Vagus Nerve Cuff Return Electrode Selection to Limit Off-Target Effects
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Solution Overview
Problem
Current vagus nerve stimulation (VNS) methods struggle to achieve selective stimulation of particular nerve types, particularly type-B nerve fibers, without activating type-A fibers, leading to undesirable side effects such as laryngeal electromyography activation or cardiac responses.
Innovation Solution
The use of a multi-electrode nerve cuff with a circumferential array of electrodes that allows for selective stimulation of type-B nerve fibers by strategically activating subsets of electrodes as cathodes and anodes, minimizing stimulation of type-A fibers.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional VNS stimulation is applied to the vagus nerve, then therapeutic benefits are achieved, but type-A motor neurons are activated causing undesirable side effects
Solution Approach 1:
The invention segments the stimulation approach by using multiple independently controllable electrodes within the nerve cuff instead of a single stimulation source. This allows selective activation of specific nerve fascicles containing type-B fibers while avoiding fascicles with type-A fibers, thereby achieving therapeutic benefits without activating motor neurons that cause side effects
Solution Approach 2:
The invention applies local quality by delivering stimulation at multiple discrete locations around the nerve circumference through the circumferential electrode array. Different electrodes can be activated with different parameters to target specific regions of the nerve, enabling selective stimulation of type-B fibers in certain fascicles while leaving type-A fiber-containing fascicles unstimulated
2Reliability
If stimulation amplitude is increased to ensure type-B fiber activation, then stimulation reliability improves, but type-A fiber activation increases causing more side effects
Solution Approach 1:
The segmentation of stimulation across multiple electrodes allows the system to achieve reliable type-B fiber activation through distributed lower-amplitude stimulation rather than high-amplitude single-point stimulation. This reduces the likelihood of activating type-A fibers while maintaining effective type-B fiber stimulation
Solution Approach 2:
The invention applies partial action by activating only the subset of electrodes necessary to achieve therapeutic effect rather than all electrodes simultaneously. This allows sufficient stimulation of type-B fibers while minimizing spread of activation to type-A fibers that would cause side effects
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
This approach enables targeted VNS that minimizes undesirable side effects, effectively reducing seizures in epilepsy and depression by selectively stimulating type-B fibers while avoiding activation of type-A fibers.
Implementation Method 1
a VNS stimulator implanted in a subject and configured to transmit periodic electrical stimulation pulses to a vagus nerve of the subject using an electrode stimulation cuff
Data Source
AI summary
The present disclosure provides systems and methods for providing vagus nerve stimulation, including configurations wherein stimulation is provided by a VNS stimulator used to transmit electrical stimulation pulses to a vagus nerve of the subject using an electrode stimulation cuff comprising a circumferential array of electrodes. In some aspects, stimulation is provided by selecting an electrode in the circumferential array of electrodes as a cathode electrode; causing the stimulator to transmit an electrical stimulation pulse to the vagus nerve using the selected cathode electrode, while (i) at least one other electrode in the circumferential array of electrodes is used as a return electrode, or (ii) all other electrodes in the circumferential array of electrodes are used as return electrodes; and repeating this process at least once, wherein a different electrode in the circumferential array of electrodes is selected as the cathode electrode.