Dipole electrical stimulation employing direct current for recovery from spinal cord injury

Abstract

A system and method to treat neuromuscular conditions, including spinal cord injury, by what is characterized as dipole (two point) cortico-muscular stimulation. Two-point stimulation, with oppositely charged electrodes, allows pulsed, direct current to pass through the cortico-muscular pathway. The electrodes are placed on nerves, muscles, or a combination of both, that are on opposite sides of the spinal column, forming a current that passes across the spinal column. Further, an active electrode can be placed on the spinal column and a reference electrode can be placed outside the central nervous system. These methods improve functional recovery of the motor pathway.

1 . A method of improving a neuromuscular condition of a vertebrate being, said method comprising:
 placing at least one active electrode at, or in proximity to, a first point and at least one reference electrode at, or in proximity to, a second point, wherein said first point is located at the central nerve system of a vertebrate being, and said second point is located outside the central nervous system of said vertebrate being;   enhancing a neural connection between said first point and said second point by passing electrical current between said at least one active electrode and said at least one reference electrode: wherein said first point is located at a spinal column of said vertebrate being; and   applying an additional electrical stimulus to the motor cortex of said vertebrate being during passing of said electrical current.   
     
     
         2 .- 6 . (canceled) 
     
     
         7 . The method of  claim 1 , wherein said additional electrical stimulus is a local stimulus in the form of at least one electrical pulse. 
     
     
         8 . The method of  claim 7 , wherein said at least one electrical pulse is applied synchronously with said passing of said electrical current. 
     
     
         9 . The method of  claim 1 , further comprising applying an additional electrical stimulus to at least one muscle of said vertebrate being during passing of said electrical current. 
     
     
         10 . (canceled) 
     
     
         11 . The method of  claim 9 , wherein said additional electrical stimulus is a stimulus in the form of at least one electrical pulse applied synchronously with passing of said electrical current. 
     
     
         12 . The method of  claim 1 , further comprising:
 applying a first additional electrical stimulus to the motor cortex of said vertebrate being during passing of said electrical current; and   applying a second additional electrical stimulus to at least one muscle of said vertebrate being during passing of said electrical current.   
     
     
         13 . The method of  claim 12 , wherein said first additional electrical stimulus is a local stimulus in the form of at least one first electrical pulse, and said second additional electrical stimulus is a stimulus in the form of at least one second electrical pulse. 
     
     
         14 . The method of  claim 13 , wherein said at least one first electrical pulse and said at least one second electrical pulse are applied synchronously with said passing of said electrical current. 
     
     
         15 . (canceled) 
     
     
         16 . The method of  claim 1 , wherein said electrical current is passed as a plurality of pulses, wherein each of said plurality of pulses has a duration from 0.5 ms to 5 ms. 
     
     
         17 . The method of  claim 1 , wherein said electrical current is passed a plurality of pulses having a frequency from 0.5 Hz to 5 Hz. 
     
     
         18 . The method of  claim 1 , further comprising providing a prompt to move a limb to said vertebrate being during, or immediately before, said passing of said electrical current; wherein said prompt is provided by an automated control unit configured to generate said prompt in synchronization with said passing of said electrical current; and wherein said vertebrate being is a human, and said second point is located in a human limb. 
     
     
         19 - 23 . (canceled) 
     
     
         24 . The method of  claim 1 , wherein said vertebrate being is a human with at least one condition selected from an injury suffered at a location in the spinal column, cerebral palsy, amyotrophic lateral sclerosis, traumatic brain injury, stroke, peripheral palsy, Erb's palsy, sciatica, and other peripheral nerve injuries due to nerve compression, tension, or torsion, and wherein said enhancing of said neural connection alleviates or reduces said at least one condition. 
     
     
         25 - 33 . (canceled) 
     
     
         34 . The method of  claim 1 , wherein each of said at least one active electrode and said at least one reference electrode is attached to said motor cortex or a muscle topically, underneath a skin, or by surgical implantation. 
     
     
         35 . The method of  claim 1 , further comprising identifying a motoneuron that affects movement of a muscle of said vertebrate being in said spinal column, wherein said muscle is subsequently attached to one of said at least one active electrode or said at least one reference electrode. 
     
     
         36 . The method of  claim 34 , further comprising:
 determining a maximal stimulus strength for said motoneuron at which no further increase in muscle contraction of said muscle is observed with an increase in strength of electrical stimulation to said motoneuron; and   setting a voltage differential between at least one active electrode and said at least one electrode during said passing of said current in proportion to said determined maximal stimulus strength.   
     
     
         37 - 42 . (canceled) 
     
     
         43 . A system for improving a neuromuscular condition of a vertebrate being, said system comprising:
 at least one active electrode, each sized and configured to be placed at, or in proximity to, a first point located at the central nerve system of a vertebrate being;   at least one reference electrode, each sized and configured to be placed at, or in proximity to, a second point that is located outside the central nervous system of said vertebrate being; a stimulator unit configured to generate electrical stimulation waveforms; and at least one first lead wire that couples said stimulator unit to said at least one active electrode and at least one second lead wire that couples said stimulator unit to said at least one reference electrode, wherein said system is configured to form a current path through a motor pathway across said spinal column between said first point and said second point.   
     
     
         44 - 53 . (canceled) 
     
     
         54 . A system for improving a neuromuscular condition of a vertebrate being, said system comprising:
 at least one active electrode, each sized and configured to be placed on, or in proximity to, a first point that is selected from the motor cortex and a muscle and is associated with a first part of a spinal column of a vertebrate being;   at least one reference electrode, each sized and configured to be placed on, or in proximity to, a second point that is selected from said motor cortex and a muscle and is associated with a second part of said spinal column;   a stimulator unit configured to generate electrical stimulation waveforms; and at least one first lead wire that couples said stimulator unit to said at least one active electrode and at least one second lead wire that couples said stimulator unit to said at least one reference electrode, wherein said system is configured to form a current path through a motor pathway across said spinal column between said first point and said second point.   
     
     
         55 . The system of  claim 54 , wherein one of said at least one active electrode and said at least one reference electrode is sized and configured to be placed on, or in proximity to, said motor cortex. 
     
     
         56 . The system of  claim 55 , wherein said one of said at least one active electrode and said at least one reference electrode is sized and configured to be placed on, or in proximity to, the motor cortex of a mammal having limbs. 
     
     
         57 . The system of  claim 55 , wherein said one of said at least one active electrode and said at least one reference electrode is sized and configured to be placed on, or in proximity to, the motor cortex of a human. 
     
     
         58 . The system of  claim 54 , wherein all of said at least one active electrode and said at least one reference electrode are sized and configured to be placed on, or in proximity to, a muscle of said vertebrate being. 
     
     
         59 . The system of  claim 58 , wherein all of said at least one active electrode and said at least one reference electrode are sized and configured to be placed on, or in proximity to, a muscle in a limb of a mammal having limbs. 
     
     
         60 . The system of  claim 58 , wherein said one of said at least one active electrode and said at least one reference electrode is sized and configured to be placed on, or in proximity to, a human limb. 
     
     
         61 . The system of  claim 54 , wherein said at least one active electrode is a single active electrode, and said at least one reference electrode is a single reference electrode. 
     
     
         62 . The system of  claim 54 , wherein said at least one active electrode is a plurality of active electrodes or said at least one reference electrode is a plurality of reference electrodes. 
     
     
         63 . The system of  claim 54 , wherein each of said at least one active electrode and said at least one reference electrode is configured for attachment to the motor cortex or a muscle of said vertebrate being topically, underneath a skin, or by surgical implantation. 
     
     
         64 . The system of  claim 54 , further comprising at least one probe for identifying a motoneuron that affects movement of a muscle of said vertebrate being and located in said spinal column by applying electrical voltage thereto. 
     
     
         65 . The system of  claim 54 , further comprising prompt means for providing a prompt to move a limb to said vertebrate being during, or immediately before, said passing of said electrical current.