Methods for treating essential tremor

• US 6,959,215 B2
• Filed: 07/17/2003
• Issued: 10/25/2005
• Est. Priority Date: 12/09/2002
• Status: Expired due to Fees

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories)
• Original Assignee: Northstar Neuroscience, Inc.
• Inventors: Wyler, Allen, Gliner, Bradford Evan
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/622,898
• Publication Number:
  US 20040111129A1
• Time in Patent Office: 831 Days
• Field of Search: 607/45, 607/48
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36135 using physiological parameters

Abstract

A method for treating essential tremor includes directing a patient to perform a muscle action, for example a postural or kinetic muscle action. The method can further include collecting information, with the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action. The essential tremor motion of the patient can then be at least reduced by applying an electrical stimulation at least proximate to a stimulation site, with the location of the stimulation site being based at least in part on the collected information. The information can include visual images (e.g. MRI, fMRI, or CT techniques) or be non-visual. In particular embodiments, the location of the stimulation site can be determined by comparing two pieces of information, for example, neural activities before and after drug intake, or neural activities at the left and right hemispheres of the brain.

Claims

1. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

eliminating an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

2. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing a computer-based routine to collect information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

3. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected on blood oxygen levels in the brain, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

4. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action;

locating a stimulation site based at least in part on the information and positioned relative to an anatomical feature of the patient; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to the stimulation site.

5. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action;

locating a stimulation site based at least in part on the information relative to a fiducial having a fixed location relative to the patient'"'"'s skull; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to the stimulation site.

6. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action a first time;

directing first information to be collected, the first information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action the first time;

affecting the patient'"'"'s motor nerves by introducing a drug into the patient'"'"'s body;

directing second information to be collected while the patient performs the muscle action a second time and while the patient is under the influence of the drug;

directing a comparison of the first information with the second information to identify a stimulation site of the brain; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to the stimulation site.

7. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by administering drugs to the patient and applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

8. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information, the electrical stimulation including a varying electrical stimulation signal having an electrical potential of from about 0.25 volts to about 5.0 volts.

9. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action that includes maintaining a muscle in a particular position;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

10. A method for treating essential tremor, comprising:

obtaining first information corresponding to a level of neural activity in the patient'"'"'s brain while the patient does not perform a muscle action;

directing a patient to perform the muscle action;

directing second information to be collected, the second information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on a comparison of the second information with the first information.

11. A method for treating essential tremor, comprising:

directing the patient to undergo a plurality of muscle actions;

selecting from the plurality of muscle actions a muscle action that produces a selected level of essential tremor motion;

directing a patient to perform the muscle action to produce the selected level of essential tremor motion;

directing information to be collected, the information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, the location of the stimulation site being based at least in part on the information.

12. A method for treating essential tremor, comprising:

identifying a muscle action subject to essential tremor;

monitoring a first image of the patient'"'"'s brain function while the patient is not performing the muscle action;

monitoring a second image of the patient'"'"'s brain function while the patient performs the muscle action;

comparing the first and second images to identify a stimulation site of the brain;

placing at least one electrode at least proximate to the stimulation site;

at least reducing the patient'"'"'s essential tremor motion by applying an electrical stimulation at least proximate to the stimulation site.

13. The method of claim 12 wherein comparing the first and second images includes comparing a first image having visual characteristic with a first value at least proximate to the stimulation site with a second image having the visual characteristic with a second value different than the first value at least proximate to the stimulation site.

14. The method of claim 12 wherein comparing the first and second images includes comparing a first image having a first baseline region and a first activity region corresponding to increased brain activity relative to the first baseline region, with a second image having a second baseline region and a second region corresponding to increased brain activity relative to the second baseline region, a location of the second activity region being different than a location of the first activity region.

15. The method of claim 12 wherein comparing the first and second images includes comparing a first image having a first baseline region and a first activity region corresponding to increased brain activity relative to the first baseline region, with a second image having a second baseline region and a second activity region corresponding to increased brain activity relative to the second baseline region, with a brain activity level of the second activity region being different than a brain activity level of the first activity region.

16. The method of claim 12 wherein identifying a stimulation site includes determining a region of the patient'"'"'s brain that corresponds to a portion of the image that changes at least one characteristic as the patient performs the muscle action.

17. The method of claim 12 wherein monitoring the first image includes monitoring a first functional MRI image, and wherein monitoring the second image includes monitoring a second functional MRI image.

18. The method of claim 12 wherein comparing the first and second images includes:

determining a first region of a first hemisphere of the patient'"'"'s brain corresponding to a portion of the image that changes at least one characteristic as the patient performs the muscle action; and

determining the stimulation location to include a second region of a second hemisphere of the patient'"'"'s brain, the second region corresponding functionally to the first region.

19. A method for treating essential tremor, comprising:

directing a patient to perform a muscle action;

while the patient performs the muscle action, directing a collection of information corresponding to a level of neural activity in the patient'"'"'s brain;

directing a comparison of a first portion of the information corresponding to a level of neural activity at the left hemisphere of the patient'"'"'s brain with a second portion of the information corresponding to a level of neural activity at the right hemisphere of the patient'"'"'s brain; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, with a location of the stimulation site being based at least in part on the comparison of the first and second portions of the information.

20. The method of claim 19 wherein at least reducing an essential tremor motion includes eliminating the essential tremor motion.

21. The method of claim 19 wherein directing information to be collected includes directing a computer-based routine to collect the information.

22. The method of claim 19, further comprising directing the formation of an image of at least a portion of the patients brain, with at least a portion of the image having features representative of the information.

23. The method of claim 19, further comprising implanting at least one electrode at least proximate to the stimulation site, and wherein applying an electrical stimulation includes applying an electrical signal to the at least one electrode.

24. The method of claim 19 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having a frequency of from about 5 Hz to about 200 Hz.

25. The method of claim 19 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having an electrical potential of from about 0.25 volts to about 5.0 volts.

26. The method of claim 19 wherein directing the patient to perform a muscle action includes directing the patient to move the muscle.

27. A method for treating essential tremor, comprising:

directing a patient to perform an action with a first muscle on a first side of the patient'"'"'s body, the first muscle being controlled by a second hemisphere of the patient'"'"'s brain;

while the patient performs the action with the first muscle, directing a collection of first information corresponding to a level of neural activity in the patient'"'"'s brain;

directing the patient to perform an action with a second muscle on a second side of the patient'"'"'s body, the second muscle mirroring the first muscle and being controlled by a first hemisphere of the patient'"'"'s brain;

while the patient perform an action with the second muscle, directing a collection of second information corresponding to a level of neural activity in the patient'"'"'s brain; and

at least reducing an essential tremor motion of the patient by applying an electrical stimulation at least proximate to a stimulation site, with a location of the stimulation site being based at least in part on a comparison of the first information with the second information.

28. The method of claim 27 wherein at least reducing an essential tremor motion includes eliminating the essential tremor motion.

29. The method of claim 27 wherein directing information to be collected includes directing a computer-based routine to collect the information.

30. The method of claim 27, further comprising directing the formation of an image of at least a portion of the patient'"'"'s brain, with at least a portion of the image having features representative of the information.

31. The method of claim 27, further comprising implanting at least one electrode at least proximate to the stimulation site, and wherein applying an electrical stimulation includes applying an electrical signal to the at least one electrode.

32. The method of claim 27 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having a frequency of from about 5 Hz to about 200 Hz.

33. The method of claim 27 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having an electrical potential of from about 0.25 volts to about 5.0 volts.

34. The method of claim 27 wherein directing the patient to perform a muscle action includes directing the patient to move the muscle.

35. A method for treating essential tremor, comprising:

directing a collection of first information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs a muscle action;

affecting the patient'"'"'s motor nerves by introducing a drug into the patient'"'"'s body;

directing a collection of second information corresponding to a level of neural activity in the patient'"'"'s brain while the patient performs the muscle action and while the patient is under the influence of the drug; and

at least reducing the patient'"'"'s essential tremor motion by applying an electrical stimulation at least proximate to a stimulation site, with a location of the stimulation site being based at least in part on the comparison of the first information with the second information.

36. The method of claim 35 wherein introducing a drug includes introducing ethyl alcohol.

37. The method of claim 35 wherein at least reducing an essential tremor motion includes eliminating the essential tremor motion.

38. The method of claim 35 wherein directing information to be collected includes directing a computer-based routine to collect the information.

39. The method of claim 35, further comprising directing the formation of an image of at least a portion of the patient'"'"'s brain, with at least a portion of the image having features representative of the information.

40. The method of claim 35, further comprising implanting at least one electrode at least proximate to the stimulation site, and wherein applying an electrical stimulation includes applying an electrical signal to the at least one electrode.

41. The method of claim 35 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having a frequency of from about 5 Hz to about 200 Hz.

42. The method of claim 35 wherein applying an electrical stimulation includes applying a varying electrical stimulation signal having an electrical potential of from about 0.25 volts to about 5.0 volts.

43. The method of claim 35 wherein directing the patient to perform a muscle action includes directing the patient to move the muscle.