Feedback method for deep brain stimulation with detection of generalized efference copy signals

• US 7,539,543 B2
• Filed: 12/16/2002
• Issued: 05/26/2009
• Est. Priority Date: 06/11/1999
• Status: Expired due to Term

• Current Assignee: Cornell Research Foundation Incorporated (Cornell University)
• Original Assignee: Cornell Research Foundation Incorporated (Cornell University)
• Inventors: Purpura, Keith, Kalik, Steven, Schiff, Nicholas D.
• Primary Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US10/320,840
• Publication Number:
  US 20030097159A1
• Time in Patent Office: 2,353 Days
• Field of Search: 607/45, 607/46, 607/49, 607/50, 607/52, 607/62, 600/544, 600/545, 600/595
• US Class Current: 607/45
• 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 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

Disclosed is a method for improving cognitive function or for improving coordination of function across a patient'"'"'s cortical regions. The method includes applying electrical stimulation to at least a portion of the patient'"'"'s subcortical structures involved in the generation and control of generalized efference copy signals. Internally generated movement of the patient is then detected and, in response to such internally generated movement, application of electrical stimulation is controlled. The method of the present invention has a number of benefits, including increasing flexibility in identifying targets for stimulation, improving the probability of successfully treating brain injury, and permitting patient biofeedback and self-regulation.

Claims

1. A method of treating a patient suffering from chronic pain and/or generalized seizures, said method comprising:

selecting a patient suffering from chronic pain and/or generalized seizures;

applying electrical stimulation to at least a portion of the patient'"'"'s subcortical structures involved in the generation and control of generalized efference copy signals under conditions effective to treat the patient'"'"'s chronic pain and/or generalized seizures;

detecting generalized efference copy signals of the patient; and

controlling said applying electrical stimulation in response to detected generalized efference copy signals of the patient.

2. The method according to claim 1, wherein the patient is suffering from chronic pain.

3. The method according to claim 1, wherein the patient is suffering from generalized seizures.

4. The method according to claim 1, wherein the patient is suffering from chronic pain and generalized seizures.

5. The method according to claim 1, wherein the subcortical structure is the patient'"'"'s intralaminar nuclei.

6. The method according to claim 5, wherein the at least a portion of the patient'"'"'s intralaminar nuclei comprises paralamellar regions.

7. The method according to claim 5, wherein electrical stimulation is applied only to at least a portion of the patient'"'"'s intralaminar nuclei.

8. The method according to claim 1, wherein electrical stimulation is applied continuously.

9. The method according to claim 1, wherein electrical stimulation is applied intermittently.

10. The method according to claim 1, wherein electrical stimulation is applied periodically.

11. The method according to claim 1, wherein said detecting is carried out by monitoring specific regional or intrahemispheric changes in distribution of power or coherence within a frequency spectrum.

12. The method according to claim 1, wherein said detecting is carried out by monitoring endogeneous eye movement by indwelling hardware.

13. A method of treating a patient suffering from a brain injury, said method comprising:

selecting a patient suffering from a brain injury;

applying electrical stimulation to at least a portion of the patient'"'"'s subcortical structures involved in the generation and control of generalized efference copy signals under conditions effective to treat the patient'"'"'s brain injury;

detecting generalized efference copy signals of the patient; and

controlling said applying electrical stimulation in response to detected generalized efference copy signals of the patient.

14. The method according to claim 13, wherein the brain injury is produced by stroke.

15. The method according to claim 13, wherein the brain injury is produced by head trauma.

16. The method according to claim 13, wherein the brain injury is produced by toxicological agents.

17. The method according to claim 13, wherein the brain injury is produced by anoxia.

18. The method according to claim 13, wherein the brain injury is produced by ischemia.

19. The method according to claim 13, wherein the brain injury is produced by nutritional deficiencies.

20. The method according to claim 13, wherein the brain injury is produced by developmental diseases.

21. The method according to claim 13, wherein the brain injury is produced by infectious diseases.

22. The method according to claim 13, wherein the brain injury is produced by neoplastic diseases.

23. The method according to claim 13, wherein the brain injury is produced by degenerative diseases.

24. The method according to claim 13, wherein the subcortical structure is the patient'"'"'s intralaminar nuclei.

25. The method according to claim 24, wherein at least a portion of the patient'"'"'s intralaminar nuclei comprises paralamellar regions.

26. The method according to claim 24, wherein electrical stimulation is applied only to the at least a portion of the patient'"'"'s intralaminar nuclei.

27. The method according to claim 13, wherein electrical stimulation is applied continuously.

28. The method according to claim 13, wherein electrical stimulation is applied intermittently.

29. The method according to claim 13, wherein electrical stimulation is applied periodically.

30. The method according to claim 13, wherein said detecting is carried out by monitoring specific regional or intrahemispheric changes in distribution of power or coherence within a frequency spectrum.

31. The method according to claim 13, wherein said detecting is carried out by monitoring endogeneous eye movement by indwelling hardware.

32. A method of treating a patient suffering from post-encephalitic parkinsonism, said method comprising:

selecting a patient suffering from post-encephalitic parkinsonism;

applying electrical stimulation to at least a portion of the patient'"'"'s subcortical structures involved in the generation and control of generalized efference copy signals under conditions effective to treat the patient'"'"'s post-encephalitic parkinsonism;

detecting generalized efference copy signals of the patient; and

controlling said applying electrical stimulation in response to detected generalized efference copy signals of the patient.

33. The method according to claim 32, wherein the subcortical structure is the patient'"'"'s intralaminar nuclei.

34. The method according to claim 33, wherein at least a portion of the patient'"'"'s intralaminar nuclei comprises paralamellar regions.

35. The method according to claim 33, wherein electrical stimulation is applied only to at least a portion of the patient'"'"'s intralaminar nuclei.

36. The method according to claim 32, wherein electrical stimulation is applied continuously.

37. The method according to claim 32, wherein electrical stimulation is applied intermittently.

38. The method according to claim 32, wherein electrical stimulation is applied periodically.

39. The method according to claim 32, wherein said detecting is carried out by monitoring specific regional or intrahemispheric changes in distribution of power or coherence within a frequency spectrum.

40. The method according to claim 32, wherein said detecting is carried out by monitoring endogeneous eye movement by indwelling hardware.

41. A method of treating a patient suffering from oculogyric crises, said method comprising:

selecting a patient suffering from oculogyric crises;

applying electrical stimulation to at least a portion of the patient'"'"'s subcortical structures involved in the generation and control of generalized efference copy signals under conditions effective to treat the patient'"'"'s oculogyric crises;

detecting generalized efference copy signals of the patient; and

controlling said applying electrical stimulation in response to detected generalized efference copy signals of the patient.

42. The method according to claim 41, wherein the subcortical structure is the patient'"'"'s intralaminar nuclei.

43. The method according to claim 42, wherein at least a portion of the patient'"'"'s intralaminar nuclei comprises paralamellar regions.

44. The method according to claim 42, wherein electrical stimulation is applied only to at least a portion of the patient'"'"'s intralaminar nuclei.

45. The method according to claim 41, wherein electrical stimulation is applied continuously.

46. The method according to claim 41, wherein electrical stimulation is applied intermittently.

47. The method according to claim 41, wherein electrical stimulation is applied periodically.

48. The method according to claim 41, wherein said detecting is carried out by monitoring specific regional or intrahemispheric changes in distribution of power or coherence within a frequency spectrum.

49. The method according to claim 41, wherein said detecting is carried out by monitoring endogeneous eye movement by indwelling hardware.