TREATMENT OF CLINICAL APPLICATIONS WITH NEUROMODULATION

• US 20110082326A1
• Filed: 11/01/2010
• Published: 04/07/2011
• Est. Priority Date: 04/09/2004
• Status: Abandoned Application

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Schneider, M. Bret, Mishelevich, David J.
• Application Number:
  US12/917,236
• Publication Number:
  US 20110082326A1
• Time in Patent Office: Days
• US Class Current: 600/13
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/02 using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence

Abstract

Described herein are systems and methods for Transcranial Magnetic Stimulation (TMS) including one or more TMS electromagnets for stimulation of target deep brain regions to stimulate, enhance and/or inhibit neural activity.

Claims

1. A method of treating a disorder by non-invasive neural stimulation, the method comprising modulating the activity of the majority of a target deep-brain region, wherein the target brain region is selected from the group consisting of:

neocortex, medial PFC, LDLPFC, RDLPFC, dorsomedial PFC, ventral PFC, VMPFC, orbitofrontal cortex (OFC), tracts between OFC and insula, cingulate genu, DACG, Pre-Gen. anterior cingulate, subgenual cingulate, posterior cingulate, striatum-DACG connections, tracts between pre-gen, anterior cingulate and insula, insula, amygdala, anterior limb of internal capsule, ventral internal capsule, target, nucleus accumbens, tract between nucleus acumbens and ventral teg., hippocampus, temporal lobes, septum, caudate (nucleus), globus pallidus, anterior nucleus of the thalamus, lateral thalamus, centromedian thalamus, thalamic subregions, subthalamic nucleus, lateral hypothalamic area nuclei, ventromedial nuclei of hypothal., cerebellum, brainstem, and pons.

2. The method of claim 1, wherein the step of modulating the activity comprises up-regulating the activity of the target region.

3. The method of claim 1, wherein the step of modulating the activity comprises down-regulating the activity of the target region.

4. The method of claim 1, wherein the step of modulating the activity comprises non-invasively stimulating the target region to modulate the activity using an array of TMS electromagnets.

5. The method of claim 1, wherein the step of modulating the activity of the target region does not substantially modulate the activity of non-target brain regions.

6. The method of claim 1, wherein the step of modulating the activity comprises applying energy to activate an array of TMS electromagnets.

7. The method of claim 1, further comprising positioning an array of TMS electromagnets to modulate each of the target brain regions.

8. The method of claim 1, wherein the disorder is selected from the group consisting of:

addiction, Alzheimer'"'"'s disease, anogasmia, attention deficit disorder, autism, cerebral palsy, depression, bipolar, depression, unipolar, epilepsy, generalized anxiety disorder, head trauma (acute), hedonism, obesity, OCD, acute pain, chronic pain, Parkinson'"'"'s disease, persistent vegetative state, phobia, PTSD, social anxiety disorder, rehab/regenesis for post-stroke, post-head trauma, hemorrhagic stroke, ischemic stroke, and Tourette'"'"'s syndrome.

9. The method of claim 1, further comprising modulating the activity of the majority of a second target brain region.

10. The method of claim 9, wherein the second target brain region is modulated simultaneously with the modulation of the first target brain region.

11. The method of claim 1, wherein the step of modulating the activity is performed by moving at least one TMS coil around a subject'"'"'s head to stimulate the target brain region.

12. A method of treating a disorder by non-invasive neural stimulation, the method comprising simultaneously modulating the activity of two or more target brain regions to up-regulate or down-regulate activity in the target brain region, wherein the target brain regions are selected from the group consisting of:

NeoCortex, Medial PFC, LDLPFC, RDLPFC, Dorsomedial PFC, Ventral PFC, VMPFC, Orbitofrontal Cortex (OFC), Tracts between OFC and Insula, Cingulate Genu, DACG, Pre-Gen. Anterior Cingulate, Subgenual Cingulate, Posterior Cingulate, Striatum-DACG Connections, Tracts between Pre-Gen. Anterior Cingulate and Insula, Insula, Amygdala, Anterior Limb of Internal Capsule, Ventral Internal Capsule, Target, Nucleus Accumbens, Tract between Nucleus Acumbens and Ventral Teg., Hippocampus, Temporal Lobes, Septum, Caudate (Nucleus), Globus Pallidus, Anterior Nucleus of the Thalamus, Lateral Thalamus, Centromedian Thalamus, Thalamic Subregions, Subthalamic Nucleus, Lateral Hypothalamic Area Nuclei, Ventromedial Nuclei of Hypothal., Cerebellum, Brainstem, and Pons.

13. The method of claim 12, wherein the step of simultaneously modulating activity comprises modulating the activity in the majority of the target brain regions.

14. The method of claim 12, wherein the step of simultaneously modulating activity comprises non-invasively stimulating.

15. The method of claim 12, wherein the step of simultaneously modulating activity comprises stimulating by deep-brain TMS.

16. The method of claim 12, wherein the step of simultaneously modulating activity comprises up-regulating activity in one target brain region.

17. The method of claim 12, wherein the step of simultaneously modulating activity comprises down-regulating activity in one target brain region.

18. The method of claim 12, wherein the step of simultaneously modulating activity comprises up-regulating activity in one target brain region while down-regulating activity in another brain region.

19. The method of claim 12, wherein the step of simultaneously modulating activity does not substantially modulate the activity of non-target brain regions.

20. The method of claim 12, wherein the step of simultaneously modulating the activity comprises applying energy to activate one or more arrays of TMS electromagnets.

21. The method of claim 12, further comprising positioning one or more arrays of TMS electromagnets to modulate each of the target brain regions.

22. The method of claim 12, wherein the disorder is selected from the group consisting of:

addiction, Alzheimer'"'"'s disease, anogasmia, attention deficit disorder, autism, cerebral palsy, depression, bipolar, depression, unipolar, epilepsy, generalized anxiety disorder, head trauma (acute), hedonism, obesity, OCD, acute pain, chronic pain, Parkinson'"'"'s disease, persistent vegetative state, phobia, PTSD, social anxiety disorder, rehab/regenesis for post-stroke, post-head trauma, hemorrhagic stroke, ischemic stroke, and Tourette'"'"'s syndrome.

23. A method of treating hedonic disorders by non-invasive neural stimulation, the method comprising applying energy to modulate activity of the Orbitofrontal Cortex (OFC).

24. The method of claim 23, wherein the hedonic disorder is selected from the group consisting of:

addiction, sexual disorders, and eating disorders.

25. The method of claim 23 wherein the step of applying energy to modulate the activity of the OFC comprises stimulating the OFC to suppress activity.

26. The method of claim 23, wherein the step of applying energy to modulate the activity of the OFC comprises simultaneously stimulating the majority of the OFC.

27. The method of claim 23, wherein the step of applying energy to modulate the activity of the OFC comprises stimulating the OFC without substantially modulating neural activity in other brain regions including those adjacent to the OFC.

28. A method of treating obesity by non-invasive neural stimulation, the method comprising applying energy to modulate the activity of the Orbitofrontal Cortex (OFC).

29. The method of claim 28, wherein the step of applying energy to modulate comprises non-invasively stimulating the OFC with at least one TMS electromagnet.

30. The method of claim 28, wherein the step of applying energy to modulate comprises simultaneously stimulating the majority of the OFC.

31. The method of claim 28, wherein the step of applying energy to modulate comprises stimulating the OFC with an array of TMS electromagnets.

32. The method of claim 28, further comprising arranging an array of TMS electromagnets to target the OFC.

33. The method of claim 28, further comprising emitting energy from an array of TMS electromagnets to focus the emitted energy on the OFC.

34. The method of claim 28, wherein the step of applying energy to modulate comprises inhibiting or suppressing activity of the OFC.

35. A method of treating addiction by non-invasive neural stimulation, the method comprising simultaneously applying energy to modulate the activity of two or more target brain regions selected from the group consisting of:

the insula, the Orbitofrontal Cortex (OFC), the tracts between the OFC and the Insula, and the DACG.

38. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate the activity comprises non-invasively stimulating using at least one TMS electromagnet.

41. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate the activity comprises simultaneously stimulating the majority of the target brain regions.

44. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate activity comprises stimulating by TMS using a plurality of TMS electromagnets.

47. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region.

50. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate activity comprises down-regulating activity in one target brain region.

53. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region while down-regulating activity in another brain region.

56. The method of any of claim 35, wherein the step of simultaneously applying energy to modulate activity does not substantially modulate the activity of non-target brain regions.

59. The method of any of claim 35, further comprising positioning one or more arrays of TMS electromagnets to modulate each of the target brain regions.

36. A method of treating depression by non-invasive neural stimulation, the method comprising simultaneously applying energy to modulate the activity of two or more target brain regions selected from the group consisting of:

the LDLPFC, the RDLPFC, the DACG, and the Orbitofrontal Cortex (OFC).

39. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate the activity comprises non-invasively stimulating using at least one TMS electromagnet.

42. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate the activity comprises simultaneously stimulating the majority of the target brain regions.

45. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate activity comprises stimulating by TMS using a plurality of TMS electromagnets.

48. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region.

51. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate activity comprises down-regulating activity in one target brain region.

54. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region while down-regulating activity in another brain region.

57. The method of any of claim 36, wherein the step of simultaneously applying energy to modulate activity does not substantially modulate the activity of non-target brain regions.

60. The method of any of claim 36, further comprising positioning one or more arrays of TMS electromagnets to modulate each of the target brain regions.

37. A method of treating pain by non-invasive neural stimulation, the method comprising simultaneously applying energy to modulate the activity of two or more target brain regions selected from the group consisting of:

the Cingulate Gyms, the DACG, the Insula and the Lateral Thalamus.

40. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate the activity comprises non-invasively stimulating using at least one TMS electromagnet.

43. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate the activity comprises simultaneously stimulating the majority of the target brain regions.

46. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate activity comprises stimulating by TMS using a plurality of TMS electromagnets.

49. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region.

52. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate activity comprises down-regulating activity in one target brain region.

55. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate activity comprises up-regulating activity in one target brain region while down-regulating activity in another brain region.

58. The method of any of claim 37, wherein the step of simultaneously applying energy to modulate activity does not substantially modulate the activity of non-target brain regions.

61. The method of any of claim 37, further comprising positioning one or more arrays of TMS electromagnets to modulate each of the target brain regions.

62. A method of treating a disorder by targeted deep-brain Transcranial Magnet Stimulation of a neuronal circuit associated with the disorder, the method comprising:

identifying a plurality of target brain regions from a neuronal circuit associated with the neuronal disorder;

aiming a plurality of TMS electromagnets at each of the target brain regions,

wherein at least one of the target brain regions comprises a deep brain target; and

applying power to the TMS electromagnets to modulate the activity of the target brain regions.

63. The method of claim 62, wherein the disorders treated are selected from the group consisting of:

addiction, Alzheimer'"'"'s disease, anogasmia, Attention Deficit Disorder, autism, cerebral palsy, bipolar depression, unipolar depression, epilepsy, generalized anxiety disorder, head trauma (acute), hedonism, obesity, OCD, acute pain, chronic pain, Parkinson'"'"'s disease, persistent vegetative state, phobia, PTSD, social anxiety disorder, post-stroke and post-heat trauma rehabilitation/regenesis, Hemorrhagic stroke, ischemic stroke, and Tourette'"'"'s syndrome.

64. The method of claim 62, wherein the step of aiming comprises simultaneously aiming the TMS electromagnets at each of the target brain regions.

65. The method of claim 62, wherein the step of aiming comprises determining positions and orientation for each of the plurality of TMS electromagnets based on the target and one or more of an atlas, brain imaging, or external landmarks on head.

66. A method of treating addiction by targeted deep-brain Transcranial Magnet Stimulation, the method comprising:

targeting one or more TMS electromagnets at each of two or more of the targets selected from the list comprising;

the Orbitofrontal Cortex (OFC), the tracts between the OFC and the Insula, the DACG, the Medial PFC, the Striatum-DACG connections, the anterior limb of the internal capsule, and the Insula; and

applying power to the one or more TMS electromagnets to modulate the activity of the targeted brain regions to treat addiction.

67. A method of treating obesity by targeted deep-brain Transcranial Magnet Stimulation, the method comprising:

targeting one or more TMS electromagnets at each of two or more of the targets selected from the list comprising;

the Orbitofrontal Cortex (OFC), the Insula, the lateral hypothalamic area nuclei, and the ventromedial nuclei of the hypothalamus; and

applying power to the one or more TMS electromagnets to modulate the activity of the targeted brain regions to treat obesity.

68. A method of treating pain by targeted deep-brain Transcranial Magnet Stimulation, the method comprising:

targeting one or more TMS electromagnets at each of two or more of the targets selected from the list comprising;

the cingulate gyrus, the DACG, the Insula and the lateral thalamus; and

applying power to the one or more TMS electromagnets to modulate the activity of the targeted brain regions to treat pain.

69. A method of treating depression by targeted deep-brain Transcranial Magnet Stimulation, the method comprising:

targeting one or more TMS electromagnets at each of two or more of the targets selected from the list comprising;

the LDLPFC, the RDLPFC, the Orbitofrontal Cortex (OFC), and the subgenual cingulate; and

applying power to the one or more TMS electromagnets to modulate the activity of the targeted brain regions to treat depression.