Methods, agents, and devices for local neuromodulation of autonomic nerves
Methods, agents, and devices to treat medical conditions through local chemical neuromodulation of the autonomic nervous system are described. Drug formulations may be injected at or near ganglia, nerve plexi, ganglionated plexi, and nerves to treat different diseases. Target sites for the treatment of cardiac and other disease conditions may include extrinsic stellate (cervicothoracic) and cervical ganglia of the sympathetic chain, and intrinsic cardiac nerves and ganglionated plexi innervating the myocardium.
1 . A system to treat a disease condition of a sympathetic nervous system in a patient, the system comprising:
a syringe;
a composition configured to be housed within the syringe, wherein the composition comprises a hydrogel and a drug configured to be delivered locally to an aqueous environment at a stellate ganglion of the patient, and responsive to an exposure to the aqueous environment at the stellate ganglion, the composition forms a hydrogel implant configured to release the drug; and
a microelectrode comprising:
an external stimulator configured to stimulate the stellate ganglion; and
one or more nanoelectrode sensors coupled to the syringe and configured to measure an electrical signal transmitted from the stimulated stellate ganglion.
2 . The system of claim 1 , wherein the composition further comprises a tricyclic antidepressant.
3 . The system of claim 1 , wherein the composition further comprises a PEG carrier.
4 . The system of claim 1 , wherein the composition further comprises a contrast agent.
5 . The system of claim 1 , wherein the hydrogel comprises a two-part dehydrated precursor mixture.
6 . The system of claim 1 , wherein the composition further comprises a biostable polymer.
7 . The system of claim 1 , wherein the composition further comprises a biodegradable polymer.
8 . The system of claim 1 , wherein the disease condition comprises trigeminal neuralgia.
9 . The system of claim 1 , wherein the composition further comprises non-dihydropyridine calcium antagonists.
10 . The system of claim 1 , wherein the composition further comprises a beta blocker.