Methods and apparatus for neuromodulation and physiologic modulation for the treatment of obesity and metabolic and neuropsychiatric disease

Abstract

The present invention teaches a method and apparatus for physiological modulation, including neural and gastrointestinal modulation, for the purposes of treating several disorders, including obesity, depression, epilepsy, and diabetes. This includes chronically implanted neural and neuromuscular modulators, used to modulate the afferent neurons of the sympathetic nervous system to induce satiety as well as to modulate the efferent neurons of the sympathetic nervous system to modulate metabolism, including metabolic rate. Furthermore, this includes neuromuscular stimulation of the stomach to effect baseline and intermittent smooth muscle contraction to increase gastric intraluminal pressure, which induces satiety, and stimulate sympathetic afferent fibers, including those in the sympathetic trunk, splanchnic nerves, and greater curvature of the stomach, to augment the perception of satiety.

1 . A method for reducing body weight in a user comprising modulating spinal cord neurons. 
   
   
       2 . The method of  1 , wherein said reducing body weight is for the treatment of obesity. 
   
   
       3 . The method of  1 , wherein modulating said spinal cord neurons comprises modulating sympathetic efferent neurons. 
   
   
       3 . The method of  1 , wherein spinal cord neurons comprise sympathetic afferent neurons. 
   
   
       4 . The method of  1 , wherein modulating said spinal cord neurons comprises modulating neurons which are project to the locus ceruleus. 
   
   
       5 . The method of  1 , wherein modulating said spinal cord neurons comprises modulating intermediolateral nucleus neurons. 
   
   
       6 . The method of  1 , wherein modulating said spinal cord neurons comprises modulating sympathetic trunk neurons. 
   
   
       7 . The method of  1 , wherein modulating said spinal cord neurons comprises modulating splanchnic nerve neurons. 
   
   
       8 . The method of  1 , wherein spinal cord neurons further modulate activity of the locus ceruleus. 
   
   
       9 . The method of  1 , wherein spinal cord neurons further modulate activity of the hypothalamus. 
   
   
       10 . The method of  1 , wherein modulating spinal cord neurons comprises selective modulation of sympathetic afferent neurons. 
   
   
       11 . The method of  1 , wherein modulating spinal cord neurons comprises selective modulation of sympathetic efferent neurons. 
   
   
       12 . The method of  1 , further comprising modulating multiple modalities. 
   
   
       13 . The method of  12  comprising modulating spinal cord afferent neurons and modulating spinal cord efferent neurons. 
   
   
       14 . A method for modulating the spinal cord to treat a user comprising:
 A. applying an electrical signal to the spinal cord; and   B. selecting stimulation parameters which cause weight reduction.   
   
   
       15 . The method as in  claim 14  wherein said selecting stimulation parameters comprises selecting stimulation parameters which cause appetite reduction. 
   
   
       16 . The method as in  claim 14  wherein said selecting stimulation parameters comprises selecting stimulation parameters which induce satiety. 
   
   
       17 . The method as in  claim 14  wherein said selecting stimulation parameters comprises selecting stimulation parameters which cause increase in metabolism. 
   
   
       18 . A method for modulating the spinal cord to treat a user comprising:
 A. selecting a user in whom body weight is to be reduced; and   B. applying an electrical signal to the spinal cord.   
   
   
       19 . The method of  claim 18  wherein said body weight is above a desired weight. 
   
   
       20 . The method of  claim 18  wherein said user has a body weight which is in the obese range.