System and method of treating stuttering by neuromodulation

• US 20030082507A1
• Filed: 10/31/2001
• Published: 05/01/2003
• Est. Priority Date: 10/31/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Stypulkowski, Paul H.
• Granted Patent: US 6,944,497 B2
• Time in Patent Office: Days
• US Class Current: 434/262
• CPC Class Codes: A61F 5/58 Apparatus for correcting stammering or stuttering
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02

Abstract

Stuttering-treatment techniques using neural stimulation and/or drug delivery. One or more electrodes and/or a catheter are implanted adjacent to sites in the brain. A signal generator and the electrode deliver stimulation to a first site. A pump and the catheter deliver one or more therapeutic drugs to a second site. The first and second sites could be: the supplementary motor area, the centromedian circuit, the dorsomedial nuclei, the lateral prefrontal circuit, or other paramedian thalamic and midbrain nuclei. The stuttering treatment could be performed via periodic transcranial magnetic stimulation. A sensor, located near the patient'"'"'s vocal folds, can be used for generating a signal responsive to activity of the patient'"'"'s speech-producing muscles. A controller adjusts one or more stimulation parameters in response to the signal from the sensor.

Claims

1. A method of therapeutically treating stuttering via an implantable pump and a catheter having a proximal end coupled to an implantable pump and a discharge portion for infusing therapeutic dosages of at least one drug, as well as a signal generator and at least one implantable electrode having a proximal end and a stimulation portion, the method comprising:

implanting the at least one electrode adjacent to a first predetermined site in the brain;

implanting the catheter so that the discharge portion lies adjacent to a second predetermined site in the brain;

coupling the proximal end of the implanted electrode to the signal generator;

coupling the catheter to the pump; and

operating the signal generator and the pump to stimulate or inhibit neurons of the first and second predetermined sites in the brain by delivering electrical stimulation to the first predetermined site and by delivering at least one drug to the second predetermined site.

2. The method of claim 1, wherein the first predetermined site is selected from the group consisting of the supplementary motor area, the perisylvian speech-language cortex, the centromedian circuit, the dorsomedial nuclei, the lateral prefrontal circuit, the mesothalamic reticular formation, the basal ganglia, and other paramedian thalamic and midbrain nuclei and fiber tracts including, the red nucleus, the habenulointerpeduncular tract, the prerubral area, the zona incerta, the thalamic primary sensory relay nuclei, the ventrooral nucleus, the ventrolateral nucleus, the parafasicular nucleus, and the intralaminar nucleus.

3. The method of claim 1, wherein the second predetermined site is selected from the group consisting of the supplementary motor area, the perisylvian speech-language cortex, the centromedian circuit, the dorsomedial nuclei, the lateral prefrontal circuit, the mesothalamic reticular formation, the basal ganglia, and other paramedian thalamic and midbrain nuclei and fiber tracts including, the red nucleus, the habenulointerpeduncular tract, the prerubral area, the zona incerta, the thalamic primary sensory relay nuclei, the ventrooral nucleus, the ventrolateral nucleus, the parafasicular nucleus, and the intralaminar nucleus.

4. A method of therapeutically treating stuttering via a signal generator and at least one implantable electrode having a proximal end and a stimulation portion, the method comprising:

implanting at least one electrode adjacent to at least one predetermined site in the brain;

coupling the proximal end of the implanted electrode to the signal generator;

operating the signal generator to stimulate or inhibit neurons of the at least one predetermined site in the brain via electrical stimulation.

5. A method of therapeutically treating stuttering via transcranial magnetic stimulation, the method comprising:

periodically stimulating, for a predetermined duration, a first predetermined site of a patient'"'"'s brain using transcranial magnetic stimulation, wherein the first predetermined site is selected from the group consisting of;

the supplementary motor area, the perisylvian speech-language cortex, the centromedian circuit, the dorsomedial nuclei, the lateral prefrontal circuit, the mesothalamic reticular formation, the basal ganglia, and other paramedian thalamic and midbrain nuclei and fiber tracts including, the red nucleus, the habenulointerpeduncular tract, the prerubral area, the zona incerta, the thalamic primary sensory relay nuclei, the ventrooral nucleus, the ventrolateral nucleus, the parafasicular nucleus, and the intralaminar nucleus.

6. The method of claim 5, wherein the predetermined duration of transcranial magnetic stimulation is approximately 30 minutes.

7. The method of claim 6, wherein the transcranial magnetic stimulation is periodically performed approximately once per week.

8. A method of therapeutically treating stuttering via an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of a least one drug, the method comprising:

implanting the catheter so that the discharge portion lies adjacent to a predetermined site in the brain; and

operating the pump to discharge at least one drug capable of stimulating neurons in to the predetermined site in the brain by delivering at least one drug.

9. A system for therapeutically treating stuttering in a patient comprising:

a signal generator;

at least one implantable lead, coupled to the signal generator, for delivering electrical stimulation to at least one predetermined site of the patient'"'"'s brain;

a sensor, located near the patient'"'"'s vocal folds, for generating a signal responsive to activity of the patient'"'"'s speech-producing muscles;

a controller that adjusts at least one stimulation parameter in response to the signal from the sensor.

10. The system of claim 9, wherein the controller detects when the patient starts speaking and starts the electrical stimulation in response to that patient having started to speak.

11. The system of claim 10, wherein the controller stops the electrical stimulation a predetermined amount of time after the patient has started to speak.

12. The system of claim 9, wherein the sensor is an electromyographic sensor.

13. The system of claim 9, wherein the sensor is an electroglottographic sensor.

14. The system of claim 9, wherein the sensor is a microphone.

15. The system of claim 9, wherein the microphone is human-implantable.

16. The system of claim 9, wherein the controller uses a speech-recognition algorithm for detecting stuttering based on the signal from the sensor.

17. A system for therapeutically treating stuttering in a patient comprising:

a pump;

at least one catheter having a proximal end coupled to the pump and a discharge end adjacent to a predetermined site in the brain;

a sensor for generating a signal responsive to activity of the patient'"'"'s speech-producing muscles; and

a controller that regulates a drug dosage in response to the signal from the sensor to reduce activity, corresponding to stuttering, of the patient'"'"'s speech-producing muscles.

18. A system for therapeutically treating stuttering in a patient, the system comprising:

a signal generator;

at least one implantable lead, coupled to the signal generator, wherein the lead delivers electrical stimulation to at least one predetermined site in the patient'"'"'s brain;

a sensor that generates a signal responsive to EEG activity in the patient'"'"'s brain; and

a controller that adjusts at least one stimulation parameter in response to the signal from the sensor.

19. A system for therapeutically treating stuttering in a patient comprising:

a pump;

at least one catheter having a proximal end coupled to the pump and a discharge end adjacent to a predetermined site in the brain;

a sensor that generates a signal responsive to EEG activity in the patient'"'"'s brain; and

a controller that regulates a drug dosage in response to the signal from the sensor to reduce activity, corresponding to stuttering, of the patient'"'"'s speech-producing muscles.