Methods, systems, and devices for pairing vagus nerve stimulation with motor therapy in stroke patients

• US 8,700,145 B2
• Filed: 10/12/2012
• Issued: 04/15/2014
• Est. Priority Date: 07/02/2008
• Status: Active Grant

• Current Assignee: Board of Regents of the University of Texas System (University of Texas System)
• Original Assignee: MicroTransponder Inc., Board of Regents of the University of Texas System (University of Texas System)
• Inventors: Kilgard, Michael P., Engineer, Navzer, Pierce, David Michael, Rennaker, Robert L.
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US13/651,349
• Publication Number:
  US 20130041419A1
• Time in Patent Office: 550 Days
• Field of Search: 607/116, 607/45, 607/2, 607/3
• US Class Current: 607/2
• CPC Class Codes: A61B 5/1124 Determining motor skills
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36092 Mental training
• CPC Class Codes: A61N 1/361 Phantom sensations, e.g. tinnitus
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36178 Burst or pulse train parameters
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2007/0026 Stimulation of nerve tissue
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: G09B 23/28 for medicine

Abstract

A method of treating motor deficits in a stroke patient, comprising assessing a patient'"'"'s motor deficits, determining therapeutic goals for the patient, based on the patient'"'"'s motor deficits, selecting therapeutic tasks based on the therapeutic goals, performing each of the selected therapeutic tasks repetitively, observing the performance of the therapeutic tasks, initiating the stimulation of the vagus nerve manually at approximately a predetermined moment during the performance of the therapeutic tasks, stimulating the vagus nerve of the patient during the performance of the selected therapeutic tasks, and improving the patient'"'"'s motor deficits.

Claims

1. A method of improving motor deficits in a stroke patient, comprising:

assessing a stroke patient'"'"'s motor deficits;

determining therapeutic goals for the patient, based on the patient'"'"'s motor deficits;

selecting one or more therapeutic tasks based on the therapeutic goals;

observing repetitive performances by the patient of the selected therapeutic task;

stimulating the vagus nerve of the patient with an implanted neurostimulator that delivers pulse trains of electrical stimulation energy to a vagus nerve while the patient is performing a movement of the selected therapeutic task;

terminating the stimulation of the vagus nerve so that there is no stimulation between movement execution; and

improving the patient'"'"'s motor deficits,

wherein the action of stimulating the vagus nerve of the patient further comprises determining respective beginnings of performances of the selected therapeutic task, and applying the pulse trains to the vagus nerve based on the determined beginnings of the performances, and

wherein the stimulation pulse trains begin after the beginning of the respective selected therapeutic tasks, wherein the vagus nerve stimulation pulse trains end prior to the end of the respective selected therapeutic tasks, and wherein the vagus nerve stimulation pulse train is not presented between performances of the selected therapeutic task.

2. The method of claim 1, wherein the pulse trains are about 500 milliseconds in duration.

3. The method of claim 1, wherein the pulse trains have an amplitude of about 0.8 milliamperes.

4. The method of claim 1, wherein a therapeutic task level is selected for each therapeutic task and the therapeutic task level may be changed between the repetitive performances.

5. A method of improving motor deficits in a stroke patient, comprising:

assessing a stroke patient'"'"'s motor deficits;

determining therapeutic goals for the patient, based on the patient'"'"'s motor deficits;

selecting a therapeutic task based on the therapeutic goals;

detecting motion during repetitive performances by the patient of the selected therapeutic task;

automatically stimulating a vagus nerve of the patient with an implanted neurostimulator that delivers pulse trains of electrical stimulation energy to the vagus nerve when a predetermined motion is detected;

ending the stimulation of the vagus nerve so that there is no stimulation between the performances; and

improving the patient'"'"'s motor deficits,

wherein the action of stimulating the vagus nerve of the patient further comprises determining respective beginnings of performances of the selected therapeutic task, and applying the pulse trains to the vagus nerve based on the determined beginnings of the performances, and

wherein the stimulation pulse trains begin after the beginning of the respective selected therapeutic tasks, wherein the vagus nerve stimulation pulse trains end prior to the end of the respective selected therapeutic tasks, and wherein the vagus nerve stimulation pulse train is not presented between performances of the selected therapeutic task.

6. The method of claim 5, wherein the pulse trains are about 500 milliseconds in duration.

7. The method of claim 5, wherein the pulse trains have an amplitude of about 0.8 milliamperes.

8. The method of claim 5, wherein the motion is detected by detecting change in color of the object by a camera.