Systems and methods for treating patient hypertonicity

• US 20080139870A1
• Filed: 12/12/2006
• Published: 06/12/2008
• Est. Priority Date: 12/12/2006
• Status: Abandoned Application

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Northstar Neuroscience, Inc.
• Inventors: Fowler, Brad, Hulvershorn, Justin, Sloan, Leif R., Gliner, Bradford E.
• Application Number:
  US11/638,326
• Publication Number:
  US 20080139870A1
• Time in Patent Office: Days
• US Class Current: 600/12
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue

Abstract

Systems and methods for treating patient hypertonicity are disclosed. A method in accordance with one embodiment includes identifying a cortical target neural population associated with hypertonicity in a patient, and reducing or eliminating patient hypertonicity by applying electromagnetic signals to the target neural population. In further particular embodiments, the electromagnetic signals are first electromagnetic signals, and the method can further include reducing or eliminating an additional patient dysfunction by applying second electromagnetic signals.

Claims

1. A method for treating a patient, comprising:

identifying a cortical target neural population of the brain associated with hypertonicity in a patient; and

reducing or eliminating patient hypertonicity by applying electromagnetic signals to the target neural population.

2. The method of claim 1 wherein applying electromagnetic signals includes applying electrical signals from a signal delivery device implanted within the patient'"'"'s skull.

3. The method of claim 1 wherein applying electromagnetic signals includes applying anodal signals.

4. The method of claim 1 wherein applying electromagnetic signals includes applying cathodal signals.

5. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals to a cortical structure of the brain and triggering signals that propagate to a sub-cortical structure.

6. The method of claim 1 wherein applying electromagnetic signals includes applying excitatory electromagnetic signals to first motor neurons that in turn inhibit second motor neurons, the second motor neurons including alpha motor neurons.

7. The method of claim 1 wherein applying electromagnetic signals includes applying electrical signals to upper neurons at the cortex of the patient'"'"'s brain or to neurons in synaptic communication with the upper neurons, to have an inhibitory effect on lower alpha motor neurons that are in synaptic communication with the upper motor neurons.

8. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals to at least one of the motor cortex, the premotor cortex, and the supplementary motor area of the patient'"'"'s brain.

9. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals at a subthreshold level.

10. The method of claim 9 wherein applying electromagnetic signals includes applying electromagnetic signals at a level that is from about 70% to about 95% of a movement threshold.

11. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals at a suprathreshold level.

12. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals prior to engaging the patient in a behavioral therapy task.

13. The method of claim 1, further comprising engaging the patient in an adjunctive therapy task.

14. The method of claim 13 wherein engaging the patient includes having the patient think about taking a physical action.

15. The method of claim 13 wherein engaging the patient includes having the patient at least attempt a physical action.

16. The method of claim 13 wherein engaging the patient includes having the patient observe an action.

17. The method of claim 1, further comprising engaging the patient in a chemical substance therapy.

18. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals simultaneously with engaging the patient in a behavioral therapy task.

19. The method of claim 1 wherein the electromagnetic signals are first electromagnetic signals, and wherein the method further comprises reducing or eliminating an additional patient dysfunction by applying second electromagnetic signals.

20. The method of claim 19 wherein the target neural population is a first target neural population, and wherein applying second electromagnetic signals includes applying the second electromagnetic signals to a second target neural population different than the first target neural population.

21. The method of claim 19, further comprising applying the second signals intermittently with the first signals.

22. The method of claim 19 wherein applying the second electromagnetic signals includes facilitating a patient neuroplastic response.

23. The method of claim 19 wherein applying the first signals includes applying the first signals in accordance with a first set of signal delivery parameters and wherein applying the second signals includes applying the second signals in accordance with a second set of signal delivery parameters different than the first set of signal delivery parameters.

24. The method of claim 23 wherein applying the first signals includes applying the first signals at a first polarity and wherein applying the second signals includes applying the second signals at a second polarity opposite the first polarity.

25. The method of claim 1 wherein the electromagnetic signals are first electromagnetic signals provided to a first target neural population to produce an acute reduction in hypertonicity, and wherein the method further comprises:

providing a long-term reduction or elimination of an additional patient dysfunction by applying second electromagnetic signals to a second target neural population different than the first, utilizing a neuroplastic effect; and

providing a long-term reduction or elimination of the patient hypertonicity by applying third electromagnetic signals to the first target neural population, utilizing a neuroplastic effect.

26. The method of claim 25 wherein applying the first signals includes applying the first signals at a level that is from about 70% to about 95% of movement threshold, and wherein applying the second and third signals includes applying the second and third signals at levels of about 25% of movement threshold.

27. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals for a period of time less than one hour.

28. The method of claim 1 wherein identifying a target neural population includes comparing patient feedback when the patient performs a first task, with patient feedback when the patient performs a second task, the first task evoking hypertonicity, the second task not evoking hypertonicity.

29. The method of claim 1 wherein identifying a target neural population includes comparing patient feedback when the patient performs a first task, with patient feedback when the patient performs a second task, the first task evoking hypertonicity while the patient is affected by a drug, the second task evoking hypertonicity while the patient is not affected by the drug.

30. The method of claim 1 wherein identifying a target neural population includes comparing feedback from the patient when the patient is at rest with feedback from the patient when the patient performs a task that evokes hypertonicity.

31. The method of claim 1 wherein reducing or eliminating hypertonicity includes reducing or eliminating spasticity.

32. The method of claim 1 wherein reducing or eliminating hypertonicity includes reducing or eliminating rigidity.

33. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals automatically.

34. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals in response to a practitioner input.

35. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals in response to a patient input.

36. The method of claim 1 wherein applying electromagnetic signals includes automatically varying a signal delivery parameter over the course of a treatment regimen.

37. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals on a generally continual basis.

38. The method of claim 1 wherein applying electromagnetic signals includes applying electromagnetic signals automatically in response to a detected indication of actual or incipient hypertonicity.

39. A method for treating a patient, comprising:

identifying a target neural population at a cortical location of a patient'"'"'s brain, the target neural population being associated with hypertonicity in the patient;

implanting an electrical signal delivery device beneath the patient'"'"'s skull and proximate to the target neural population; and

reducing or eliminating patient hypertonicity by applying anodal electrical signals to the target neural population to stimulate upper motor neurons that in turn inhibit lower alpha motor neurons with which the upper motor neurons are synaptically coupled.

40. The method of claim 39, further comprising engaging the patient in a behavioral therapy while the patient'"'"'s hypertonicity is reduced or eliminated under the influence of the anodal electrical signals.

41. A method for treating a patient, comprising:

identifying a target neural population of the central nervous system associated with hypertonicity in a patient;

reducing or eliminating patient hypertonicity by applying first electromagnetic signals to the target neural population in accordance with a first set of signal delivery parameters; and

applying second electromagnetic signals in accordance with a second set of signal delivery parameters different than the first set of signal delivery parameters to an area of the central nervous system to reduce or eliminate an additional patient dysfunction.

42. The method of claim 41 wherein applying the second electromagnetic signals includes applying the second electromagnetic signals to an area of the central nervous system where a change in an intrinsic neural activity is suspected of occurring to carry out a particular physical function and/or cognitive function.

43. The method of claim 41 wherein applying the second electromagnetic signals includes applying the second electromagnetic signals to the target neural population.

44. The method of claim 41 wherein the target neural population is a first target neural population and wherein applying the second electromagnetic signals includes applying the second electromagnetic signals to a second target neural population different than the first target neural population.

45. The method of claim 41 wherein applying the first electromagnetic signals includes applying the first electromagnetic signals with an anodic potential, and wherein applying the second electromagnetic signals includes applying the second electromagnetic signals with a cathodic potential.

46. The method of claim 41, further comprising engaging the patient in an adjunctive behavioral therapy.

47. The method of claim 46 wherein applying the first electromagnetic signals is performed before engaging the patient in the behavioral therapy, and wherein applying the second electromagnetic signals is performed while engaging the patient in the behavioral therapy.

48. The method of claim 46 wherein applying the first electromagnetic signals is performed both before and while engaging the patient in the behavioral therapy, and wherein applying the second electromagnetic signals is performed while engaging the patient in the behavioral therapy.

49. The method of claim 48 wherein applying the first electromagnetic signals while engaging the patient in the behavioral therapy is performed at pre-selected time intervals.

50. The method of claim 48 wherein applying the first electromagnetic signals while engaging the patient in the behavioral therapy is performed in response to an indication that the effect of the first electromagnetic signals applied before the behavioral therapy has diminished.

51. The method of claim 41 wherein the intrinsic neural activity arises in association with a naturally occurring physiological process that facilitates at least partial functional recovery following neurologic damage.

52. A patient treatment system, comprising:

a signal delivery device configured to deliver electromagnetic signals to a cortical brain structure of a patient;

a sensor coupleable to the patient, the sensor being configured to detect an indication of incipient or actual patient hypertonicity; and

a controller coupled to the signal delivery device and the sensor to receive sensor signals corresponding to the indication, and direct the delivery of electromagnetic signals to the patient, based at least in part on the sensor signals.

53. The system of claim 52 wherein the signal delivery device includes at least one electrode carried by a support member and configured to be implanted beneath the patient'"'"'s skull.

54. The system of claim 52 wherein the sensor includes an accelerometer configured to be coupled to the patient to detect patient movement.

55. The system of claim 52 wherein the sensor includes an EEG sensor.

56. The system of claim 52 wherein the sensor includes an EMG sensor.