Peripheral Nerve Stimulation Mapping for Selective Branch Recruitment
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Solution Overview
Problem
The complex anatomy of the vagus nerve makes it challenging to determine which portion to stimulate for therapeutic effect while avoiding side effects, such as dysarthria, cough, and impaired organ function, due to its multiple branches and fascicles.
Innovation Solution
A method and system for selective nerve stimulation using multiple trunk electrodes at different circumferential and longitudinal locations, recording action potentials at branch electrodes, and determining neural element coupling to selectively recruit desired neural populations while avoiding undesired ones, employing current steering and hyperpolarizing pre-pulses.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If electrical stimulation is delivered to the vagus nerve trunk to achieve therapeutic effect, then therapeutic benefit is improved, but side effects such as dysarthria, cough, and impaired organ function worsen due to stimulation of multiple neural populations
Solution Approach 1:
The vagus nerve trunk is segmented into multiple fascicles, each containing different neural populations. By delivering stimulation to the trunk and selectively activating specific fascicles through their unique action potential propagation patterns, the system achieves selective neural element recruitment without directly targeting individual fascicles, thereby providing therapeutic benefit while avoiding side effects from unwanted branch stimulation
Solution Approach 2:
The system uses action potential sensing at the nerve trunk to detect which neural populations are being recruited by stimulation. This feedback mechanism allows real-time monitoring and adjustment of stimulation parameters to ensure selective recruitment of therapeutic neural elements while avoiding activation of neural populations that would cause side effects
2Adaptability or versatility
If multiple trunk electrodes are used to selectively recruit specific neural elements, then selectivity is improved, but device complexity worsens
Solution Approach 1:
The same set of trunk electrodes serves multiple functions: delivering electrical stimulation to activate neural elements and sensing action potentials to identify which neural populations are recruited. This multi-functionality reduces the need for separate electrode sets and simplifies the overall device architecture while maintaining high selectivity
Solution Approach 2:
The system uses the nerve trunk itself as the sensing medium by detecting action potentials that propagate along the trunk during stimulation. This self-service approach eliminates the need for additional complex sensing mechanisms or separate electrode arrays, achieving high selectivity with minimal added device complexity
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables precise stimulation of therapeutic nerve branches while minimizing side effects by mapping and calibrating stimulation locations, optimizing therapeutic outcomes and reducing adverse reactions.
Implementation Method 1
delivering electrical stimulation to the trunk using one or more of a plurality of trunk electrodes
Implementation Method 2
recording action potentials evoked by the first and second electrical stimulations
Implementation Method 3
recording action potentials evoked by the first and second electrical stimulations at at least one of the plurality of branches
Data Source
AI summary
Methods and systems for providing peripheral nerve stimulation are disclosed. Stimulation is delivered to a trunk of the nerve using electrodes configured at different circumferential locations about the nerve. Action potentials evoked by the stimulation within branches of the nerve are measured to map neural element within the trunk to the branches. The mapping can inform the selection of stimulation parameters that provide a therapeutic benefit and/or avoid unwanted side effects.