Methods for treating tinnitus by drug microinfusion from a neural prosthesis inserted in the brain

• US 5,676,655 A
• Filed: 02/06/1996
• Issued: 10/14/1997
• Est. Priority Date: 02/09/1994
• Status: Expired due to Term

• Current Assignee: University of Iowa Research Foundation
• Original Assignee: University of Iowa Research Foundation
• Inventors: Howard, Matthew A. III, Bauer, Carol A., McCulloch, Timothy M.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US08/597,355
• Time in Patent Office: 616 Days
• Field of Search: 604/116, 604/131, 604/151
• US Class Current: 604/116
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61F 11/00 Methods or devices for treatment of the ears or hearing sense implantable prostheses that substitute or replace internal ear parts, e.g. ear-drums, A61F2/18; methods or devices to cause a change in the state of auditory consciousness A61M21/00; electrotherapy applying electrical stimulation of the auditory system, or circuits therefor A61N1/36; radiotherapy using optical stimulation of the auditory system A61N5/06; electro-acoustic hearing aids H04R25/00; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand headwear, e.g. caps or helmets, with means for protecting the ears A42B1/0188, A42B3/16
• CPC Class Codes: A61F 11/20 Ear surgery
• CPC Class Codes: A61F 5/0026 Anti-eating devices using electrical stimulation
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 27/006 Cerebrospinal drainage; Accessories therefor, e.g. valves
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1428 with manual pumping action
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/0541 Cochlear electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• 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 method for implanting a neural prosthetic drug delivery apparatus into a target zone of a patient'"'"'s brain for reducing or eliminating the effects of tinnitus. The apparatus includes a catheter which is inserted into the patient'"'"'s auditory cortex or thalamus. The catheter microinfuses drugs which suppress or eliminate abnormal neural activity into geometrically separate locations of the patient'"'"'s cortex or thalamus, thereby reducing or eliminating the effects of tinnitus.

Claims

1. A method of treating a tinnitus patient, comprising the steps of:

obtaining an image of a target zone of the patient'"'"'s brain;

inserting a catheter of a neural prosthetic apparatus into said target zone of the patient'"'"'s brain using the image as a guide, said neural prosthetic apparatus comprising a drug reservoir for containing a drug, said drug reservoir coupled to said catheter, said catheter having a plurality of drug delivery ports for outputting said drug, said drug suppressing abnormal neural activity;

providing a supply of said drug for outputting into said target zone of the patient'"'"'s brain;

outputting said drug into said target zone of the patient'"'"'s brain;

monitoring the patient'"'"'s response to said drug outputted into said target zone of the patient'"'"'s brain; and

manually adjusting the amount of said drug outputted into said target zone of the patient'"'"'s brain according to the patient'"'"'s response to said drug outputted.

2. The method of claim 1, wherein said inserting step comprises the steps of:

inserting a catheter of a neural prosthetic apparatus into said target zone of the patient'"'"'s brain, wherein said catheter includes a recording/stimulating electrode, said recording/stimulating electrode having a plurality of electrical contacts, said electrical contacts electrically coupled to a stimulation device, said stimulation device for outputting electrical signals;

outputting electrical discharges from said plurality of electrical contacts, said electrical discharges outputted according to said electrical signals outputted from said stimulation device;

receiving electrical discharges at said recording/stimulating electrode, said electrical discharges received from said target zone of the patient'"'"'s brain; and

positioning said catheter within said target zone of the patient'"'"'s brain, said electrical discharges received providing physiologic confirmation of proper catheter position within said target zone of the patient'"'"'s brain.

3. The method of claim 1, wherein said step of outputting said drug comprises the steps of:

connecting said catheter to a pump-reservoir, said pump-reservoir for supplying said drug to said plurality of drug delivery ports; and

pumping said drug from said pump-reservoir through said catheter to said plurality of drug delivery ports and infusing said drug from said plurality of drug delivery ports into geometrically separate locations within said target zone of the patient'"'"'s brain, said geometrically separate locations corresponding to the respective external positions of said plurality of drug delivery ports on said catheter.

4. The method of claim 3, further comprising the steps of:

locating said pump-reservoir beneath the patient'"'"'s scalp; and

securing said pump-reservoir to the patient'"'"'s skull.

5. The method of claim 4, further comprising the step of recharging said pump-reservoir with said drug, said pump-reservoir including an externally accessible valve, said step of recharging comprising injecting said drug into said pump-reservoir through said valve.

6. The method of claim 3, wherein said pumping step comprises the step of adjusting the rate of said pumping said drug, the rate of said pumping said drug adjusted according to the patient'"'"'s response to said drug, said drug capable of suppressing abnormal neural activity and alleviating the symptoms of tinnitus.

7. The method of claim 6, wherein said adjusting the rate of said pumping said drug step comprises adjusting the rate of said pumping by percutaneous radio control.

8. The method of claim 1, wherein said obtaining step comprises obtaining an image of said target zone of the patient'"'"'s brain, said target zone including one of an ordinary cortex and a medial geniculate nucleus of a thalamus, and said inserting step comprises inserting the catheter into said target zone of the patient'"'"'s brain, said target zone including one of the auditory cortex and the medial geniculate nucleus of the thalamus.

9. The method of claim 1, wherein said step of outputting said drug comprises outputting a drug which blocks abnormal neural activity, said drug including one of an anticonvulsant, a neurotransmitter, and a local anesthetic.

10. The method of claim 1, wherein said step of obtaining an image of a target zone of the patient'"'"'s brain comprises:

acquiring digital data corresponding to a three dimensional digital image of the patient'"'"'s brain;

storing said digital data corresponding to said three dimensional digital image in a memory of a computer;

transforming said digital data corresponding to from said three dimensional digital image to yield transformed digital data, said transformed digital data corresponding to a modified three dimensional digital image, said modified three dimensional digital image showing the location and orientation of said target zone of the patient'"'"'s brain.

11. The method of claim 1, wherein said inserting step comprises the steps of:

a) inserting a catheter of a neural prosthetic apparatus into said target zone of the patient'"'"'s brain, wherein said catheter includes a recording/stimulating electrode, said recording/stimulating electrode having a plurality of electrical contacts, said plurality of electrical contacts electrically coupled to a stimulation device, said stimulation device for outputting electrical signals;

b) outputting electrical discharges from said plurality of electrical contacts, said electrical discharges outputted from said plurality of electrical contacts according to said electrical signals outputted from said stimulation device;

c) monitoring the patient'"'"'s response to said electrical discharges outputted from said plurality of electrical contacts;

d) adjusting the position of said catheter within said target zone of the patient'"'"'s brain according to the patient'"'"'s response to said electrical discharges outputted from said plurality of electrical contacts; and

e) repeating steps b), c) and d) until the proper position of said catheter within said target zone of the patient'"'"'s brain is achieved.

12. The method of claim 1, wherein said inserting step comprises the steps of:

a) inserting a catheter of a neural prosthetic apparatus into said target zone of the patient'"'"'s brain, wherein said catheter includes a recording/stimulating electrode, said recording/stimulating electrode having a plurality of electrical contacts, each of said plurality of electrical contacts capable of receiving electrical discharges from said target zone of the patient'"'"'s brain, and said neural prosthetic apparatus capable of recording said electrical discharges received from said target zone of the patient'"'"'s brain;

b) receiving electrical discharges at said plurality of electrical contacts, said electrical discharges received according to the position of said catheter within said target zone of the patient'"'"'s brain;

c) recording the position on said catheter of said electrical contacts receiving said electrical discharges received;

d) adjusting the position of said catheter within said target zone of the patient'"'"'s brain according to the position on said catheter of said electrical contacts receiving said electrical discharges received; and

e) repeating steps b), c) and d) until the proper position of said catheter within said target zone of the patient'"'"'s brain is achieved.