Monitoring and regulating physiological states and functions via sensory neural inputs to the spinal cord

Patent metadata

Field	Value
Publication number	US-9622671-B2
Application number	US-201313843023-A
Country	US
Kind code	B2
Filing date	Mar 15, 2013
Priority date	Mar 20, 2012
Publication date	Apr 18, 2017
Grant date	Apr 18, 2017

Abstract

Methods and apparatuses for monitoring and regulating physiological states and functions are disclosed. Several embodiments include application of one or more microelectrode arrays to a dorsal root ganglion for measurement of sensory neuron activity, or stimulation of sensory reflex circuits. The methods and apparatuses can be used, for example, for monitoring or controlling bladder function in a patient.

First claim

We claim:

1. A method of monitoring a physiological state of an organ or a tissue in a patient, comprising:
contacting at least one dorsal root ganglion in the patient with a microarray, wherein the microarray comprises a plurality of individual electrodes and is coupled to a computer, the method further comprising:
performing with the computer a calibration phase and a monitoring phase, wherein:
(A) the calibration phase comprises:
measuring sensory neuron activity with the individual electrodes; and
correlating the sensory neuron activity measured with the individual electrodes in the array with the physiological state of the organ or the tissue in the patient to identify individual electrodes in the array that measure the sensory neuron activity associated with the physiological state; and

(B) the monitoring phase comprises:
measuring the sensory neuron activity associated with the physiological state with the identified individual electrodes; and
outputting an indication of the physiological state of the organ or the tissue to an effector, a user interface, a computer readable storage medium, and/or a local or remote computer system, to monitor the physiological state of the organ or the tissue in the patient.

2. The method of claim 1 , wherein the microarray penetrates the dorsal root ganglion.

3. The method of claim 1 , wherein the microarray is closely coupled to the surface of the dorsal root ganglion.

4. The method of claim 1 , wherein the effector is a neuroprosthesis, an orthosis, an exoskeleton, an assistive device, or a drug pump.

5. The method of claim 1 , wherein the user interface alerts the patient to the indication of the physiological state.

6. The method of claim 1 , wherein the plurality of individual electrodes comprises at least 5 electrodes with a surface area of less than 200,000 μm 2 each.

7. The method of claim 1 , wherein:
(1) the organ is a bladder or a bowel and the physiological state is fullness;
(2) the organ is a bladder or a bowel and the physiological state is lack of fullness;
(3) the organ is a stomach or intestine and the physiological state is fullness;
(4) the organ is a stomach or intestine and the physiological state is lack of fullness;
(5) the tissue is a muscle and the physiological state is contraction;
(6) the tissue is a muscle and the physiological state is relaxation; or
(7) the organ or tissue is an organ or tissue comprising a sensory receptor and the physiological state is sensation.

8. The method of claim 7 , wherein the organ or tissue is an organ or tissue comprising a sensory receptor and the physiological state is sensation of pain, heat, cold, and/or a mechanical stimulus.

9. The method of claim 1 , wherein the organ is a bladder, urethra, and/or urethral sphincter, the physiological state is bladder pressure, bladder volume, urethral pressure, urethral flow, urethral sphincter distension, and/or urethral sphincter contraction, and the indication of the physiological state is outputted to the user interface.

10. The method of claim 1 , wherein the organ is a rectum and/or an anal sphincter, the physiological state is rectal pressure, rectal volume, anal sphincter distension and/or anal sphincter contraction, and the indication of the physiological state is outputted to the user interface.

11. The method of claim 1 , wherein the physiological state comprises a symptom of a movement disorder.

12. The method of claim 11 , wherein the symptom of the movement disorder is tremor, rigidity, and/or spasticity, due to the movement disorder in the patient.

13. The method of claim 12 , further comprising treating the symptom of the movement disorder in the patient, wherein
the patient has a neuroprosthesis that activates to treat the symptom; and
outputting the indication of the symptom comprises outputting a signal that activates the neuroprosthesis to treat the symptom in the patient.

14. The method of claim 13 , wherein the neuroprosthesis is a brain stimulator.

15. The method of claim 1 , comprising monitoring a pressure ulcer in the patient, wherein the tissue is a tissue susceptible to pressure ulcer, the physiological state is harmful tissue compression, and wherein outputting the indication of harmful tissue compression in the tissue susceptible to the pressure ulcer monitors the pressure ulcer in the patient.

16. The method of claim 15 , wherein the indication of harmful tissue compression in the tissue susceptible to the pressure ulcer is outputted to a user interface that alerts the patient of the harmful tissue pressure.

17. The method of claim 1 , comprising closed-loop control of a limb action in the patient, wherein
the physiological function is limb action comprising posture, movement and/or force generation;
the tissue is muscle;
the physiological state is limb posture, movement, force, and/or or stiffness in the patient;
the patient has a prosthesis, orthosis, exoskeleton, or other assistive device that activates to control the limb action in the patient; and wherein
outputting the indication of limb state comprises outputting a signal that activates the neuroprosthesis to control the limb action in the patient.

18. The method claim 1 , further comprising inducing a physiological function of an organ or a tissue in a patient, comprising a second calibration phase and an inducement phase, wherein:
(C) the second calibration phase comprises:
stimulating sensory neuron activity with individual electrodes to activate a sensory reflex circuit that induces the physiological function of the organ or the tissue;
measuring activation of the physiological function of the organ or the tissue;
correlating activation of the physiological function with the stimulated sensory neuron to identify individual electrodes that can activate the sensory reflex circuit that induces the physiological function; and

(D) the inducement phase comprises:
activating the sensory reflex circuit by stimulating sensory neuron activity with the identified individual electrodes to induce the physiological function in the patient.

19. The method of claim 18 , wherein the inducement phase is under user control.

20. The method of claim 18 , wherein outputting the indication of the physiological state of the organ or the tissue triggers stimulation of the sensory neuron activity with the identified individual electrodes to activate the sensory reflex circuit that induces the physiological function in the patient.

21. The method of claim 18 , comprising inducing bladder and/or bowel continence in the patient, wherein
(1) the organ is a bladder, urethra, and/or urethral sphincter, the physiological state is lack of bladder fullness and/or incontinence, and the physiological function is continence, and wherein outputting the indication of physiological state triggers stimulation of the sensory neuron activity with the identified individual electrodes to activate a sensory reflex circuit that induces bladder continence in the patient; or
(2) the organ is a rectum and/or anal sphincter, the physiological state is lack of bowel fullness and/or incontinence, and the physiological function is continence, and wherein outputting the indication of the physiological state triggers stimulation of the sensory neuron activity with the identified individual electrodes to activate a sensory reflex circuit that induces bowel continence in the patient.

22. The method of claim 18 , comprising inducing bladder voiding in the pa

Assignees

• Univ Of Pittsburgh—Of The Commonwealth System Of Higher Education

Inventors

• Weber Douglas
• Gaunt Robert
• Bruns Timothy

Classifications

• A61B5/4393

  Sexual arousal or erectile dysfunction evaluation, e.g. tumescence evaluation · CPC title

• A61B5/4836

  Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence) · CPC title

• A61B5/205

  Determining bladder or urethral pressure · CPC title

• A61N1/36082

  Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease · CPC title

• A61B5/1107

  Measuring contraction of parts of the body, e.g. organ or muscle · CPC title