Multiple lead method for deep brain stimulation

• US 20080103547A1
• Filed: 03/20/2007
• Published: 05/01/2008
• Est. Priority Date: 09/21/2004
• Status: Active Grant

• Current Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Inventors: Okun, Michael S., Foote, Kelly D.
• Granted Patent: US 8,295,935 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

New methods for deep brain stimulation (DBS) surgery using two or more electrical leads are provided. The methods are useful for treating a wide variety of brain-associated disorders including movement-related disorders, psychiatric disorders, metabolic/eating disorders, memory disorders, and pain. Methods featuring stimulation of distinct target areas of a subject'"'"'s brain, such as the thalamic ventralis intermedius (VIM) and the ventralis oralis (VOA/VOP) using multiple electrical leads for treatment of tremor provide superior clinical outcomes to stimulation with single leads implanted in these target areas.

Claims

1. A method of deep brain stimulation (DBS) for treatment of a disorder associated with the brain, comprising:

(a) positioning two or more electrical leads remote with respect to each other in the brain of a subject having need thereof; and

(b) applying electrical stimulation to at least one of said electrical leads under conditions wherein said electrical stimulation eliminates or ameliorates at least one symptom of the disorder.

2. The method of claim 1, wherein the brain-associated disorder is selected from the group consisting of a movement-related disorder, a psychiatric disorder, a metabolic/eating disorder, a memory disorder, and pain.

3. The method of claim 2, wherein the disorder is a movement-related disorder selected from the group consisting of Parkinson'"'"'s disease, Huntington'"'"'s disease, Tourette/OCD, tremor, epilepsy, and dystonia.

4. The method of claim 2, wherein the disorder is a psychiatric disorder selected from the group consisting of depression, mania, phobia, OCD, schizophrenia, and addiction.

5. The method of claim 2, wherein the disorder is a metabolic/eating disorder selected from the group consisting of obesity, anorexia nervosa, vomiting disorder, and bulimia nervosa.

6. The method of claim 3, wherein the symptom of the movement-related disorder comprises at least one selected from the group consisting of tremor, rigidity, akinesia, tic, akathesia, restlessness, and gait irregularity.

7. The method of claim 3, wherein the disorder is tremor, selected from the group consisting of complex tremor, parkinsonian tremor, dystonic tremor, myoclonic tremor, essential tremor, poststroke tremor, multiple sclerosis tremor, and post-traumatic tremor.

8. The method of claim 1, wherein the electrical leads are positioned within two or more anatomically or physiologically distinct target regions of said brain.

9. The method of claim 8, wherein the target regions of the brain are selected from the group consisting of area 25, anterior limb of internal capsule, nucleus accumbens, inferior peduncle, paramedian nucleus, subthalamic nucleus, globus pallidus, hypothalamus, thalamus, subthalamus, centromedian nucleus of thalamus, ventral intermediate nucleus of thalamus (VIM), nucleus ventralis oralis (VOA), posterior region of the nucleus ventralis oralis (VOP), pallidal receiving area (VOA/VOP), insula, medial leminiscus, brainstem nuclei, medial forebrain bundle cerebral cortex, and temporal lobe.

10. The method of claim 1, wherein stimulation of at least two electrical leads positioned within two or more anatomically or physiologically distinct target regions of the brain eliminates or ameliorates a symptom of the brain disorder to a greater extent than stimulation by one of said electrical leads.

11. The method of claim 1, wherein electrical current is applied intermittently to at least one of the electrical leads.

12. The method of claim 1, wherein electrical current is applied continuously to at least one of the electrical leads.

13. The method of claim 1, wherein electrical current is applied alternately to two or more electrical leads.

14. The method of claim 1, wherein the electrical current is applied concurrently to two or more electrical leads.

15. A method of deep brain stimulation (DBS) for treatment of a movement-related disorder, comprising:

(a) positioning two or more electrical leads remote with respect to each other in the brain of a subject in need thereof, wherein at least one of said electrical leads is positioned within a target region of the brain associated with a movement-related disorder; and

(b) applying electrical stimulation to at least one of said electrical leads under conditions wherein said electrical stimulation eliminates or ameliorates at least one symptom of the movement-related disorder.

16. The method of claim 15, wherein movement-related disorder is tremor selected from the group consisting of complex tremor, parkinsonian tremor, dystonic tremor, myoclonic tremor, essential tremor, post-stroke tremor, multiple sclerosis tremor, and post-traumatic tremor.

17. The method of claim 15, wherein the electrical leads are positioned within two or more anatomically or physiologically distinct target regions of said brain.

18. The method of claim 15, wherein the target regions of the brain are selected from the group consisting of VIM, VOA, VOP, and VOA/VOP.

19. The method of claim 18, wherein at least one of the electrical leads is positioned in a brain area selected from the VIM, VOA, VOP or VOA/VOP.

20. The method of claim 18, wherein at least one of the electrical leads is positioned in the VIM and at least one of the electrical leads is positioned in the VOA/VOP.

21. A method of deep brain stimulation (DBS) for treatment of a psychiatric disorder, comprising:

(a) positioning two or more electrical leads remote with respect to each other in the brain of a subject having need thereof, wherein at least one of said electrical leads is positioned within a target region of the brain associated with a psychiatric disorder; and

(b) applying electrical stimulation to at least one of said electrical leads under conditions wherein said electrical stimulation eliminates or ameliorates at least one symptom of the psychiatric disorder.

22. The method of claim 21, wherein the target regions of the brain are selected from the group consisting of area 25, anterior limb of internal capsule, nucleus accumbens, and inferior peduncle, thalamus, hypothalamus, subthalamus, and cortex.