Modulation of the brain to affect psychiatric disorders

• US 20030181954A1
• Filed: 12/24/2002
• Published: 09/25/2003
• Est. Priority Date: 12/24/2001
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Rezai, Ali R.
• Granted Patent: US 7,623,927 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A method for treating neurological conditions by proper placement of a probe and sensing, stimulating or both, in pre-determined areas of the brain, especially the intralaminar nuclei (ILN”). Moreover, stimulation is controlled and offered when certain conditions within the area of interest are detected. Stimulation and sensing include biological, electrical, chemical or combinations thereof.

Claims

1. A method of treating a disorder associated with a specific area in a brain comprising:

implanting a device in contact with an intralaminar nuclei of the brain;

sensing activity in the specific area of the brain wherein the sensing activity occurs at a location distal from the device location; and

operating the device to modulate the intralaminar nuclei in response to said activity to thereby affect the disorder associated with the specific area of the brain.

2. The method of claim 1, wherein the stimulation is electrical.

3. The method of claim 2, wherein the device is an electrode assembly.

4. The method of claim 1, wherein the activity being sensed is electrical activity.

5. The method of claim 1, wherein the stimulation is chemical.

6. The method of claim 5, wherein the device is a sustained-release matrix.

7. The method of claim 5, wherein the activity being sensed is chemical activity.

8. The method of claim 1, wherein the specific area of the brain is different than the intralaminar nuclei.

9. The method of claim 1, wherein said specific area is selected from the group consisting of the pre-frontal cortex, orbitofrontal cortex, anterior limb of the internal capsule, Nucleus Accumbens, inferior, middle, superior frontal gyrus, medial frontal gyrus, ventral striatum, the ventral Pallidum anterior nucleus of the thalamus, dorsomedial nucleus of the thalamus, intralaminar thalamic nuclei, the cingulate cortex, Amygdala, Hippocampus, Parahippocampal Gyrus, Pre-Cuneus Gyrus, Anterior Medial Pallidum, Mamillary bodies, the lateral hypothlamus the Locus Ceruleus, the Dorsal Raphe Nucleus, ventral tegmentum, the Substantia Nigra Pars Compacta and reticulata, the dorsal surface of the Cerebellar Hemisphere and anterior lateral surface of Cerebellar Hemispheres.

10. The method of claim 1, wherein said specific area is selected from the group consisting of the Ventral Striatum, the Ventral Pallidum, the Anterior Medial &

Ventral Pallidum, Hippocampus, ParaHippocampal Gyrus, Pre-Cuneus Gyrus, the Lateral Hypothlamus, Ventral Tegmentum, the Dorsal Surface of the Cerebellar Hemisphere, and Anterior Lateral Surface of Cerebellar Hemispheres.

11. The method of claim 1, wherein said specific area is selected from the group consisting of the Ventral Pallidum and the Anterior Medial &

Ventral Pallidum.

12. The method of claim 1, wherein said psychiatric disorders is selected from the group consisting of OCD, depression, anxiety disorders, schizophrenia, particularly OCD.

13. The method of claim 1, wherein said psychiatric disorders is selected from the group consisting of autism, dyslexia, obsessive compulsive disorder, generalized anxiety disorder, post traumatic stress disorder, panic attacks, social phobia, major depression, bipolar disorder, schizophrenia, and substance abuse disorders/addictions.

14. The method of claim 1, wherein said step of sensing occurs epidurally, subdurally, or on the scalp.

15. The method of claim 1, wherein said step of sensing occurs at the local milieu of the electrode and/or microinfusion cannula.

32. The method of claim 1, wherein said specific area is selected from the group consisting of the Ventral Pallidum and the Anterior Medial &

Ventral Pallidum.

33. The method of claim 1, wherein the psychiatric disorders is selected from the group consisting of OCD, depression, anxiety disorders, schizophrenia, particularly OCD.

16. A method of affecting a psychiatric activity in a specific area in a brain comprising:

placing an electrode in contact with an intralaminar nuclei of the brain; and

operating the device to provide stimulation to the intralaminar nuclei to thereby affect the specific area of the brain.

17. The method of claim 16, wherein the stimulation is electrical.

18. The method of claim 17, wherein the device is an electrode assembly.

19. The method of claim 16, wherein the activity being sensed is electrical activity.

20. The method of claim 16, wherein the stimulation is chemical.

21. The method of claim 20, wherein the device is a sustained-release matrix.

22. The method of claim 21, wherein the activity being sensed is chemical activity.

23. The method of claim 16, wherein the specific area of the brain is different than the intralaminar nuclei.

24. The method of claim 16, wherein said specific area is selected from the group consisting of the pre-frontal cortex, orbitofrontal cortex, anterior limb of the internal capsule, Nucleus Accumbens, inferior, middle, superior frontal gyrus, medial frontal gyrus, ventral striatum, the ventral Pallidum anterior nucleus of the thalamus, dorsomedial nucleus of the thalamus, intralaminar thalamic nuclei, the cingulate cortex, Amygdala, Hippocampus, Parahippocampal Gyrus, Pre-Cuneus Gyrus, Anterior Medial Pallidum, Mamillary bodies, the lateral hypothlamus the Locus Ceruleus, the Dorsal Raphe Nucleus, ventral tegmentum, the Substantia Nigra Pars Compacta and reticulata, the dorsal surface of the Cerebellar Hemisphere and anterior lateral surface of Cerebellar Hemispheres.

25. A method of effecting psychiatric activity in a patient comprising:

identifying a portion of the patient'"'"'s ILN which is in communication with a predetermined region of the patient'"'"'s brain, said predetermined region of said patient'"'"'s brain being associated with the psychiatric activity; and

modulating the portion of the patient'"'"'s ILN to effectuate the psychiatric activity.

26. The method of claim 25, wherein the identification of a portion of the patient'"'"'s ILN is based upon a composite of other patient'"'"'s ILN activity.

27. The method of claim 25, wherein the identifying step is independent of an exhibition of a pathologic condition in the predetermined region of said patient'"'"'s brain.

28. The method of claim 25, wherein the psychiatric activity is selected from the group consisting of happiness, fear, anger, anxiety, euphoria, and sadness.

29. The method of claim 25, wherein the modulation of the portion of the patient'"'"'s ELN is accomplished using chemical stimulation.

30. The method of claim 25, wherein the modulation of the portion of the patient'"'"'s ILN is accomplished using electrical stimulation.

31. A method of treating a psychiatric disorder associated with a specific area in a brain comprising:

placing a device in communication with a region of the brain associated with the psychiatric disorder; and

operating the device to modulate a specific area of the brain associated with the psychiatric disorder, wherein the specific area is selected from the group consisting of the Ventral Striatum, the Ventral Pallidum, the Anterior Medial &

Ventral Pallidum, Hippocampus, ParaHippocampal Gyrus, Pre-Cuneus Gyrus, the Lateral Hypothlamus, Ventral Tegmentum, the Dorsal Surface of the Cerebellar Hemisphere, and Anterior Lateral Surface of Cerebellar Hemispheres.