Methods and apparatus for effectuating a lasting change in a neural-function of a patient
First Claim
1. A method of effectuating a neural-function of a patient associated with a first location of the brain of the patient, comprising:
- identifying a stimulation site by generating remotely from the first location an intended neural activity and determining a region of the brain where the generated neural activity is present;
positioning at least a first electrode at the stimulation site; and
applying an electrical potential to pass a current through the first electrode.
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Accused Products
Abstract
The following disclosure describes several methods and apparatus for intracranial electrical stimulation to treat or otherwise effectuate a change in neural-functions of a patient. Several embodiments of methods in accordance with the invention are directed toward enhancing or otherwise inducing a lasting change in neural activity to effectuate a particular neural-function. Such lasting change in neural activity is defined as “neuroplasticity.” The methods in accordance with the invention can be used to treat brain damage (e.g., stroke, trauma, etc.), brain disease (e.g., Alzheimer'"'"'s, Pick'"'"'s, Parkinson'"'"'s, etc.), and/or brain disorders (e.g., epilepsy, depression, etc.). The methods in accordance with the invention can also be used to enhance neural-function of normal, healthy brains (e.g., learning, memory, etc.), or to control sensory functions (e.g., pain). Certain embodiments of methods in accordance with the invention electrically stimulate the brain at a stimulation site where neuroplasticity is occurring. The stimulation site may be different than the region in the brain where neural activity is typically present to perform the particular neural function according to the functional organization of the brain. In one embodiment in which neuroplasticity related to the neural-function occurs in the brain, the method can include identifying the location where such neuroplasticity is present. In an alternative embodiment in which neuroplasticity is not occurring in the brain, an alternative aspect is to induce neuroplasticity at a stimulation site where it is expected to occur. Several embodiments of these methods that are expected to produce a lasting effect on the intended neural activity at the stimulation site use electrical pulses that increase the resting membrane potential of neurons at the stimulation site to a subthreshold level.
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Citations
123 Claims
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1. A method of effectuating a neural-function of a patient associated with a first location of the brain of the patient, comprising:
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identifying a stimulation site by generating remotely from the first location an intended neural activity and determining a region of the brain where the generated neural activity is present;
positioning at least a first electrode at the stimulation site; and
applying an electrical potential to pass a current through the first electrode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A method of effectuating a neural-function of a brain of a patient associated with a first location in the brain, comprising:
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identifying a stimulation site in and/or on the brain where neural activity has changed in response to a change in the neural-function in the first location of the brain;
positioning a first electrode at the stimulation site;
positioning a second electrode at the stimulation site; and
applying an electrical potential between the first and second electrodes. - View Dependent Claims (29, 30, 31, 32, 33, 35, 37, 39, 40, 41, 42)
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34. The method of clam 33 wherein detecting the neural activity comprises taking functional MRI images of the brain and monitoring neural activity at the second location.
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36. The method of clam 35 wherein detecting a change in the neural activity comprises taking functional MRI images of the brain while the patient learns the task.
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38. The method of clam 37 wherein detecting a change in the neural activity comprises taking functional MRI images of the brain while the patient learns the task.
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43. A method of treating a loss of a neural-function at a first cortical location of a brain of a patient, comprising:
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selecting a stimulation site at a cortical region of the brain where neural activity is expected to occur to compensate for the loss of neural-function at the first cortical location of the brain;
positioning a first electrode at a first area of the stimulation site proximate to the pia mater in the cortical region;
positioning a second electrode at a second area of the stimulation site proximate to the pia mater in the cortical region; and
applying an electrical potential between the first and second electrodes. - View Dependent Claims (44, 45, 46)
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47. A method of treating a neural-function in a brain of a patient using an apparatus having a support member, a pulse system carried by the support member, and an electrode assembly including first and second electrodes at an interior surface of the support member, comprising:
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implanting the support member in the patient proximate to a skull of the patient to position the pulse system proximate to the skull and to position the first and second electrodes proximate to a stimulation site on and/or in the brain of the patient; and
controlling the pulse system to apply an electrical potential between the first and second electrodes at the stimulation site.
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48. A method of treating a neural-function in a brain of a patient using an apparatus having a support member, a pulse system carried by the support member, and an electrode assembly including first and second electrodes at an interior surface of the support member, comprising:
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implanting the support member proximate to a skull of the patient to position the first and second electrodes at least proximate to the pia mater of the brain of the patient at a first cortical location;
mechanically biasing the support member and/or the first and second electrodes to resiliently press the first and second electrodes against one of the dura mater or the pia mater of the brain of the patient at the first cortical region; and
controlling a pulse generator coupled to the first and second electrodes to apply an electrical potential between the first and second electrodes in the first cortical region of the brain.
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49. A method of treating a neural-function in a brain of a patient, comprising:
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selecting a stimulation site in a first cortical region of the brain;
determining an electrical stimulation threshold for inducing a response in cells at the stimulation site; and
applying an electrical stimulation at an intensity lower than the stimulation threshold between first and second electrodes proximate to the pia mater of the first cortical region of the brain. - View Dependent Claims (50, 51, 52, 53, 54, 56, 58, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70)
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55. The method of clam 54 wherein detecting the neural activity comprises taking functional MRI images of the brain and monitoring neural activity at the second location.
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57. The method of clam 56 wherein detecting a change in the neural activity comprises taking functional MRI images of the brain while the patient learns the task.
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59. The method of clam 58 wherein detecting a change in the neural activity comprises taking functional MRI images of the brain while the patient learns the task.
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71. An apparatus for applying electrical stimulation to a region of a brain of a patient, comprising:
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an implantable support member configured to be implanted into the patient at least partially within the skull of the patient;
a pulse system carried by the support member;
a first electrode carried by the support member, the first electrode being coupled to the pulse system; and
a second electrode carried by the support member, the second electrode being spaced apart from the first electrode, and the second electrode being coupled to the pulse system. - View Dependent Claims (72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94)
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95. An apparatus for applying electrical stimulation to a region of a brain of a patient, comprising:
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an implantable support member configured to be implanted into the patient proximate to a skull of the patient, the support member including an attachment element to fix the support member to the skull;
a pulse system carried by the support member;
a first electrode at a first region of the support member, the first electrode being coupled to the pulse system; and
a second electrode at a second region of the support member spaced apart from the first electrode, the second electrode being coupled to the pulse system. - View Dependent Claims (96, 97, 98, 99, 100, 101)
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102. An apparatus for applying electrical stimulation to a region of a brain of a patient, comprising:
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an implantable support member configured to be implanted into the patient proximate to a skull of the patient;
a pulse system carried by the support member;
a first electrode at a first region of the support member, the first electrode being coupled directly to the pulse system within the support member; and
a second electrode at a second region of the support member spaced apart from the first electrode, the second electrode being coupled directly to the pulse system within the support member. - View Dependent Claims (103, 104, 105, 106, 107, 108)
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109. An apparatus for applying electrical stimulation to a cortical region of a brain of a patient, comprising:
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an implantable support member configured to be implanted into the patient proximate to a skull of the patient;
a mechanical biasing element carried by the support member, the mechanical biasing element being elastically deformable; and
a first electrode and a second electrode, wherein the biasing element is configured to press the first and second electrodes against the brain of the patient. - View Dependent Claims (110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120)
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121. An apparatus for applying electrical stimulation to a cortical region of a brain of a patient, comprising:
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an implantable support member configured to be implanted into the patient proximate to a skull of the patient;
a pulse system within the support member;
a biasing element carried by the support member; and
an electrode attached to the biasing element and electrically coupled to the pulse system. - View Dependent Claims (122, 123)
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Specification