Trajectory-based deep-brain stereotactic transcranial magnetic stimulation

• US 8,052,591 B2
• Filed: 05/05/2006
• Issued: 11/08/2011
• Est. Priority Date: 05/05/2006
• Status: Active Grant

• Current Assignee: US Department of Veterans Affairs (Government of the United States of America), Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Schneider, M. Bret, Mishelevich, David J.
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): HOPKINS, CHRISTINE D
• Application Number:
  US11/429,504
• Publication Number:
  US 20070260107A1
• Time in Patent Office: 2,013 Days
• Field of Search: 600 9- 15, 607/2, 607/3
• US Class Current: 600/14
• CPC Class Codes: A61N 2/004 specially adapted for a specific therapy
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/008 for pain treatment or analgesia
• CPC Class Codes: A61N 2/02 using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence

Abstract

The present invention provides for Stereotactic Transcranial Magnetic Stimulation (sTMS) at predetermined locations with the brain or spinal cord and incorporates an array of electromagnets arranged in a specified configuration where selected coils in the array are pulsed simultaneously. Activation of foci demonstrated by functional MRI or other imaging techniques can be used to locate the neural region affected. Imaging techniques can also be utilized to determine the location of the designated targets.

Claims

1. A method for generating higher magnetic-field stimulation at a deep brain target than at more superficial cortical non-target brain regions, the method comprising the steps of:

selecting a deep brain target,

positioning an array of electromagnets about a patient'"'"'s head,

orienting the electromagnets so that components of magnetic-field energy from at least two of the electromagnets intersect at the deep brain target, wherein the deep brain target is deeper in the brain and further from the electromagnets than the more superficial cortical non-target brain regions; and

simultaneously energizing at least two of the electromagnets, whereby a stimulating vector component of the magnetic field received at the deep brain target produces stimulation at the deep-brain target which is greater than that produced at the more superficial cortical brain locations between the deep brain target and the electromagnets.

2. The method of claim 1, wherein the orienting step includes orienting the electromagnets such that, during the energizing step, radial components of energy emitted by at least three of the energized electromagnets intersect at the target.

3. The method of claim 1, wherein the energizing step includes the step of energizing at least two of the electromagnets using different magnitudes of power.

4. The method of claim 1, wherein the energizing step includes the step of energizing at least two of the electromagnets using current of opposite polarity.

5. The method of claim 1, in which the stimulating vector component is comprised of energy emitted from a plurality of the electromagnets.

6. The method of claim 1, further including the step of moving the array during the energizing step.

7. The method of claim 1, further including the step of, during the energizing step, automatically moving the array along multiple axes.

8. The method of claim 1, including the step of moving at least one of the electromagnets longitudinally and angularly relative to a target structure.

9. The method of claim 1, further including the step of reciprocating the electromagnets along an axis perpendicular to a radial component of the magnetic field of one of the electromagnets.

10. The method of claim 1, wherein the energizing step includes energizing the electromagnets according to a pulse pattern, and wherein the method further includes interrupting the pulse pattern and then resuming the pulse pattern after an interval of time.

11. The method of claim 1, in which the orienting step positions at least two electromagnets within a plane, and at least one electromagnet outside the plane.

12. The method of claim 1, where the magnetic field further causes stimulation of neural tissue, said stimulation of neural tissue generating electrical signals, and wherein the effect of the stimulating vector component on the target is augmented by the electrical signals.

13. The method in claim 1, wherein each electromagnet produces energy having a radial component, and wherein the orienting step includes orienting at least two of electromagnets such that the radial component from a first one of the two electromagnets occupies a first plane and the radial component from a second one of the two electromagnets occupies a second plane that is different from the first plane.

14. The method of claim 13, in which the first and second planes are at arbitrary angles relative to one another.

15. The method in claim 1, where the target is determined using imaging of the brain.

16. The method of claim 15, wherein the imaging step is carried out using functional MRI.

17. The method in claim 1, wherein the energizing step includes energizing a first one of the electromagnets at a first pulse frequency and energizing a second one of the electromagnets at a second, different pulse frequency.

18. The method in claim 1, wherein the energizing step includes energizing a first one of the electromagnets at a first pulse pattern and energizing a second one of the electromagnets at a second, different pulse pattern.

19. The method in claim 1, wherein the method further includes the steps of selecting a second target, and wherein the energizing step results in stimulation at the second target.

20. The method in claim 1, where the energizing step causes the electromagnets to emit patterns of pulses.

21. The method of claim 1, wherein stimulation of the target treats a condition in the patient, the condition selected from the group of conditions consisting of depression, chronic pain, Alzheimer'"'"'s Disease, obsessive compulsive disorder, addictions, obesity, and Parkinson'"'"'s Disease.

22. The method of claim 1, wherein the step of positioning an array of electromagnets about a patient'"'"'s head comprises positioning the electromagnets around the subject'"'"'s head in a non-overlapping arrangement so that none of the electromagnets is interposed between another electromagnet and the patient'"'"'s head.

23. The method of claim 1, wherein positioning an array of electromagnets about a patient'"'"'s head comprises positioning an array of transcranial magnetic coil electromagnets about a patient'"'"'s head.

24. The method of claim 1, wherein selecting a deep brain target comprises selecting a deep brain region from the group consisting of:

subthalamic nucleus, globus pallidus extema, anterior cingulate gyrus, posterior cingulate gyms, subgenual cingulate gyrus, anterior cingulate, dorsal cingulate gyrus, ventromedial nucleus of thalamus, ventrolateral nucleus of thalamus, anterior limb of the internal capsule, nucleus accumbens, septal nucleus, and hippocampus.

25. A method for generating higher magnetic-field stimulation at a deep brain target than at more superficial cortical non-target brain regions, the method comprising the steps of:

selecting a deep brain target;

positioning an array of electromagnets about a patient'"'"'s head;

orienting the electromagnets to deliver components of magnetic-field energy from at least two of the electromagnets to the deep brain target wherein the deep brain target is deeper in the brain and further from the electromagnets than the more superficial cortical non-target brain regions; and

energizing at least two of the electromagnets, whereby the combined magnetic-field energy emitted from the at least two electromagnets stimulates the deep brain target more that it stimulates the non-target brain regions located between the deep brain target and the electromagnets.

26. The method of claim 25, wherein selecting a deep brain target comprises selecting a deep brain region from the group consisting of:

subthalamic nucleus, globus pallidus extema, anterior cingulate gyrus, posterior cingulate gyrus, subgenual cingulate gyrus, anterior cingulate, dorsal cingulate gyrus, ventromedial nucleus of thalamus, ventrolateral nucleus of thalamus, anterior limb of the internal capsule, nucleus accumbens, septal nucleus, and hippocampus.

27. A method for generating higher magnetic-field stimulation at a deep brain target than at more superficial cortical non-target brain regions, the method comprising the steps of:

selecting a deep brain target;

positioning an array of electromagnets about a patient'"'"'s head;

orienting the electromagnets so that components of magnetic-field energy from at least two of the electromagnets intersect at the deep brain target to deliver magnetic-field energy components to the deep brain target wherein the deep brain target is deeper in the brain and further from the electromagnets than the more superficial cortical non-target brain regions; and

simultaneously energizing at least two of the electromagnets, whereby a stimulation from the electromagnets that is received at the deep brain target is greater than that received at the more superficial non-target brain regions located between the deep brain target and the electromagnets.

28. The method of claim 27, wherein selecting a deep brain target comprises selecting a deep brain region from the group consisting of:

subthalamic nucleus, globus pallidus extema, anterior cingulate gyrus, posterior cingulate gyrus, subgenual cingulate gyrus, anterior cingulate, dorsal cingulate gyrus, ventromedial nucleus of thalamus, ventrolateral nucleus of thalamus, anterior limb of the internal capsule, nucleus accumbens, septal nucleus, and hippocampus.

29. A method for generating magnetic-field stimulation more intensely at a deep brain target than at more superficial non-target regions of the brain, the method comprising the steps of:

positioning an array of electromagnets about a patient'"'"'s head;

orienting the electromagnets so that components of magnetic-field energy from at least two of the electromagnets intersect at the deep brain target to deliver magnetic-field energy to a deep brain target wherein the deep brain target is deeper in the brain and further from the electromagnets than the more superficial non-target brain regions; and

simultaneously energizing at least two of the electromagnets from different positions about the patient'"'"'s head to stimulate the deep brain target with a magnetic field at the target that is greater than the magnetic field received at the non-target brain regions located more superficially, between the deep brain target and the electromagnets.

30. A method for generating higher stimulation at a deep brain target within the brain than at more superficial cortical non-target brain regions, the method comprising the steps of:

selecting a deep brain target;

positioning an array of electromagnets about a patient'"'"'s head in a non-overlapping arrangement so that none of the electromagnets is interposed between another electromagnet and the patient'"'"'s head, wherein the array of electromagnets is oriented so that components of magnetic-field energy from at least two of the electromagnets intersect at the deep brain target to deliver magnetic-field energy to the deep brain target; and

simultaneously energizing at least two of the electromagnets to emit magnetic energy, whereby the energy received at the deep brain target produces stimulation at the deep-brain target which is greater than that produced at the more superficial cortical non-target brain locations between the deep brain target and the electromagnets.

31. The method of claim 30, wherein selecting a deep brain target comprises selecting a deep brain region from the group consisting of:

subthalamic nucleus, globus pallidus extema, anterior cingulate gyrus, posterior cingulate gyrus, subgenual cingulate gyms, anterior cingulate, dorsal cingulate gyms, ventromedial nucleus of thalamus, ventrolateral nucleus of thalamus, anterior limb of the internal capsule, nucleus accumbens, septal nucleus, and hippocampus.