# US 10,307,324 B2 · Selective recruitment and activation of fiber types in nerves for the control of undesirable brain state changes > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,307,324 B2 - Document ID: US10307324B2 - Status: Granted - Kind: B2 - Application number: 15/429,705 - Filed: 2017-02-10 - Published: 2017-06-01 - Granted: 2019-06-04 - Earliest claimed: 2013-02-13 - Applicants: Ivan Osorio - Inventors: Ivan Osorio - Web page: https://patentgrep.com/patent/US10307324B2 ## CPC - A61H 9/0092: {Cuffs therefor} - A61B 17/12: for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord - A61F 7/12: Devices for heating or cooling internal body cavities - A61H 39/08: Devices for applying needles to such points, i.e. for acupuncture {; Acupuncture needles or accessories therefor} - A61N 1/0529: {Electrodes for brain stimulation} - A61N 1/0556: {Cuff electrodes} - A61N 1/36053: {adapted for vagal stimulation (A61N1/36114 takes precedence)} - A61N 1/36064: {Epilepsy} - A61N 1/36082: {Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease} - A61N 1/36096: {Mood disorders, e.g. depression, anxiety or panic disorder} - A61N 1/36146: {specified by the stimulation parameters} - A61F 2007/126: {for invasive application, e.g. for introducing into blood vessels} - A61H 2201/0207: heated - A61H 2201/0214: cooled - A61H 2201/0242: by a fluid circulating in the apparatus - A61H 2201/0285: with Peltier elements - A61H 2201/5005: for controlling frequency distribution, modulation or interference of a driving signal - A61H 2205/027: Ears - A61H 2230/045: used as a control parameter for the apparatus - A61H 2230/065: used as a control parameter for the apparatus - A61H 2230/405: used as a control parameter for the apparatus - A61H 2230/425: used as a control parameter for the apparatus - A61H 2230/605: used as a control parameter for the apparatus - A61H 2230/655: used as a control parameter for the apparatus - A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract We disclose methods and medical device systems for selectively recruiting a nerve fiber type within a cranial nerve, a peripheral nerve or a spinal root. Such a method may comprise applying a first pressure, a heating, and/or a cooling to a second location of the nerve, the pressure, heating, or cooling sufficient to substantially block at least one of activation or conduction in at least one fiber population through the second location of the nerve for a blocking time period; and applying an electrical signal to a first location during the blocking time period. ## Claims ### Claim 1 A medical device system for selectively stimulating a nerve fiber type within a cranial nerve, a peripheral nerve or a spinal root, comprising: an electrode adapted to be coupled to a first location of a cranial nerve, a peripheral nerve or a spinal root, the electrode capable of applying an electrical signal to at least one of a first nerve fiber type or a second nerve fiber type at the first location, wherein the first nerve fiber type has a different native activation threshold from the second nerve fiber type; a nerve pressure device adapted to be coupled to a second location of the cranial nerve, the peripheral nerve or the spinal root, the nerve pressure device being capable of applying a first pressure to the second location; a medical device operatively coupled to the electrode and the nerve pressure device, the medical device comprising: a controller; an electrical signal generator configured to apply the electrical signal to the first location of the cranial nerve, the peripheral nerve, or the spinal root using the electrode to activate at least the second nerve fiber type at the first location to conduct towards the second location and towards a target innervated structure or system; and a pressure signal generator configured to apply the first pressure to the second location of the cranial nerve, the peripheral nerve, or the spinal root using the nerve pressure device, the first pressure attenuating conduction of the first nerve fiber type so that a higher fraction of the second nerve fiber type relative to the first nerve fiber type conduct away from the second location towards the target innervated structure or system. ### Claim 2 (depends on 1) The medical device system of claim 1, wherein the first nerve fiber type is an A-fiber and the second nerve fiber type is a B-fiber or a C-fiber. ### Claim 3 (depends on 1) The medical device system of claim 1, wherein the first nerve fiber type is a myelinated fiber and the second nerve fiber type is an unmyelinated fiber. ### Claim 4 (depends on 1) The medical device system of claim 1, further comprising: a sensor to receive at least one body data stream; wherein the electrical signal generator is adapted to apply the electrical signal to the first location of the cranial nerve, the peripheral nerve or the spinal root based upon the at least one body data stream. ### Claim 5 (depends on 4) The medical device system of claim 4, wherein the second location is proximal to the heart, relative to the first location, and the electrical signal is applied as a therapy for a cardio-vascular condition. ### Claim 6 (depends on 5) The medical device system of claim 5, wherein the at least one body data stream comprises sensed body data of at least one of the following: EKG, blood pressure, respirations, skin resistance, catecholamine concentrations, concentrations of metabolites of catecholamines, autonomic signals, metabolic signals, glucose levels, or lactic acid concentrations. ### Claim 7 (depends on 1) The medical device system of claim 1, wherein at least one parameter defining the electrical signal is programmably selected, the at least one parameter selected from a pulse current, a pulse width, a frequency, an on-time and an off-time. ### Claim 8 (depends on 1) The medical device system of claim 1, wherein the nerve pressure device is capable of applying a plurality of pressures at the second location, wherein the pressure signal generator is capable of applying the plurality of pressures to the second location using the nerve pressure device, and wherein the plurality of pressures are selectable. ### Claim 9 A medical device system for selectively stimulating a nerve fiber type within a cranial nerve, a peripheral nerve or a spinal root, comprising: an electrode adapted to be coupled to a first location of a cranial nerve, a peripheral nerve or a spinal root, the electrode capable of applying an electrical signal to at least one of a first nerve fiber type or a second nerve fiber type at the first location, wherein the first nerve fiber type has a different native activation threshold from the second nerve fiber type, and wherein the first nerve fiber type is an A-fiber and the second nerve fiber type is a B-fiber or a C-fiber; a nerve pressure device adapted to be coupled to a second location of the cranial nerve, the peripheral nerve or the spinal root, the nerve pressure device being capable of applying a first pressure to the second location; a medical device operatively coupled to the electrode and the nerve pressure device, the medical device comprising: a controller; an electrical signal generator configured to apply the electrical signal to the first location of the cranial nerve, the peripheral nerve, or the spinal root using the electrode to activate at least the second nerve fiber type at the first location to conduct towards the second location and towards a target innervated structure or system; and a pressure signal generator configured to apply the first pressure to the second location of the cranial nerve, the peripheral nerve, or the spinal root using the nerve pressure device, the first pressure attenuating conduction of the first nerve fiber type so that a higher fraction of the second nerve fiber type relative to the first nerve fiber type conduct away from the second location towards the target innervated structure or system. ### Claim 10 (depends on 9) The medical device system of claim 9, wherein the first nerve fiber type is a myelinated fiber and the second nerve fiber type is an unmyelinated fiber. ### Claim 11 (depends on 9) The medical device system of claim 9, wherein the second location is proximal to the heart, relative to the first location, and the electrical signal is applied as a therapy for a cardio-vascular condition. ### Claim 12 (depends on 9) The medical device system of claim 9, wherein the at least one body data stream comprises sensed body data of at least one of the following: EKG, blood pressure, respirations, skin resistance, catecholamine concentrations, concentrations of metabolites of catecholamines, autonomic signals, metabolic signals, glucose levels, or lactic acid concentrations. ### Claim 13 (depends on 9) The medical device system of claim 9, wherein at least one parameter defining the electrical signal is programmably selected, the at least one parameter selected from a pulse current, a pulse width, a frequency, an on-time and an off-time. ### Claim 14 (depends on 9) The medical device system of claim 9, wherein the nerve pressure device is capable of applying a plurality of pressures at the second location, wherein the pressure signal generator is capable of applying the plurality of pressures to the second location using the nerve pressure device, and wherein the plurality of pressures are selectable. ### Claim 15 A medical device system for selectively stimulating a nerve fiber type within a cranial nerve, a peripheral nerve or a spinal root, comprising: an electrode adapted to be coupled to a first location of a cranial nerve, a peripheral nerve or a spinal root, the electrode capable of applying an electrical signal to at least one of a first nerve fiber type or a second nerve fiber type at the first location, wherein the first nerve fiber type has a different native activation threshold from the second nerve fiber type, the first nerve fiber type being a myelinated fiber and the second nerve fiber type being an unmyelinated fiber; a nerve pressure device adapted to be coupled to a second location of the cranial nerve, the peripheral nerve or the spinal root, the nerve pressure device being capable of applying a first pressure to the second location; a medical device operatively coupled to the electrode and the nerve pressure device, the medical device comprising: a controller; an electrical signal generator configured to apply the electrical signal to the first location of the cranial nerve, the peripheral nerve, or the spinal root using the electrode to activate at least the second nerve fiber type at the first location to conduct towards the second location and towards a target innervated structure or system; and a pressure signal generator configured to apply the first pressure to the second location of the cranial nerve, the peripheral nerve, or the spinal root using the nerve pressure device, the first pressure attenuating conduction of the first nerve fiber type so that a higher fraction of the second nerve fiber type relative to the first nerve fiber type conduct away from the second location towards the target innervated structure or system. ### Claim 16 (depends on 15) The medical device system of claim 15, further comprising: a sensor to receive at least one body data stream; wherein the electrical signal generator is adapted to apply the electrical signal to the first location of the cranial nerve, the peripheral nerve or the spinal root based upon the at least one body data stream. ### Claim 17 (depends on 16) The medical device system of claim 16, wherein the second location is proximal to the heart, relative to the first location, and the electrical signal is applied as a therapy for a cardio-vascular condition. ### Claim 18 (depends on 17) The medical device system of claim 17, wherein the at least one body data stream comprises sensed body data of at least one of the following: EKG, blood pressure, respirations, skin resistance, catecholamine concentrations, concentrations of metabolites of catecholamines, autonomic signals, metabolic signals, glucose levels, or lactic acid concentrations. ### Claim 19 (depends on 15) The medical device system of claim 15, wherein at least one parameter defining the electrical signal is programmably selected, the at least one parameter selected from a pulse current, a pulse width, a frequency, an on-time and an off-time. ### Claim 20 (depends on 15) The medical device system of claim 15, wherein the nerve pressure device is capable of applying a plurality of pressures at the second location, wherein the pressure signal generator is capable of applying the plurality of pressures to the second location using the nerve pressure device, and wherein the plurality of pressures are selectable.