Methods and apparatus for effectuating a lasting change in a neural-function of a patient

• US 7,756,584 B2
• Filed: 09/27/2002
• Issued: 07/13/2010
• Est. Priority Date: 07/13/2000
• Status: Expired due to Fees

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Firlik, Andrew D., Sheffield, W. Douglas, Firlik, Katrina S.
• Primary Examiner(s): Evanisko; George R
• Assistant Examiner(s): Kahelin; Michael
• Application Number:
  US10/260,720
• Publication Number:
  US 20030130706A1
• Time in Patent Office: 2,846 Days
• Field of Search: 607/2, 607/45, 607/46, 600/544, 600/545, 606/130
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• 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
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

The following disclosure is drawn to methods of electrically stimulating areas of the brain in which neuroplasticity are occurring. The stimulation site may be different than the region in the brain where neural activity is typically present to perform the particular neural function according to the functional organization of the brain. The disclosure provides methods of identify the location in which neuroplasticity is occurring, not occurring or expected to occur.

Claims

1. A method of effectuating a neural-function of a patient, comprising:

selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region;

positioning at least a first electrode at the stimulation site; and

applying an electrical potential to pass a current through the first electrode.

2. The method of claim 1 wherein moving the impaired body part comprises passively moving the impaired body part.

3. The method of claim 1 wherein moving the impaired body part comprises passively moving the impaired body part via attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

4. The method of claim 1 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.

5. The method of claim 1 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.

6. The method of claim 1 wherein moving the impaired body part includes directly contacting and moving the impaired body part.

7. The method of claim 1 wherein detecting a region of the brain includes detecting a region of the brain using fMRI.

8. The method of claim 1 wherein applying an electrical potential includes applying an electrical potential at a level that raises a resting potential of neurons at the stimulation site to a subthreshold level.

9. The method of claim 8 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 10%-95% of a difference between an unstimulated resting potential and a threshold potential for the neurons.

10. The method of claim 8 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 60%-80% of a difference between an unstimulated resting potential and a threshold potential for the neurons.

11. A method of effectuating a neural-function of a patient, comprising:

selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain, wherein triggering a neural signal includes moving, stimulating, or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region; and

applying an electrical signal directly to the stimulation site effective to carry out the neural function.

12. The method of claim 11 wherein moving the impaired body part comprises passively moving the impaired body part.

13. The method of claim 11 wherein moving the impaired body part comprises passively moving the impaired body part via attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

14. The method of claim 11 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.

15. The method of claim 11 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.

16. A method of effectuating a neural-function of a patient, comprising:

selecting a stimulation site by (a) activating a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain, wherein activating a neural signal includes moving, stimulating, or moving and stimulating the impaired body part, (b) detecting a cortical region where a response to neural activity occurs in the brain of the patient in reaction to the neural signal associated with the impaired body part, the detected cortical region being at a cortical location of the brain different than a normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region; and

applying an electrical stimulation directly to the stimulation site.

17. The method of claim 16 wherein moving the impaired body part comprises passively moving the impaired body part.

18. The method of claim 16 wherein moving the impaired body part comprises passively moving the impaired body part by attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

19. The method of claim 16 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.

20. The method of claim 16 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.

21. A method for treating a patient, comprising:

selecting a signal delivery site by a process that comprises;

applying a signal directly to a portion of the patient'"'"'s body external to the patient'"'"'s brain to trigger a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain;

detecting a cortical region of the brain in which a response to neural activity occurs in response to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part; and

selecting the signal delivery site to be within the detected cortical region; and

passing an electrical current through the signal delivery site.

23. The method of claim 21 wherein applying a signal directly to a portion of the patient'"'"'s body includes applying a signal directly to the impaired body part.

24. The method of claim 21 wherein detecting a region of the brain includes detecting a region of the brain using fMRI.

25. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential at a level that raises a resting potential of neurons at the stimulation site to a subthreshold level.

26. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 10%-95% of a difference between an unstimulated resting potential and a threshold potential for the neurons.

27. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 60%-80% of a difference between an unstimulated resting potential and a threshold potential for the neurons.

22. The method 21 of claim wherein applying a signal includes applying an electrical signal.

28. A method of effectuating a neural-function of a patient, comprising:

selecting a stimulation site by (a) triggering a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region;

positioning at least a first electrode within the patient'"'"'s skull, external to a cortical surface of the brain at the stimulation site; and

applying an electrical potential to pass a current through the first electrode.

29. The method of claim 28 wherein selecting a stimulation site includes selecting a stimulation site on a patent-specific basis.

30. A method of effectuating a neural-function of a patient, comprising:

selecting one or more stimulation sites by (a) triggering a neural signal from an impaired body part affected by neural dysfunction of the patient'"'"'s brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, and (c) selecting the patient'"'"'s brain stimulation sites to be located within the patient'"'"'s skull, within the detected cortical region, and on a cortical surface of the brain;

positioning at least a first electrode at the one or more stimulation sites; and

applying an electrical potential to pass a current through the first electrode.

31. The method of claim 30 wherein moving the impaired body part comprises passively moving the impaired body part.

32. The method of claim 30 wherein moving the impaired body part comprises passively moving the impaired body part by attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

33. The method of claim 30 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.

34. The method of claim 30 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.