METHODS AND APPARATUS FOR EFFECTUATING A LASTING CHANGE IN A NEURAL-FUNCTION OF A PATIENT

• US 20080161880A1
• Filed: 08/06/2007
• Published: 07/03/2008
• Est. Priority Date: 07/13/2000
• Status: Abandoned Application

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Northstar Neuroscience, Inc.
• Inventors: Firlik, Andrew D., Gliner, Bradford Evan, Levy, Alan J., Firlik, Katrina S., Balzer, Jeffrey, Morgan, Carlton B.
• Application Number:
  US11/834,642
• Publication Number:
  US 20080161880A1
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/37514 Brain implants
• CPC Class Codes: A61N 1/37518 Anchoring of the implants, e.g. fixation
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

The following disclosure describes several methods and apparatus for intracranial electrical stimulation to treat or otherwise effectuate a change in neural-functions of a patient. Several embodiments of methods in accordance with the invention are directed toward enhancing or otherwise inducing a lasting change in neural activity to effectuate a particular neural-function. Such lasting change in neural activity is defined as “neuroplasticity.” The methods in accordance with the invention can be used to treat brain damage (e.g., stroke, trauma, etc.), brain disease (e.g., Alzheimer'"'"'s, Pick'"'"'s, Parkinson'"'"'s, etc.), and/or brain disorders (e.g., epilepsy, depression, etc.). The methods in accordance with the invention can also be used to enhance neural-function of normal, healthy brains (e.g., learning, memory, etc.), or to control sensory functions (e.g., pain). Certain embodiments of methods in accordance with the invention electrically stimulate the brain at a stimulation site where neuroplasticity is occurring. The stimulation site may be different than the region in the brain where neural activity is typically present to perform the particular neural function according to the functional organization of the brain. In one embodiment in which neuroplasticity related to the neural-function occurs in the brain, the method can include identifying the location where such neuroplasticity is present. In an alternative embodiment in which neuroplasticity is not occurring in the brain, an alternative aspect is to induce neuroplasticity at a stimulation site where it is expected to occur. Several embodiments of these methods that are expected to produce a lasting effect on the intended neural activity at the stimulation site use electrical pulses that increase the resting membrane potential of neurons at the stimulation site to a subthreshold level.

Claims

1-123. -123. (canceled)

124. A method of stimulating the brain of a patient, comprising:

implanting an electrode under the skull of the patient at the stimulation site, wherein the electrode comprises an elongated member having a stimulation portion, and wherein the stimulation portion of the elongated member is positioned under the cortex;

determining a threshold for the individual patient at which an electrical signal directly triggers a neural reaction in response to the signal; and

applying electrical stimulation directly to the brain below the implanted electrode at a level less than the determined threshold.

125. The method of claim 124 wherein determining the threshold comprises applying an electrical signal to the stimulation site via the implanted electrode at a level that causes the neural response without additional intrinsic input.

126. The method of claim 124 wherein determining the threshold comprises applying the electrical signal to the stimulation site via the implanted electrode at a level that causes action potentials to fire without additional intrinsic input.

127. The method of claim 124 wherein the patient has been diagnosed with depression and the stimulation site is selected to treat the depression.

128. The method of claim 127 wherein determining the threshold comprises applying an electrical signal to the stimulation site via the implanted electrode at a level that causes the neural response without additional intrinsic input.

129. The method of claim 127 wherein determining the threshold comprises applying an electrical signal to the stimulation site via the implanted electrode at a level that causes action potentials to fire without additional intrinsic input.

130. The method of claim 124 wherein the stimulation is applied at a level less than approximately 80% of the determined threshold.

131. The method of claim 124 wherein the stimulation is applied at a level less than approximately 60% of the determined threshold.

132. The method of claim 124 wherein the stimulation is applied at a level of approximately 50% of the determined threshold.

133. A method of stimulating the brain of a patient, comprising:

implanting an electrode under the skull of the patient at the stimulation site, wherein the electrode comprises an elongated member having a stimulation portion, and wherein the stimulation portion of the elongated member is positioned under the cortex;

estimating a threshold for the individual patient at which an electrical signal directly triggers a neural reaction in response to the signal; and

applying electrical stimulation directly to the brain below the implanted electrode at a level less than the estimated threshold.

134. The method of claim 133 wherein the stimulation is applied at a level less than approximately 80% of the determined threshold.

135. The method of claim 133 wherein the stimulation is applied at a level less than approximately 60% of the determined threshold.

136. The method of claim 133 wherein the stimulation is applied at a level of approximately 50% of the determined threshold.

137. The method of claim 133 wherein estimating the threshold comprises determining the threshold by applying an electrical signal to the stimulation site via the implanted electrode at a level that causes the neural response without additional intrinsic input.

138. The method of claim 137 wherein the stimulation is applied at a level less than approximately 80% of the determined threshold.

139. The method of claim 137 wherein the stimulation is applied at a level less than approximately 60% of the determined threshold.

140. The method of claim 137 wherein the stimulation is applied at a level of approximately 50% of the determined threshold.