Method of treating movement disorders by electrical stimulation and/or drug infusion of the pendunulopontine nucleus

• US 6,356,784 B1
• Filed: 04/30/1999
• Issued: 03/12/2002
• Est. Priority Date: 04/30/1999
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rise, Mark T., Lozano, Andres M.
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US09/303,146
• Time in Patent Office: 1,047 Days
• Field of Search: 604/21, 604/500, 604/503, 604/22, 604/522, 607/115, 607/116, 607/118, 607/139, 607/2, 607/3, 607/45
• US Class Current: 607/2
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• 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 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators

Abstract

The present invention discloses techniques for treating movement disorders by electrical stimulation and/or drug infusion. The present invention utilizes an implantable signal generator and an electrode and/or an implantable pump and catheter. High electrical stimulation pulses and/or drug therapy is provided to the Pedunculopontine Nucleus (PPN). A sensor may be used to detect various symptoms of the movement disorders. A microprocessor algorithm may then analyze the output from the sensor to regulate the stimulation and/or drug therapy delivered to the PPN.

Claims

1. A method for treating movement disorders by means of an implantable signal generator and a lead having a proximal end coupled to the signal generator and a distal portion having at least one electrode, the method comprising the steps of:

(a) implanting at least one electrode so that the stimulation portion lies at least in direct communication with tissue elements of a pedunculopontine nucleus (PPN);

(b) coupling the proximal end of the implanted electrode to the signal generator; and

(c) operating the signal generator to stimulate the PPN.

2. A method, as claimed in claim 1, further comprising the steps of:

(d) sensing the extent of the movement disorder and generating a sensor signal; and

(e) regulating the operation of the electrode in response to the sensor signal.

3. A method, as claimed in claim 2, wherein said step of regulating comprises the step of executing a control algorithm.

4. A method, as claimed in claim 3, wherein said step of generating a sensor signal includes the steps of detecting a symptom of the movement disorder and communicating with the control algorithm by telemetry.

5. A method, as claimed in claim 2, wherein the step of sensing includes the step of sensing a physiological symptom of the movement disorder.

6. A method, as claimed in claim 2, wherein the step of sensing includes the step of sensing a chemical symptom of the movement disorder.

7. A method, as claimed in claim 2, wherein the step of regulating includes the step of adjusting at least one parameter of the stimulation, the parameter being selected from the group consisting of amplitude, pulse width and frequency.

8. A method, as claimed in claim 7, further comprising the step of:

(f) adjusting at least one parameter of the stimulation downward to decrease the effects of the stimulation.

9. A method, as claimed in claim 1, wherein the step of operating includes the step of selecting amplitude, width and frequency of stimulation by the electrode.

10. A method, as claimed in claim 1, wherein said step of operating includes the step of operating the signal generator to provide a burst of electrical energy to initiate movement.

11. A method, as claimed in claim 1, wherein said step of operating includes the step of operating the signal generator to pulse at a repetition rate of 2-2500 Hertz.

12. A method, as claimed in claim 1, wherein the step of operating includes the step of operating the signal generator to pulse at a repetition rate of 10-2500 Hertz.

13. A method, as claimed in claim 1, further comprising the steps of:

(d) implanting at least one secondary electrode so that a secondary stimulation portion lies in communication with a predetermined portion of a brain;

(e) coupling the secondary electrode to the signal generator; and

(f) operating the signal generator to stimulate the brain.

14. A method, as claimed in claim 1, further comprising the steps of:

(d) implanting at least one catheter so that a secondary stimulation portion lies in communication with a predetermined portion of a brain;

(e) coupling the catheter to a pump; and

(f) operating the pump to deliver drug to the brain.

15. A therapeutic treatment method for treating movement disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of at least one drug, the method comprising the steps of:

(a) implanting the catheter so that the discharge portion lies in at least direct communication with tissue element of a pedunculopontine nucleus (PPN);

(b) coupling the catheter to the pump; and

(c) operating the pump to deliver the drug to the PPN.

16. A method, as claimed in claim 15, wherein the step of operating includes the step of delivering to the PPN at least one drug selected from the group consisting of an anesthetic, a GABA agonist, a GABA antagonist, a glutamate antagonist, a glutamate agonist, a degrading enzyme, a reputake blocker, and a dopamine antagonist.

17. A method, as claimed in claim 16, wherein the step of operating includes the step of selecting a time interval for drug delivery.

18. A method, as claimed in claim 15, wherein the step of operating includes the step of selecting a drug dosage.

19. A method, as claimed in claim 15, further comprising the steps of:

(d) sensing the extent of the movement disorder and generating a sensor signal; and

(e) regulating the operation of the pump in response to the sensor signal.

20. A method, as claimed in claim 15, wherein the step of regulating includes the step of adjusting drug dosage and time interval for drug delivery.

21. A method of using one or more drugs to therapeutically treat a neural disorder over a predetermined time period by means of an implantable pump and a catheter having a proximal end coupled to said pump and a discharge portion for infusing therapeutic dosages of said one or more drugs, as well as a signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:

(a) surgically implanting the electrode so that the stimulation portion lies at least in direct communication with tissue elements of a pedunculopontine nucleus (PPN);

(b) surgically implanting said catheter so that the discharge portion lies adjacent a predetermined infusion site in a brain;

(c) operating the signal generator to stimulate the PPN; and

(d) operating the pump to discharge a predetermined dosage of at least one drug through the discharge portion of the catheter into the predetermined infusion site.