Spinal Cord Neurostimulation for Closed-Loop Blood Pressure Control
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Solution Overview
Problem
Existing therapies fail to precisely control autonomic dysfunction, particularly blood pressure fluctuations, in individuals with spinal cord injuries due to the lack of understanding of the sympathetic nervous system connectome post-injury, leading to potentially life-threatening conditions like hypotension and hypertension.
Innovation Solution
A system for neuromodulation and neurostimulation that includes a rationally designed electrode targeting sympathetic pre- and post-ganglionic neurons responsible for blood pressure control, combined with closed-loop controllers and novel stimulation paradigms, specifically delivering stimulation to the spinal cord at level T9-L1, using a lead with electrodes positioned epidurally or subdurally to modulate these neurons.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If spinal cord injury occurs, then motor and sensory functions are lost, but autonomic blood pressure control is also disrupted leading to life-threatening instability
Solution Approach 1:
The patent implements a closed-loop feedback system where blood pressure is continuously monitored and stimulation parameters are automatically adjusted based on real-time blood pressure values. The controller compares measured blood pressure against target ranges and modifies stimulation intensity accordingly, creating a self-regulating system that maintains blood pressure stability despite spinal cord injury.
Solution Approach 2:
The system enables the injured spinal cord to self-regulate blood pressure through electrical stimulation of sympathetic pathways. By directly stimulating the sympathetic nervous system at the spinal level, the system bypasses damaged descending pathways and allows the intrinsic spinal autonomic circuits to maintain blood pressure control independently.
2Reliability
If electrical stimulation is applied to control blood pressure, then blood pressure stability improves, but precise targeting of sympathetic pathways is required
Solution Approach 1:
The patent divides the spinal cord into specific functional segments (T1-L2 vertebral levels) corresponding to sympathetic outflow regions. By segmenting the stimulation target into discrete vertebral levels and using multiple electrodes at different positions, the system can selectively stimulate specific sympathetic pathways responsible for blood pressure control while avoiding adjacent neural structures.
Solution Approach 2:
The patent applies different stimulation parameters to different electrode positions and spinal segments. Each electrode delivers customized stimulation intensity and frequency tailored to the specific physiological response observed at that location, optimizing blood pressure control while minimizing side effects from over-stimulation of adjacent areas.
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 control over blood pressure by adapting stimulation parameters in real-time to maintain it within a predetermined target range, reducing the risk of hypotension and hypertension, thereby improving the quality of life for individuals with spinal cord injuries.
Implementation Method 1
A system for neuromodulation and/or neurostimulation that includes a rationally designed electrode targeting sympathetic pre- and post-ganglionic neurons responsible for blood pressure control, combined with closed-loop controllers and novel stimulation paradigms, specifically delivering stimulation to the spinal cord at level T9-L1
Data Source
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AI summary
A system (10) for activating a sympathetic circuitry in response to electrical stimulation, comprising: at least one stimulation unit (14) comprising a lead (20) for electrical stimulation of a spinal cord, wherein the lead (20) is configured to stimulate functional cardiovascular hotspots in the spinal cord, and wherein the lead (20) comprises electrodes that are designed to target sympathetic pre- and post-ganglionic neurons responsible for blood pressure control.