Neurostimulation for affecting sleep disorders

• US 20050177192A1
• Filed: 01/31/2003
• Published: 08/11/2005
• Est. Priority Date: 02/01/2002
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Gonzalez-Martinez, Jorge Alvaro, Rezai, Ali, Sharan, Ashwini
• Granted Patent: US 8,612,005 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A method of affecting a sleep disorder in a subject having the sleep disorder and a method of affecting a normal awakeness-sleep cycle in a subject having an abnormal awakeness-sleep cycle, said methods comprising: a) identifying at least one nucleus in a brain of the subject, said nucleus being a nucleus of the sleep circuitry of the brain; and b) stimulating the at least one identified nucleus so as to modulate the nucleus, thereby affecting the sleep disorder.

Claims

1. A method of affecting a sleep disorder in a subject having the sleep disorder said method comprising:

a) identifying at least one nucleus in a brain of the subject, said nucleus being a nucleus of the sleep circuitry of the brain; and

b) stimulating the at least one identified nucleus so as to modulate the nucleus, thereby affecting the sleep disorder.

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

3. The method of claim 2, wherein the electrical stimulation is performed by an electrode system.

4. The method of claim 3, further comprising:

synchronizing the electrode system with an externally programmable internal synchronizable clock to activate the system at at least one time point.

5. The method of claim 4, wherein the electrode is implanted within the brain proximate to the identified nucleus.

6. The method of claim 1, wherein the stimulating is effected by chemical stimulation.

7. The method of claim 6, wherein the chemical stimulation is performed by a pump or slow release matrix.

8. The method of claim 7, wherein the pump or slow release matrix is subcutaneously implanted in the skull of the subject wherein the chemical is infused proximate to the identified nucleus.

9. The method of claim 8, wherein the chemical is a neurotransmitter, a neurotransmitter mimic, an agent for affecting a sleep disorder or mixtures thereof.

10. The method of claim 1, wherein the stimulating is effected by electrical stimulation and chemical stimulation.

11. The method of claim 1, further comprising:

i) monitoring sleep rhythms of the brain by at least one sensor; and

ii) providing a closed-loop feedback from the at least one sensor wherein the stimulation of the at least one nucleus is regulated.

12. The method of claim 11, wherein the at least one sensor is proximate to the cortex or subcortex of the brain.

13. The method of claim 11, further comprising at least one sensor which is an internal or exterior vital sign sensor.

14. The method of claim 13, wherein the vital sign is heart rate, respiration, rapid eye movement (REM), body tone, brain activity, or combinations thereof.

15. The method of claim 14, wherein the at least one sensor detects approach of REM and the feedback loop inhibits the identified nucleus.

16. The method of claim 14, wherein the at least one sensor detects approach of REM and the feedback loop inhibits the identified nucleus.

17. The method of claim 1, wherein the identified at least one nucleus is the Locus Coeruleus.

18. The method of claim 1, wherein the identified at least one nucleus is the Dorsal Raphe Nucleus.

19. The method of claim 1, wherein the identified at least one nucleus is the posterior hypothalamus.

20. The method of claim 1, wherein the identified at least one nucleus is the Nucleus Reticularis pontis oralis.

21. The method of claim 1, wherein the identified at least one nucleus is the Nucleus Reticularis pontis caudalis.

22. The method of claim 1, wherein the identified at least one nucleus is the basal forebrain.

23. The method of claim 1, wherein the identified at least one nucleus is a Supra-Chiasmatic Nucleus of the hypothalamus.

24. The method of claim 1, wherein the sleep disorder is narcolepsy.

25. The method of claim 22, wherein the narcolepsy is manifested by the symptoms of at least one of sleep attacks, sleep paralysis, cataplexy, or hypnagogic hallucinations.

26. The method of claim 1, wherein the sleep disorder is insomnia.

27. The method of claim 1, wherein the sleep disorder is sleep apnea.

28. The method of claim 1, wherein the sleep disorder is hypersomnia.

29. The method of claim 1, wherein the sleep disorder is jet lag phenomenon.

30. A method of affecting a normal awakeness-sleep cycle in a subject having an abnormal awakeness-sleep cycle said method comprising:

a) identifying at least one nucleus in a brain of the subject, said nucleus being a nucleus of the sleep circuitry of the brain; and

b) stimulating the identified at least one nucleus so as to modulate the nucleus, thereby re-establishing the normal awakeness-sleep cycle in the subject.

31. The method of claim 30, wherein the stimulating is effected by electrical stimulation.

32. The method of claim 31, wherein the electrical stimulation is performed by an electrode system.

33. The method of claim 32, further comprising:

synchronizing the electrode system with an externally programmable internal synchronizable clock to activate the system at at least one time point.

34. The method of claim 33, wherein the electrode is implanted within the brain proximate to the identified nucleus.

35. The method of claim 30, wherein the stimulating is effected by chemical stimulation.

36. The method of claim 35, wherein the chemical stimulation is performed by a pump or slow release matrix.

37. The method of claim 36, wherein the pump or slow release matrix is subcutaneously implanted in the skull of the subject wherein the chemical is infused proximate to the identified nucleus.

38. The method of claim 37, wherein the chemical is a neurotransmitter, a neurotransmitter mimic, or an agent for affecting a sleep disorder or mixtures thereof.

39. The method of claim 30, wherein the stimulating is effected by electrical stimulation and chemical stimulation.

40. The method of claim 30, further comprising:

i) monitoring sleep rhythms of the brain by at least one sensor; and

ii) providing a closed-loop feedback from the at least one sensor wherein the stimulation of the at least one nucleus is regulated.

41. The method of claim 40, wherein the at least one sensor is proximate to the cortex or subcortex of the brain.

42. The method of claim 40, further comprising at least one sensor which is an internal or exterior vital sign sensor.

43. The method of claim 42, wherein the vital sign is heart rate, respiration, rapid eye movement (REM), body tone, brain activity, or combinations thereof.

44. The method of claim 42, wherein the at least one sensor detects approach of REM and the feedback loop inhibits the identified nucleus.

45. The method of claim 42, wherein the at least one sensor detects approach of REM and the feedback loop activates the identified nucleus.

46. The method of claim 30, wherein the identified at least one nucleus is the Locus Coeruleus.

47. The method of claim 30, wherein the identified at least one nucleus is the Dorsal Raphe Nucleus.

48. The method of claim 30, wherein the identified at least one nucleus is the posterior hypothalamus.

49. The method of claim 30, wherein the identified at least one nucleus is the Nucleus Reticularis pontis oralis.

50. The method of claim 30, wherein the identified at least one nucleus is the Nucleus Reticularis pontis caudalis.

51. The method of claim 30, wherein the identified at least one nucleus is the basal forebrain.

52. The method of claim 30, wherein the identified at least one nucleus is a Supra-Chiasmatic Nucleus of the hypothalamus.

53. The method of claim 30, wherein the abnormal awakeness-sleep cycle is due to sleep deprivation.

54. The method of claim 30, wherein the abnormal awakeness-sleep cycle is due to jet lag phenomenon.

55. Use of an electrode system adapted to be implanted within a brain of a subject having a sleep disorder, wherein the electrode is implanted proximate to at least one nucleus of the brain, said nucleus being a nucleus of the sleep circuitry of the brain, and provided with a stimulation signal to stimulate the at least one nucleus to affect the sleep disorder.

56. Use of an electrode system adapted to be implanted within a brain of a subject having a sleep disorder for affecting the sleep disorder.

57. Use of a chemical stimulus to be infused into a brain of a subject having a sleep disorder, wherein the chemical stimulus is infused proximate to at least one nucleus of the brain, said nucleus being a nucleus of the sleep circuitry of the brain, to affect the sleep disorder.

58. Use of an electrode system adapted to be implanted within a brain of a subject having an abnormal awakeness-sleep cycle, wherein the electrode is implanted proximate to at least one nucleus of the brain, said nucleus being a nucleus of the sleep circuitry of the brain, and provided with a stimulation signal to stimulate the at least one nucleus to affect the abnormal awakeness-sleep cycle.

59. Use of an electrode system adapted to be implanted within a brain of a subject having an abnormal awakeness-sleep cycle for affecting the abnormal awakeness-sleep cycle.

60. Use of a chemical stimulus to be infused into a brain of a subject having an abnormal awakeness-sleep cycle, wherein the chemical stimulus is infused proximate to at least one nucleus of the brain, said nucleus being a nucleus of the sleep circuitry of the brain, to affect the abnormal awakeness-sleep cycle.