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WO2013011474A2 - Système de stimulation de nerf - Google Patents

Système de stimulation de nerf Download PDF

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Publication number
WO2013011474A2
WO2013011474A2 PCT/IB2012/053676 IB2012053676W WO2013011474A2 WO 2013011474 A2 WO2013011474 A2 WO 2013011474A2 IB 2012053676 W IB2012053676 W IB 2012053676W WO 2013011474 A2 WO2013011474 A2 WO 2013011474A2
Authority
WO
WIPO (PCT)
Prior art keywords
implantable
nerve
electrode
electrodes
rechargeable battery
Prior art date
Application number
PCT/IB2012/053676
Other languages
English (en)
Other versions
WO2013011474A3 (fr
Inventor
Jacob GREENSHPAN
Original Assignee
Greenshpan Jacob
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Greenshpan Jacob filed Critical Greenshpan Jacob
Publication of WO2013011474A2 publication Critical patent/WO2013011474A2/fr
Publication of WO2013011474A3 publication Critical patent/WO2013011474A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes
    • A61N1/0553—Paddle shaped electrodes, e.g. for laminotomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36107—Sexual dysfunction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0521—Genital electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes
    • A61N1/0558—Anchoring or fixation means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control

Definitions

  • the present invention relates to medical devices and methods, in particular for nerve stimulation.
  • Nerves are part of the peripheral and central nervous systems of humans and animals. Nerves convey signals from the skin and organs to the central nervous system and vice versa. Nerves may suffer functional defects due to normal wear and tear, physical injuries, infection and failure of blood vessels surrounding the nerves. These functional defects may be accompanied by pain, numbness, weakness, and in some cases, paralysis.
  • ED erectile dysfunction
  • ED is a medical condition in which a male patient is incapable of obtaining penile erection spontaneously.
  • ED exists in many segments of the adult male population, and may be a result of psychogenic, vasculogenic, hormonal or neurogenic causes.
  • ED occurs in high incidence after radical prostatectomy, radical cystectomy and abdominoperineal resection.
  • ED occurs occasionally after transurethral resection of a prostate, external sphincterotomy, internal urethrotomy and prostatic abscess. Mechanical, vascular, neurological and psychological etiologies have been suggested.
  • IPG Implantable Pulse Generator
  • An IPG typically includes one or more electrodes, an electrical pulse generator, a battery and a housing.
  • the electrical pulse generator generates a waveform capable of stimulating the target nerve.
  • the electrodes receive the waveform from the generator, they draw energy from the battery and generate an electric field of suitable strength to stimulate the target nerve.
  • an implantable device comprising: at least one power source member, at least one pulse generating member and at least one electrode that is adapted to be implanted at the suprapubic level of the patient's neurovascular bundle of the phallus, and adapted to electrically stimulate the neurovascular bundle upon selective activation by the patient.
  • the disclosure notes that optimal lead placement to the phallic neurovascular bundle via the dorsal vein is critical to the operation and success of the device.
  • Electrodes are used also for controlling the function of other organs.
  • DiUbaldi in US Patent Application No. US 2009/093,858, titled “Implantable Pulse Generators and Methods for Selective Nerve Stimulation", the entire contents of which is incorporated herein by reference, discloses an implantable pulse generator including a surgically implantable housing, a battery, a first waveform generator, a second waveform generator, a modulator and electrodes. This implantable pulse generator is adapted to stimulate a target nerve or a body part.
  • At least one electrode sized and configured to be located on, in, or near a targeted component of the pudendal nerve, that innervates the external genitalia as well as sphincters for the bladder and the rectum.
  • the electrode is used for controlling physiological functions of the urinary tract.
  • Tanagho et al. in US Patent No. 4,607,639 titled “Method and System for Controlling Bladder Evacuation”
  • 4,771,779 titled “System for Controlling Bladder Evacuation", the entire contents of which is incorporated herein by reference, comprises first and second implanted stimulation systems having electrodes respectively positioned on nerves controlling external sphincter and bladder functions.
  • the present invention relates to a system and methods for stimulating a nerve.
  • the system comprises a three-dimensionally configured structure of electrodes structure.
  • the three dimensional configuration is a particular feature of the invention intended to provide a solution for the challenge of ensuring direct contact of an electrode with a nerve, in contrast to systems where electrodes are arranged in one or two- dimensions.
  • the present system is suitable for stimulating any organ or body part that is controlled by the nervous system.
  • the system is adapted to stimulate a nerve in the peripheral nervous system, the autonomous nervous system and the central nervous system, thus facilitating the enhancement of malfunctioning organs or body parts due to damaged nerves.
  • the system can be used to facilitate the control of the stomach by stimulating the appropriate nerves that control the various functions of the stomach; retrieving the ability of pineal erection for patients suffering from ED; or enhancing sexual stimulation by providing suitable electrical pulses to a nerve.
  • a system for stimulating a nerve comprising: an implantable electrode structure having a base and a plurality of electrodes; an implantable controller having a stimulator, adapted to deliver electrical pulses to the electrodes, a transmitter adapted to transmit signals to other components of the system, a receiver adapted to receive signals from other components of the system, and a processor adapted to process the various activities executed by system; and an implantable power source adapted to provide electrical power to the implantable controller.
  • the implantable electrode structure further comprises a plurality of non-conductive branches extending from the base, and at least one of the electrodes located on the branches, thereby producing a three dimensional array of electrodes.
  • a method for determining which electrode is located near a nerve comprising: transmitting an electrical signal from a first electrode; measuring electrical potential in the rest of the electrodes; determining in which electrode a higher electrical potential was measured; determining that the electrodes that measured a higher electrical potential are near the nerve that was stimulated by the first electrode; repeating the above cycle with all electrodes of the implantable electrode structure transmitting an electrical potential; and determining which electrodes are located near the same nerve.
  • FIG. 1 is a schematic view of an embodiment of a nerve stimulation system of the present invention
  • FIG. 2 is a perspective view of an exemplary implantable electrode structure of the nerve stimulation system of Fig. 1 ;
  • FIGs. 3a and 3b are perspective views of additional exemplary implantable electrode structures
  • Fig. 4 is a perspective view of the implantable electrode structure of Fig. 3b in the vicinity of a nerve;
  • FIG. 5 is a schematic view of an implanted implantable electrode structure and an implantable electrode controller having a rechargeable battery being charged with an external battery charger;
  • FIG. 6 is a schematic view of an implanted implantable electrode structure and an implantable electrode controller having a rechargeable battery that is connected to photo-galvanic cells and being charged by an external light source;
  • FIG. 7 is a schematic view of an implantable electrode structure and an implantable electrode controller having a rechargeable battery that is connected to a transformer and charged by an external changing magnetic field;
  • Fig. 8 is a perspective view of an embodiment of a remote controller
  • FIG. 9 is a side view of an embodiment of an injection device of an implantable controller and an implantable electrode structure
  • FIG. 10 is a cross-section side view of an exemplary implantable electrode structure having a branch with an inner tubule and openings;
  • FIG. 11 is a side view of an exemplary implantable electrode structure adapted to produce an electrical potential in a specific site in a tissue
  • Fig. 12 is a bottom sectional view of an exemplary implantable electrode structure in the vicinity of two nerves.
  • Fig. 1 shows an embodiment of a nerve stimulation system of the present invention, a portion of which is adapted to be implantable in a patient's body near the prostate.
  • the nerve stimulation system comprises an implantable electrode structure 10, an implantable controller 20 and an implantable power source 30, all shown implanted in a patient's body; a remote controller 40; and a physician station 50.
  • FIG. 2 shows details of implantable electrode structure 10 comprising a base
  • Electrodes 146 are made of a conductive material, e.g. a metal.
  • branches 14 are generally cylindrical and electrodes 146 are ring-shaped and disposed at the perimeter (surface) of their respective branches. However, numerous other branch and electrode shapes can be used.
  • Each electrode 146 is connected to a conductor such as wire 16, e.g. wire or conductor, adapted to transfer electrical stimulation to each electrode 146 separately and independently relative to the other electrodes 146.
  • All the electrode wires 16 are connected to an electrode controller 18, adapted to transmit electrical pulses to the electrodes 146 via the electrode wires 16.
  • the electrode controller 18 is disposed inside the base 12, and the electrode wires 16 that extend from the electrode controller 18, each electrode wire 16 directing to a single electrode 146is inside base 12 and branches 14.
  • the electrode controller 18 is connected to the implantable controller 20, either wirelessly or via an electrode controller wire 182, enabling the implantable controller 20 to communicate with the electrode controller 18.
  • implantable controller 20 transmits commands to the electrode controller 18 (e.g. a command to activate a specific electrode 146; a command to activate several specific electrodes 146; and a command determining the parameters of electrical pulses transmitted via the electrodes 146, such as voltage, current, frequency of alternating current and pulse duration.
  • the shape of the implantable electrode structure 10 is not limited to the rectangular shape shown in Fig. 2.
  • Fig. 3a shows an embodiment of the implantable electrode structure 10 that is concave
  • Fig 3b shows another embodiment, in which the implantable electrode structure 10 is convex.
  • implantable electrode structure 10 is in a shape and dimensions adapted to fit the structure and dimensions of an implantation site in a patient's body and the patient's physiological needs.
  • the concave implantable electrode structure 10, shown in Fig. 3a is adapted to treat medical conditions of rectal sphincter muscles due to damage to the cavernous nerve.
  • Fig. 4 shows the way in which the three-dimensional arrangement of the electrodes 146 on the branches 14 of a concave implantable electrode structure 10 ensures stimulation of an adjacent nerve 900.
  • Nerve 900 runs randomly inside a tissue, thus making it difficult to locate the nerve 900 and attach to it an electrode.
  • the instant invention overcomes this problem by the three-dimensional arrangement of the electrodes 146 on the branches 14.
  • implantable electrode structure 10 is placed in the vicinity of a nerve 900, while only electrodes 146a and 146b are in contact with the nerve 900 and allow transmission of electrical pulses to the nerve 900. On the other hand, the remaining electrodes 146 are not in contact with the nerve.
  • the implantable controller 20 comprises a stimulator, adapted to deliver electrical pulses to the electrodes 146; a transmitter, adapted to transmit signals to other components of the system; a receiver adapted to receive signals from other components of the system; and a processor adapted to process the various activities executed by the nerve stimulation system, including but not limited to: electrical power management and electrode stimulation pattern.
  • the processor processes the activities following activation by a signal from an implanted or external source; or an implanted or external switch.
  • the processor is pre-programmed to execute activities automatically.
  • implantable power source 30 is integrated with the implantable controller 20, while in another embodiment implantable power source 30 is separated from the implantable controller 20.
  • the implantable power source 30 is a replaceable battery, when the replaceable battery 30 is out of power it is removed from the patient's body and replaced by a fresh replaceable battery by any mean for removing and implanting objects from/into a patient's body known in the art, e.g. surgery and injection.
  • the implantable controller 20 is removed from the patient's body by any method known in the art, the used-up replaceable battery 30 is replaced by a fresh rechargeable battery 30 and the implantable controller 20 is implanted back in the patient's body by any method known in the art.
  • FIG. 5 shows an embodiment in which an implantable controller 20 with an integrated rechargeable battery 30a is implanted in a patient's body near the prostate.
  • the rechargeable battery 30a is charged by an external charger 600, connected to a charging catheter 602, having at least one charging connector (not shown) at its tip 604.
  • the charging catheter 602 is temporarily passed through the urethra until the at least one charging connector come in contact with the implantable controller 20 and charge the integrated rechargeable battery 30a.
  • an implantable controller 20 with an implantable rechargeable battery 30b is implanted in a patient's body near the prostate.
  • the implantable rechargeable battery 30b is connected to implantable photo-galvanic cells 700, via a connecting means, e.g. a photo-galvanic cell wire 702.
  • the implantable photo-galvanic cells 700 are adapted to convert light energy to electricity.
  • An external light source 704 is adapted to shed light on the body area under which the photo- galvanic cells 700 are implanted.
  • An example of a light source, suitable for lightening the implantable photo-galvanic cells 700 is "soft laser", which is able to penetrate live tissues without heating extensively the tissue or causing any other damage to the tissue.
  • the maximum penetration depth of a "soft laser” light beam is in the range of 30-45 mm. Therefore, the implantable photo-galvanic cells 700 are implanted under the skin in an appropriate distance. Lightening the spot under which the implantable photo-galvanic cells 700 are implanted with a "soft laser” light beam causes the implantable photo-galvanic cells 700 to convert the light energy that reaches the implantable photo-galvanic cells 700 to electricity, and the electricity is transferred to the rechargeable battery through the photo-galvanic wire 702.
  • a system for charging an implantable rechargeable battery comprising: implantable photo-glavanic cells 700 connected to an implantable rechargeable battery 30 via a connecting means 702; and an external light source 704, e.g. soft laser light source.
  • the system is adapted to recharge an implantable rechargeable battery 30 supplying electricity to any implantable system or device known in the art, e.g. implantable pacemakers and implantable pumps.
  • Fig. 7 shows an embodiment of an implantable controller 20 with an integrated rechargeable battery 30c implanted in a patient's body near the prostate.
  • the rechargeable battery 30c is connected by a transformer connector 802 to an implantable transformer 800 adapted to convert a changing magnetic field to electricity.
  • the implantable transformer 800 comprises coils and a metal core.
  • the rechargeable battery 30c is charged by using an external magnetic field generator 804 adapted to produce a changing magnetic field.
  • the magnetic field generator 804 is placed in the vicinity of the place in the patient's body where the implantable transformer 800 is implanted. When the magnetic field generator 804 is turned on, a changing magnetic field is produced, and converted to electricity by the implantable transformer 800, and the electricity is transferred through the transformer connector 802 to the rechargeable battery 30c, which is recharged.
  • a system for charging an implantable rechargeable battery 30, comprising: an implantable transformer 800 connected to an implantable rechargeable battery 30 via a transformer connector 802; and an external magnetic field generator 804.
  • the system is adapted to recharge an implantable rechargeable battery 30b supplying electricity to any implantable system or device known in the art, e.g. implantable pacemakers and implantable pumps.
  • implantable power source 30 is a crystal, e.g. a quartz crystal, known in the art as generating an electrical potential in a given voltage and frequency, in response to an electromagnetic or electric current in the vicinity of the crystal.
  • a crystal e.g. a quartz crystal, known in the art as generating an electrical potential in a given voltage and frequency, in response to an electromagnetic or electric current in the vicinity of the crystal.
  • Fig. 8 shows an embodiment of an external remote controller 40, used outside the patient's body, and adapted to control the implantable controller 20 by transmitting information to and receiving information from the implantable controller 20.
  • the remote controller 40 comprises a display 44; at least one key 42; a communication module and a storage and processing unit (not shown as these components are inside the remote controller 40).
  • the display 44 is adapted to display information regarding the function of the implantable controller 20.
  • the at least one key 42 is adapted to be pressed by the user and trigger a function by the implantable controller 20.
  • keys 42 include an "ON” key, which triggers the implantable controller 20 to start stimulating a nerve; an "OFF” key for stopping a stimulation of a nerve by the implantable controller 20; and a "CHECK” key for checking various aspects of the function of the implantable controller 20 and the remote controller 40, e.g. implantable power source 30 life.
  • the communication module is adapted to enable a coded communication of the remote controller 40 with the implantable controller 20 and the physician station 50.
  • the storage and processing unit comprises a micro-processor for storing and processing data, and is adapted to enable operations, e.g.
  • the display 44 is a touch screen adapted to display information and serve as a key.
  • the nerve stimulation system includes a physician station 50, adapted to control various aspects of the function of the system.
  • functions that are controlled by the physician station 50 include: display of function parameters; testing the performance of the system; calibrating the system; charging of a rechargeable battery 30a-c; emergency procedures when un-desired pulses are delivered to a patient's nerve; and supporting any procedure performed by a physician.
  • the physician station 50 comprises a processor, e.g. a computer or a portable computer.
  • the physician station 50 communicates wirelessly with the implantable controller 20.
  • the physician station 50 is connected either wirelessly or by a wire with the remote controller.
  • the implantable controller 20 and implantable electrode structure 10 are implanted in a patient's body using any suitable procedure, e.g. surgery and injection.
  • the surgery procedure involves a placement of the implantable controller 20 and implantable electrode structure 10 in a patient's body using any surgery procedure known in the art, including but not limited to traditional, robotic and laparoscopic surgery technique.
  • the transplant of the implantable controller 20 and implantable electrode structure 10 is conducted during a prostatectomy operation in cases neural erection malfunction is expected.
  • Fig. 9 shows an embodiment of an injection device used during the injection procedure of the implantable controller 20 and implantable electrode structure 10.
  • the implantable controller 20 and the implantable electrode structure 10 are placed inside the injection device 60 and then injected into a desired location in a patient's body.
  • the injection of the implantable controller 20 and the implantable electrode structure 10 is accompanied by an imaging procedure, e.g. magnetic resonance imaging, computed tomography and ultra-sound scanning.
  • Fig. 10 shows an embodiment of two branches 14a and 14b and an injecting branch 15 of an implantable electrode structure 10, of which injecting branch 15 is adapted to inject a fluid or a suspension into the vicinity of injecting branch 15 in a patient's body, e.g. a tissue or a nerve.
  • Branches 14a and 14b have each at least one electrode 146.
  • Injecting branch 15 has in its inner part at least one tubule 150, and at least one opening 152 along the injecting branch 15, the at least one opening 152 is a continuation of the tubule 150 in one side, and is open towards the surrounding space of the injecting branch 15.
  • the at least one opening 152 is adapted to transfer a fluid or a suspension from the tubule 150 into the surrounding of injecting branch 15, e.g. a tissue or a nerve near injecting branch 15.
  • the at least one tubule 150 is a continuation of a feeding tube 154, adapted to conduct a liquid or a suspension from a reservoir (not shown) into the at least one tubule 150.
  • an implantable electrode structure 10 comprises at least one injecting branch 15 having at least one tubule 150 having at least one opening 152 and a feeding tube 154, as disclosed above.
  • injecting branch 15 further comprises at least one electrode 146.
  • the injecting branch 15 having at least one electrode 146 is adapted to either inject a fluid or a suspension into the vicinity of the injecting branch 15, or to produce an electrical potential in a tissue near the electrode 146, or both simultaneously.
  • a fluid is conducted through a feeding tube 154 into an at least one tubule 150 inside an injecting branch 15, and then injected through an at least one opening 152 into the surrounding of the injecting branch 15.
  • Any type of fluid known in the art that is needed to be injected into a patient's tissue or on a nerve is injected, e.g.: a medication for curing a tissue or a nerve; a material, which upon injection onto a damaged area of a nerve hardens to a conductive material for supporting pulse conduction through the damaged area of the nerve.
  • a suspension is conducted through a feeding tube 154 into an at least one tubule 150 inside an injecting branch 15, and then injected through an at least one opening 152 into the surrounding of the branch 14.
  • Any type of suspension known in the art that is needed to be injected into a patient's tissue or on a nerve is injected.
  • An example of such a suspension is a suspension of stem cells to be injected onto or near a damaged area of a nerve. The injected stem cells adhere to the damaged nerve tissue and transform to a fresh nerve tissue, thus curing the damaged area of the nerve.
  • the three-dimensional arrangement of the electrodes 146 is adapted to produce an electrical potential in a specific site in a tissue, while abolishing or reducing the electrical potential in another site.
  • Fig. 11 shows an implantable electrode structure with electrode 146e between electrodes 146d and 146f and adjacent to them. Electrode 146e transmits an electrical signal. However this electrical signal might induce un-desired electrical signals in the adjacent electrodes 146d and 146f. In order to reduce or abolish the electrical potential in the area near electrode 146d, for example, electrode 146d transmits an electrical signal, which is in a phase 180° opposite relative to the phase of the electrical signal transmitted from electrode 146e.
  • the electrical signal near electrode 146d is abolished or getting lower than the electrical potential near electrode 146e.
  • This method is applicable also in embodiments in which it is desired to reduce or abolish the electrical potential near more than one electrode, e.g. reducing or abolishing the electrical potential near electrodes 146d and 146f when electrode 146e transmits an electrical signal.
  • both electrodes 146d and 146f transmit an electrical signal, which is in a phase 180° opposite relative to the phase of the electrical signal transmitted from electrode 146e.
  • each electrode 146 is adapted to functions either as a transmitter or a receiver, or both.
  • the electrode 146 is adapted to sense electrical potential or conductivity in its vicinity.
  • the electrode 146 is adapted to electrically stimulate a nerve or tissue in its vicinity.
  • at least one receiver electrode 146 is adapted to measure the electrical potential or conductivity of a tissue in response to an electrical stimulation by at least one another electrode 146.
  • Fig. 12 is an embodiment of a bottom view of an implantable electrode structure 10 in the vicinity of two nerves 900a and 900b.
  • a method for locating a nerve and determine which electrode 146 is near the nerve, using transmitter and receiver electrodes 146, is as follows. Since Fig. 12 is a bottom view of an implantable electrode structure 10, showing tips of branches 14, the disclosure will refer to electrodes 146 on the branches 14, even though the electrodes 146 are not seen in Fig. 12.
  • a transmitter electrode 146, located on branch 14d transmits an electrical stimulus. If branch 14d is located near nerve 900a, as shown in Fig.
  • a receiver electrode 146 located on branch 14e measures an electrical potential higher or similar to the electrical potential stimulated by electrode 146 on branch 14d, because both electrodes 146 are located near nerve 900a.
  • a receiver electrodes located on branch 14f which is not near a nerve
  • a receiver electrode 146 located on branch 14g which is located near nerve 900b
  • the method described using Fig. 12 is for locating a nerve two-dimensionally. However, since in one embodiment more than one electrode 146 is located on a branch 14, then the allocation of an electrode 146 near a nerve is conducted three-dimensionally.
  • an implantable electrode structure 10 in which each electrode 146 is a transmitter and receiver all together, is implanted in a patient's body.
  • a method for determining which electrode 146 is located near a nerve comprises: transmitting an electrical signal from a first electrode 146; measuring electrical potential in the rest of the electrodes 146; determining in which electrode 146 a higher electrical potential was measured; repeating the above cycle with all electrodes 146 on the implantable electrode structure 10 transmitting an electrical potential; determining which electrodes 146 are located near the same nerve.
  • This method is adapted to determine which electrodes 146 are near the same nerve also when the implantable electrode structure 10 is planted near more than one nerve.
  • the nerve stimulation system is adapted to stimulate a nerve in order to activate a target organ in a patient's body.
  • a more optimal activation of the target organ is achieved when the nerve innervating the target organ is stimulated in an as more distant point from the target organ.
  • the nerve stimulation system is adapted to cure a damaged nerve by an electrical stimulation at the damaged area of the nerve.
  • a method of curing a damaged nerve by an electrical stimulation at the damaged area of the nerve comprises: implanting the implantable electrode structure 10 into a patient's body near a damaged nerve; allocating a damaged area of the nerve by employing the method for determining which electrode 146 is located near a nerve; and stimulating at least one electrode 146, which is near the damaged area of the nerve.
  • the nerve stimulation system is adapted to cure a damaged nerve by injecting an appropriate liquid or suspension near the damaged area of the nerve.
  • a method of curing a damaged nerve by injecting a fluid or a suspension comprises: implanting the implantable electrode structure 10 into a patient's body near a nerve suspected to be damaged; allocating a damaged area of the nerve by employing the method for determining which electrode 146 is located near a nerve; and injecting an appropriate liquid or suspension from an at least one injecting branch 15, which is near the damaged area of the nerve.
  • the nerve stimulation system is adapted to be part of a method of curing a damaged nerve using stem cells, by destroying stem cells that are not in the vicinity of the damaged nerve.
  • This method is important in the sense that extra stem cells, not actively participating in the cure process of the damaged nerve, might spread in a patient's body and increase the chance for cancer and other ailments. This method is applicable when the damaged nerve is still partially active.
  • the method comprises: implanting the implantable electrode structure 10 into a patient's body near a nerve suspected to be damaged; applying stem cells to the area of the damaged nerve; determining which electrode 146 is located near the nerve by employing the method for determining which electrode 146 is located near a nerve; and stimulating at least one electrode 146 that is not near the nerve with a high electrical potential, thereby destroying unnecessary stem cells that are not in the vicinity of the nerve.
  • the nerve stimulation system is adapted to enhance orgasm during sexual intercourse.
  • an implantable electrode structure 10 is implanted near the pudendal nerve, which is responsible for much of the genitals sense. Then the electrodes 146 located near the pudendal nerve are determined by the method for determining which electrode 146 is located near a nerve as described above, and the pudendal nerve is stimulated during sexual intercourse to enhance orgasm, by stimulating the electrodes 146 that were determined as being near the pudendal nerve.
  • a key 42 for controlling the stimulation of orgasm is included in the remote controller 40.
  • a method for controlling the maximum number of erections per given time period comprises: 1. pre-determining a maximal number of erections per given time period, e.g. a day, allowed for a given patient; 2. counting the number of erections stimulated by the nerve stimulation system during the given time period; 3. if the number of stimulated erections during the given time period equals the pre-determined maximal number of erections per the given time period, disabling an additional request for an erection; 4. Sending an order to the remote controller 40 to display a message to the patient regarding the disabling of the request for erection; 5.
  • step 1 when the given time period is over, zeroing the counted number of erections per the given time period and starting over again from step 2; 6. If the condition of the given patient requires a change of the maximal number of erections per the given time period, starting over from step 1.
  • a method for controlling the maximum duration of an erection comprises: 1. pre-determining a maximal duration of an erection allowed for a given patient; 2. measuring the duration of an erection stimulated by the nerve stimulation system; 3. if the duration of a stimulated erection equals the pre-determined maximal duration of erection, disabling the erection by terminating the electrical stimulation; 4. Sending an order to the remote controller 40 to display a message to the patient regarding the termination of the erection; 5. If the condition of the given patient requires a change of the maximal duration of an erection, starting over from step 1.
  • Other methods that are employed when the nerve stimulation system is used for stimulating an erection including but not limited to: a method for controlling a minimal interval between erections; a method for controlling time or frequency parameters of erections; and a method for blocking the function of the nerve stimulation system in cases when the system is over-used.
  • Additional exemplary methods applied by the nerve stimulation system include, but are not limited to: a method for optimizing power consumption by minimizing voltage and current of the electrical pulse to optimal levels; a method for determining the minimal number of electrodes to stimulate a nerve; and a method for using effective electrodes in a rotational manner.
  • Examples of media adapted to store algorithms that execute the various methods described above and others include, but not limited to: electrode controller 18 which is part of implantable electrode structure 10; a processor in implantable controller 20; remote controller 40; physician station 50; or a combination thereof.

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  • Health & Medical Sciences (AREA)
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  • Animal Behavior & Ethology (AREA)
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  • Neurology (AREA)
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  • Orthopedic Medicine & Surgery (AREA)
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Abstract

L'invention porte sur un système pour stimuler un nerf, comprenant : une structure d'électrode implantable ayant une base et une pluralité d'électrodes ; un dispositif de commande implantable ayant un stimulateur, apte à fournir des impulsions électriques aux électrodes, un émetteur apte à émettre des signaux vers d'autres composants du système, un récepteur apte à recevoir des signaux d'autres composants du système, et un processeur apte à traiter les différentes activités exécutées par le système ; et une source d'énergie implantable apte à fournir de l'énergie électrique au dispositif de commande implantable. La structure d'électrode implantable comprend en outre une pluralité de branches non conductrices s'étendant à partir de la base, et au moins l'une des électrodes étant située sur les branches, produisant ainsi un réseau tridimensionnel d'électrodes.
PCT/IB2012/053676 2011-07-19 2012-07-19 Système de stimulation de nerf WO2013011474A2 (fr)

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US61/509,455 2011-07-19

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WO2015120222A1 (fr) * 2014-02-06 2015-08-13 The Charles Stark Draper Laboratory, Inc. Réseau de microélectrodes destinées à servir d'interface avec des neurones dans des fascicules
US9821163B2 (en) 2014-10-13 2017-11-21 Ecole Polytechnique Federal De Lausanne (Epfl) Systems and methods for treating sexual disorders using electro-stimulation
CN108471978A (zh) * 2015-11-30 2018-08-31 株式会社理光 神经刺激设备和生物磁场测量系统
US20200022650A1 (en) * 2016-11-17 2020-01-23 Brainlab Ag Time-synchronized deep brain stimulation optimization
US11141589B1 (en) 2021-02-11 2021-10-12 Comphya SA Electro-stimulation systems and methods for rehabilitation and treatment of sexual disorders
US11141590B1 (en) 2021-02-11 2021-10-12 Comphya SA Electro-stimulation systems and methods for rehabilitation and treatment of sexual disorders
CN114534094A (zh) * 2022-02-11 2022-05-27 苏州景昱医疗器械有限公司 神经刺激电极、神经刺激装置和神经刺激系统

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Cited By (13)

* Cited by examiner, † Cited by third party
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US9662229B2 (en) 2014-02-06 2017-05-30 The Charles Stark Draper Laboratory, Inc. Array of microelectrodes for interfacing to neurons within fascicles
WO2015120222A1 (fr) * 2014-02-06 2015-08-13 The Charles Stark Draper Laboratory, Inc. Réseau de microélectrodes destinées à servir d'interface avec des neurones dans des fascicules
US9821163B2 (en) 2014-10-13 2017-11-21 Ecole Polytechnique Federal De Lausanne (Epfl) Systems and methods for treating sexual disorders using electro-stimulation
US10300279B2 (en) 2014-10-13 2019-05-28 Ecole Polytechnique Federale De Lausanne (Epfl) Systems and methods for treating sexual disorders using electro-stimulation
CN108471978B (zh) * 2015-11-30 2021-05-14 株式会社理光 神经刺激设备和生物磁场测量系统
CN108471978A (zh) * 2015-11-30 2018-08-31 株式会社理光 神经刺激设备和生物磁场测量系统
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US10722701B2 (en) 2015-11-30 2020-07-28 Ricoh Company, Ltd. Nerve stimulation apparatus and biomagnetic field measurement system
US20200022650A1 (en) * 2016-11-17 2020-01-23 Brainlab Ag Time-synchronized deep brain stimulation optimization
US12011290B2 (en) * 2016-11-17 2024-06-18 Brainlab Ag Time-synchronized deep brain stimulation optimization
US11141589B1 (en) 2021-02-11 2021-10-12 Comphya SA Electro-stimulation systems and methods for rehabilitation and treatment of sexual disorders
US11141590B1 (en) 2021-02-11 2021-10-12 Comphya SA Electro-stimulation systems and methods for rehabilitation and treatment of sexual disorders
CN114534094A (zh) * 2022-02-11 2022-05-27 苏州景昱医疗器械有限公司 神经刺激电极、神经刺激装置和神经刺激系统

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