Selective stimulation to modulate the sympathetic nervous system
Systems, methods and devices are provided for the targeted treatment of a variety of medical conditions by directly neuromodulating a target anatomy associated with the condition while minimizing or excluding undesired neuromodulation of other anatomies. Typically, the target anatomy includes one or more dorsal root ganglia, dorsal roots, dorsal root entry zones, or portions thereof. Such target stimulation areas are utilized due in part to their effect on the sympathetic nervous system.
1. A method of treating a condition or disorder in a patient necessitating weight control, comprising:
implanting a first stimulation lead with at least one electrode positioned to selectively stimulate a dorsal root ganglion (DRG) in the patient;
implanting a second stimulation lead with at least one electrode positioned to stimulate neural tissue of a sympathetic chain of the patient that is downstream from the DRG wherein the neural tissue of the sympathetic chain of the patient is selected from the group consisting of: a celiac ganglion, an interior mesenteric ganglion, and a superior mesenteric ganglion; and
applying electrical stimulation, from at least one implantable pulse generator and using the first and second stimulation leads, to the DRG and to the neural tissue of the sympathetic chain to selectively modulate gastric motility and hunger in the patient and to modulate hormonal regulation to treat the condition or disorder of the patient necessitating weight control.
2. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion within a thoracic vertebral level of a spine of the patient.
3. The method of treating a condition or disorder in a patient necessitating weight control according to claim 2 wherein after performing the implanting a second stimulation lead step the second stimulation lead is positioned to stimulate neural tissue of the sympathetic chain of the patient comprising a ganglion of the sympathetic chain within a thoracic vertebral level of a spine of the patient.
4. The method of treating a condition or disorder in a patient necessitating weight control according to claim 3 wherein the ganglion of the sympathetic chain is one of a celiac ganglion and a superior mesenteric ganglion.
5. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion within a lumbar vertebral level of a spine of the patient.
6. The method of treating a condition or disorder in a patient necessitating weight control according to claim 5 wherein after performing the implanting a second stimulation lead step the second stimulation lead is positioned to stimulate neural tissue of the sympathetic chain of the patient comprising a ganglion of the sympathetic chain within a lumbar vertebral level of a spine of the patient.
7. The method of treating a condition or disorder in a patient necessitating weight control according to claim 6 wherein the ganglion of the sympathetic chain is an interior mesenteric ganglion.
8. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion on a first thoracic vertebral level of a spine of the patient; and implanting a third stimulation lead with at least one electrode positioned to selectively stimulate a dorsal root ganglion (DRG) in the patient on a second thoracic vertebral level of a spine of the patient.
9. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion on a first lumbar vertebral level of a spine of the patient; and
implanting a third stimulation lead with at least one electrode positioned to selectively stimulate a dorsal root ganglion (DRG) in the patient on a second lumbar vertebral level of a spine of the patient.
10. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion on a first side of a thoracic vertebral level of a spine of the patient; and implanting a third stimulation lead with at least one electrode positioned to selectively stimulate a dorsal root ganglion (DRG) in the patient on a second side of the thoracic vertebral level of a spine of the patient.
11. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead step the first stimulation lead is positioned to selectively stimulate a dorsal root ganglion on a first side of a lumbar vertebral level of a spine of the patient; and implanting a third stimulation lead with at least one electrode positioned to selectively stimulate a dorsal root ganglion (DRG) in the patient on a second side of the lumbar vertebral level of a spine of the patient.
12. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on the same side of the spine of the patient.
13. The method of treating a condition or disorder in a patient necessitating weight control according to claim 12 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on the same spinal level of the spine of the patient.
14. The method of treating a condition or disorder in a patient necessitating weight control according to claim 12 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on different spinal levels of the spine of the patient.
15. The method of treating a condition or disorder in a patient necessitating weight control according to claim 1 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on different sides of the spine of the patient.
16. The method of treating a condition or disorder in a patient necessitating weight control according to claim 15 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on the same spinal level of the spine of the patient.
17. The method of treating a condition or disorder in a patient necessitating weight control according to claim 15 wherein after performing the implanting a first stimulation lead and implanting the second stimulation lead steps the first stimulation lead and the second stimulation lead are implanted on different spinal levels of the spine of the patient.