# US 2019/0167996 A1 · Treatment of pain using electrical nerve conduction block

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- Number: US 2019/0167996 A1
- Document ID: US20190167996A1
- Status: Published application
- Kind: A1
- Application number: 16/266,236
- Filed: 2019-02-04
- Published: 2019-06-06
- Earliest claimed: 2012-06-15
- Assignees: Case Western Reserve University
- Applicants: Case Western Reserve University
- Inventors: Niloy Bhadra; Narendra Bhadra; Kevin L. Kilgore; Scott Lempka; Jesse Wainright; Tina Vrabec; Manfred Franke
- Web page: https://patentgrep.com/patent/US20190167996A1

## CPC

- A61N 1/0551: {Spinal or peripheral nerve electrodes}
- A61N 1/06: for high-frequency therapy
- A61N 1/20: continuous direct currents
- A61N 1/36021: {for treatment of pain}
- A61N 1/36062: {Spinal stimulation}
- A61N 1/36071: {Pain}
- A61N 1/36125: {Details of circuitry or electric components}
- A61N 1/0456: {Specially adapted for transcutaneous electrical nerve stimulation [TENS]}
- A61N 1/0556: {Cuff electrodes}
- A61N 1/205: {for promoting a biological process}
- A61N 1/36017: {with leads or electrodes penetrating the skin}
- A61N 1/3615: {Intensity}
- A61N 1/36171: {Frequency}
- 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

Described herein are systems and methods for the treatment of pain using electrical nerve conduction block (ENCB). Contrary to other methods of pain treatment, the ENCB can establish a direct block of neural activity, thereby eliminating the pain. Additionally, the ENCB can be administered without causing electrochemical damage. An example method can include: placing at least one electrode contact in electrical communication with a region of a subject's spinal cord; applying an electrical nerve conduction block (ENCB) to a nerve in the region through the at least one electrode contact; and blocking neural activity with the ENCB to reduce the pain or other unwanted sensation in the subject.

## Claims

### Claim 1

A method comprising:
placing at least one electrode contact in electrical communication with a subject's spinal cord;
applying an electrical nerve conduction block (ENCB) to one or more regions of the spinal cord through the at least one electrode contact; and
blocking neural activity in the one or more regions of the spinal cord with the ENCB to reduce an unwanted sensation in the subject.

### Claim 2 (depends on 1)

The method of claim 1, wherein the at least one electrode contact comprises a high charge capacity material that prevents formation of damaging electrochemical reaction products at a charge delivered by the ENCB.

### Claim 3 (depends on 1)

The method of claim 1, wherein the ENCB comprises at least one of a monophasic DC waveform, a charge balanced direct current (CBDC) waveform, a substantially CBDC waveform, and a high frequency alternating current (HFAC) waveform.

### Claim 4 (depends on 1)

The method of claim 1, wherein the neural activity to be blocked comprises paresthesia due to spinal cord stimulation,
wherein the at least one electrode contact is placed rostral to a location of a spinal cord stimulation electrode of a spinal cord stimulation system.

### Claim 5 (depends on 1)

The method of claim 1, further comprising:
placing at least three electrode contacts in electrical communication with the subject's spinal cord;
applying a HFAC waveform through the central one of the at least three electrode contacts;
blocking an onset response associated with the HFAC by applying a CBDC waveform by the electrode contacts surrounding the central one of the at least three electrode contacts for a time associated with the onset response; and
blocking the neural activity in the spinal cord or spinal roots with the CBDC block for the time associated with the onset response and with the HFAC waveform thereafter.

### Claim 6 (depends on 5)

The method of claim 5, wherein the time associated with the onset response is less than 10 seconds.

### Claim 7 (depends on 5)

The method of claim 5, wherein the time associated with the onset response is less than 5 seconds.

### Claim 8 (depends on 5)

The method of claim 5, wherein the time associated with the onset response is less than 2 seconds.

### Claim 9 (depends on 1)

The method of claim 1, further comprising applying an activation signal with a frequency of 1 kilohertz or less by a stimulating contact of a spinal cord stimulation system,
wherein the ENCB and the activation signal are combined to cause a collision block in one or more nerve fibers.

### Claim 10 (depends on 9)

The method of claim 9, wherein the ENCB comprises a HFAC waveform with a frequency between 5 kHz and 50 Hz.

### Claim 11 (depends on 9)

The method of claim 9, wherein the ENCB comprises a HFAC waveform with an amplitude that is at least one of between 1 and 10 Vpp and between 1 and 10 mApp.

### Claim 12 (depends on 1)

The method of claim 1, further comprising adjusting a degree of the block over time through open loop control, closed loop control, or user control to block an adjusted amount of the unwanted sensation.

### Claim 13 (depends on 1)

The method of claim 1, wherein the at least one electrode contact is placed subdurally within the subject's spinal cord.

### Claim 14 (depends on 1)

The method of claim 1, wherein the unwanted sensation is pain due to at least one of cancer, pancreatitis, neuroma, post-hepatic neuralgia, back pain, headache, joint replacement, surgery, injury, tissue damage, and endometriosis.

### Claim 15

A system comprising:
a stimulating electrode comprising at least one stimulating electrode contact configured to be placed in electrical communication with a region of a subject's spinal cord;
a stimulating waveform generator coupled to the stimulating electrode and configured to generate an electrical stimulation waveform to be delivered by the at least one stimulating electrode contact;
a blocking electrode comprising at least one blocking electrode contact configured to be placed in electrical communication with another region of the subject's spinal cord; and
a blocking waveform generator coupled to the blocking electrode and configured to generate an electrical nerve conduction block (ENCB) waveform to be delivered by the at least one blocking contact.

### Claim 16 (depends on 15)

The spinal cord stimulation system of claim 15, wherein the at least one blocking electrode contact comprises a high charge capacity material that prevents formation of damaging electrochemical reaction products at a charge delivered by the ENCB waveform.

### Claim 17 (depends on 16)

The spinal cord stimulation system of claim 16, wherein the high charge capacity material is capable of delivering at least 100 μC before irreversible electrochemical reactions take place forming the damaging electrochemical reaction products.

### Claim 18 (depends on 16)

The spinal cord stimulation system of claim 16, wherein the high charge capacity material comprises at least one of platinum black, iridium oxide, titanium nitride, tantalum, carbon, and poly(ethylenedioxythiophene).

### Claim 19 (depends on 15)

The spinal cord stimulation system of claim 15, wherein the ENCB waveform comprises at least one of a monophasic direct current waveform, a charge balanced direct current (CBDC) waveform, a substantially CBDC waveform, and a high frequency alternating current (HFAC) waveform.

### Claim 20 (depends on 15)

The spinal cord stimulation system of claim 15, wherein the blocking electrode comprises at least three blocking electrode contacts.