Devices, systems and methods for treatment of neuropsychiatric disorders

• US 9,238,139 B2
• Filed: 04/14/2014
• Issued: 01/19/2016
• Est. Priority Date: 10/05/2009
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: DeGiorgio, Christopher, Cook, Ian A., Covalin, Alejandro, Miller, Patrick R., Schrader, Lara
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US14/252,658
• Publication Number:
  US 20140228906A1
• Time in Patent Office: 645 Days
• Field of Search: 607/45
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0456 Specially adapted for transcutaneous electrical nerve stimulation [TENS]
• CPC Class Codes: A61N 1/0476 Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)
• CPC Class Codes: A61N 1/0492 Patch electrodes A61N1/0412, A61N1/0428 take precedence
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36075 Headache or migraine
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36096 Mood disorders, e.g. depression, anxiety or panic disorder
• CPC Class Codes: A61N 1/3616 Voltage density or current density
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36175 Pulse width or duty cycle

Abstract

The present disclosure relates to methods, devices and systems used for the treatment of mood, anxiety, post traumatic stress disorder, and cognitive and behavioral disorders (collectively, neuropsychiatric disorders) via stimulation of the superficial elements of the trigeminal nerve (“TNS”). More specifically, cutaneous methods of stimulation of the superficial branches of the trigeminal nerve located extracranially in the face, namely the supraorbital, supratrochlear, infraorbital, auriculotemporal, zygomaticotemporal, zygomaticoorbital, zygomaticofacial, infraorbital, nasal and mentalis nerves (also referred to collectively as the superficial trigeminal nerve) are disclosed herein.

Claims

1. A cutaneous electrode assembly for trigeminal nerve stimulation for treatment of a neuropsychiatric disorder, the cutaneous electrode assembly comprising:

a first pair of contacts configured for placement on a first region of a patient'"'"'s face;

a second pair of contacts configured for placement on a second region of the patient'"'"'s face; and

an insulating connection region connecting the first pair of contacts and the second pair of contacts,

wherein the first pair of contacts and the second pair of contacts are configured to contact a portion of the patient'"'"'s face overlying the cutaneous distribution of at least one branch of the trigeminal nerve and to stimulate said branch of said nerve with minimal or no current penetration below the surface of the skull, and wherein the first pair of contacts and the second pair of contacts are spaced apart according to the distance between the at least one branch of the trigeminal nerve on one side of the patient'"'"'s face and the at least one branch of the trigeminal nerve on an opposing side of the patient'"'"'s face.

2. The cutaneous electrode assembly of claim 1, wherein the at least one branch of the trigeminal nerve is selected from the group consisting of:

superficial ophthalmic branch, infraorbital branch, and the mentalis branch.

3. The cutaneous electrode assembly of claim 1, wherein the at least one branch of the trigeminal nerve is a supraorbital nerve.

4. The cutaneous electrode assembly of claim 1, wherein the at least one branch of the trigeminal nerve is an auriculotemporal nerve.

5. The cutaneous electrode assembly of claim 1, wherein the at least one branch of the trigeminal nerve is a zygomaticofacial nerve.

6. The cutaneous electrode assembly of claim 1, further comprising a retainer element configured to secure the electrode assembly to a patient'"'"'s forehead.

7. The electrode assembly of claim 1, wherein the neuropsychiatric disorder is depression.

8. A kit for trigeminal nerve stimulation for treatment of a neuropsychiatric disorder or condition, the kit comprising:

the cutaneous electrode assembly according to claim 1; and

instructions for placement of the electrode assembly on a patient for treatment of a neuropsychiatric disorder.

9. The kit of claim 8, further comprising:

a neurostimulator; and

instructions for applying electrical signals to the electrode assembly for treatment of a neuropsychiatric disorder.

10. A system for trigeminal nerve stimulation for treatment of a neuropsychiatric disorder or condition, the system comprising:

a neurostimulator; and

a cutaneous electrode assembly comprising;

a first pair of contacts configured for placement on a first region of a patient'"'"'s face;

a second pair of contacts configured for placement on a second region of the patient'"'"'s face; and

an insulating connection region connecting the first pair of contacts and the second pair of contacts, wherein the first pair of contacts and the second pair of contacts are configured to contact a portion of the patient'"'"'s face overlying the cutaneous distribution of at least one branch of the trigeminal nerve, and wherein the first pair of contacts and the second pair of contacts are spaced apart according to the distance between the at least one branch of the trigeminal nerve on one side of the patient'"'"'s face and the at least one branch of the trigeminal nerve on an opposing side of the patient'"'"'s face.

11. The system of claim 10, further comprising a cable and lead wires operably connecting the neurostimulator and the cutaneous electrode assembly.

12. The system of claim 10, further comprising a regulation device configured to regulate current output to minimize or prevent current penetration below the surface of the skull bone.

13. The system of claim 10, wherein the at least one branch of the trigeminal nerve is selected from the group consisting of:

superficial ophthalmic branch, infraorbital branch, and mentalis branch.

14. The system of claim 10, further comprising a retainer element configured to secure the electrode assembly to the patient'"'"'s forehead.

15. The system of claim 10, wherein the at least one branch of the trigeminal nerve is a supraorbital nerve.

16. The system of claim 10, wherein the at least one branch of the trigeminal nerve is an auriculotemporal nerve.

17. The system of claim 10, wherein the at least one branch of the trigeminal nerve is a zygomaticofacial nerve.