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 device for treating disease, comprising:
 (A) an implantable pulse generator, comprising a processor configured to generate a signal which modulates the spinal neurons to induce weight loss;   (B) a conducting member attached to said implantable pulse generator; and   (C) a modulator, wherein said modulator comprises a spinal neuromodulatory interface connected to said implantable pulse generator via said conducting member and which delivers reversible modulation to neurons of the sympathetic nervous system.   
   
   
       2 . The device for treating disease as in  claim 1  wherein said modulator is in communication with intermediolateral neurons. 
   
   
       3 . The device for treating disease as in  claim 1  wherein said modulator is in communication with the intermediolateral nucleus. 
   
   
       4 . The device for treating disease as in  claim 1  wherein said modulator is in communication with thoracic spinal neurons. 
   
   
       5 . The device for treating disease as in  claim 1  wherein said modulator is in communication with the abdominal spinal neurons. 
   
   
       6 . The device for treating disease as in  claim 1  wherein said modulator is configured to modulate neural activity for the treatment of obesity. 
   
   
       7 . The device for treating disease as in  claim 1  wherein said modulator is configured to modulate neural activity for the control of metabolism. 
   
   
       8 . The device for treating disease as in  claim 1  wherein said modulator is configured to modulate neural activity for the control of body weight. 
   
   
       9 . The device for treating disease as in  claim 1  wherein said modulator delivers electrical energy. 
   
   
       10 . The device for treating disease as in  claim 1  wherein said modulator comprises an anterior central spinal neuromodulatory interface. 
   
   
       11 . The device for treating disease as in  claim 1  wherein said modulator comprises at least one of an anterior right lateral spinal neuromodulatory interface and an anterior left lateral spinal neuromodulatory interface. 
   
   
       12 . The device for treating disease as in  claim 1  wherein said modulator comprises a posterior central spinal neuromodulatory interface. 
   
   
       13 . The device for treating disease as in  claim 1  wherein said modulator comprises at least one of a posterior right lateral spinal neuromodulatory interface and a posterior left lateral spinal neuromodulatory interface. 
   
   
       14 . The device for treating disease as in  claim 1  wherein said modulator comprises at least one of a right lateral spinal neuromodulatory interface and a left lateral spinal neuromodulatory interface. 
   
   
       15 . The device for treating disease as in  claim 1  wherein said modulator is configured to deliver energy to afferent neurons. 
   
   
       16 . The device for treating disease as in  claim 1  wherein said modulator is configured to deliver energy to efferent neurons. 
   
   
       17 . The device for treating disease as in  claim 1  wherein said modulator is configured to deliver energy to somatosensory neurons. 
   
   
       18 . A device for treating a condition in a user, comprising:
 (A) a pulse generator, comprising a processor configured to generate a signal which modulates the spinal cord to induce weight loss;   (B) a signal transmitting member, configured to transmit said signal from said pulse generator to a modulator; and   (C) the modulator, wherein said modulator delivers at least one modality of energy to at least a component of the user's sympathetic nervous system.   
   
   
       19 . The device as in claim  125 , wherein said modulator delivers electrical energy. 
   
   
       20 . A device for treating disease, comprising:
 (A) an implantable pulse generator, comprising a processor configured to generate at least one signal which modulates spinal neurons to induce weight loss;   (B) a conducting member attached to said implantable pulse generator; and   (C) a modulator, wherein said modulator comprises at least one spinal neuromodulatory interface connected to said implantable pulse generator via said conducting member and which delivers reversible multimodal modulation.