Neurostimulation for treating sensory deficits, and associated systems and methods

Patent metadata

Field	Value
Publication number	US-2024001121-A1
Application number	US-202318344579-A
Country	US
Kind code	A1
Filing date	Jun 29, 2023
Priority date	Jul 1, 2022
Publication date	Jan 4, 2024
Grant date	—

Abstract

Stimulation for treating sensory deficits in patients with spinal cord injuries and/or peripheral polyneuropathy, and associated systems and methods. A representative method includes addressing the patient's somatosensory dysfunction, resulting from neuropathy and/or spinal cord injury, by directing an electrical therapy signal to the patient's spinal cord region, the therapy signal having a frequency in a frequency range from 200 Hz to 100 kHz.

First claim

1 . A method of treating a patient having sensation loss associated with diabetic neuropathy, the method comprising:
programming a signal generator to deliver, via at least one implanted signal delivery element, a paresthesia-free electrical signal having a frequency within a frequency range of from about 1.2 kHz to about 100 kHz to the patient's spinal cord, wherein the paresthesia-free electrical signal activates a first subset of neurons within the spinal cord to modify a state of a second subset of neurons and thereby increase afferent neural activity generated in the second subset of neurons in response to a sensory input.

2 . The method of claim 1 wherein the activated first subset of neurons modify the state of the second subset of neurons by reducing pathological neural activity within the second subset of neurons.

3 . The method of claim 1 wherein the first subset of neurons includes inhibitory interneurons, and wherein the second subset of neurons includes central afferent transmission neurons and/or peripheral afferent transmission neurons.

4 . The method of claim 3 wherein the second subset of neurons includes central afferent projection neurons.

5 . The method of claim 1 wherein the first subset of neurons include non-adapting neurons.

6 . The method of claim 1 wherein the second subset of neurons includes adapting neurons.

7 . The method of claim 1 wherein the electrical signal increases the afferent neural activity induced by the sensory input in the second subset of neurons by at least 50% relative to an afferent neural activity induced by the sensory input in the second subset of neurons in the absence of the electrical signal.

8 . The method of claim 1 wherein the electrical signal increases the afferent neural activity induced by the sensory input in the second subset of neurons by at least 100% relative to an afferent neural activity induced by the sensory input in the second subset of neurons in the absence of the electrical signal.

9 . The method of claim 1 wherein the increased afferent neural activity enables the patient to perceive the sensory input.

10 . The method of claim 1 wherein the frequency range is from about 5 kHz to about 15 kHz.

11 . The method of claim 1 wherein the paresthesia-free electrical signal has:
a pulse width in a pulse width range of from about 10 seconds to about 333 microsecond; and
an amplitude in an amplitude range of from about 0.5 mA to about 10 mA.

12 . The method of claim 1 wherein programming the signal generator is performed at least partially in response to the patient having the sensation loss.

13 . The method of claim 1 , further comprising:
identifying reduced neural activity in the second subset of neurons in the absence of the paresthesia-free electrical signal, wherein programming the signal generator to deliver the paresthesia-free electrical signal is performed at least partially in response to identifying the reduced neural activity in the second subset of neurons.

14 . A method of treating a patient having sensation loss associated with diabetic neuropathy, the method comprising:
programming a signal generator to deliver, via at least one implanted signal delivery element, a paresthesia-free electrical signal having a frequency within a frequency range of from about 1.2 kHz to about 100 kHz to the patient's spinal cord, wherein the paresthesia-free electrical signal (a) reduces pathological neural activity in the patient, and (b) enhances transmission of afferent neural signals generated in response to a sensory input, thereby at least partially restoring the sensation that was lost in association with the diabetic neuropathy.

15 . The method of claim 14 wherein, by reducing the pathological neural activity in the patient, the paresthesia-free electrical signal enables the afferent neural signals generated in response to the sensory input to be propagated to the patient's sensory cortex.

16 . The method of claim 14 wherein the pathological neural activity is present in a second subset of neurons, and wherein the paresthesia-free electrical signal activates a first subset of neurons, different than the second subset of neurons, to reduce the pathological neural activity in the second subset of neurons.

17 . The method of claim 16 wherein the first subset of neurons includes inhibitory interneurons, and wherein the second subset of neurons includes peripheral and/or central afferent transmission neurons.

18 . The method of claim 14 wherein the frequency range is from about 5 kHz to about 15 kHz, and wherein the paresthesia-free electrical signal has a pulse width in a pulse width range of from about 20 microseconds to about 100 microseconds and an amplitude within an amplitude range of from about 0.5 mA to about 10 mA.

19 . The method of claim 14 wherein programming the signal generator is performed at least partially in response to the patient having the pathological neural activity.

20 . A method of treating a patient having sensation loss associated with diabetic neuropathy, the method comprising:
delivering, via at least one implanted signal delivery element, a paresthesia-free electrical signal having a frequency within a frequency range of from about 1.2 kHz to about 100 kHz to the patient's spinal cord, wherein the paresthesia-free electrical signal (a) reduces pathological neural activity in the patient, and (b) enhances transmission of afferent neural signals generated in response to a sensory input, thereby at least partially restoring the sensation that was lost in association with the diabetic neuropathy.

21 . The method of claim 20 wherein the paresthesia-free electrical signal enables the afferent neural signal generated in response to the sensory input to be propagated to the patient's sensory cortex by reducing the pathological neural activity in the patient.

22 . The method of claim 20 wherein the paresthesia-free electrical signal activates a first subset of neurons, and wherein the activation of the first subset of neurons reduces the pathological neural activity in a second subset of neurons, different than the first subset of neurons.

23 . The method of claim 22 wherein the first subset of neurons includes inhibitory interneurons, and wherein the second subset of neurons includes peripheral and/or central afferent transmission neurons.

24 . The method of claim 20 wherein the frequency range is from about 5 kHz to about 15 kHz, and wherein the paresthesia-free electrical signal has a pulse width in a pulse width range of from about 20 microseconds to about 100 microseconds and an amplitude within an amplitude range of from about 0.5 mA to about 10 mA.

25 . The method of claim 20 , further comprising:
identifying that the patient has pathological neural activity contributing to the patient's sensation loss before delivering the paresthesia-free electrical, wherein delivering the paresthesia-free electrical signal is performed at least partially in response to identifying that the patient has the pathological neural activity contributing to the patient's sensation loss.

26 . A patient treatment system for treating sensation loss in a patient, the system comprising:
an implantable signal delivery element postionable proximate a patient's spinal cord region; and a signal generator having a controller programmed with instructions that, when executed, cau

Assignees

• Nevro Corp

Inventors

• Lee Dongchul
• Bradley Kerry
• Lee Kwan Yeop

Classifications

• A61N1/36062 Primary

  Spinal stimulation · CPC title

• A61N1/36171

  Frequency · CPC title

• A61N1/36175

  Pulse width or duty cycle · CPC title

• A61N1/36157

  Current (A61N1/3616 takes precedence) · CPC title

• A61N1/36071

  Pain · CPC title