SYSTEMS AND METHODS FOR TREATING MEDICAL CONDITIONS BY STIMULATION OF MEDIAL THALAMIC REGION

• US 20080215101A1
• Filed: 10/12/2007
• Published: 09/04/2008
• Est. Priority Date: 10/13/2006
• Status: Active Grant

• Current Assignee: IntElect Medical, Inc. (Boston Scientific Corporation), Cleveland Clinic Foundation, Cornell Research Foundation Incorporated (Cornell University)
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Rezai, Ali, Kokones, Scott, Schiff, Nicholas
• Granted Patent: US 9,539,425 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• 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 1/361 Phantom sensations, e.g. tinnitus

Abstract

A system for treating medical conditions by neuromodulation of one or more target sites in the nervous system. In certain embodiments, at least one of the target sites is the medial thalamic region, including the intralaminar nucleus and the adjacent white and grey matter. In certain embodiments, where there is more than one target site, the other target sites is elsewhere in the nervous system, including the globus pallidus interna, subthalamic nucleus, corpus callosum, cerebellum, cerebral cortex (including the premotor cortex, motor cortex, and sensory cortex), ventral striatum, lateral thalamus, substantia nigra, and pedunculopontine nuclei. The medical conditions include movement disorders or improvement of movement function, stroke, neuropsychiatric or neuropsychologic disorders, neurodevelopmental disorders, and pain. Methods for treating medical conditions by neuromodulation of the intralaminar nuclei either alone or in combination with another target site(s) is also provided.

Claims

1. A system for treating a condition selected from the group consisting of:

a movement disorder or improvement of movement function, stroke, neuropsychiatric or neuropsychologic disorder, neurodevelopmental disorder, and pain;

wherein the system comprises;

a first therapy delivery device for positioning at a first target site, wherein the first target site is the medial thalamic region; and

a controller in communication with the first therapy delivery device for enabling the first therapy delivery device to deliver a stimulus to the first target site.

2. The system of claim 1, wherein the first therapy delivery device is an electrode.

3. The system of claim 2, wherein the stimulus is a pre-recoded waveform.

4. The system of claim 1, wherein the first therapy delivery device is a drug port.

5. The system of claim 1, further comprising a second therapy delivery device for positioning at a second target site, wherein the second target site is not the intralaminar nuclei, and wherein the controller is in communication with the second therapy delivery device for enabling the second therapy delivery device to deliver a stimulus to the second target site.

6. The system of claim 5, wherein the system is for treating a movement disorder, and wherein the second target site is the globus pallidus interna, a subthalamic nucleus, lateral thalamus, substantia nigra, pedunculopontine nuclei, premotor cortex, motor cortex, and sensory cortex.

7. The system of claim 1, wherein the movement disorder is selected from the group consisting of Parkinson'"'"'s disorder, dystonia, tremor, and spasticity.

8. The system of claim 5, wherein the system is for improving movement function, and wherein the second target site is the globus pallidus interna, a subthalamic nucleus, lateral thalamus, substantia nigra, pedunculopontine nuclei, premotor cortex, motor cortex, or sensory cortex.

9. The system of claim 8, wherein the movement function is postural stability, gait, limb movement, balance, speech, swallowing, axial musculature control, or autonomic control.

10. The system of claim 1, wherein the system is for treating a neurodevelopmental disorder.

11. The system of claim 10, wherein the neurodevelopmental disorder is autism or mental retardation.

12. The system of claim 1, wherein the system is for treating stroke, and wherein the second target site is the corpus callosum, cerebellum, cortex, or any combination thereof.

13. The system of claim 12, wherein the cortex is the premotor cortex, motor cortex, or sensory cortex, or any combination thereof.

14. The system of claim 1, wherein the system is for treating pain.

15. The system of claim 5, wherein the controller coordinates the delivery of stimuli through the first and second therapy delivery devices.

16. The system of claim 15, wherein the delivery of stimuli through the first and second therapy delivery devices are simultaneous.

17. The system of claim 15, wherein the delivery of stimuli through the first and second therapy delivery devices are alternating.

18. The system of claim 15, wherein the delivery of stimuli through the first and second therapy delivery devices are time-delayed.

19. The system of claim 1, further comprising a sensor for detecting a bodily activity associated with the medical condition and generating a sensor signal, wherein the controller is in communication with the sensor and controls the delivery of stimulus through the first therapy delivery device in response to the sensor signal.

20. The system of claim 19, wherein the controller controls the delivery of stimulus through the second therapy delivery device in response to the sensor signal.

21. The system of claim 2, wherein the electrical signals delivered to the electrode are of sufficient strength to cause localized tissue damage at the target site.

22. A system for treating a psychiatric condition comprising:

a first therapy delivery device for positioning at an intralaminar nuclei;

a second therapy delivery device for positioning at a target site in the nervous system, wherein the target site is the pre-frontal cortex, frontal lobe, dorsolateral frontal cortex, medial frontal cortex, temporal cortex, orbitofrontal cortex, subgenual cingulated cortex, amygdala, nucleus accumbens, or ventral striatum; and

a controller in communication with both the first therapy delivery device and the second therapy delivery device, wherein the controller delivers stimuli through the first therapy delivery device and second therapy delivery device.

23. The system of claim 22, wherein the psychiatric disorder is an attention, mood, anxiety, apathy, arousal, connectivity, or addiction disorder and the target site is the ventral striatum.

24. The system of claim 22, wherein the first and second therapy delivery devices are both electrodes.

25. The system of claim 24, wherein the stimuli are pre-recorded waveforms.

26. The system of claim 22, wherein the controller coordinates the delivery of stimuli through the first and second therapy delivery devices.

27. The system of claim 26, wherein the delivery of stimuli through the first and second therapy delivery devices are simultaneous.

28. The system of claim 26, wherein the delivery of stimuli through the first and second therapy delivery devices are alternating.

29. The system of claim 26, wherein the delivery of stimuli through the first and second therapy delivery devices are time-delayed.

30. The system of claim 24, wherein the electrical signals delivered to at least one of the electrodes are of sufficient strength to cause localized tissue damage at the target site.

31. A method of treating a condition selected from the group consisting of:

a movement disorder or improvement of movement function, stroke, neuropsychiatric or neuropsychologic disorder, neurodevelopmental disorder, and pain;

wherein the method comprises;

delivering a first stimulus to a first target site, wherein the first target site is the intralaminar nuclei.

32. The method of claim 31, further comprising positioning a first therapeutic delivery device at the intralaminar nuclei, and delivering a stimulus through the first therapeutic delivery device.

33. The method of claim 32, wherein the first therapy delivery device is an electrode.

34. The method of claim 33, wherein the stimulus is a pre-recorded waveform.

35. The method of claim 32, wherein the first therapy delivery device is a drug port.

36. The method of claim 31, further comprising delivering a second stimulus to a second target site, wherein the second target site is not the intralaminar nuclei.

37. The method of claim 31, wherein the condition being treated is a movement disorder or improvement of movement function, and wherein the second target site is the globus pallidus interna, a subthalamic nucleus, lateral thalamus, substantia nigra, pedunculopontine nuclei, premotor cortex, motor cortex, and sensory cortex.

38. The method of claim 31, wherein the movement disorder is selected from the group consisting of Parkinson'"'"'s disorder, dystonia, tremor, and spasticity.

39. The method of claim 31, wherein the movement function is postural stability, gait, limb movement, balance, speech, swallowing, control of axial musculature, or autonomic control.

40. The method of claim 36, wherein the delivery of the first stimulus and delivery of the second stimulus are coordinated.

41. The method of claim 40, wherein the delivery of the first stimulus and delivery of the second stimulus are simultaneous.

42. The method of claim 40, wherein the delivery of the first stimulus and delivery of the second stimulus are alternating.

43. The method of claim 40, wherein the delivery of the first stimulus and delivery of the second stimulus are time-delayed.

44. The method of claim 33, wherein delivering the first stimulus through the electrode causes localized tissue damage at the first target site.

45. The method of claim 31, wherein the method is for treating pain.

46. A method of treating a psychiatric condition comprising:

delivering a first stimulus to the intralaminar nuclei; and

delivering a second stimulus to a target site in the nervous system, wherein the target site is the pre-frontal cortex, frontal lobe, dorsolateral frontal cortex, medial frontal cortex, temporal cortex, orbitofrontal cortex, subgenual cingulated cortex, amygdala, nucleus accumbens, or ventral striatum.

47. The method of claim 46, further comprising positioning a first therapeutic delivery device at the intralaminar nuclei, and positioning a second therapeutic delivery device at the target site.

48. The method of claim 46, wherein the psychiatric disorder is an attention, mood, anxiety, apathy, arousal, connectivity, or addiction disorder and the target site is the ventral striatum.

49. The method of claim 47, wherein the first therapy delivery device is an electrode.

50. The method of claim 49, wherein the stimulus is a pre-recorded waveform.

51. The method of claim 47, wherein the first therapy delivery device is a drug port.

52. The method of claim 46, wherein the delivery of the first stimulus and delivery of the second stimulus are coordinated.

53. The method of claim 52, wherein the delivery of the first stimulus and delivery of the second stimulus are simultaneous.

54. The method of claim 52, wherein the delivery of the first stimulus and delivery of the second stimulus are alternating.

55. The method of claim 52, wherein the delivery of the first stimulus and delivery of the second stimulus are time-delayed.

56. The method of claim 49, wherein delivering the first stimulus through the electrode causes localized tissue damage in the intralaminar nuclei.

57. The method of claim 47, wherein the second therapy delivery device is an electrode, and wherein delivering the second stimulus through the electrode causes localized tissue damage at the target site.