Implantable microstimulators and methods for unidirectional propagation of action potentials
View Patent ↗Miniature implantable stimulators (i.e., microstimulators) are capable of producing unidirectionally propagating action potentials (UPAPs). The methods and configurations described may, for instance, arrest action potentials traveling in one direction, arrest action potentials of small diameters nerve fibers, arrest action potentials of large diameter nerve fibers. These methods and systems may limit side effects of bidirectional and/or less targeted stimulation.
1. A method for arresting propagation of action potentials in a direction along a nerve, the method comprising:
providing a microstimulator comprising a plurality of electrodes including at least a first cathode and a first real anode, the microstimulator further comprising a capsule, electrical circuitry coupled to the plurality of electrodes and disposed in the capsule, and a power source disposed in the capsule and coupled to the electrical circuitry and to the plurality of electrodes, wherein at least two of the plurality of electrodes are provided on the capsule;
applying a relatively high-amplitude depolarizing cathodic current to one or more nerves via the first cathode, which cathodic current initiates bidirectional action potentials in large diameter nerve fibers and small diameter nerve fibers;
limiting propagation of the action potentials beyond the microstimulator to one direction in both the small and large diameter fibers by, before the action potentials pass the first real anode, beginning an application of a relatively high-amplitude hyperpolarizing anodic current to the nerve via the first real anode at a side of the cathode where arrest of action potentials is desired, which high-amplitude anodic current arrests the action potentials in the large diameter nerve fibers and the small diameter nerve fibers initiated by the cathodic current applied via the first cathode, wherein the hyperpolarizing anodic current is at least one of higher in amplitude or of longer duration than the depolarizing cathodic current; and
tapering the anodic current.
2. The method of claim 1 wherein providing the microstimulator comprises providing a programmably configurable microstimulator.
3. The method of claim 1 wherein the relatively high-amplitude depolarizing cathodic current is applied at an amplitude of about 0.01 mA to about 15 mA and a pulse width of about 0.01 msec to about 5.0 msec and the relatively high-amplitude hyperpolarizing anodic current is applied at an amplitude of about 0.1 mA to about 15 mA and a pulse width of about 0.05 msec to about 10.0 msec.
4. The method of claim 1 further comprising:
providing at least a second real anode as one of the plurality of electrodes of the microstimulator; and
applying a lower amplitude anodic current to the nerve via the second real anode at the side of the first cathode where propagation of action potentials is desired, which lower amplitude anodic current has an amplitude that is lower than the relatively high-amplitude hyperpolarizing anodic current and reduces a virtual cathode created near the first real anode.
5. The method of claim 4 wherein providing a microstimulator with the first cathode, the first real anode, and the second real anode comprises providing the programmably configurable microstimulator with at least three activated electrodes programmably configured as the first cathode, the first real anode, and the second real anode.
6. The method of claim 4 wherein the relatively high-amplitude depolarizing cathodic current is applied at an amplitude of about 0.01 mA to about 15 mA and a pulse width of about 0.01 msec to about 5.0 msec and the relatively high-amplitude hyperpolarizing anodic current is applied at an amplitude of about 0.1 mA to about 15 mA and a pulse width of about 0.05 msec to about 10.0 msec and the lower amplitude anodic current is applied at an amplitude of about 0.01 mA to about 10 mA and a pulse width of about 0.01 msec to about 5.0 msec.
7. The method of claim 1 wherein the microstimulator includes a fixation device.
8. The method of claim 7 wherein the fixation device includes a nerve cuff.
9. The method of claim 1 wherein the microstimulator includes at least one lead.
10. The method of claim 1 further comprising applying the relatively high-amplitude hyperpolarizing anodic current to a more distal portion of the nerve than the relatively high-amplitude cathodic current, thereby effectively selecting afferent fibers of the nerve.
11. The method of claim 1 further comprising applying the relatively high-amplitude hyperpolarizing anodic current to a more proximal portion of the nerve than the relatively high-amplitude cathodic current, thereby effectively selecting efferent fibers of the nerve.
12. The method of claim 1 further comprising sensing a physical condition of a patient and adjusting the application of currents to the nerve based on the sensed physical condition.
13. The method of claim 12 wherein the sensed physical condition of the patient comprises the action potentials propagating along the nerve.
14. The method of claim 1 , wherein each of the plurality of electrodes is provided on the capsule of the microstimulator.
15. The method of claim 1 wherein the hyperpolarizing anodic current is higher in amplitude than the depolarizing cathodic current.
16. The method of claim 1 wherein the hyperpolarizing anodic current is of longer duration than the depolarizing cathodic current.
17. The method of claim 1 wherein the hyperpolarizing anodic current is higher in amplitude and of longer duration than the depolarizing cathodic current.