System and method for neuromodulation using composite patterns of stimulation or waveforms

• US 9,211,408 B2
• Filed: 02/26/2013
• Issued: 12/15/2015
• Est. Priority Date: 04/13/2005
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Machado, Andre
• Primary Examiner(s): PATTON, AMANDA K
• Application Number:
  US13/776,875
• Publication Number:
  US 20130338726A1
• Time in Patent Office: 1,022 Days
• Field of Search: 607/5, 607 45- 46, 607/57
• US Class Current: 1/1
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• 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 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/36189 using modulation techniques

Abstract

A neurostimulation system can include a memory, a playback system, a stimulation electrode, and a controller. The memory can store data for first and second input waveforms. The playback system can provides first and second output waveforms, based on the first and second input waveforms in the memory, respectively, to form composite patterns of stimulation or waveforms. The first output waveform can be different than the second output waveform. The second output waveform can be periodically superimposed on the first output waveform. The controller can be in communication with the stimulation electrode. The controller can be configured to control application of the composite pattern of stimulation or waveform to a target site in a body of a subject suffering from a medical condition.

Claims

1. A neurostimulation system comprising:

memory that stores data for first and second input waveforms;

a playback system that provides first and second output waveforms, based on the first and second input waveforms in the memory, respectively, to form composite patterns of stimulation or waveforms, the first output waveform comprising randomly spaced-apart pulses, the second output waveform periodically superimposed on the first output waveform at irregular intervals, the second output waveform having a greater frequency than the first output waveform.

2. The system of claim 1, further comprising a sensor for sensing a bodily activity.

3. The system of claim 1, wherein the waveform data stored in the memory is associated with the performance of specific physical tasks.

4. The system of claim 1, wherein the first and second output waveforms are identical to or derived from the first and second input waveforms.

5. A method for neuromodulation to treat a medical condition in a subject comprising:

applying composite patterns of stimulation or waveforms to a target site of a cortico-ponto-cerebellar pathway or a dentate-thalamo-cortical pathway in the nervous system of the subject, the composite patterns of stimulation or waveforms comprising a first output waveform and a second output waveform, the first output waveform comprising randomly spaced-apart pulses, the second output waveform periodically superimposed on the first output waveform at irregular intervals, the second output waveform having a greater frequency than the first output waveform, wherein delivery of the second output waveform is triggered by a sensed bodily activity.

6. The method of claim 5 further comprising:

recording a first input waveform;

recording a second input waveform from a first site in the nervous system of a source subject; and

obtaining the first and second output waveforms, respectively, from the first and second input waveforms.

7. The method of claim 6, wherein the first and second output waveforms are identical to or derived from the first and second input waveforms, respectively.

8. The method of claim 6, wherein the source subject and the subject suffering from the medical condition are different subjects.

9. The method of claim 6, wherein the source subject and the subject suffering from the medical condition are the same subject.

10. The method of claim 6, wherein the first site anatomically corresponds to the target site.

11. The method of claim 6, wherein the first site is anatomically different than the target site.

12. The method of claim 6, wherein the first site is healthy or at least partially functioning, and the target site is diseased.

13. The method of claim 6, further comprising modifying the second input waveform to generate the second output waveform.

14. The method of claim 5, wherein the medical condition results from a neurological insult.

15. The method of claim 14, wherein the neurological insult includes trauma or stroke.

16. The method of claim 5, wherein the target site comprises a cerebellar pathway or pathway from the cerebral cortex to the cerebellum or cerebellum to the cerebral cortex.

17. The method of claim 5, wherein a substantial number of stimulation pulses comprising a period of the first output waveform occur at the beginning of the period.

18. The method of claim 5, wherein a substantial number of stimulation pulses comprising a period of the first output waveform occur at the end of the period.

19. The method of claim 5, wherein the second output waveform is characterized by a duration that is greater or less than the duration of the first output waveform.

20. The method of claim 5, further comprising, in response to the sensed bodily activity or nerve activity associated with a bodily activity, modifying the second output waveform.

21. The method of claim 5, wherein the composite pattern of stimulation or waveforms comprising a first output waveform that is overlaid with multiple output waveforms.

22. The method of claim 5, wherein the target site is a site of the cortico-ponto-cerebellar pathway or the dentate-thalamo-cortical pathway and the sensed bodily activity is sensed from a site different than the target site of the cortico-ponto-cerebellar pathway or the dentate-thalamo-cortical pathway.

23. The method of claim 5, wherein the target site is a site of the cortico-ponto-cerebellar pathway or the dentate-thalamo-cortical pathway and the sensed bodily activity is sensed from a site that is the same as the target site of the cortico-ponto-cerebellar pathway or the dentate-thalamo-cortical pathway.

24. A neurostimulation system comprising:

memory that stores data for first and second input waveforms;

a playback system that provides first and second output waveforms, based on the first and second input waveforms in the memory, respectively, to form composite patterns of stimulation or waveforms, the first output waveform comprising randomly spaced-apart pulses, the second output waveform periodically superimposed on the first output waveform at irregular intervals, the second output waveform having a greater frequency than the first output waveform;

a stimulation electrode; and

a controller in communication with the stimulation electrode, the controller being configured to control application of the composite patterns of stimulation or waveforms to a target site in a body of a subject suffering from a medical condition.