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

• US 9,333,355 B2
• Filed: 12/04/2014
• Issued: 05/10/2016
• 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): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US14/560,735
• Publication Number:
  US 20150094785A1
• Time in Patent Office: 523 Days
• US Class Current: 1/1
• 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 stimulation control device, comprising:

a stimulation initiation system configured to output stimulation initiation signals to a vagus nerve stimulator;

a manual input system configured to be engaged by an operator to cause output of a first stimulation initiation signal;

a motion detection system configured to be engaged by the operator to cause output of a second stimulation initiation signal; and

a selection input system configured to enable the operator to select between using the manual input system and the motion detection system,

wherein

the stimulation control device is configured such that engaging the manual input system causes the output of the first stimulation initiation signal from the stimulation initiation system to the vagus nerve stimulator, and

the stimulation control device is configured such that engaging the motion detection system enables the output of the second stimulation initiation signal from the stimulation initiation system to the vagus nerve stimulator.

2. The stimulation control device of claim 1, wherein:

the motion detection system is configured such that engaging the motion detection system enables automatic output of the second stimulation initiation signal from the stimulation initiation system to the vagus nerve stimulator.

3. The stimulation control device of claim 1, wherein:

the motion detection system is configured such that engaging the motion detection system enables automatic output of the second stimulation initiation signal from the stimulation initiation system to the vagus nerve stimulator based on a detection of a movement performed by a patient to which the vagus nerve stimulator provides stimulation.

4. The stimulation control device of claim 1, further comprising:

a visual output system configured to provide data to the operator.

5. The stimulation control device of claim 4, wherein:

the visual output system is configured to enable input by the operator, thereby enabling the operator to engage the selection input system to select between using the manual input system and the motion detection system to respectively cause the output of the first stimulation initiation signal or the output of the second stimulation initiation signal from the stimulation initiation system to the vagus nerve stimulator.

6. The stimulation control device of claim 1, wherein:

the manual input system includes a manual switch configured to be engaged by an operator to cause the output of the first stimulation initiation signal.

7. A system, comprising:

a vagus nerve stimulator;

a stimulation control device communicably connected to the vagus nerve stimulator including a stimulation initiation output to provide stimulation initiation signals to the vagus nerve stimulator;

a manual control system configured to be engaged to provide a stimulation initiation signal from the stimulation control device upon a manual input;

a motion detection system configured to be engaged to provide a stimulation initiation signal from the stimulation control device upon detection of motion; and

a visual output system configured to provide data to the operator, the visual output system being configured to enable input by the operator to select between using the manual control system and the motion detection system to provide the respective stimulation initiation signal,

wherein the system is configured such that the motion detection system, when selected, sends a signal to the stimulation control device upon a detection of a movement so that the stimulation control device sends a stimulation initiation signal to the vagus nerve stimulator, and such that the manual control system, when selected, sends a signal to the stimulation control device so that the stimulation control device sends a stimulation initiation signal to the vagus nerve stimulator.

8. The system of claim 7, wherein:

the motion detection system is configured such that engaging the motion detection system enables automatic output of the signal from the motion detection system to the stimulation control device.

9. The system of claim 7, wherein:

the vagus nerve stimulator includes an implantable pulse generator.

10. The system of claim 9, wherein:

the vagus nerve stimulator further includes a lead and an electrode.

11. The system of claim 10, wherein:

the lead connects the electrode to the implantable pulse generator.

12. The system of claim 11, wherein:

the implantable pulse generator is configured to be implanted in a chest of a human patient; and

the lead is configured to place the electrode into signal communication with the implantable pulse generator when the implantable pulse generator is adapted to be implanted in the chest and the electrode is adapted to be implanted proximate or at the vagus nerve of the patient in the neck of the patient.

13. The stimulation control device of claim 7, wherein:

the manual input system includes a manual switch configured to be engaged by an operator to cause the output of the respective stimulation initiation signal.

14. A system comprising:

a means for detecting motion of a patient;

a means for providing vagus nerve stimulation to a patient; and

a display means for providing data, the display means being configured to enable an input by an operator to select between a manual control mode of the means for providing vagus nerve stimulation and an automated control mode of the means for providing vagus nerve stimulation,

wherein in the automated control mode the means for providing vagus nerve stimulation is configured to automatically provide vagus nerve stimulation to the patient upon a detection of a motion of the patient by the means for detecting motion.

15. The system of claim 14, wherein:

the system is configured to evaluate movement of the patient detected by the means for detecting motion.

16. The system of claim 15, wherein:

the system is configured to control the providing of the vagus nerve stimulation to the patient by the means for providing vagus nerve stimulation based on evaluation of the movement of the patient.

17. The system of claim 15, wherein:

the system is configured to time the providing of the vagus nerve stimulation to the patient by the means for providing vagus nerve stimulation based on evaluation of the movement of the patient.

18. The system of claim 15, wherein:

the system is configured to pair the providing of the vagus nerve stimulation to the patient by the means for providing vagus nerve stimulation with a subset of movements of movements detected by the means for detecting movement.

19. The system of claim 14, wherein:

the system is configured to evaluate movement of the patient detected by the means for detecting motion by comparing movements that the patient generates relative to other past movements generated by the patient, and

the system is configured to identify which movements generated by the patient are an improvement over other past movements based on one or more predefined criteria.

20. The system of claim 19, wherein:

the system is configured to control the providing of the vagus nerve stimulation to the patient by the means for providing vagus nerve stimulation based on an identification of a movement generated by the patient that is an improvement over other past movements.