METHOD AND DEVICE FOR DETECTING AND TREATING DEPRESSION

• US 20100049263A1
• Filed: 10/14/2009
• Published: 02/25/2010
• Est. Priority Date: 01/24/2006
• Status: Active Grant

• Current Assignee: Helen L. Reeve
• Original Assignee: Helen L. Reeve
• Inventors: Reeve, Helen L.
• Granted Patent: US 8,391,984 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A system is described for detecting and/or treating depression that may be incorporated into an implantable device such as a cardiac rhythm management device. The device may determine that depression is present by analysis of heart rate variability measured using the cardiac sensing channels of the device and/or by detection of blood-borne factors that are associated with depression. If depression is detected, the device may be configured to automatically delivery therapy such as neuromodulation and/or drug delivery.

Claims

1. (canceled)

2. An implantable device for treatment of depression, the device comprising:

a device housing;

a plurality of electrodes disposed external to the device housing and configured and arranged to provide neural stimulation;

at least one pulse generator disposed in the device housing, coupled to the plurality of electrodes, and configured and arranged to provide stimulation pulses to the plurality of electrodes;

sensing circuitry disposed in the device housing, coupled to at least one of the plurality of electrodes, and configured and arranged to receive electrical signals from the at least one of the plurality of electrodes and to detect parameters associated with depression based, at least in part, on the electrical signals and to direct the at least one pulse generator to deliver stimulation pulses to at least one of the plurality of electrodes.

3. The implantable device of claim 2, further comprising a nerve cuff with at least one of the plurality of electrodes disposed on the nerve cuff.

4. The implantable device of claim 2, wherein each of the plurality of electrodes is coupled to the sensing circuitry.

5. The implantable device of claim 2, further comprising a bidirectional bus coupled between i) the plurality of electrodes and ii) the at least one pulse generator and sensing circuitry.

6. The implantable device of claim 2, further comprising a lead wherein at least one of the plurality of electrodes is disposed on the lead.

7. The implantable device of claim 2, further comprising a drug delivery system coupled to the sensing circuitry.

8. The implantable device of claim 2, wherein at least one of the electrodes is configured and arranged for implantation into a brain of a patient.

9. The implantable device of claim 2, further comprising one or more chemical sensing channels coupled to the sensing circuitry and configured and arranged to generate a signal indicative of the concentration of one or more blood-borne markers associated with depression.

10. The implantable device of claim 2, further comprising a magnetically or tactilely actuatable switch coupled to the at least one pulse generator and configured and arranged to permit a patient with the implantable device to manually actuate the switch to deliver stimulation pulses to the plurality of electrodes.

11. A kit, comprising:

at least one lead with a plurality of electrodes disposed on the lead, wherein the electrodes are configured and arranged to provide neural stimulation;

an implantable control unit comprising

a housing;

at least one pulse generator disposed in the housing, coupleable to the plurality of electrodes, and configured and arranged to provide stimulation pulses to the plurality of electrodes;

sensing circuitry disposed in the housing, coupleable to at least one of the plurality of electrodes, and configured and arranged to receive electrical signals from the at least one of the plurality of electrodes and to detect parameters associated with depression based, at least in part, on the electrical signals and to direct the at least one pulse generator to deliver stimulation pulses to the plurality of electrodes.

12. The kit of claim 11, wherein the implantable control unit further comprises a bidirectional bus coupled between i) the plurality of electrodes and ii) the at least one pulse generator and sensing circuitry.

13. A method of treating depression using an implantable device, the method comprising;

monitoring electrical signals from the at least one of a plurality of implanted stimulation electrodes using sensing circuitry disposed in an implanted device housing;

detecting, using the sensing circuitry, parameters associated with depression based, at least in part, on the electrical signals; and

directing at least one pulse generator disposed in the device housing to deliver electrical stimulation pulses to at least one of the plurality of stimulation electrodes in response to the monitoring of the electrical signals.

14. The method of claim 13, further comprising implanting the device housing and plurality of stimulation electrodes in a patient.

15. The method of claim 13, wherein implanting the plurality of stimulation electrodes comprises implanting at least one of the stimulation electrodes in a brain of the patient.

16. The method of claim 13, wherein implanting the plurality of stimulation electrodes comprises implanting a nerve cuff around a nerve of the patient, wherein the nerve cuff comprises at least one of the plurality of electrodes.

17. The method of claim 16, wherein implanting the nerve cuff comprises implanting the nerve cuff around a vagus nerve of the patient.

18. The method of claim 13, wherein at least one of the plurality of stimulation electrodes is disposed on a satellite unit that is wirelessly coupled to the at least sensing circuitry,

the method further comprising directing the satellite unit to deliver electrical stimulation pulses to the at least one of the plurality of stimulation electrodes on the satellite unit in response to the monitoring of the electrical signals.

19. The method of claim 13, further comprising directing an implanted drug delivery system coupled to the sensing circuitry to deliver a therapeutic amount of a drug in response to the monitoring of the electrical signals.

20. The method of claim 13, further comprising generating a signal indicative of the concentration of one or more blood-borne markers of depression in a sensing channel and delivering the signal to the sensing circuitry.

21. The method of claim 13, wherein monitoring electrical signals from the at least one of the plurality of implanted stimulation electrodes comprises monitoring neural activity using the at least one of the plurality of implanted stimulation electrodes.