CNS assay for prediction of therapeutic efficacy for neuropathic pain and other functional illnesses

• US 20060074298A1
• Filed: 09/30/2005
• Published: 04/06/2006
• Est. Priority Date: 10/01/2004
• Status: Active Grant

• Current Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Original Assignee: Mclean Hospital (Mass General Brigham, Inc.)
• Inventors: Borsook, David, Becerra, Lino, Shaw, Marnie E.
• Granted Patent: US 7,860,552 B2
• Time in Patent Office: Days
• US Class Current: 600/425
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/4058 for evaluating the central nervous system A61B5/4806, A61B5/4821 take precedence
• CPC Class Codes: A61B 5/4824 Touch or pain perception evaluation A61B5/4821 takes precedence

Abstract

In general, the invention features methods for identifying therapeutic interventions for functional illnesses, e.g., neuropathic pain or depression, and methods for identifying markers for functional illnesses by employing an acute painful stimulus or other stimulus for a functional illness and measuring levels of CNS activity.

Claims

1. A method for identifying a therapeutic intervention for a functional illness, said method comprising the steps of:

(a) administering a candidate therapeutic intervention to a subject;

(b) administering an acute painful stimulus to said subject; and

(c) measuring a level of activation of the central nervous system (CNS) indicative of said functional illness in said subject, wherein a modification of said level of CNS activation relative to a control level of activation characteristic of said functional illness is indicative of the efficacy of said candidate therapeutic for said functional illness.

3. The method of claim 1, wherein said functional illness comprises neuropathic pain.

4. The method of claim 3, wherein said neuropathic pain comprises post herpetic neuralgia, HIV neuropathy, diabetic neuropathy, Fabry'"'"'s disease, peripheral neuropathy, trigeminal neuralgia, post incisional neuropathic pain, phantom limb pain, reflex sympathetic dystrophy, causalgia, anesthesia dolorosa, intercoastal neuralgia, post-traumatic localized pain, complex regional pain syndrome, or neuropathic pain caused by trauma, lead, or chemotherapy.

8. The method of claim 1, wherein said acute painful stimulus comprises a change in temperature, mechanical force, a pin prick, or administration of a compound.

10. The method of claim 1, wherein said level of activation is measured by functional magnetic resonance imaging.

12. The method of claim 1, wherein said therapeutic intervention comprises a compound, a physical stimulus, an electrical stimulus, a thermal stimulus, electromagnetic radiation, counseling, or a surgical, medical, or dental procedure.

22. The method of claim 1, wherein said therapeutic intervention is administered subtherapeutically.

2. (canceled)

5-7. -7. (canceled)

9. (canceled)

11. (canceled)

13-21. -21. (canceled)

23-24. -24. (canceled)

25. A method for identifying a marker for a functional illness, said method comprising the steps of:

(a) administering a stimulus for said functional illness to a subject, wherein said subject is not suffering from said functional illness;

(b) measuring the level of activation of the CNS in said subject; and

(c) comparing said level of CNS activation in step (b) to a control level of CNS activation to identify said marker for said functional illness.

27. The method of claim 25, wherein said functional illness comprises neuropathic pain.

32. The method of claim 25, wherein said stimulus is an acute painful stimulus.

35. The method of claim 25, wherein said level of activation is measured by functional magnetic resonance imaging.

37. The method of claim 25, wherein said therapeutic intervention comprises a compound, a physical stimulus, an electrical stimulus, a thermal stimulus, electromagnetic radiation, counseling, or a surgical, medical, or dental procedure.

26. (canceled)

28-31. -31. (canceled)

33-34. -34. (canceled)

36. (canceled)

38-47. -47. (canceled)

48. A method for identifying a therapeutic intervention for a psychiatric disorder, said method comprising the steps of:

(a) administering a candidate therapeutic intervention to a subject;

(b) administering a stimulus for said psychiatric disorder to said subject; and

(c) measuring the level of CNS activation in said subject, wherein a modification of said level of CNS activation relative to a control level of CNS activation characteristic of said psychiatric disorder is indicative of the efficacy of said candidate therapeutic intervention for said psychiatric disorder.

49. The method of claim 48, wherein said psychiatric disorder comprises an affective disorder, an anxiety disorder, attention deficit hyperactivity disorder, a memory disorder, post traumatic stress disorder, a psychotic disorder, a substance abuse disorder, an addiction, a phobia, or obsessive compulsive disorder.

50. The method of claim 49, wherein said psychiatric disorder comprises depression, bipolar disorder, mania, dysphoria, anxiety, panic disorder, schizophrenia, or schizoaffective disorder.

51. The method of claim 48, wherein said level of activation is measured by functional magnetic resonance imaging.

53. The method of claim 48, wherein said therapeutic intervention comprises a compound, a physical stimulus, an electrical stimulus, a thermal stimulus, electromagnetic radiation, counseling, or a surgical, medical, or dental procedure.

55. The method of claim 48, wherein said level of activation is measured in one or more regions of the CNS.

57. The method of claim 48, wherein said level of activation is not measured with reference to specific regions of the CNS.

63. The method of claim 48, wherein said therapeutic intervention is administered subtherapeutically.

52. (canceled)

54. (canceled)

56. (canceled)

58-62. -62. (canceled)

64-65. -65. (canceled)