The present disclosure is directed to the area of implantable photobiomodulation (PBM) or PBM/electrical stimulation systems and methods of making and using the systems. The present disclosure is also directed to implantable PBM or PBM/electrical stimulation systems that include an electrode disposed on or over a light emitter.
Implantable electrical stimulation systems have proven therapeutic in a variety of diseases and disorders. For example, spinal cord stimulation systems have been used as a therapeutic modality for the treatment of chronic pain syndromes. Peripheral nerve stimulation has been used to treat chronic pain syndrome and incontinence. Functional electrical stimulation systems have been applied to restore some functionality to paralyzed extremities in spinal cord injury patients. Stimulation of the brain, such as deep brain stimulation, can be used to treat a variety of diseases or disorders.
Stimulators have been developed to provide therapy for a variety of treatments. A stimulator can include a control module (with a pulse generator), one or more leads, and an array of stimulator electrodes on each lead. The stimulator electrodes are in contact with or near the nerves, muscles, or other tissue to be stimulated. The pulse generator in the control module generates electrical pulses that are delivered by the electrodes to body tissue.
Photobiomodulation (PBM) can also provide therapeutic benefits in a variety of diseases and disorders by itself or in combination with electrical stimulation. PBM can provide treatment for symptoms, as well as full or partial relief from pain and other effects of the disease or disorder. A PBM system may include one or more light sources and, often, one or more optical fibers to carry the light to the desired modulation site.
In one aspect, an implantable photobiomodulation lead includes a lead body having a proximal end portion and a distal end portion; at least one light emitter disposed along, or coupled to, the distal end portion of the lead body and configured to emit light out of the photobiomodulation lead; and at least one electrode disposed on or over the at least one light emitter and in a path of the light emitted by at least one of the at least one light emitter.
In at least some aspects, the at least one electrode is transparent or translucent. In at least some aspects, at least one of the at least one electrode includes graphene, carbon nanotubes, or indium tin oxide.
In at least some aspects, at least one of the at least one electrode is a mesh electrode that allow transmission of at least 50% of light through the mesh electrode. In at least some aspects, at least one of the at least one electrode defines a grid of holes that allow transmission of at least 50% of light through the electrode. In at least some aspects, the least one light emitter includes a plurality of waveguides, wherein at least one of the waveguides extends into or through at least one of the holes of the grid of holes.
In at least some aspects, at least one of the at least one light emitter is a light source. In at least some aspects, at least one of the at least one light emitter is configured to emit light from a distal tip of the photobiomodulation lead. In at least some aspects, at least one of the at least one light emitter is configured to emit light from a side of the photobiomodulation lead. In at least some aspects, at least one of the at least one light emitter is a directional light emitter.
In at least some aspects, the photobiomodulation lead further includes a paddle body attached to the distal end portion of the lead body, wherein at least one of the at least one light emitter is disposed on the paddle body. In at least some aspects, the photobiomodulation lead further includes a cuff body attached to the distal end portion of the lead body, wherein at least one of the at least one light emitter is disposed on the cuff body.
In at least some aspects, the at least one electrode is a plurality of electrodes and the plurality of electrodes includes at least one set of segmented electrodes disposed at a same longitudinal position along the photobiomodulation lead. In at least some aspects, the photobiomodulation lead further includes an optical assembly including at least one of the at least one light emitter and an insulative layer between at least a portion of the at least one electrode and a portion of the optical assembly.
In at least some aspects, at least one of the at least one light emitter is an optical waveguide configured to receive light from a light source and to emit the light out of the photobiomodulation lead. In at least some aspects, at least one of the at least one electrode is disposed on the optical waveguide, the photobiomodulation lead further including a conductive trace extending along the optical waveguide from the at least one of the at least one electrode. In at least some aspects, the photobiomodulation lead further includes the light source disposed within the photobiomodulation lead.
In at least some aspects, the at least one light emitter includes a plurality of light emitters, wherein the plurality of light emitters includes a set of light emitters disposed in a ring within the photobiomodulation lead.
In another aspect, a photobiomodulation system includes any of the photobiomodulation leads of described above and an implantable control module coupled or coupleable to the photobiomodulation lead and configured to control emission of light by the at least one light emitter.
In a further aspect, a method of photobiomodulation of tissue includes emitting light from the at least one light emitter of any of the photobiomodulation leads described above implanted in the tissue.
Non-limiting and non-exhaustive embodiments of the present invention are described with reference to the following drawings. In the drawings, like reference numerals refer to like parts throughout the various figures unless otherwise specified.
For a better understanding of the present invention, reference will be made to the following Detailed Description, which is to be read in association with the accompanying drawings, wherein:
The present disclosure is directed to the area of implantable photobiomodulation (PBM) or PBM/electrical stimulation systems and methods of making and using the systems. The present disclosure is also directed to implantable PBM or PBM/electrical stimulation systems that include an electrode disposed on or over a light emitter.
The systems described herein can produce PBM or both PBM and electrical stimulation. In at least some of these embodiments, PBM can be provided through a modification of an electrical stimulation system. PBM may include, but is not necessarily limited to, biomodulation or stimulation resulting from response to particular wavelengths or wavelength ranges of light or from thermal effects generated using light or from any combination thereof.
An implantable PBM or PBM/electrical stimulation system includes at least one light source, such as a light emitting diode (LED), light emitting transistor (LET), laser diode, a vertical cavity side-emitting laser (VCSEL), an organic light emitting diode (OLED), organic light emitting transistor (OLET), a lamp, or any other suitable light source.
When the proximal end 109a, 109b of the lead 102 is inserted into the port 111, the connector contacts 145 can be aligned with a plurality of terminals 132 (
The optional power source 112 can provide power to the electronic subassembly 110. The electronic subassembly 110 is, at least in some embodiments, programmable and is configured to direct the PBM and, if present, electrical stimulation. The electronic subassembly 110 is electrically coupled to the connector contacts 144 and controls a light source 150 (
The lead 103 includes a lead body 106, one or more proximal ends 109a, 109b, one or more distal ends 113, at least one light emitter 126 disposed along the distal end, one or more optional electrodes 134 disposed along the distal end, and one or more optional terminals 132 (
The light emitter 126 of any of the embodiments described herein (unless indicated otherwise) can be a light source or can be a light emission region of an optical waveguide 136 (
When the light emitter 126 is a light emission region, the light source can be disposed in the control module 102, lead 103, or other components. Light from the light source is transmitted along one or more optical waveguides 136 (
Although
Examples of PBM and PBM/electrical stimulation systems can be found at, for example, U.S. Pat. Nos. 9,415,154; 10,335,607; and 10,814,140; and U.S. Patent Applications Publications Nos. 2020/0155854; 2021/0008388; 2021/0008389; 2021/0016111; and 2022/0072329, all of which are incorporated herein by reference in their entireties. Examples of electrical and PBM/electrical stimulation systems with leads that can be used or modified to include the elements described herein are found in, for example, U.S. Pat. Nos. 6,181,969; 6,295,944; 6,391,985; 6,516,227; 6,609,029; 6,609,032; 6,741,892; 7,244,150; 7,450,997; 7,672,734; 7,761, 165; 7,783,359; 7,792,590; 7,809,446; 7,949,395; 7,974,706; 8,831,742; 8,688,235; 6,175,710; 6,224,450; 6,271,094; 6,295,944; 6,364,278; and 6,391,985; U.S. Patent Applications Publication Nos. 2007/0150036; 2009/0187222; 2009/0276021; 2010/0076535; 2010/0268298; 2011/0004267; 2011/0078900; 2011/0130817; 2011/0130818; 2011/0238129; 2011/0313500; 2012/0016378; 2012/0046710; 2012/0071949; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320; 2012/0203321; 2012/0316615; 2013/0105071; 2011/0005069; 2010/0268298; 2011/0130817; 2011/0130818; 2011/0078900; 2011/0238129; 2011/0313500; 2012/0016378; 2012/0046710; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320; and 2012/0203321, all of which are incorporated herein by reference in their entireties.
In at least some embodiments, the light source 150 includes an emitter element 180, a flange 182 or other housing, and at least two contacts 184. The emitter element 180 may also include a protective material (such as a ceramic or polymeric material) disposed around the actual light emitting structure. The flange 182 can be made of any suitable material and may provide structural or positional stability for the emitter element 180 within the optical assembly 160. The contacts 184 can be pins, pads, or any other structure that provides for electrical coupling of the emitter element 180 to other components, such as the conductive cables 168 or feedthrough pins 166. The conductive cables 168 of the optical assembly 160 can be conductive wires, pins, or any other suitable conductive structure to electrically couple the contacts 184 of the light source 150 to the feedthrough pins 166. It will be understood that in other embodiments, the contacts 184 can be coupled directly to the feedthrough pins 166 without the use of conductive cables.
In at least some embodiments, the emitter cover 162 is disposed over the light source 150 and is, optionally, an optical component such as an optical diffuser or lens. For example, a sapphire optical diffuser dome can be positioned over the light emitter. In other embodiments, the emitter cover 162 may be an optically transparent or translucent material to seal the light source 150 within the optical assembly 160. In some embodiments, the emitter cover 162 can be part of a package that forms the light source 150.
In at least some embodiments, biomodulation and electrical stimulation can be applied to the same, similar, adjacent, nearby, or overlapping target regions. In at least some embodiments, one or more electrodes 634 can be disposed on the optical assembly 160, as illustrated in
In at least some embodiments, particularly when a portion of the electrode(s) 634 covers the emitter cover 162 as illustrated in
In at least some embodiments, as illustrated in the cross-section of
The electrode(s) 634 can be used for any suitable purpose. For example, for cortical stimulation, the electrode(s) can be used for sensing depth and the optical assembly can be used for photobiomodulation or optical stimulation of a larger area of the brain. This may be used to treat conditions, such as Alzheimer's or Parkinson's disease. As another example, for spinal cord stimulation, the electrode(s) 634 can be used to identify a target for photobiomodulation. In at least some embodiments, electrical stim is turned off while photobiomodulation is on. As another example, the electrode(s) 634 can be used for sensing or for providing electrical stimulation or for any combination of the purposes disclosed herein.
One or more (or all) of the light emitters 126 are covered by an electrode 634, as illustrated in
One or more of the electrodes 634 are disposed over the light emitter(s) 126, as illustrated in
One or more electrodes 634 can be disposed over the optical assembly 160, as illustrated in
In at least some embodiments, selected components (for example, a power source 170, an antenna 1718, a receiver 1702, a processor 1704, and a memory 1705) of the PBM or PBM/electrical stimulation system can be positioned on one or more circuit boards or similar carriers within a sealed housing of a control module 102. Any suitable processor 1704 can be used and can be as simple as an electronic device that, for example, produces signals to direct or generate PBM or PBM/electrical stimulation at a regular interval or the processor can be capable of receiving and interpreting instructions from an external programming unit 1708 that, for example, allows modification of delivery parameters or characteristics.
The processor 1704 is generally included to control the timing and other characteristics of the PBM or PBM/electrical stimulation system. For example, the processor 1704 can, if desired, control one or more of the timing, pulse frequency, amplitude, and duration of the PBM or PBM/electrical stimulation. In addition, the processor 1704 can select one or more of the electrodes 134 to provide electrical stimulation, if desired. In some embodiments, the processor 1704 selects which of the electrode(s) are cathodes and which electrode(s) are anodes.
Any suitable memory 1705 can be used. The memory 1705 illustrates a type of computer-readable media, namely computer-readable storage media. Computer-readable storage media may include, but is not limited to, nonvolatile, non-transitory, removable, and non-removable media implemented in any method or technology for storage of information, such as computer readable instructions, data structures, program modules, or other data. Examples of computer-readable storage media include RAM, ROM, EEPROM, flash memory, or other memory technology, magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by a processor.
The processor 1704 is coupled to a light source 150. Any suitable light source can be used including, but not limited to, LEDs, OLEDs, laser diodes, VCSELs, lamps, light bulbs, or the like or any combination thereof. In at least some embodiments, the PBM or PBM/electrical stimulation system may include multiple light sources. In at least some embodiments, each of the multiple light sources may emit light having a different wavelength or different wavelength range. Any suitable wavelength or wavelength range can be used including, but not limited to, visible, near infrared, and ultraviolet wavelengths or wavelength ranges. A wavelength or wavelength range of a light source may be selected to obtain a specific therapeutic, chemical, or biological effect.
Any power source 170 can be used including, for example, a battery such as a primary battery or a rechargeable battery. Examples of other power sources include super capacitors, nuclear or atomic batteries, fuel cells, mechanical resonators, infrared collectors, flexural powered energy sources, thermally-powered energy sources, bioenergy power sources, bioelectric cells, osmotic pressure pumps, and the like. As another alternative, power can be supplied by an external power source through inductive coupling via an antenna 1718 or a secondary antenna. The external power source can be in a device that is mounted on the skin of the user or in a unit that is provided near the user on a permanent or periodic basis. In at least some embodiments, if the power source 1712 is a rechargeable battery, the battery may be recharged using the antenna 1718 and a recharging unit 1716. In some embodiments, power can be provided to the battery for recharging by inductively coupling the battery to the external recharging unit 1716.
In at least some embodiments, the processor 1704 is coupled to a receiver 1702 which, in turn, is coupled to an antenna 1718. This allows the processor 1704 to receive instructions from an external source, such as programming unit 1708, to, for example, direct the delivery parameters and characteristics. The signals sent to the processor 1704 via the antenna 1718 and the receiver 1702 can be used to modify or otherwise direct the operation of the PBM or PBM/electrical stimulation system. For example, the signals may be used to modify the characteristics or delivery parameters of the PBM or PBM/electrical stimulation system. The signals may also direct the PBM or PBM/electrical stimulation system 1700 to cease operation, to start operation, to start charging the battery, or to stop charging the battery. In other embodiments, the PBM or PBM/electrical stimulation system does not include the antenna 1718 or receiver 1702 and the processor 1704 operates as initially programmed.
In at least some embodiments, the antenna 1718 is capable of receiving signals (e.g., RF signals) from an external programming unit 1708 (such as a clinician programmer or patient remote control or any other device) which can be programmed by a user, a clinician, or other individual. The programming unit 1708 can be any unit that can provide information or instructions to the PBM or PBM/electrical stimulation system 1700. In at least some embodiments, the programming unit 1708 can provide signals or information to the processor 1704 via a wireless or wired connection. One example of a suitable programming unit is a clinician programmer or other computer operated by a clinician or other user to select, set, or program delivery parameters for the PBM or PBM/electrical stimulation system. Another example of the programming unit 1708 is a remote control such as, for example, a device that is worn on the skin of the user or can be carried by the user and can have a form similar to a pager, cellular phone, or remote control, if desired. In at least some embodiments, a remote control used by a patient may have fewer options or capabilities for altering delivery parameters than a clinician programmer.
Optionally, the PBM or PBM/electrical stimulation system 1700 may include a transmitter (not shown) coupled to the processor 1704 and the antenna 1718 for transmitting signals back to the programming unit 1708 or another unit capable of receiving the signals. For example, the PBM or PBM/electrical stimulation system 1700 may transmit signals indicating whether the PBM or PBM/electrical stimulation system 1700 is operating properly or not or indicating when the battery needs to be charged or the level of charge remaining in the battery. The processor 1704 may also be capable of transmitting information about the delivery parameters or characteristics so that a user or clinician can determine or verify the delivery parameters or characteristics.
The above specification provides a description of the manufacture and use of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention also resides in the claims hereinafter appended.
This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 63/399,976, filed Aug. 22, 2022, which is incorporated herein by reference.
Number | Date | Country | |
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63399976 | Aug 2022 | US |