US20050251220A1 - Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation - Google Patents

Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation Download PDF

Info

Publication number
US20050251220A1
US20050251220A1 US10661641 US66164103A US2005251220A1 US 20050251220 A1 US20050251220 A1 US 20050251220A1 US 10661641 US10661641 US 10661641 US 66164103 A US66164103 A US 66164103A US 2005251220 A1 US2005251220 A1 US 2005251220A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
patient
nerve
apparatus
disorder
electrode
Prior art date
Legal status (The legal status 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 status listed.)
Abandoned
Application number
US10661641
Inventor
Burke Barrett
Reese Terry
Original Assignee
Barrett Burke T
Terry Reese S Jr
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

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36082Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36114Cardiac control, e.g. by vagal stimulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/37211Means for communicating with stimulators
    • A61N1/37217Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile

Abstract

A method and apparatus for treating patients with neuropsychiatric disorder includes unilaterally or bilaterally stimulating one or both of the left and right branches of a patient's vagus nerve directly or indirectly with an electrical pulse signal generated by an implantable neurostimulator with at least one operatively coupled nerve electrode to apply the pulse signal to the selected nerve branch at a location in the vicinity of the patient's diaphragm, either slightly above or slightly below the diaphragm. The implantable neurostimulator is programmable to enable physician programming of electrical and timing parameters of the pulse signal, to generate the desired therapy regimen for alleviating the disorder. Patient activation of the device is permitted in the case of treating a neuropsychiatric disorder such as depression, where the patient is able to sense a symptom of a disorder.

Description

    BACKGROUND OF THE INVENTION
  • The present invention relates generally to methods and apparatus for treating or controlling medical, psychiatric or neurological disorders by application of modulating electrical signals to a selected nerve or nerve bundle of the patient, and more particularly to techniques for treating patients with neuropsychiatric disorders by application of such signals to the vagus nerve or other suitable cranial nerve, using an implantable neurostimulator. Specifically, the invention is directed toward treating the symptoms of neuropsychiatric disorders such as schizophrenia, depression, and borderline personality disorder, by selective modulation of vagus nerve activity.
  • Although schizophrenia was initially thought to have only psychological origins, more recent psychobiology and psychopharmacology findings have indicated that the illness is primarily organic in nature. Electrophysiologic studies of patients with schizophrenia have supported an organic etiology. Although not entirely consistent, electroencephalogram (EEG) studies have tended to reveal abnormalities in these patients. Also, some parallels have been found between schizophrenia and epilepsy.
  • Developments in psychobiology and psychopharmacology have also provided considerable evidence that major depressive disorder and bipolar depression are biological rather than psychological diseases. The conclusion that depression has a biological basis is also supported by numerous electrophysiological and endocrine studies. Deficiency of brain neurotransmitters has been associated with depression. In particular, abnormally low concentrations of the neurotransmitter serotonin and its metabolites and norepinephrine have been found in depressed patients. Several serotonin uptake inhibitors, which increase the amount of serotonin at the synapse have been shown to be effective antidepressants. Iincreased activity of the vagus nerve has been postulated to be associated with release of increased amounts of serotonin and norepinephrine in the brain.
  • Borderline personality disorder is a poorly understood, but recognized psychiatric disorder which seems to have some overlap of schizophrenia and depression. Patients tend to be poorly functional without florid psychosis or overt depression. Lahmeyer et al. reported, in J. Clin. Psych. (1989) 50(6):217-225, that sleep architecture in patients with borderline personality disorder is disturbed in that REM latency is decreased and REM density is increased. This was found to be particularly true if patients suffered coexisting depression, a history of affective illness or a family history of psychopathology. Sleep abnormalities were reported to appear similar to those seen in affective disorders.
  • It is an object of the present invention to apply the techniques of selective modulation of vagus nerve electrical activity, using a neurostimulator device which may be implantable, or used external to the body with only a small portion of the circuitry implanted or with only the nerve electrode(s) and associated lead(s) implanted percutaneously in the body, to the treatment of neuropsychiatric disorders including schizophrenia, depression, and borderline personality disorder, as well as other neuropsychiatric disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders.
  • In U.S. Pat. No. 5,299,569 (sometimes referred to herein as “the '569 patent”), assigned to the same assignee as the present application, Wernicke et al disclosed methods and devices for treating and controlling certain neuropsychiatric disorders by selective stimulation of the vagus nerve. A neurostimulator which is preferably but not necessarily implantable selectively applies the therapy to treat the specific neuropsychiatric disorder such as schizophrenia, depression, borderline personality disorder, or other related disorder. The therapy is delivered in a manner to stimulate or modulate the vagal activity of the patient in a predetermined manner to treat and relieve the symptoms of the disorder, although it may not be effective in alleviating the underlying root cause of the disorder. The neurostimulator is programmed by the attending physician to generate a pulsed electrical signal that provides the desired therapeutic modality for treatment.
  • In the '569 patent, the applicants reported their conclusion that vagal stimulation can be effective for treating schizophrenia, for example. One observation toward that conclusion is that fast desynchronous (beta) activity and paroxysmal (synchronous) activity of the EEG have both been reported in studies of this disorder. At some stimulation parameters, vagal stimulation will synchronize the EEG, with a resultant beneficial effect on treatment of the disorder where increased beta wave activity is present. A second observation is the apparent relationship between schizophrenia and temporal lobe epilepsy. The temporal lobes are part of the limbic system, which they postulated is malfunctioning in patients with schizophrenia. Vagal stimulation can suppress temporal (complex partial) seizures, which are generated in the limbic system. The structures of this system are interconnected, and the beneficial effect of vagal stimulation seen in the temporal lobes may be transmitted to other brain structures, leading to a similar effect on schizophrenia. In this case, the abnormality being treated is a synchronous paroxysmal (epileptiform) discharge, and the therapy is designed to desynchronize the EEG.
  • In the treatment, different signal parameters and threshold curves are used to activate the various fibers of the patient's vagus nerve for selective modulation thereof by appropriately setting pulse width and amplitude of the electrical signal to be delivered by the neurostimulator to the patient's vagus nerve. It was recommended that to increase desynchronous activity of the EEG for treatment of a neuropsychiatric disorder, it would be prudent to use a short pulse train for the stimulus because the fibers could become refractory to the stimulation within a relatively short time interval. Then, after a suitable recovery period, another short pulse train may be applied to achieve further treatment. The precise pattern to be used, including the length of the time intervals on and off, depends upon and is adjusted to the individual patient and the particular disorder being treated.
  • The basic stimulation strategy called for modulating the activity of a number of brain structures, including the limbic system, the reticular formation, and the hippocampus through selective stimulation of the vagus nerve, which projects directly or indirectly to these brain structures. The strategy may be implemented by circadian programming to automatically activate the stimulus generator to continuously, periodically or intermittently generate an electrical signal appropriate for application to the patient's vagus nerve to modulate its activity and that of these brain structures. In another aspect, the treatment is carried out by applying the selectively modulating electrical signals to the patient's vagus nerve in response to the occurrence of one or more predetermined detectable events.
  • In the case of depression, vagal stimulation may be used to alter sleep state architecture as a modality that may produce a beneficial antidepressant effect. Certain stimulation parameters for the vagus nerve may produce synchronization of brain activity which leads to the biochemical changes required to relieve depression, without causing seizures. It is also noted in the '569 patent that vagal stimulation may be effective in the treatment of borderline personality disorder, at least because of the abnormalities in sleep architecture attendant with such disorders and the capability of vagal stimulation to alter sleep states. Recently, left cervical vagus nerve stimulation has been shown to have antidepressant effects in the treatment of patients with major depression and bipolar disorder (Rush et al, Biological Psychiatry, February, 2000).
  • Methods and apparatus for treating and controlling neuropsychiatric disorders according to the '569 patent involves applying electrical stimuli to the patient's vagus nerve or other appropriate cranial nerve, which may activate a specific group of fibers from among all of the fiber groups of the selected nerve(s), and selectively synchronize or desynchronize the patient's EEG and/or vary REM activity according to the specific nature of the disorder, and/or alter brain serotonin concentrations. Also, it was contemplated that the methods of treating and controlling neuropsychiatric disorders could be implemented by sensing a symptom of the disorder or the occurrence of a predetermined detectable event and thereafter automatically or manually effecting modulation of vagal activity through the application of preselected stimuli to the patient's vagus nerve to suppress the disorder. For example, by means of implanted surface or depth electrodes specific characteristics of the patient's EEG may be sensed for triggering the therapy. Alternatively, eye movement sensing electrodes may be implanted at or near the outer periphery of each eye socket to sense muscle movement or actual eye movement, and electrically connected via electrical leads to a sense signal analysis circuit of neurostimulator for rapid eye movement (REM) detection in a pattern indicative of the disorder to be treated. But since these sensing techniques involve complex and delicate electrode/lead implantation procedures, and in some instances a need for spectral analysis and/or programmable spectral or pattern recognition, it was preferred that the treatment be applied continuously, periodically or intermittently or in accordance with the patient's circadian rhythm. In the preferred implementation of the '569 patent, the electrode assembly is surgically implanted on the vagus nerve in a cervical location, in the patient's neck. The nerve electrodes may be wrapped about the vagus nerve, and the assembly secured to the nerve by a spiral anchoring tether.
  • It is a principal aim of the present invention to provide a new technique for treating neuropsychiatric disorders using stimulation of a suitable cranial nerve, especially the vagus nerve.
  • SUMMARY OF THE INVENTION
  • According to the present invention, a method of treating patients suffering from neuropsychiatric disorder, such as but not limited to schizophrenia, depression, or borderline personality disorder, comprises unilateral or bilateral stimulation of the left and right vagi in the immediate vicinity of the patient's diaphragm. Preferably, the treatment is administered at either a supra-diaphragmatic position (i.e., above the diaphragm) or sub-diaphragmatic position (i.e., below the diaphragm) in the ventral cavity. The stimulating electrical signal is preferably applied to the vagus two to three inches above or below the diaphragm, and may be applied either synchronously or asynchronously to both the right and left branches, preferably in the form of a series of pulses applied intermittently to both branches according to a predetermined on/off duty cycle. The intermittent application is preferably chronic, rather than acute. However, continuous application or acute application by bilateral stimulation of the right and left vagi or unilateral stimulation of either branch of the nerve is also contemplated.
  • Automatic delivery of bilateral intermittent stimulation is preferred, but alternatively in the case of certain neuropsychiatric disorders application of the stimulating electrical signal to the right and left vagi may be controlled by an external commencement signal produced by the patient's placement of an external magnet or use of other appropriate device or signaling mechanism in proximity to the location of the implanted device.
  • Preferably, the same stimulating electrical signal is applied to both the right and left vagi, but as an alternative, a stimulating electrical signal might be applied to the right vagus which is different from the stimulating electrical signal applied to the left vagus. And although two separate nerve stimulator generators may be implanted for stimulating the left and right vagi, respectively, as an alternative a single nerve stimulator generator may be implanted for bilateral stimulation if the same signal is to be applied to both the left and right branches of the vagus nerve, whether delivered synchronously or asynchronously to the vagi.
  • Preferably, the current magnitude of the stimulating signal is programmed to be less than about 6 mA, to be below the retching level of the patient as determined by the implanting physician at the time the implant procedure is performed. This is desirable to avoid patient nausea during periods of vagus nerve stimulation. Preferably, the pulse width is set to a value not exceeding about 500 microseconds (μs), the pulse repetition frequency is set at about 20-30 Hertz (Hz), the VNS regimen follows alternating periods of stimulation and no stimulation, with the second period about 1.8 to 6 times the length of the first period in the alternating sequence (i.e., the on/off duty cycle is 1:1.8 to 1:6).
  • Alternative techniques include indirect stimulation of the vagus, either bilaterally or unilaterally, at a location near one or both branches of the nerve or elsewhere, which has the effect of stimulating the vagus nerve as well. This may be accomplished through afferents or efferents, for example. It is also contemplated that direct or indirect unilateral or bilateral stimulation, applied in the vicinity of the patient's diaphragm, of one or more of the other cranial nerves of suitable sensory, motor or mixed fiber types may be effective in treating neuropsychiatric disorder, as an alternative to vagus nerve stimulation.
  • Some differences may be observed from stimulator to stimulator in magnitude of current in the pulses of the stimulation signal, and may be attributable to things such as patient impedance, variation of the vagus nerve from right to left or between patients, and variation in contact between the vagus and the electrode implanted thereon from implant to implant.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The above and still further aims, objectives, aspects, features and attendant advantages of the present invention will be better understood from a consideration of the following detailed description of a presently contemplated best mode of practicing the invention, by reference to a preferred exemplary method and embodiment thereof, taken in conjunction with the accompanying Figures of drawing, in which:
  • FIG. 1 is a simplified partial front view of a patient (in phantom) having an implanted neurostimulator for generating the desired signal stimuli which are applied directly and bilaterally at a near-diaphragmatic location to the right and left branches of the patient's vagus via an implanted lead/nerve electrode system electrically connected to the neurostimulator;
  • FIG. 2 is a simplified partial front view of a patient similar to that of FIG. 1, but in which a pair of implanted neurostimulators is used for generating the desired signal stimuli;
  • FIG. 3 is a simplified partial front view of a patient in which an implanted neurostimulator and associated electrode is used for unilateral stimulation of only one branch of the vagus nerve at the near-diaphragmatic location; and
  • FIG. 4 is a simplified partial front view of a patient in which the signal stimuli are applied at a portion of the nervous system remote from the vagus nerve, for indirect stimulation of the vagus nerve at the near-diaphragmatic location.
  • DESCRIPTION OF THE PRESENTLY CONTEMPLATED BEST MODE AND ALTERNATIVE MODES OF PRACTICE
  • A generally suitable form of neurostimulator for use in the apparatus and method of the present invention is disclosed, for example, in U.S. Pat. No. 5,154,172, assigned to the same assignee as the instant application (the device also referred to from time to time herein as a NeuroCybernetic Prosthesis or NCP device (NCP is a trademark of Cyberonics, Inc. of Houston, Tex., the assignee)). Certain parameters of the electrical stimuli generated by the neurostimulator are programmable, preferably by means of an external programmer (not shown) in a conventional manner for implantable electrical medical devices.
  • Referring to FIG. 1, the neurostimulator (sometimes referred to herein as stimulus generator, signal generator, pulse generator, or simply the device), identified in the drawing by reference number 10 is implanted in a patient 12, preferably in the abdominal region, for example, via a left laporotomy incision. For the preferred implementation and method of direct bilateral stimulation, lead-electrode pair 15, 16 is also implanted during the procedure, and the proximal end(s) of the lead(s) electrically connected to the neurostimulator. The lead-electrode may be of a standard bipolar lead nerve electrode type available from Cyberonics, Inc.
  • It will be understood that the overall device generally is required to be approved or sanctioned by government authority for marketing as a medical device implantable in a patient together with electrode means to treat the involuntary movement disorder by stimulation of a selected cranial nerve (e.g., the vagus nerve) of the patient. The treatment is performed using a predetermined sequence of electrical impulses generated by the pulse generator and applied to the selected cranial nerve at a location in a range, preferably, from about two to about three inches above or below the patient's diaphragm, for alleviating symptoms of the neuropsychiatric disorder in the patient. In the United States, the government agency for sanctioning such marketing and use is the U.S. Food and Drug Administration (FDA), while in other countries, sanctioning is typically handled by the counterpart of the FDA for the respective country. Thus, in the United States the same device may not be marketed or used to administer therapy to treat two different diseases or disorders absent FDA approval of the device for both.
  • According to the preferred method of the invention, the nerve electrodes 17, 18 are implanted on the right and left branches 19, 20, respectively, of the patient's vagus nerve at either a supra-diaphragmatic or sub-diaphragmatic location. The nerve electrodes are equipped with tethers for maintaining each electrode in place without undue stress on the coupling of the electrode onto the nerve itself. Preferably, the location of this coupling is approximately two to three inches above or below the patient's diaphragm 22 for each branch 19, 20.
  • Neurostimulator 10 generates electrical stimuli in the form of electrical impulses according to a programmed regimen for bilateral stimulation of the right and left branches of the vagus. During the implant procedure, the physician checks the current level of the pulsed signal to ascertain that the current is adjusted to a magnitude at least slightly below the retching threshold of the patient. Typically, if this level is programmed to a value less than approximately 6 mA, the patient does not experience retching attributable to the VNS although variations may be observed from patient to patient. In any event, the maximum amplitude of the current should be adjusted accordingly until an absence of retching is observed, with a suitable safety margin. The retching threshold may change noticeably with time over a course of days after implantation, so the level should be checked especially in the first few days after implantation to determine whether any adjustment is necessary to maintain an effective regimen.
  • The bilateral stimulation regimen of the VNS preferably employs an intermittent pattern of a period in which a repeating series of pulses is generated for stimulating the nerve, followed by a period in which no pulses are generated. The on/off duty cycle of these alternating periods of stimulation and no stimulation preferably has a ratio in which the off time is approximately 1.8 to 0.6 times the length of the on time. Nominally, the width of each pulse is set to a value not greater than about 500 μs, and the pulse repetition frequency is programmed to be in a range of about 20 to 30 Hz. The electrical and timing parameters of the stimulating signal used for VNS as described herein for the preferred embodiment will be understood to be merely exemplary and not as constituting limitations on the scope of the invention.
  • The intermittent aspect of the bilateral stimulation resides in applying the stimuli according to a prescribed duty cycle. The pulse signal is programmed to have a predetermined on-time in which a train or series of electrical pulses of preset parameters is applied to the vagus branches, followed by a predetermined off-time. Nevertheless, continuous application of the electrical pulse signal may also be effective in treating neuropsychiatric disorders.
  • Also, as shown in FIG. 2, dual implanted NCP devices 10 a and 10 b may be used as the pulse generators, one supplying the right vagus and the other the left vagus to provide the bilateral stimulation. At least slightly different stimulation for each branch may be effective as well. Use of implanted stimulators for performing the method of the invention is preferred, but treatment may conceivably be administered using external stimulation equipment on an out-patient basis, albeit only somewhat less confining than complete hospitalization. Implantation of one or more neurostimulators, of course, allows the patient to be completely ambulatory, so that normal daily routine activities including on the job performance is unaffected.
  • The desired stimulation of the patient's vagus nerve may also be achieved by performing unilateral supra-diaphragmatic or sub-diaphragmatic stimulation of either the left branch or the right branch of the vagus nerve, as shown in FIG. 3. A single neurostimulator 10 is implanted together with a lead 15 and associated nerve electrode 17. The nerve electrode 17 is implanted on either the right branch 19 or the left branch 20 of the nerve, preferably in a location in a range of from about two to about three inches above or below the patient's diaphragm 22. The electrical signal stimuli are the same as described above.
  • In a technique illustrated in FIG. 4, the signal stimuli are applied at a portion of the nervous system remote from the vagus nerve, for indirect stimulation of the vagus nerve in the vicinity of the diaphragmatic location. Here, at least one signal generator 10 is implanted together with one or more electrodes 17 subsequently operatively coupled to the generator via lead 15 for generating and applying the electrical signal internally to a portion of the patient's nervous system other than the vagus nerve, to provide indirect stimulation of the vagus nerve in the vicinity of the desired location. Alternatively, the electrical signal stimulus may be applied non-invasively to a portion of the patient's nervous system for indirect stimulation of the vagus nerve at the diaphragmatic location.
  • In treating schizophrenia, preferably circadian programming is used to desynchronize the EEG during the patient's normal waking hours, and to synchronize the EEG at night to improve sleep. Alternatively, detection strategies such as EEG detection of beta waves over the central temporal region, and/or of abnormal sleep patterns may be employed to trigger the stimulation. The vagal stimulation may be performed continuously, periodically, or intermittently during prescribed segments of the patient's circadian cycle. For example, daytime stimulation may be periodic with a random frequency for the stimulating pulse waveform, with parameter selection for EEG desynchronization; and nighttime stimulation may employ a periodically applied pattern with parameters selected to synchronize the patient's EEG (e.g., at 90 Hz, 1 mA, 0.10 μs for the pulse waveform), alternating with desynchronizing stimuli at predetermined intervals (e.g., 100 minute separation) to produce low voltage fast (REM) activity. This regimen of vagal stimulation is programmed into the neurostimulator device.
  • Since the schizophrenic patient is generally unable to recognize the symptoms of the disorder, no provision is made for patient activation of the neurostimulator for treatment of this particular disorder.
  • The preferred range of stimulation parameters for treatment of schizophrenia are pulse width of from 0.05 to 1.5 μs, output current of from 0.1 to 5.0 mA, pulse repetition frequency of from 5 to 150 Hz, on time from 5 to 500 sec, and off time from 5 to 500 sec.
  • Another activation modality for daytime stimulation is to program the output of the neurostimulator to the maximum amplitude which the patient can tolerate, with cycling on and off for a predetermined period of time followed by a relatively long interval without stimulation.
  • For patients suffering from depression, the preferred stimulation strategy is circadian programming for nighttime stimulation to increase REM activity, and to increase synchronization of the EEG during the patient's normal waking hours. Alternatively, a strategy may be employed for EEG detection of alpha or beta waveforms, and/or EEG detection and analysis of REM activity during sleep at night, followed by large signal, infrequent stimulation when the neurostimulator is activated by the detection circuitry. As noted above, the detection may be implemented using surface or depth sensing electrodes and EEG spectral or REM analysis circuitry.
  • The depression patient can recognize symptoms of the disorder, and therefore may be provided with a neurostimulator which is implemented for manual activation to deliver the therapy. In the case of manual activation, the therapy applied is intended to synchronize the EEG. It is unlikely that an antidepressant effect would be achieved quickly, so the neurostimulator should be programmed to generate the stimulus for a relatively long period of time in response to manual activation. The treatment is designed, in part, to increase the activity of the vagus nerve by which to evoke a release of a greater amount of the neurotransmitters serotonin and/or norepinephrine, natural antidepressants, in the patient's brain.
  • Patient activation of the neurostimulator for treatment of depression or other applicable neuropsychiatric disorder may involve use of an external control magnet for operating a reed switch in the implanted device, for example. Certain other techniques of manual and automatic activation of implantable medical devices are disclosed in U.S. Pat. No. 5,304,206 to R. G. Baker, Jr. et al. (referred to herein as “the '206 patent”), which is assigned to the same assignee as the present application. According to the '206 patent, means for manually activating or deactivating the stimulus generator may include a sensor such as a piezoelectric element 31 mounted to the inner surface of the generator case and adapted to detect light taps by the patient on the implant site. One or more taps applied in fast sequence to the skin above the location of the stimulus generator in the patient's body may be programmed into the device as the signal for activation of the generator, whereas two taps spaced apart by a slightly longer time gap is programmed as the signal for deactivation, for example. The therapy regimen performed by the implanted device(s) remains that which has been pre-programmed by means of the external programmer, according to the prescription of the patient's physician in concert with recommended programming techniques provided by the device manufacturer. In this way, the patient is given limited but convenient control over the device operation, to an extent which is determined by the program dictated and/or entered by the attending physician.
  • A preferred range of stimulation parameters to treat depression is pulse width from 0.05 to 1.5 msec, output current from 0.1 to 5.0 mA, pulse repetition frequency from 5 to 150 Hz, on time from 5 to 500 sec, and off time from 5 to 500 sec.
  • The circadian programming may also be set for synchronization of sleep patterns at night (e.g., output stimulating signal of 20 Hz, 500 μs, and 2 mA, cycled at 300 seconds on and 30 seconds off).
  • An activation modality for daytime stimulation may be similar to that described above for treating schizophrenia, in the treatment of depression.
  • For borderline personality disorder, the treatment preferably is designed to modify the patient's sleep patterns toward a normal pattern. A detection strategy may be to employ implanted electrodes to sense muscle movement or actual eye movement during sleep, and to analyze the detected REM activity; or to perform EEG detection with surface or depth EEG electrodes, followed by spectral analysis of the EEG. Again, however, circadian programming of the output signal for automatic stimulation in continuous, periodic or intermittent patterns is preferred for the sake of avoiding additional invasive procedures. Usually, patient activation of the neurostimulation generator is not a viable option for the borderline personality disorder patient.
  • The preferred ranges of stimulation parameters for treatment of borderline personality disorder are pulse width from 0.05 to 1.5 msec, output current from 0.1 to 5.0 mA, frequency from 5 to 150 Hz, on time 5 to 1500 sec, and off time 5 to 1500 sec.
  • The circadian programming may employ specific patterns at night to modify REM activity for the purpose of increasing REM latency and to decrease REM intensity, tailored for each individual patient. Such a regimen of stimulation is best designed where the patient exhibits historically consistent sleep patterns, and would require defining the stimulation pattern for discrete time block during the sleep period.
  • If sense electrodes are to be utilized to detect onset of the disorder being treated, a signal analysis circuit would be incorporated in the neurostimulator. Upon detection of the symptom of interest of the disorder being treated, the processed digital signal is supplied to a microprocessor in the neurostimulator device, to trigger application of the stimulating signal to the patient's vagus nerve.
  • The principles of the invention may be applicable to selected cranial nerves other than the vagus nerve, to achieve the desired results. Hence, although certain preferred methods and modes of treating and controlling neuropsychiatric disorders through a regimen generally of cranial nerve and specifically vagus nerve stimulation directly or indirectly at a near-diaphragmatic location have been described herein, it will be appreciated by persons of ordinary skill in the art of nerve stimulation for treatment of diseases and disorders that variations and modifications may be made within the scope of the present invention as defined by the appended claims. It is therefore intended that the invention shall be limited only as required by the appended claims and by the rules of applicable law.

Claims (11)

  1. 1-22. (canceled)
  2. 23. Apparatus for treating patients suffering from a specified neuropsychiatric disorder, comprising a pulse generator sanctioned by government authority for implantation in a patient together with electrode means to stimulate a selected cranial nerve of the patient with a predetermined sequence of electrical impulses from said pulse generator applied to the selected cranial nerve at a location in a range from about two to about three inches above or below the patient's diaphragm, for ameliorating symptoms of the specified neuropsychiatric disorder in the patient.
  3. 24. The apparatus of claim 23, wherein said pulse generator is programmable to enable physician programming of the electrical and timing parameters of said sequence of electrical impulses.
  4. 25. The apparatus of claim 23, wherein the selected cranial nerve is the vagus nerve, and said electrode means comprises at least one nerve electrode for implantation on the patient's vagus nerve for direct stimulation thereof at said location.
  5. 26. The apparatus of claim 25, wherein said electrode means comprises a pair of nerve electrodes for implantation of a respective one of said pair on left and right branches of the patient's vagus nerve for direct bilateral stimulation thereof at said location.
  6. 27. The apparatus of claim 23, wherein said electrode means comprises at least one electrode for implantation internally to a portion of the patient's nervous system remote from the selected cranial nerve to indirectly stimulate the selected cranial nerve in the vicinity of said location.
  7. 28. The apparatus of claim 23, including means associated with the pulse generator for enabling patient activation of the pulse generator to stimulate the selected cranial nerve in the vicinity of said location.
  8. 29. The apparatus of claim 23, wherein said specified neuropsychiatric disorder is schizophrenia, depression, borderline personality disorder, or related disorder.
  9. 30. Apparatus for treating patients suffering from a neuropsychiatric disorder from among schizophrenia, depression, borderline personality disorder, or related disorder, said apparatus comprising a pulse generator approved by a government agency of competent authority to be implanted with at least one interconnected nerve electrode in a patient to treat the neuropsychiatric disorder by applying a programmed sequence of electrical impulses generated by said pulse generator to a branch of the patient's vagus nerve via said electrode implanted on said nerve at a location in a range from about two to about three inches above or below the patient's diaphragm, for relieving symptoms of the neuropsychiatric disorder.
  10. 31. The apparatus of claim 30, wherein said pulse generator is adapted to be programmed by an attending physician to provide electrical and timing parameters of said impulses.
  11. 32. The apparatus of claim 30, wherein said nerve electrode is connected to an electrical lead of sufficient length to enable said at least one nerve electrode to be implanted on at least one of the left and right branches of said vagus nerve at said location.
US10661641 2001-07-28 2003-09-15 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation Abandoned US20050251220A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US09917603 US6622047B2 (en) 2001-07-28 2001-07-28 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation
US10661641 US20050251220A1 (en) 2001-07-28 2003-09-15 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US10661641 US20050251220A1 (en) 2001-07-28 2003-09-15 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation

Publications (1)

Publication Number Publication Date
US20050251220A1 true true US20050251220A1 (en) 2005-11-10

Family

ID=25439039

Family Applications (2)

Application Number Title Priority Date Filing Date
US09917603 Expired - Fee Related US6622047B2 (en) 2001-07-28 2001-07-28 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation
US10661641 Abandoned US20050251220A1 (en) 2001-07-28 2003-09-15 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US09917603 Expired - Fee Related US6622047B2 (en) 2001-07-28 2001-07-28 Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation

Country Status (3)

Country Link
US (2) US6622047B2 (en)
EP (1) EP1420854A4 (en)
WO (1) WO2003011392A9 (en)

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8150508B2 (en) 2006-03-29 2012-04-03 Catholic Healthcare West Vagus nerve stimulation method
US8391970B2 (en) 2007-08-27 2013-03-05 The Feinstein Institute For Medical Research Devices and methods for inhibiting granulocyte activation by neural stimulation
US8412338B2 (en) 2008-11-18 2013-04-02 Setpoint Medical Corporation Devices and methods for optimizing electrode placement for anti-inflamatory stimulation
US8612002B2 (en) 2009-12-23 2013-12-17 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8729129B2 (en) 2004-03-25 2014-05-20 The Feinstein Institute For Medical Research Neural tourniquet
US8788034B2 (en) 2011-05-09 2014-07-22 Setpoint Medical Corporation Single-pulse activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US8886339B2 (en) 2009-06-09 2014-11-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8914114B2 (en) 2000-05-23 2014-12-16 The Feinstein Institute For Medical Research Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US8996116B2 (en) 2009-10-30 2015-03-31 Setpoint Medical Corporation Modulation of the cholinergic anti-inflammatory pathway to treat pain or addiction
US9211409B2 (en) 2008-03-31 2015-12-15 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation of T-cell activity
US9211410B2 (en) 2009-05-01 2015-12-15 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9572983B2 (en) 2012-03-26 2017-02-21 Setpoint Medical Corporation Devices and methods for modulation of bone erosion
US9616234B2 (en) 2002-05-03 2017-04-11 Trustees Of Boston University System and method for neuro-stimulation
US9662490B2 (en) 2008-03-31 2017-05-30 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation and administration of an anti-inflammatory drug
US9833621B2 (en) 2011-09-23 2017-12-05 Setpoint Medical Corporation Modulation of sirtuins by vagus nerve stimulation

Families Citing this family (148)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8036741B2 (en) 1996-04-30 2011-10-11 Medtronic, Inc. Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure
US7747325B2 (en) 1998-08-05 2010-06-29 Neurovista Corporation Systems and methods for monitoring a patient's neurological disease state
US7853329B2 (en) 1998-08-05 2010-12-14 Neurovista Corporation Monitoring efficacy of neural modulation therapy
US9042988B2 (en) 1998-08-05 2015-05-26 Cyberonics, Inc. Closed-loop vagus nerve stimulation
US7209787B2 (en) 1998-08-05 2007-04-24 Bioneuronics Corporation Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease
US8762065B2 (en) 1998-08-05 2014-06-24 Cyberonics, Inc. Closed-loop feedback-driven neuromodulation
US9375573B2 (en) 1998-08-05 2016-06-28 Cyberonics, Inc. Systems and methods for monitoring a patient's neurological disease state
US9415222B2 (en) 1998-08-05 2016-08-16 Cyberonics, Inc. Monitoring an epilepsy disease state with a supervisory module
EP1198271A4 (en) 1999-06-25 2009-01-21 Univ Emory Devices and methods for vagus nerve stimulation
US7117033B2 (en) * 2000-05-08 2006-10-03 Brainsgate, Ltd. Stimulation for acute conditions
US8010189B2 (en) 2004-02-20 2011-08-30 Brainsgate Ltd. SPG stimulation for treating complications of subarachnoid hemorrhage
US9233245B2 (en) 2004-02-20 2016-01-12 Brainsgate Ltd. SPG stimulation
US7146209B2 (en) 2000-05-08 2006-12-05 Brainsgate, Ltd. Stimulation for treating eye pathologies
US7561919B2 (en) 2002-11-14 2009-07-14 Brainsgate Ltd. SPG stimulation via the greater palatine canal
US7120489B2 (en) 2000-05-08 2006-10-10 Brainsgate, Ltd. Method and apparatus for stimulating the sphenopalatine ganglion to modify properties of the BBB and cerebral blood flow
US7684859B2 (en) 2002-04-25 2010-03-23 Brainsgate Ltd. Stimulation of the OTIC ganglion for treating medical conditions
US20050209654A1 (en) * 2002-05-09 2005-09-22 Boveja Birinder R Method and system for providing adjunct (add-on) therapy for depression, anxiety and obsessive-compulsive disorders by providing electrical pulses to vagus nerve(s)
US20030212440A1 (en) * 2002-05-09 2003-11-13 Boveja Birinder R. Method and system for modulating the vagus nerve (10th cranial nerve) using modulated electrical pulses with an inductively coupled stimulation system
US7636597B2 (en) 2002-11-14 2009-12-22 Brainsgate, Ltd. Surgical tools and techniques for stimulation
US8064994B2 (en) * 2003-01-14 2011-11-22 The United States Of America As Represented By The Department Of Veterans Affairs Cervical vagal stimulation induced weight loss
EP1624926A4 (en) * 2003-05-06 2009-05-13 Aspect Medical Systems Inc System and method of assessment of the efficacy of treatment of neurological disorders using the electroencephalogram
US20040226556A1 (en) 2003-05-13 2004-11-18 Deem Mark E. Apparatus for treating asthma using neurotoxin
US20060069415A1 (en) * 2003-11-20 2006-03-30 Advanced Neuromodulation Systems, Inc. Electrical stimulation system, lead, and method providing modified reduced neuroplasticity effect
WO2005051480A3 (en) * 2003-11-20 2006-06-15 Advanced Neuromodulation Sys Electrical stimulation system, lead, and method providing reduced neuroplasticity effects
US9050469B1 (en) 2003-11-26 2015-06-09 Flint Hills Scientific, Llc Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals
US20060025828A1 (en) 2004-07-28 2006-02-02 Armstrong Randolph K Impedance measurement for an implantable device
US7734340B2 (en) * 2004-10-21 2010-06-08 Advanced Neuromodulation Systems, Inc. Stimulation design for neuromodulation
WO2006047264A1 (en) * 2004-10-21 2006-05-04 Advanced Neuromodulation Systems, Inc. Peripheral nerve stimulation to treat auditory dysfunction
CA2593079C (en) * 2004-12-27 2014-08-19 North Shore-Long Island Jewish Research Institute Treating inflammatory disorders by electrical vagus nerve stimulation
WO2006076478A2 (en) * 2005-01-12 2006-07-20 Aspect Medical Systems, Inc. System and method for prediction of adverse events during treatment of psychological and neurological disorders
US20060161226A1 (en) * 2005-01-18 2006-07-20 Mcmickle George R Apparatus and method for reducing follicular cell apoptosis
US9314633B2 (en) 2008-01-25 2016-04-19 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US20060173493A1 (en) * 2005-01-28 2006-08-03 Cyberonics, Inc. Multi-phasic signal for stimulation by an implantable device
US8565867B2 (en) 2005-01-28 2013-10-22 Cyberonics, Inc. Changeable electrode polarity stimulation by an implantable medical device
US7711419B2 (en) * 2005-07-13 2010-05-04 Cyberonics, Inc. Neurostimulator with reduced size
EP1745818A1 (en) * 2005-07-20 2007-01-24 Cyberonics, Inc. Vagus nerve stimulation by electrical signals for controlling cerebellar tremor
US8660647B2 (en) * 2005-07-28 2014-02-25 Cyberonics, Inc. Stimulating cranial nerve to treat pulmonary disorder
US7856273B2 (en) 2005-07-28 2010-12-21 Cyberonics, Inc. Autonomic nerve stimulation to treat a gastrointestinal disorder
US7706874B2 (en) 2005-07-28 2010-04-27 Cyberonics, Inc. Stimulating cranial nerve to treat disorders associated with the thyroid gland
US7499752B2 (en) 2005-07-29 2009-03-03 Cyberonics, Inc. Selective nerve stimulation for the treatment of eating disorders
US20070027486A1 (en) * 2005-07-29 2007-02-01 Cyberonics, Inc. Medical devices for enhancing intrinsic neural activity
US7532935B2 (en) * 2005-07-29 2009-05-12 Cyberonics, Inc. Selective neurostimulation for treating mood disorders
US20070027499A1 (en) * 2005-07-29 2007-02-01 Cyberonics, Inc. Neurostimulation device for treating mood disorders
US8055347B2 (en) 2005-08-19 2011-11-08 Brainsgate Ltd. Stimulation for treating brain events and other conditions
US20070073354A1 (en) 2005-09-26 2007-03-29 Knudson Mark B Neural blocking therapy
US7860566B2 (en) * 2005-10-06 2010-12-28 The Cleveland Clinic Foundation System and method for achieving regular slow ventricular rhythm in response to atrial fibrillation
US7489561B2 (en) 2005-10-24 2009-02-10 Cyberonics, Inc. Implantable medical device with reconfigurable non-volatile program
US8428731B2 (en) * 2005-10-27 2013-04-23 Cyberonics, Inc. Sequenced therapy protocols for an implantable medical device
US8694118B2 (en) 2005-10-28 2014-04-08 Cyberonics, Inc. Variable output ramping for an implantable medical device
US7957796B2 (en) 2005-10-28 2011-06-07 Cyberonics, Inc. Using physiological sensor data with an implantable medical device
US20070100377A1 (en) * 2005-10-28 2007-05-03 Cyberonics, Inc. Providing multiple signal modes for a medical device
US7555344B2 (en) * 2005-10-28 2009-06-30 Cyberonics, Inc. Selective neurostimulation for treating epilepsy
US8725243B2 (en) 2005-12-28 2014-05-13 Cyberonics, Inc. Methods and systems for recommending an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders
US8868172B2 (en) 2005-12-28 2014-10-21 Cyberonics, Inc. Methods and systems for recommending an appropriate action to a patient for managing epilepsy and other neurological disorders
US20070173890A1 (en) * 2006-01-24 2007-07-26 Cyberonics, Inc. Stimulation mode adjustment for an implantable medical device
US7996079B2 (en) 2006-01-24 2011-08-09 Cyberonics, Inc. Input response override for an implantable medical device
US7606622B2 (en) * 2006-01-24 2009-10-20 Cardiac Pacemakers, Inc. Method and device for detecting and treating depression
US7974697B2 (en) * 2006-01-26 2011-07-05 Cyberonics, Inc. Medical imaging feedback for an implantable medical device
US7657310B2 (en) 2006-01-26 2010-02-02 Cyberonics, Inc. Treatment of reproductive endocrine disorders by vagus nerve stimulation
US7769455B2 (en) * 2006-01-27 2010-08-03 Cyberonics, Inc. Power supply monitoring for an implantable device
US7801601B2 (en) 2006-01-27 2010-09-21 Cyberonics, Inc. Controlling neuromodulation using stimulus modalities
US8180462B2 (en) 2006-04-18 2012-05-15 Cyberonics, Inc. Heat dissipation for a lead assembly
US7962220B2 (en) 2006-04-28 2011-06-14 Cyberonics, Inc. Compensation reduction in tissue stimulation therapy
US7869885B2 (en) 2006-04-28 2011-01-11 Cyberonics, Inc Threshold optimization for tissue stimulation therapy
US8078283B2 (en) 2006-06-20 2011-12-13 Ebr Systems, Inc. Systems and methods for implantable leadless bone stimulation
US7894907B2 (en) * 2006-06-20 2011-02-22 Ebr Systems, Inc. Systems and methods for implantable leadless nerve stimulation
WO2007150003A3 (en) 2006-06-23 2008-11-06 Neurovista Corp Minimally invasive monitoring systems and methods
US8478420B2 (en) 2006-07-12 2013-07-02 Cyberonics, Inc. Implantable medical device charge balance assessment
US20080027524A1 (en) 2006-07-26 2008-01-31 Maschino Steven E Multi-electrode assembly for an implantable medical device
US7797041B2 (en) * 2006-10-11 2010-09-14 Cardiac Pacemakers, Inc. Transcutaneous neurostimulator for modulating cardiovascular function
US7797046B2 (en) 2006-10-11 2010-09-14 Cardiac Pacemakers, Inc. Percutaneous neurostimulator for modulating cardiovascular function
US7869867B2 (en) 2006-10-27 2011-01-11 Cyberonics, Inc. Implantable neurostimulator with refractory stimulation
US8295934B2 (en) 2006-11-14 2012-10-23 Neurovista Corporation Systems and methods of reducing artifact in neurological stimulation systems
WO2008092133A3 (en) 2007-01-25 2008-09-12 Neurovista Corp Methods and systems for measuring a subject's susceptibility to a seizure
US7706875B2 (en) * 2007-01-25 2010-04-27 Cyberonics, Inc. Modulation of drug effects by vagus nerve stimulation
US9898656B2 (en) 2007-01-25 2018-02-20 Cyberonics, Inc. Systems and methods for identifying a contra-ictal condition in a subject
US7974707B2 (en) 2007-01-26 2011-07-05 Cyberonics, Inc. Electrode assembly with fibers for a medical device
US8036736B2 (en) 2007-03-21 2011-10-11 Neuro Vista Corporation Implantable systems and methods for identifying a contra-ictal condition in a subject
US8364273B2 (en) * 2007-04-24 2013-01-29 Dirk De Ridder Combination of tonic and burst stimulations to treat neurological disorders
US7869884B2 (en) 2007-04-26 2011-01-11 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7962214B2 (en) 2007-04-26 2011-06-14 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7904175B2 (en) 2007-04-26 2011-03-08 Cyberonics, Inc. Trans-esophageal vagus nerve stimulation
US7974701B2 (en) * 2007-04-27 2011-07-05 Cyberonics, Inc. Dosing limitation for an implantable medical device
US9788744B2 (en) 2007-07-27 2017-10-17 Cyberonics, Inc. Systems for monitoring brain activity and patient advisory device
US7860569B2 (en) 2007-10-18 2010-12-28 Brainsgate, Ltd. Long-term SPG stimulation therapy for prevention of vascular dementia
US8868203B2 (en) 2007-10-26 2014-10-21 Cyberonics, Inc. Dynamic lead condition detection for an implantable medical device
US8942798B2 (en) 2007-10-26 2015-01-27 Cyberonics, Inc. Alternative operation mode for an implantable medical device based upon lead condition
US9259591B2 (en) 2007-12-28 2016-02-16 Cyberonics, Inc. Housing for an implantable medical device
US8260426B2 (en) 2008-01-25 2012-09-04 Cyberonics, Inc. Method, apparatus and system for bipolar charge utilization during stimulation by an implantable medical device
US8483831B1 (en) 2008-02-15 2013-07-09 Holaira, Inc. System and method for bronchial dilation
US20090264954A1 (en) * 2008-04-18 2009-10-22 Medtronic, Inc. Therapy target selection for psychiatric disorder therapy
US8204603B2 (en) 2008-04-25 2012-06-19 Cyberonics, Inc. Blocking exogenous action potentials by an implantable medical device
ES2398052T3 (en) 2008-05-09 2013-03-13 Innovative Pulmonary Solutions, Inc. Systems for treating bronchial tree
US8788042B2 (en) 2008-07-30 2014-07-22 Ecole Polytechnique Federale De Lausanne (Epfl) Apparatus and method for optimized stimulation of a neurological target
US8457747B2 (en) 2008-10-20 2013-06-04 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
US8417344B2 (en) 2008-10-24 2013-04-09 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
CA2743575C (en) 2008-11-12 2017-01-31 Ecole Polytechnique Federale De Lausanne Microfabricated neurostimulation device
US8849390B2 (en) 2008-12-29 2014-09-30 Cyberonics, Inc. Processing for multi-channel signals
US8588933B2 (en) 2009-01-09 2013-11-19 Cyberonics, Inc. Medical lead termination sleeve for implantable medical devices
US8255057B2 (en) 2009-01-29 2012-08-28 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8239028B2 (en) 2009-04-24 2012-08-07 Cyberonics, Inc. Use of cardiac parameters in methods and systems for treating a chronic medical condition
US8827912B2 (en) 2009-04-24 2014-09-09 Cyberonics, Inc. Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters
US8786624B2 (en) 2009-06-02 2014-07-22 Cyberonics, Inc. Processing for multi-channel signals
CA2779135A1 (en) 2009-10-27 2011-05-12 Innovative Pulmonary Solutions, Inc. Delivery devices with coolable energy emitting assemblies
CN106618731A (en) 2009-11-11 2017-05-10 赫莱拉公司 Systems, apparatuses, and methods for treating tissue and controlling stenosis
US8911439B2 (en) 2009-11-11 2014-12-16 Holaira, Inc. Non-invasive and minimally invasive denervation methods and systems for performing the same
WO2011067297A9 (en) 2009-12-01 2012-04-05 ECOLE POLYTECHNIQUE FéDéRALE DE LAUSANNE Microfabricated surface neurostimulation device and methods of making and using the same
US9643019B2 (en) 2010-02-12 2017-05-09 Cyberonics, Inc. Neurological monitoring and alerts
JP5927176B2 (en) 2010-04-01 2016-06-01 エコーレ ポリテクニーク フェデラーレ デ ローザンヌ (イーピーエフエル) Device for interacting with nerve tissue, and methods of making and using it
US8478428B2 (en) 2010-04-23 2013-07-02 Cyberonics, Inc. Helical electrode for nerve stimulation
US8874229B2 (en) 2010-04-28 2014-10-28 Cyberonics, Inc. Delivering scheduled and unscheduled therapy without detriment to battery life or accuracy of longevity predictions
US8649871B2 (en) 2010-04-29 2014-02-11 Cyberonics, Inc. Validity test adaptive constraint modification for cardiac data used for detection of state changes
US8423134B2 (en) 2010-04-29 2013-04-16 Medtronic, Inc. Therapy using perturbation and effect of physiological systems
US8639327B2 (en) 2010-04-29 2014-01-28 Medtronic, Inc. Nerve signal differentiation in cardiac therapy
US8620425B2 (en) 2010-04-29 2013-12-31 Medtronic, Inc. Nerve signal differentiation in cardiac therapy
US8831732B2 (en) 2010-04-29 2014-09-09 Cyberonics, Inc. Method, apparatus and system for validating and quantifying cardiac beat data quality
US8562536B2 (en) 2010-04-29 2013-10-22 Flint Hills Scientific, Llc Algorithm for detecting a seizure from cardiac data
US8679009B2 (en) 2010-06-15 2014-03-25 Flint Hills Scientific, Llc Systems approach to comorbidity assessment
US8641646B2 (en) 2010-07-30 2014-02-04 Cyberonics, Inc. Seizure detection using coordinate data
WO2012030831A1 (en) 2010-08-30 2012-03-08 Advanced Neuromodulation Systems, Inc. Use of a new stimulation design to treat neurological disorder
US8571643B2 (en) 2010-09-16 2013-10-29 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8382667B2 (en) 2010-10-01 2013-02-26 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8684921B2 (en) 2010-10-01 2014-04-01 Flint Hills Scientific Llc Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
US8337404B2 (en) 2010-10-01 2012-12-25 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8718763B2 (en) 2011-01-19 2014-05-06 Medtronic, Inc. Vagal stimulation
US8781582B2 (en) 2011-01-19 2014-07-15 Medtronic, Inc. Vagal stimulation
US8781583B2 (en) 2011-01-19 2014-07-15 Medtronic, Inc. Vagal stimulation
US8706223B2 (en) 2011-01-19 2014-04-22 Medtronic, Inc. Preventative vagal stimulation
US8725259B2 (en) 2011-01-19 2014-05-13 Medtronic, Inc. Vagal stimulation
DE102011009528B4 (en) 2011-01-26 2013-09-05 Cerbomed Gmbh Device for transcutaneous stimulation of a nerve of the human body
US8577459B2 (en) 2011-01-28 2013-11-05 Cyberonics, Inc. System and method for estimating battery capacity
US8562523B2 (en) 2011-03-04 2013-10-22 Flint Hills Scientific, Llc Detecting, assessing and managing extreme epileptic events
US9504390B2 (en) 2011-03-04 2016-11-29 Globalfoundries Inc. Detecting, assessing and managing a risk of death in epilepsy
US8562524B2 (en) 2011-03-04 2013-10-22 Flint Hills Scientific, Llc Detecting, assessing and managing a risk of death in epilepsy
US8761884B2 (en) 2011-04-14 2014-06-24 Cyberonics, Inc. Device longevity prediction for a device having variable energy consumption
US8725239B2 (en) 2011-04-25 2014-05-13 Cyberonics, Inc. Identifying seizures using heart rate decrease
US9402550B2 (en) 2011-04-29 2016-08-02 Cybertronics, Inc. Dynamic heart rate threshold for neurological event detection
US8761885B2 (en) 2011-04-29 2014-06-24 Cyberonics, Inc. Battery life estimation based on voltage depletion rate
US9398933B2 (en) 2012-12-27 2016-07-26 Holaira, Inc. Methods for improving drug efficacy including a combination of drug administration and nerve modulation
US9610444B2 (en) 2013-03-15 2017-04-04 Pacesetter, Inc. Erythropoeitin production by electrical stimulation
US9056195B2 (en) 2013-03-15 2015-06-16 Cyberonics, Inc. Optimization of cranial nerve stimulation to treat seizure disorderse during sleep
US9675796B2 (en) 2013-11-10 2017-06-13 Brainsgate Ltd. Implant and delivery system for neural stimulator
US9302109B2 (en) 2014-04-25 2016-04-05 Cyberonics, Inc. Cranial nerve stimulation to treat depression during sleep
US9585611B2 (en) 2014-04-25 2017-03-07 Cyberonics, Inc. Detecting seizures based on heartbeat data
US9782584B2 (en) 2014-06-13 2017-10-10 Nervana, LLC Transcutaneous electrostimulator and methods for electric stimulation
US9474894B2 (en) 2014-08-27 2016-10-25 Aleva Neurotherapeutics Deep brain stimulation lead
US9403011B2 (en) 2014-08-27 2016-08-02 Aleva Neurotherapeutics Leadless neurostimulator
WO2017134587A1 (en) 2016-02-02 2017-08-10 Aleva Neurotherapeutics, Sa Treatment of autoimmune diseases with deep brain stimulation

Citations (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4867164A (en) * 1983-09-14 1989-09-19 Jacob Zabara Neurocybernetic prosthesis
US5025807A (en) * 1983-09-14 1991-06-25 Jacob Zabara Neurocybernetic prosthesis
US5941906A (en) * 1997-10-15 1999-08-24 Medtronic, Inc. Implantable, modular tissue stimulator
US5995872A (en) * 1997-04-30 1999-11-30 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6026326A (en) * 1997-01-13 2000-02-15 Medtronic, Inc. Apparatus and method for treating chronic constipation
US6044846A (en) * 1994-06-24 2000-04-04 Edwards; Stuart D. Method to treat esophageal sphincters
US6083249A (en) * 1997-04-30 2000-07-04 Medtronic, Inc. Apparatus for sensing and stimulating gastrointestinal tract on-demand
US6091992A (en) * 1997-12-15 2000-07-18 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6104955A (en) * 1997-12-15 2000-08-15 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6102922A (en) * 1995-09-22 2000-08-15 Kirk Promotions Limited Surgical method and device for reducing the food intake of patient
US6167311A (en) * 1999-06-14 2000-12-26 Electro Core Techniques, Llc Method of treating psychological disorders by brain stimulation within the thalamus
US6176242B1 (en) * 1999-04-30 2001-01-23 Medtronic Inc Method of treating manic depression by brain infusion
US6216039B1 (en) * 1997-05-02 2001-04-10 Medtronic Inc. Method and apparatus for treating irregular gastric rhythms
US6266564B1 (en) * 1998-04-30 2001-07-24 Medtronic, Inc. Method and device for electronically controlling the beating of a heart
US6299569B1 (en) * 1992-12-28 2001-10-09 Retrograce Systems Inc. Exercisers and exercise methods
US6321124B1 (en) * 1997-05-28 2001-11-20 Transneuronix, Inc. Implant device for electrostimulation and/or monitoring of endo-abdominal cavity tissue
US6356788B2 (en) * 1998-10-26 2002-03-12 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for depression, migraine, neuropsychiatric disorders, partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6366814B1 (en) * 1998-10-26 2002-04-02 Birinder R. Boveja External stimulator for adjunct (add-on) treatment for neurological, neuropsychiatric, and urological disorders
US6381495B1 (en) * 1997-05-28 2002-04-30 Transneuronix, Inc. Medical device for use in laparoscopic surgery
US6418344B1 (en) * 2000-02-24 2002-07-09 Electrocore Techniques, Llc Method of treating psychiatric disorders by electrical stimulation within the orbitofrontal cerebral cortex
US6449512B1 (en) * 2001-08-29 2002-09-10 Birinder R. Boveja Apparatus and method for treatment of urological disorders using programmerless implantable pulse generator system
US6477423B1 (en) * 1997-05-28 2002-11-05 Transneuronix, Inc. Medical device for use in laparoscopic surgery
US6505074B2 (en) * 1998-10-26 2003-01-07 Birinder R. Boveja Method and apparatus for electrical stimulation adjunct (add-on) treatment of urinary incontinence and urological disorders using an external stimulator
US6510332B1 (en) * 1999-08-30 2003-01-21 Transneuronix, Inc. Electrode leads for use in laparoscopic surgery
US6532388B1 (en) * 1996-04-30 2003-03-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
US6535764B2 (en) * 2001-05-01 2003-03-18 Intrapace, Inc. Gastric treatment and diagnosis device and method
US6542776B1 (en) * 1999-04-14 2003-04-01 Transneuronix Inc. Gastric stimulator apparatus and method for installing
US6564101B1 (en) * 1998-02-02 2003-05-13 The Trustees Of Columbia University In The City Of New York Electrical system for weight loss and laparoscopic implanation thereof
US6587719B1 (en) * 1999-07-01 2003-07-01 Cyberonics, Inc. Treatment of obesity by bilateral vagus nerve stimulation
US6587726B2 (en) * 1998-06-11 2003-07-01 Cprx Llc Stimulatory device and methods to electrically stimulate the phrenic nerve
US6600953B2 (en) * 2000-12-11 2003-07-29 Impulse Dynamics N.V. Acute and chronic electrical signal therapy for obesity
US6606523B1 (en) * 1999-04-14 2003-08-12 Transneuronix Inc. Gastric stimulator apparatus and method for installing
US6606518B1 (en) * 1999-08-06 2003-08-12 Transneuronix, Inc. Apparatus and process for stimulation of a state of complete continence in the neospincter in the preparation of continent neostomies
US6609025B2 (en) * 2001-01-02 2003-08-19 Cyberonics, Inc. Treatment of obesity by bilateral sub-diaphragmatic nerve stimulation
US6609030B1 (en) * 2000-02-24 2003-08-19 Electrocore Techniques, Llc Method of treating psychiatric diseases by neuromodulation within the dorsomedial thalamus
US6611715B1 (en) * 1998-10-26 2003-08-26 Birinder R. Boveja Apparatus and method for neuromodulation therapy for obesity and compulsive eating disorders using an implantable lead-receiver and an external stimulator
US6615084B1 (en) * 2000-11-15 2003-09-02 Transneuronix, Inc. Process for electrostimulation treatment of morbid obesity
US6615081B1 (en) * 1998-10-26 2003-09-02 Birinder R. Boveja Apparatus and method for adjunct (add-on) treatment of diabetes by neuromodulation with an external stimulator
US6612983B1 (en) * 2000-03-28 2003-09-02 Medtronic, Inc. Pancreatic secretion response to stimulation test protocol
US6650943B1 (en) * 2000-04-07 2003-11-18 Advanced Bionics Corporation Fully implantable neurostimulator for cavernous nerve stimulation as a therapy for erectile dysfunction and other sexual dysfunction
US6662053B2 (en) * 2000-08-17 2003-12-09 William N. Borkan Multichannel stimulator electronics and methods
US6684104B2 (en) * 1999-04-14 2004-01-27 Transneuronix, Inc. Gastric stimulator apparatus and method for installing
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation
US6708064B2 (en) * 2000-02-24 2004-03-16 Ali R. Rezai Modulation of the brain to affect psychiatric disorders
US6754536B2 (en) * 2001-01-31 2004-06-22 Medtronic, Inc Implantable medical device affixed internally within the gastrointestinal tract
US6760626B1 (en) * 2001-08-29 2004-07-06 Birinder R. Boveja Apparatus and method for treatment of neurological and neuropsychiatric disorders using programmerless implantable pulse generator system
US6775573B2 (en) * 2001-03-01 2004-08-10 Science Medicus Inc. Electrical method to control autonomic nerve stimulation of gastrointestinal tract
US6819956B2 (en) * 1998-08-05 2004-11-16 Dilorenzo Daniel J. Optimal method and apparatus for neural modulation for the treatment of neurological disease, particularly movement disorders
US6826428B1 (en) * 2000-04-11 2004-11-30 The Board Of Regents Of The University Of Texas System Gastrointestinal electrical stimulation
US6832114B1 (en) * 2000-11-21 2004-12-14 Advanced Bionics Corporation Systems and methods for modulation of pancreatic endocrine secretion and treatment of diabetes
US6853862B1 (en) * 1999-12-03 2005-02-08 Medtronic, Inc. Gastroelectric stimulation for influencing pancreatic secretions
US6895278B1 (en) * 1999-04-14 2005-05-17 Transneuronix, Inc. Gastric stimulator apparatus and method for use

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4702254A (en) 1983-09-14 1987-10-27 Jacob Zabara Neurocybernetic prosthesis
US5299569A (en) * 1991-05-03 1994-04-05 Cyberonics, Inc. Treatment of neuropsychiatric disorders by nerve stimulation
US5304206A (en) 1991-11-18 1994-04-19 Cyberonics, Inc. Activation techniques for implantable medical device
US5707400A (en) * 1995-09-19 1998-01-13 Cyberonics, Inc. Treating refractory hypertension by nerve stimulation
DE69727878T2 (en) * 1996-10-18 2005-01-05 St. Jude Medical Ab An apparatus for the treatment of tachycardia by stimulation of the respiratory system

Patent Citations (55)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4867164A (en) * 1983-09-14 1989-09-19 Jacob Zabara Neurocybernetic prosthesis
US5025807A (en) * 1983-09-14 1991-06-25 Jacob Zabara Neurocybernetic prosthesis
US6299569B1 (en) * 1992-12-28 2001-10-09 Retrograce Systems Inc. Exercisers and exercise methods
US6044846A (en) * 1994-06-24 2000-04-04 Edwards; Stuart D. Method to treat esophageal sphincters
US6102922A (en) * 1995-09-22 2000-08-15 Kirk Promotions Limited Surgical method and device for reducing the food intake of patient
US6532388B1 (en) * 1996-04-30 2003-03-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
US6026326A (en) * 1997-01-13 2000-02-15 Medtronic, Inc. Apparatus and method for treating chronic constipation
US6238423B1 (en) * 1997-01-13 2001-05-29 Medtronic, Inc. Apparatus and method for treating chronic constipation
US6083249A (en) * 1997-04-30 2000-07-04 Medtronic, Inc. Apparatus for sensing and stimulating gastrointestinal tract on-demand
US5995872A (en) * 1997-04-30 1999-11-30 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6327503B1 (en) * 1997-04-30 2001-12-04 Medtronic, Inc Method and apparatus for sensing and stimulating gastrointestinal tract on-demand
US6216039B1 (en) * 1997-05-02 2001-04-10 Medtronic Inc. Method and apparatus for treating irregular gastric rhythms
US6321124B1 (en) * 1997-05-28 2001-11-20 Transneuronix, Inc. Implant device for electrostimulation and/or monitoring of endo-abdominal cavity tissue
US6477423B1 (en) * 1997-05-28 2002-11-05 Transneuronix, Inc. Medical device for use in laparoscopic surgery
US6381495B1 (en) * 1997-05-28 2002-04-30 Transneuronix, Inc. Medical device for use in laparoscopic surgery
US5941906A (en) * 1997-10-15 1999-08-24 Medtronic, Inc. Implantable, modular tissue stimulator
US6115635A (en) * 1997-12-15 2000-09-05 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6104955A (en) * 1997-12-15 2000-08-15 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6091992A (en) * 1997-12-15 2000-07-18 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6564101B1 (en) * 1998-02-02 2003-05-13 The Trustees Of Columbia University In The City Of New York Electrical system for weight loss and laparoscopic implanation thereof
US6266564B1 (en) * 1998-04-30 2001-07-24 Medtronic, Inc. Method and device for electronically controlling the beating of a heart
US6587726B2 (en) * 1998-06-11 2003-07-01 Cprx Llc Stimulatory device and methods to electrically stimulate the phrenic nerve
US6819956B2 (en) * 1998-08-05 2004-11-16 Dilorenzo Daniel J. Optimal method and apparatus for neural modulation for the treatment of neurological disease, particularly movement disorders
US6366814B1 (en) * 1998-10-26 2002-04-02 Birinder R. Boveja External stimulator for adjunct (add-on) treatment for neurological, neuropsychiatric, and urological disorders
US6611715B1 (en) * 1998-10-26 2003-08-26 Birinder R. Boveja Apparatus and method for neuromodulation therapy for obesity and compulsive eating disorders using an implantable lead-receiver and an external stimulator
US6356788B2 (en) * 1998-10-26 2002-03-12 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for depression, migraine, neuropsychiatric disorders, partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6615081B1 (en) * 1998-10-26 2003-09-02 Birinder R. Boveja Apparatus and method for adjunct (add-on) treatment of diabetes by neuromodulation with an external stimulator
US6505074B2 (en) * 1998-10-26 2003-01-07 Birinder R. Boveja Method and apparatus for electrical stimulation adjunct (add-on) treatment of urinary incontinence and urological disorders using an external stimulator
US6684104B2 (en) * 1999-04-14 2004-01-27 Transneuronix, Inc. Gastric stimulator apparatus and method for installing
US6542776B1 (en) * 1999-04-14 2003-04-01 Transneuronix Inc. Gastric stimulator apparatus and method for installing
US6895278B1 (en) * 1999-04-14 2005-05-17 Transneuronix, Inc. Gastric stimulator apparatus and method for use
US6606523B1 (en) * 1999-04-14 2003-08-12 Transneuronix Inc. Gastric stimulator apparatus and method for installing
US6176242B1 (en) * 1999-04-30 2001-01-23 Medtronic Inc Method of treating manic depression by brain infusion
US6167311A (en) * 1999-06-14 2000-12-26 Electro Core Techniques, Llc Method of treating psychological disorders by brain stimulation within the thalamus
US6587719B1 (en) * 1999-07-01 2003-07-01 Cyberonics, Inc. Treatment of obesity by bilateral vagus nerve stimulation
US6606518B1 (en) * 1999-08-06 2003-08-12 Transneuronix, Inc. Apparatus and process for stimulation of a state of complete continence in the neospincter in the preparation of continent neostomies
US6510332B1 (en) * 1999-08-30 2003-01-21 Transneuronix, Inc. Electrode leads for use in laparoscopic surgery
US6853862B1 (en) * 1999-12-03 2005-02-08 Medtronic, Inc. Gastroelectric stimulation for influencing pancreatic secretions
US6418344B1 (en) * 2000-02-24 2002-07-09 Electrocore Techniques, Llc Method of treating psychiatric disorders by electrical stimulation within the orbitofrontal cerebral cortex
US6609030B1 (en) * 2000-02-24 2003-08-19 Electrocore Techniques, Llc Method of treating psychiatric diseases by neuromodulation within the dorsomedial thalamus
US6708064B2 (en) * 2000-02-24 2004-03-16 Ali R. Rezai Modulation of the brain to affect psychiatric disorders
US6612983B1 (en) * 2000-03-28 2003-09-02 Medtronic, Inc. Pancreatic secretion response to stimulation test protocol
US6650943B1 (en) * 2000-04-07 2003-11-18 Advanced Bionics Corporation Fully implantable neurostimulator for cavernous nerve stimulation as a therapy for erectile dysfunction and other sexual dysfunction
US6826428B1 (en) * 2000-04-11 2004-11-30 The Board Of Regents Of The University Of Texas System Gastrointestinal electrical stimulation
US6662053B2 (en) * 2000-08-17 2003-12-09 William N. Borkan Multichannel stimulator electronics and methods
US6615084B1 (en) * 2000-11-15 2003-09-02 Transneuronix, Inc. Process for electrostimulation treatment of morbid obesity
US6832114B1 (en) * 2000-11-21 2004-12-14 Advanced Bionics Corporation Systems and methods for modulation of pancreatic endocrine secretion and treatment of diabetes
US6600953B2 (en) * 2000-12-11 2003-07-29 Impulse Dynamics N.V. Acute and chronic electrical signal therapy for obesity
US6609025B2 (en) * 2001-01-02 2003-08-19 Cyberonics, Inc. Treatment of obesity by bilateral sub-diaphragmatic nerve stimulation
US6754536B2 (en) * 2001-01-31 2004-06-22 Medtronic, Inc Implantable medical device affixed internally within the gastrointestinal tract
US6775573B2 (en) * 2001-03-01 2004-08-10 Science Medicus Inc. Electrical method to control autonomic nerve stimulation of gastrointestinal tract
US6535764B2 (en) * 2001-05-01 2003-03-18 Intrapace, Inc. Gastric treatment and diagnosis device and method
US6449512B1 (en) * 2001-08-29 2002-09-10 Birinder R. Boveja Apparatus and method for treatment of urological disorders using programmerless implantable pulse generator system
US6760626B1 (en) * 2001-08-29 2004-07-06 Birinder R. Boveja Apparatus and method for treatment of neurological and neuropsychiatric disorders using programmerless implantable pulse generator system
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation

Cited By (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8914114B2 (en) 2000-05-23 2014-12-16 The Feinstein Institute For Medical Research Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US9987492B2 (en) 2000-05-23 2018-06-05 The Feinstein Institute For Medical Research Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US9616234B2 (en) 2002-05-03 2017-04-11 Trustees Of Boston University System and method for neuro-stimulation
US8729129B2 (en) 2004-03-25 2014-05-20 The Feinstein Institute For Medical Research Neural tourniquet
US8219188B2 (en) 2006-03-29 2012-07-10 Catholic Healthcare West Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
US9533151B2 (en) 2006-03-29 2017-01-03 Dignity Health Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8615309B2 (en) 2006-03-29 2013-12-24 Catholic Healthcare West Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8660666B2 (en) 2006-03-29 2014-02-25 Catholic Healthcare West Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8280505B2 (en) 2006-03-29 2012-10-02 Catholic Healthcare West Vagus nerve stimulation method
US8738126B2 (en) 2006-03-29 2014-05-27 Catholic Healthcare West Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
US9289599B2 (en) 2006-03-29 2016-03-22 Dignity Health Vagus nerve stimulation method
US9108041B2 (en) 2006-03-29 2015-08-18 Dignity Health Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8150508B2 (en) 2006-03-29 2012-04-03 Catholic Healthcare West Vagus nerve stimulation method
US8391970B2 (en) 2007-08-27 2013-03-05 The Feinstein Institute For Medical Research Devices and methods for inhibiting granulocyte activation by neural stimulation
US9662490B2 (en) 2008-03-31 2017-05-30 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation and administration of an anti-inflammatory drug
US9211409B2 (en) 2008-03-31 2015-12-15 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation of T-cell activity
US8412338B2 (en) 2008-11-18 2013-04-02 Setpoint Medical Corporation Devices and methods for optimizing electrode placement for anti-inflamatory stimulation
US9211410B2 (en) 2009-05-01 2015-12-15 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9849286B2 (en) 2009-05-01 2017-12-26 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9700716B2 (en) 2009-06-09 2017-07-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US9174041B2 (en) 2009-06-09 2015-11-03 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8886339B2 (en) 2009-06-09 2014-11-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8996116B2 (en) 2009-10-30 2015-03-31 Setpoint Medical Corporation Modulation of the cholinergic anti-inflammatory pathway to treat pain or addiction
US8612002B2 (en) 2009-12-23 2013-12-17 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US9162064B2 (en) 2009-12-23 2015-10-20 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8855767B2 (en) 2009-12-23 2014-10-07 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US9993651B2 (en) 2009-12-23 2018-06-12 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8788034B2 (en) 2011-05-09 2014-07-22 Setpoint Medical Corporation Single-pulse activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9833621B2 (en) 2011-09-23 2017-12-05 Setpoint Medical Corporation Modulation of sirtuins by vagus nerve stimulation
US9572983B2 (en) 2012-03-26 2017-02-21 Setpoint Medical Corporation Devices and methods for modulation of bone erosion

Also Published As

Publication number Publication date Type
WO2003011392A2 (en) 2003-02-13 application
EP1420854A4 (en) 2011-02-23 application
WO2003011392A3 (en) 2003-12-18 application
EP1420854A2 (en) 2004-05-26 application
US20030023282A1 (en) 2003-01-30 application
WO2003011392A9 (en) 2004-04-22 application
US6622047B2 (en) 2003-09-16 grant

Similar Documents

Publication Publication Date Title
US6671556B2 (en) Vagal nerve stimulation techniques for treatment of epileptic seizures
US5025807A (en) Neurocybernetic prosthesis
US6879859B1 (en) External pulse generator for adjunct (add-on) treatment of obesity, eating disorders, neurological, neuropsychiatric, and urological disorders
US4702254A (en) Neurocybernetic prosthesis
US4867164A (en) Neurocybernetic prosthesis
US7174213B2 (en) Electrical stimulation strategies to reduce the incidence of seizures
US7689276B2 (en) Dynamic nerve stimulation for treatment of disorders
US5928272A (en) Automatic activation of a neurostimulator device using a detection algorithm based on cardiac activity
US7483747B2 (en) Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy
US20100274315A1 (en) Selective high frequency spinal cord modulation for inhibiting pain with reduced side effects, and associated systems and methods, including practitioner processes
US20070233194A1 (en) Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
US20080027503A1 (en) Vagus Nerve Stimulation by Electrical Signals for Controlling Cerebellar Tremor
US7680538B2 (en) Method of treating obstructive sleep apnea using electrical nerve stimulation
US20060259077A1 (en) Cervical wagal stimulation induced weight loss
US7747324B2 (en) Electrical stimulation treatment of bronchial constriction
US7890185B2 (en) Treatment of disorders by unidirectional nerve stimulation
US6701190B2 (en) System and method for varying characteristics of electrical therapy
US6169924B1 (en) Spinal cord stimulation
US20030036781A1 (en) Method for treating obsessive-compulsive disorder with electrical stimulation of the brain internal capsule
US7734355B2 (en) Treatment of disorders by unidirectional nerve stimulation
US20070066997A1 (en) Methods and systems for placing an implanted stimulator for stimulating tissue
US8688212B2 (en) Implantable neurostimulator-implemented method for managing bradycardia through vagus nerve stimulation
US6449512B1 (en) Apparatus and method for treatment of urological disorders using programmerless implantable pulse generator system
US7437196B2 (en) Systems and methods for selecting stimulation sites and applying treatment, including treatment of symptoms of Parkinson's disease, other movement disorders, and/or drug side effects
US20070173890A1 (en) Stimulation mode adjustment for an implantable medical device