IP Library Granted Patent US 12,440,139
Granted Patent B2
US 12,440,139 · App. 17/747,081 · Granted Oct 14, 2025

System and method for non-invasively monitoring autonomic nerve activity

Inventor: Peng-Sheng Chen (Indianapolis, IN)
Assignee: Indiana University Research and Technology Corporation
A61B5/24A61B5/05A61B5/4029A61B5/6877A61B5/725A61N1/0456A61N1/0476A61N1/0504A61N1/0551A61N1/36017A61N1/36053A61N1/36031A61N1/36034A61N1/3627A61N1/36592
View Patent ↗
Loading inventors, assignments & file history…
Monitor This Case
Get email alerts when status or documents change.
Order Certified Copies
Most orders are placed with the USPTO same day — all within 24 business hours.
Order via The Patent Place →
Pre-filled with this patent's details
Quick Facts
Patent No.
US 12,440,139
App. No.
17/747,081
Granted
Oct 14, 2025
Kind
B2
Abstract

System and methods for monitoring and/or controlling nerve activity in a subject are provided. In one embodiment, a system includes electrodes configured to be placed proximate to a subject's skin, and a signal detector configured to detect electrical signals using the electrodes. The system also includes a signal processor configured to receive the electrical signals to generate filtered signals, the filter configured to attenuate at least signals having frequencies corresponding to heart muscle activity during a heartbeat. The signal processor is also configured to identify a skin nerve activity using the filtered signals, estimate a sympathetic nerve activity using the identified skin nerve activity, and further to generate a report indicative of the estimated sympathetic nerve activity. In some aspects, the system further includes a signal generator to deliver the electrical stimulation to the subject's skin.

Claims (54)

1. A method for monitoring nerve activity in a subject, the method comprising:

amplifying electrical signals received from one or more electrodes of a plurality of electrodes, the one or more electrodes being placed in locations proximate to a subject's skin to generate a plurality of amplified signals;

applying a filter to the plurality of electrical signals to generate a plurality of filtered signals;

identifying, with a signal processor, a skin nerve activity using the plurality of filtered signals;

estimating, with the signal processor, a sympathetic nerve activity using the identified skin nerve activity;

generating a report indicative of the estimated sympathetic nerve activity;

generating, with a signal generator, electrical stimulation: based upon the estimated sympathetic nerve activity, based on manually-input instructions from an operator, and/or intermittently; and

applying the electrical stimulation to the subject with one or more cutaneously-placed electrodes of the plurality of electrodes or with one or more subcutaneously-placed electrodes of the plurality of electrodes,

wherein the electrical stimulation:

is applied with the one or more cutaneously-placed electrodes or the one or more subcutaneously-placed electrodes, at a location other than a vagus nerve, and

remodels a neural structure spaced away from the one or more cutaneously-placed electrodes or the one or more subcutaneously-placed electrodes.

2. The method of claim 1 , wherein the electrodes for applying the electrical stimulation are placed in a cutaneous arrangement.

3. The method of claim 1 , wherein the filter includes a high-pass filter with a cutoff frequency of at least 100 Hz.

4. The method of claim 1 , wherein the filter comprises a low-pass filter with a cutoff frequency of at least approximately 0.5 Hz.

5. The method of claim 1 , wherein the sympathetic nerve activity comprises a stellate ganglion nerve activity.

6. The method of claim 1 , wherein the method further comprises determining a medical condition of the subject using the estimated sympathetic nerve activity.

7. The method of claim 1 , wherein the report includes information derived from average signals, signal variations, signal frequencies, frequency variations, identified events, or event timings, the report being retrieved from a memory.

8. The method of claim 1 , wherein the report is in the form of real time data.

9. The method of claim 1 , wherein the electrical stimulation delivered with the one or more cutaneously-placed electrodes or with the one or more subcutaneously-placed electrodes includes electrical stimulation that causes the neural structure to include cells having pyknotic nuclei.

10. The method of claim 1 , wherein the electrical stimulation delivered with the one or more cutaneously-placed electrodes or with the one or more subcutaneously-placed electrodes includes electrical stimulation for reducing stellate ganglion activity.

11. The method of claim 1 , wherein the electrical stimulation is generated based on the estimated sympathetic nerve activity.

12. The method of claim 1 , wherein the electrical stimulation is generated based on the estimated sympathetic nerve activity and the electrodes for applying the electrical stimulation are placed in a subcutaneous arrangement under a layer of tissue that is under the skin.

13. The method of claim 1 , wherein the electrical stimulation is applied with the one or more subcutaneously-placed electrodes, the one or more electrodes from which the electrical signals are received being different from the one or more subcutaneously-placed electrodes that apply the electrical stimulation.

14. A method for monitoring nerve activity in a subject, the method comprising:

amplifying electrical signals received from a plurality of electrodes placed in locations proximate to a subject's skin to generate a plurality of amplified signals;

applying a filter to the plurality of electrical signals to generate a plurality of filtered signals;

identifying, with a signal processor, a skin nerve activity using the plurality of filtered signals;

estimating, with the signal processor, a sympathetic nerve activity using the identified skin nerve activity;

generating a report indicative of the estimated sympathetic nerve activity;

generating, with a signal generator, electrical stimulation; and

applying the electrical stimulation to the subject with an electrode that is placed at a location other than a vagus nerve, the electrical stimulation causing remodeling of a neural structure.

15. The method of claim 14 , wherein the electrodes for applying electrical stimulation are placed in a cutaneous arrangement.

16. The method of claim 14 , wherein the electrodes for applying electrical stimulation are placed in a subcutaneous arrangement.

17. The method of claim 14 , wherein the filter includes a high-pass filter with a cutoff frequency of at least 100 Hz.

18. The method of claim 14 , wherein the filter comprises a low-pass filter with a cutoff frequency of at least approximately 0.5 Hz.

19. The method of claim 14 , wherein the sympathetic nerve activity comprises a stellate ganglion nerve activity.

20. The method of claim 14 , wherein the method further comprises determining a medical condition of the subject using the estimated sympathetic nerve activity.

21. The method of claim 14 , wherein the report includes information derived from average signals, signal variations, signal frequencies, frequency variations, identified events, or event timings, the report being retrieved from a memory.

22. The method of claim 14 , wherein the report is in the form of real time data.

23. The method of claim 14 , wherein the electrical stimulation includes electrical stimulation generated intermittently for reducing stellate ganglion activity.

24. The method of claim 14 , wherein the electrical stimulation is generated based on the estimated sympathetic nerve activity.

25. The method of claim 14 , wherein the electrical stimulation is generated automatically based on programming for the signal generator.

26. The method of claim 14 , wherein the electrical stimulation is delivered according to a treatment protocol that is identified automatically.

27. A method for monitoring nerve activity in a subject, the method comprising:

amplifying electrical signals received from one or more electrodes of a plurality of electrodes, the one or more electrodes being placed in locations proximate to a subject's skin to generate a plurality of amplified signals;

applying a filter to the plurality of electrical signals to generate a plurality of filtered signals, the filter being capable of attenuating at least electrical signals having frequencies that correspond to heart muscle activity during a heartbeat;

identifying, with a signal processor, a skin nerve activity using the plurality of filtered signals;

estimating, with the signal processor, a sympathetic nerve activity using the identified skin nerve activity;

deriving information from the sympathetic nerve activity that was estimated using the identified skin nerve activity and according to the filtered signals; and

generating a report indicative of the estimated sympathetic nerve activity and the derived information,

wherein the report includes information associated with changes, when present, to detected sympathetic nerve activities, and

wherein the changes, when present, to detected sympathetic nerve activities includes a change resulting from electrical stimulation applied to remodel a neural structure with electrical stimulation that was generated with an electrode located at a location other than a vagus nerve and spaced away from the neural structure, the change being reflected in the filtered signals.

28. The method of claim 27 , wherein the derived information includes at least one of: average signals, signal variations, signal frequencies, frequency variations, identified events, event timings, or deviations from a baseline.

29. The method of claim 1 , wherein the electrical stimulation is applied, intermittently, for a period of at least two weeks.

Continuity (5)
Division 15490230 · Apr 18, 2017
Continuation PCTUS2015056419 · Oct 20, 2015
Provisional Application 62158323 · May 7, 2015
Provisional Application 62065854 · Oct 20, 2014
Related Publication 20220273216A1 · Sep 1, 2022
References Cited (83)
US 6487450B1 · Chen · 2002 [cited by applicant]
US 6824538B2 · Chen · 2004 [cited by applicant]
US 6937896B1 · Kroll · 2005 [cited by applicant]
US 10478623B2 · Chen · 2019 [cited by applicant]
US 11357432B2 · Chen · 2022 [cited by applicant]
US 20030055349A1 · Yonce · 2003 [cited by applicant]
US 20030078629A1 · Chen · 2003 [cited by applicant]
US 20030144710A1 · Haugland et al. · 2003 [cited by applicant]
US 20060004413A1 · Chen · 2006 [cited by applicant]
US 20060004414A1 · Chen · 2006 [cited by applicant]
US 20060074451A1 · Chen · 2006 [cited by examiner]
US 20080015659A1 · Zhang et al. · 2008 [cited by applicant]
US 20110218415A1 · Chen et al. · 2011 [cited by applicant]
US 20120185013A1 · Sivard · 2012 [cited by examiner]
US 20120289856A1 · Motogi et al. · 2012 [cited by applicant]
US 20130030319A1 · Hettrick · 2013 [cited by examiner]
US 20130131746A1 · Simon et al. · 2013 [cited by applicant]
US 20130172967A1 · You · 2013 [cited by applicant]
US 20140081355A1 · Marsh et al. · 2014 [cited by applicant]
US 20140135886A1 · Cook et al. · 2014 [cited by applicant]
US 20140214118A1 · Greiner et al. · 2014 [cited by applicant]
US 20140214124A1 · Greiner et al. · 2014 [cited by applicant]
US 20140214134A1 · Peterson · 2014 [cited by applicant]
US 20140276789A1 · Dandler et al. · 2014 [cited by applicant]
US 20140316297A1 · McCaughan et al. · 2014 [cited by applicant]
US 20170063458A1 · Miyaho et al. · 2017 [cited by applicant]
US 20170215752A1 · Chen · 2017 [cited by applicant]
WO 0399377A1 · 2003 [cited by applicant]
WO 2006094022A2 · 2006 [cited by applicant]
WO 2010053766A1 · 2010 [cited by applicant]
WO 2014089549A1 · 2014 [cited by applicant]
Adelman, et al., Small-Conductance Ca2+-Activated K+ Channels: Form and Function, Annual Review of Physiology, 2012, 74:245-269. [cited by applicant]
Armour, Functional Anatomy of Intrathoracic Neurons Innervating the Atria and Ventricles, Heart Rhythm, 2010, 7(7):994-996. [cited by applicant]
Baron, et al., Sympathetic and Afferent Neurones Projecting Into Forelimb and Trunk Nerves and the Anatomical Organization of the Thoracic Sympathetic Outflow of the Rat, Journal of the Autonomic Nervous System, 1995, 5… [cited by applicant]
Bode, et al., Differential Effects of Defibrillation on Systemic and Cardiac Sympathetic Activity, Heart, 1998, 79:560-567. [cited by applicant]
Chen, et al., Role of the Autonomic Nervous System in Atrial Fibrillation: Pathophysiology and Therapy, Gire. Res., 2014, 114(9):1500-1515. [cited by applicant]
Choi, et al., Intrinsic Cardiac Nerve Activity and Paroxysmal Atrial Tachyarrhythmia in Ambulatory Dogs, Circulation, 2010, 121:2615-2623. [cited by applicant]
Chowdhury, et al., Surface Electromyography Signal Processing and Classification Techniques, Sensors, 2013, 13:12431-12466. [cited by applicant]
Converse, Jr., et al., Sympathetic Overactivity in Patients with Chronic Renal Failure, The New England Journal of Medicine, 1992, 327:1912-1918. [cited by applicant]
Donadio, et al., Skin Sympathetic Adrenergic Innervation: An Immunofluorescence Confocal Study, Ann. Neurol., 2006, 59:376-381. [cited by applicant]
Doytchinova, et al., Subcutaneous Nerve Activity and Spontaneous Ventricular Arrhythmias in Ambulatory Dogs, Heart Rhythm, 2015, 12(3):612-620. [cited by applicant]
Ellison, et al., Sympathetic Nerve Pathways to the Human Heart, and Their Variations, American Journal of Anatomy, 1969, 124:149-162. [cited by applicant]
European Search Report and Search Opinion Received for EP Application No. 15851670.8, mailed on May 22, 2018, 7 pages. [cited by applicant]
Gatzoulis, et al., Electrical Storm is an Independent Predictor of Adverse Long-Term Outcome in the Era of Implantable Defibrillator Therapy, Europace, 2005, 7:184-192. [cited by applicant]
Grillner, The Motor Infrastructure: From Ion Channels to Neuronal Networks, Nature Reviews, 2003, 4:573-586. [cited by applicant]
Grossman, et al., Some Factors Affecting the Reliability of Surface Electromyography, Psychosomatic Medicine, 1966, 28(1):78-83. [cited by applicant]
International Preliminary Report on Patentability received for PCT Patent Application No. PCT/US2015/056419, mailed on May 4, 2017, 11 pages. [cited by applicant]
Jiang, et al., Using Skin Sympathetic Nerve Activity to Estimate Stellate Ganglion Nerve Activity in Dogs, Heart Rhythm, 2015, 12(6):1324-1332. [cited by applicant]
Jung, et al., Circadian Variations of Stellate Ganglion Nerve Activity in Ambulatory Dogs, Heart Rhythm, 2006, 3:78-85. [cited by applicant]
Kawashima, The Autonomic Nervous System of the Human Heart with Special Reference to Its Origin, Course, and Peripheral Distribution, Anal. Embryol., 2005, 209:425-438. [cited by applicant]
Kligfield, et al., Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part 1: The Electrocardiogram and Its Technology, Circulation, 2007, 115:1306-1324. [cited by applicant]
Komi, et al., EMG Frequency Spectrum, Muscle Structure, and Fatigue During Dynamic Contractions in Man, European Journal of Applied Physiology, 1979, 42:41-50. [cited by applicant]
Leimbach, Jr., et al., Direct Evidence from Intraneural Recordings for Increased Central Sympathetic Outflow in Patients with Heart Failure, Circulation, 1986, 73(5):913-919. [cited by applicant]
Leuenberger, et al., Control of Skin Sympathetic Nerve Activity During Intermittent Static Handgrip Exercise, Circulation, 2003, 108:2329-2335. [cited by applicant]
Luo, et al., A Comparison of Commonly Used QT Correction Formulae: The Effect of Heart Rate on the QTc of Normal ECGs, Journal of Electrocardiology, 2004, 37:81-90. [cited by applicant]
Marx, et al., Distribution of Sympathetic Fiber Areas in the Sensory Nerves of Forearm: An Immunohistochemical Study in Cadavers, Rom. J. Morphol. Embryol., 2011, 52(2):605-611. [cited by applicant]
McAuley, et al., Frequency Peaks of Tremor, Muscle Vibration and Electromyographic Activity at 10 Hz, 20 Hz and 40 Hz During Human Finger Muscle Contraction May Reflect Rhythmicities of Central Neural Firing, Experiment… [cited by applicant]
Middlekauff, et al., Independent Control of Skin and Muscle Sympathetic Nerve Activity in Patients with Heart Failure, Circulation, 1994, 90:1794-1798. [cited by applicant]
Morrison, Differential Control of Sympathetic Outflow, Am. J. Physiol. Regulatory Integrative Comp. Physiol., 2001, 281:R683-R698. [cited by applicant]
Moss, et al., Unilateral Cervicothoracic Sympathetic Ganglionectomy for the Treatment of Long QT Interval Syndrome, New England Journal of Medicine, 1971, 285:903-904. [cited by applicant]
Nademanee, et al., Treating Electrical Storm: Sympathetic Blockade Versus Advanced Cardiac Life Support-Guided Therapy, Circulation, 2000, 102:742-747. [cited by applicant]
Noll, et al., Role of Sympathetic Nervous System in Hypertension and Effects of Cardiovascular Drugs, European Heart Journal, 1998, 19(Suppl F):F32-F38. [cited by applicant]
Ogawa, et al., Left Stellate Ganglion and Vagal Nerve Activity and Cardiac Arrhythmias in Ambulatory Dogs With Pacing-Induced Congestive Heart Failure, Journal of the American College of Cardiology, 2007, 50(4):335-343. [cited by applicant]
Onkka, et al., Sympathetic Nerve Fibers and Ganglia in Canine Cervical Vagus Nerves: Localization and Quantitation, Heart Rhythm, 2013, 10(4):585-591. [cited by applicant]
PCT International Search Report and Written Opinion, PCT/US2015/056419, dated Jan. 6, 2016. [cited by applicant]
Ramsaroop, et al., Thoracic Origin of a Sympathetic Supply to the Upper Limb: The ‘Nerve of Kuntz’ Revisited, J. AnaT., 2001, 199:675-682. [cited by applicant]
Robinson, et al., Estimating Sympathetic Tone by Recording Subcutaneous Nerve Activity in Ambulatory Dogs, J. Cardiovasc. Electrophysiol, 2015, 26(1):70-78. [cited by applicant]
Salmanpour, et al., Sympathetic Neural Recruitment Patterns During the Valsalva Maneuver, 33rd Annual Intemational Conference of the IEEE EMBS, 2011, pp. 6951-6954. [cited by applicant]
Schalow, et al., Microanatomy and No. of Nerve Fibres of the Lower Intercostal Nerves with Respect to a Nerve Anastomosis. Donor Nerve Analysis. I (IV), Electromyogr. Clin. Neurophysiol, 1992, 32:171-185. [cited by applicant]
Schwartz, et al., Left Cardiac Sympathetic Denervation in the Management of High-Risk Patients Affected by the Long-QT Syndrome, Circulation, 2004, 109:1826-1833. [cited by applicant]
Seki, et al., Sympathetic Nerve Fibers in Human Cervical and Thoracic Vagus Nerves, Heart Rhythm, 2014, 11(8):1411-1417. [cited by applicant]
Shen, et al., Continuous Low-Level Vagus Nerve Stimulation Reduces Stellate Ganglion Nerve Activity and Paroxysmal Atrial Tachyarrhythmias in Ambulatory Canines, Circulation, 2011, 123:2204-2212. [cited by applicant]
Shen, et al., Low-Level Vagus Nerve Stimulation Upregulates Small Conductance Calcium Activated Potassium Channels in the Stellate Ganglion, Heart Rhythm, 2013, 10(6):910-915. [cited by applicant]
Swirski, et al., Leukocyte Behavior in Atherosclerosis, Myocardial Infarction, and Heart Failure, Science, 2013, 339(6116):161-166. [cited by applicant]
Tan, et al., Neural Mechanisms of Paroxysmal Atrial Fibrillation and Paroxysmal Atrial Tachycardia in Ambulatory Canines, Circulation, 2008, 118(9):916-925. [cited by applicant]
Taniguchi, et al., Cutaneous Distribution of Sympathetic Postganglionic Fibers from Stellate Ganglion: A Retrograde Axonal Tracing Study Using Wheat Germ Agglutinin Conjugated with Horseradish Peroxidase, Journal of Ane… [cited by applicant]
Vaseghi, et al., Cardiac Sympathetic Denervation in Patients with Refractory Ventricular Arrhythmias or Electrical Storm: Intermediate and Long-Term Follow-Up, Heart Rhythm, 2014, 11(3):360-366. [cited by applicant]
Victor, et al., Effects of the Cold Presser Test on Muscle Sympathetic Nerve Activity in Humans, Hypertension, 1987, 9:429-436. [cited by applicant]
Viskin, et al., The Response of the QT Interval to the Brief Tachycardia Provoked by Standing, Joimal of the American College of Cardiology, 2010, 55:1955-1961. [cited by applicant]
Wilde, et al., Left Cardiac Sympathetic Denervation for Catecholaminergic Polymorphic Ventricular Tachycardia, New England Journal of Medicine, 2008, 358:2024-2029. [cited by applicant]
Yu, et al., Low-Level Transcutaneous Electrical Stimulation of the Auricular Branch of the Vagus Nerve: A Noninvasive Approach to Treat the Initial Phase of Atrial Fibrillation, Heart Rhythm, 2013, 0:1-8. [cited by applicant]
Zhou, et al., Spontaneous Stellate Ganglion Nerve Activity and Ventricular Arrhythmia in a Canine Model of Sudden Death, Heart Rhythm, 2008, 5:131-139. [cited by applicant]
Zipes, et al., Neural Modulation of Cardiac Arrhythmias and Sudden Cardiac Death, Heart Rhythm, 2006, 3(1):108-113. [cited by applicant]