Case Western Reserve University

Axon Engineering, Inc.

Other

J Thomas Mortimer

James D Sweeney

Graham Harold Creasey

Narendra Bhadra

Thomas P Kicher

Timothy J Crish

Warren M Grill, Jr

Avram Scheiner

Michael E Miller

Harish Aiyar

Zi-Ping Fang

Ira J Ungar

Claude G Veraart

E Byron Marsolais

Gregory G Naples

Volker Grunewald

David A Ksienski

Claude S Veraart

Tomislav Bakula

Brian D Schmit

Methods and apparatuses for controlling bladder discharge in a patient are described. The method includes coupling a first electrode to a sacral ventral root of the patient and coupling a second electrode to a sacral dorsal root of the patient. The method may be applied to spinal cord injured patients without dorsal root section.

Combined stimulation of ventral and dorsal sacral roots for control of bladder function

A method and device for producing visual sensations within blind persons includes installing a self-sizing spiral nerve cuff electrode about the optic nerve of a blind person then transmitting electrical pulses to the nerve to generate phosphenes within the patient's visual field.

Device and method for production of visual sensations by optic nerve stimulation

A tool for implanting spiral nerve cuff electrodes about a nerve which can be maneuvered into difficult-to-access areas within the body of a mammal. The tool consists of a handle/control device which is coupled to an electrode holding valve assembly at the distal end of the tool by a flexible connection, allowing for accurate positioning of the electrode at the implantation site. The tool handle/control device is coupled to the valve assembly such that the control device can be rotated to release the electrode, which is held to the valve assembly by a vacuum, while the handle is held steady to ensure the precise location of the electrode at a site remote from the handle. The vacuum holding the electrode can be removed from portions of the electrode sequentially, allowing the spiral electrode to curl around the nerve.

Spiral nerve cuff electrode implantation tool

A customizable interactive educational system 30 includes an assembly of data modules 60 which control the inputting, categorizing, and formatting of educational data which have been determined to be well-accepted principles. The well-accepted principles create a primary knowledge base stored as a professor customizable interactive textbook (CITbook) 40. The primary knowledge base is organized by at least subject matter, topic, and knowledge level and the data are linked to each other in predetermined sequences. Data managers 200 allow a professor teaching a course to select and manipulate portions of the primary knowledge base of the professor CITbook 40 to generate a customized student version 50 in accordance with the course being taught and personal data added by the professor. The data added or altered by the professor is visually distinguished from the well-accepted data. Maps are generated which include link sequences connecting the selected subjects and topics in a primary sequence based on the course being taught. Secondary links are generated interconnecting the selected subjects and topics in multiple directions allowing the student to access reference data by selecting one of the secondary links. A presentation manager 250 executes the primary sequence and presents the selected subjects and topics contained in the primary sequence to the student. The secondary links allow the student to dynamically change the primary sequence thereby accessing background or advanced topics.

Customizable interactive textbook

Polymer-metal foil structure for neural stimulating electrodes

A device for coupling nerve cuff electrodes for stimulating nerves to a signal source for applying electrical signals for activation. The device comprises a carrier plate composed of a non-conductive material which contains a series of grooves for receiving selected nerve trunks. On either side of each groove is located a slot along the length of the groove, and a plurality of contacts are embedded within each groove. The contacts are releasably coupled to a power source which supplies a stimulating signal to the nerves. A spiral cuff electrode is wrapped through the slots to secure the nerve within the contact and provide for electrical conduction.

Nerve cuff electrode carrier

A surgical instrument for implanting electrodes within the muscular tissue of the diaphragm of a mammal through the abdomen. The instrument has an elongate frame with a first handle at one end. A needle for carrying the electrode is rotatably mounted on the other end of the instrument. The needle is located within a channel below the outer surface of the frame when the instrument is not in use. A second handle is connected to the needle by an actuating mechanism such that when the instrument is operated by moving the second handle toward the first handle, the needle rotates out from the frame to enable the instrument to accurately implant the electrode.

Electrode delivery instrument

A laparoscopic vacuum delivery device is used for placing an epimysial electrode at the phrenic nerve motor point. The vacuum delivery device is adapted to hold the epimysial electrode while the electrode is introduced through a port into the abdomen during a laparoscopic procedure. The electrode is forcibly held against the diaphragm muscle surface for test stimulation using a suction ported through the delivery device. Multiple test sites may be explored by controlling the suction to and the position of the delivery device. The electrode is secured at an optimal location on the diaphragm muscle using an endoscopic stapler.

Laproscopic vacuum delivery apparatus for a diaphragm daper

First and second electrical wires (10), (12) are wrapped helically around a polyprolene core (22). Along a single helical portion (A), a sheath (24) is placed over the spiral wound wires and core. In an open double helix portion (B), the core with spiral wound wires is wrapped into an open helix. At an electrical stimulation portion (C), insulation is removed from the wires such that bare conductors (14), (16) are wrapped spirally around the core. The core with the spiral wrapped conductors is wrapped in an open helix. A plurality of barbs (32) are mechanically connected along the entire length of the exposed electrical conductor surface. The core extends beyond the end of the electrical conductor surface to facilitate insertion into a selected site with a cannula (64).

Double helix functional stimulation electrode

A sheet (30) of polymeric material defines a cuff portion (A), a contact portion (B), and an interconnecting elongated lead portion (C). Using physical vapor deposition (PVD), chemical vapor deposition (CVD), or other thin film deposition techniques, a plurality of electrodes (12), contact pads (16), and interconnecting leads (14) are deposited on the base layer. An elastomer covering layer (18) is laminated to the base layer. The elastomeric covering layer is stretched along direction (24) before lamination, such that at least the cuff portion is elastomerically biased to curl into a spiral. Windows (20) are defined in the elastomeric portion to provide for electrical conduction between the electrodes (12) and nerve tissue about which the cuff electrode is wrapped. The electrodes are arced (FIG. 6) such that they are more recessed adjacent sides of the window than adjacent the center in order to provide a substantially uniform flux density across the electrode surface.

Thin film implantable electrode and method of manufacture

Cuff electrodes (40a, 40b) are surgically implanted around S.sub.3 sacral ventral root nerve trunks (16a, 16b). The sacral ventral roots have smaller diameter nerve fibers (20a, 20b) which convey action potentials to cause detrusor activation to contract the bladder (10) and larger diameter nerve fibers (18a, 18 b) which carry action potentials for causing contraction of a urethral sphincter (12) to block the flow of urine from the bladder. A current source (50) causes current pulses (52) between such electrical contacts (46, 48) and a central electrical contact (44). The current pulses have an appropriate amplitude and waveform to initiate action potentials adjacent the central contact and to block the propagation of action potentials adjacent the end electrodes along the larger diameter nerve fibers (which have fewer nodes between the contacts) but not the smaller diameter nerve fibers (which have more nodes between the electrodes). In this manner, action potentials are electrically excited to propagate at least downstream on the smaller diameter nerve fibers causing contraction of the bladder. Concurrently, blocking action potentials are allowed to propagate upstream on at least the larger diameter nerve fibers, collision blocking naturally occurring action potentials propagating downstream. The transmission of action potentials downstream on the larger diameter nerve fibers is blocked by the current pulses allowing the urinary sphincter to relax.

Micturitional assist device

A single electrode, asymmetric electrode cuff (B) is disposed around a nerve trunk (A). A signal generator (C) is connected between a cathode (20) disposed asymmetrically in the electrode cuff and an anode (22) disposed in an electrically conductive relationship within the body tissue. The signal generator applies a stimulus signal (FIG. 3) which generates unidirectionally propagating action potentials on the nerve trunk. The electrode cuff includes a dielectric sleeve (10) in which the cathode is positioned a first distance (L1) from an escape end (14) and a second distance (L2) from an arrest end (16). The first distance is at least 1.7, and preferably about 7, times the second distance. This asymmetry causes a primary or forward stimulus signal current (30) to be correspondingly greater than a secondary or reverse current (32).

Asymmetric single electrode cuff for generation of unidirectionally

A nerve trunk (A) has an annular electrode cuff (B) positioned therearound for imposing electrical signals on to the nerve trunk for the purpose of generating unidirectionally propagated action potentials. The electrode cuff includes an annular cathode (30) having a circular passage therethrough of a first diameter. An annular anode (40) has a larger circular passage therethrough of a second diameter, which second diameter is about 1.2 to 3.0 times the first diameter. A non-conductive sheath (50) extends around the anode, cathode, and nerve trunk. The anode and cathode are placed asymmetrically to one side of the non-conductive sheath. Specifically, a first length (L1) along the electrode sheath between a first end (56) and the cathode is at least twice a second length (L2) between the anode and cathode. A third length (L3) between the anode and a second end (58) of the conductive sheath is smaller than the first or second lengths. With this geometry, the majority of the current applied to the anode electrode flows to the cathode along path segments (62b and 62d) with lesser amounts of current flowing in the path segments (64a), (64b), (66a), and (66b).

Asymmetric shielded two electrode cuff

An electrode cuff (B) including a dielectric sleeve (10) and an annular cathode electrode (20) is disposed around a nerve trunk (A). An anode electrode (22) is disposed in body fluids in electrical communication with the nerve trunk. The cathode electrode is disposed off center within the dielectric sleeve. The flow of electric current from the anode to the cathode has a much greater amplitude along the nerve in the direction extending along the nerve trunk toward the cathode from the end of the dielectric sleeve toward which the cathode electrode is closest. A signal generator (C) applies a pulse train across the anode and cathode electrodes. The pulse train includes a plurality of alternating first amplitude pulse portions (40) and opposite polarity pulse portions (42). Each first polarity pulse includes a sharp leading edge (50) which rises abruptly to a preset amplitude (52). A trailing edge (56) of each first pulse portion decays smoothly into a leading edge (60) of each opposite polarity pulse portion without a discontinuity therebetween. The opposite polarity pulse portion has an amplitude (62) which is smaller than the triggering amplitude and a duration which is longer than the first polarity pulse portion duration. The amplitude and duration of the first and opposite polarity pulse portions are selected such that the net charge transfer in each direction is substantially the same.

Antidromic pulse generating wave form for collision blocking

A self-curling sheet (A) of non-conductive material is biased to curl into a tight spiral. A cut out (22) is removed from one corner of the sheet such that, when the sheet spirals, a passage (28) defined axially therethrough has one portion with a smaller diameter and another portion with a larger diameter. A pair of conductive strips (40, 50) are disposed on the self-curling sheet such that one extends peripherally around each of the larger and smaller diameter regions of the passage therethrough. The conductive segments may be electrically conductive for applying electrical impulses or fluid conductive for infusing medications. In use, a first edge (14) of the self-curling sheet is disposed adjacent a nerve trunk which is to receive the cuff therearound. The self-curling sheet is controllably permitted to curl around the nerve forming an annular cuff therearound.

Growing community of inventors

Chagrin Falls, OH, United States of America

J Thomas Mortimer