising determining a maximum amplitude of the therapy signal that the electrode can tolerate based at least in part on the pulse width, the electrode material, and/or the surface area of the electrode, and wherein applying the therapy signal comprises applying the therapy signal at an amplitude less than or equal to the maximum amplitude.

7. The method of claim 3 wherein the therapy signal includes a plurality of biphasic pulses having an anodic pulse phase and a cathodic pulse phase, and wherein at least one of the anodic pulse phase or the cathodic pulse phase has the pulse width in the pulse width range from about 200 ms to about 2 seconds.

8. The method of claim 7 wherein the biphasic pulses include a ramping period between the anodic pulse phase and the cathodic pulse phase.

9. The method of claim 8 wherein the ramping period has a duration substantially equal to the pulse width.

10. The method of claim 7 wherein the anodic pulse phase and the cathodic pulse phase have different pulse widths and/or amplitudes.

11. The method of claim 7 wherein the anodic pulse phase and the cathodic pulse phase have the same pulse width and amplitude.

12. The method of claim 3 wherein the therapy signal includes a plurality of monophasic pulses, and wherein the plurality of monophasic pulses have the pulse width in the pulse width range from about 200 ms to about 2 seconds.

13. The method of claim 3 wherein the pulse width is about 500 ms or greater.

14. The method of claim 3 wherein the pulse width range is from about 200 ms to about 1 second.

15. The method of claim 3 wherein the pulse width range is from about 200 ms to about 700 ms.

16. The method of claim 3 wherein the pulse width is greater than 500 milliseconds and less than 1 second.

17. A method for treating a patient, comprising:
programming a signal generator to deliver a therapy signal having a pulse width in a pulse width range of from about 200 ms to about 2 seconds to a target neural population in the patient's spinal cord region via at least one implanted signal delivery element, wherein the therapy signal directly suppresses at least a subset of the target neural population.

18. The method of claim 17 wherein the therapy signal has an amplitude below an activation threshold of the subset of neurons.

19. The method of claim 17 , further comprising:
determining a maximum amplitude of the therapy signal that does not evoke a clinically discernable response; and
programming the signal generator to deliver the therapy signal at an amplitude less than or equal to the maximum amplitude.

20. The method of claim 17 wherein the signal delivery element includes an electrode, the method further comprising:
determining a maximum amplitude of the therapy signal that the electrode can tolerate based at least in part on the pulse width, the electrode material, and/or the surface area of the electrode; and
programming the signal generator to deliver the therapy signal at an amplitude less than or equal to the maximum amplitude.

21. The method of claim 17 wherein the therapy signal includes a plurality of biphasic pulses having an anodic pulse phase and a cathodic pulse phase, and wherein at least one of the anodic pulse phase or the cathodic pulse phase has the pulse width in the pulse width range from about 200 ms to about 2 seconds.

22. The method of claim 21 wherein the biphasic pulses include a ramping period between the anodic pulse phase and the cathodic pulse phase.

23. The method of claim 22 wherein the ramping period has a duration substantially equal to the pulse width.

24. The method of claim 21 wherein the anodic pulse phase and the cathodic pulse phase have different pulse widths and/or amplitudes.

25. The method of claim 21 wherein the anodic pulse phase and the cathodic pulse phase have the same pulse width and amplitude.

26. The method of claim 17 wherein the therapy signal includes a plurality of monophasic pulses, and wherein the plurality of monophasic pulses have the pulse width in the pulse width range from about 200 ms to about 2 seconds.

27. The method of claim 17 wherein the pulse width is about 500 ms or greater.

28. The method of claim 17 wherein the pulse width range is from about 200 ms to about 1 second.

29. The method of claim 17 wherein the pulse width range is from about 200 ms to about 700 ms.

30. The method of claim 17 wherein the pulse width is greater than 500 milliseconds and less than 1 second.

Assignees

• Nevro Corp

Inventors

• Bradley Kerry
• Lee Dongchul

Classifications

• A61N1/36071 Primary

  Pain · CPC title

• A61N1/36062 Primary

  Spinal stimulation · CPC title

• A61N1/36175

  Pulse width or duty cycle · CPC title

• A61N1/36192

  Amplitude modulation · CPC title

• A61N1/3616

  Voltage density or current density · CPC title