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

• US 9,533,152 B2
• Filed: 11/21/2014
• Issued: 01/03/2017
• 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: 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:
  US14/550,357
• Publication Number:
  US 20150073493A1
• Time in Patent Office: 774 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 method, comprising:

treating motor deficits via the actions of;

directing a patient to execute a plurality of therapeutic motions; and

applying a plurality of vagus nerve stimulation pulse trains of electrical stimulation energy to the patient, respective trains of the plurality of trains being in temporal proximity to execution of respective therapeutic motions of the plurality of therapeutic motions exposed to the patient to improve the patient'"'"'s motor deficits,

wherein the pulse trains are no longer than about 500 milliseconds in duration.

2. The method of claim 1, further comprising:

detecting a respective beginning of a therapeutic motion of the plurality of therapeutic motions; and

applying a respective vagus nerve stimulation pulse train of the plurality of pulse trains based on the detected beginning.

3. The method of claim 1, further comprising:

automatically detecting a respective beginning of a therapeutic motion of the plurality of therapeutic motions; and

automatically applying a respective vagus nerve stimulation pulse train of the plurality of pulse trains based on the detected beginning.

4. The method of claim 1, further comprising:

selecting a therapeutic task level for each therapeutic motion.

5. The method of claim 1, wherein the action of applying a plurality of vagus nerve stimulation pulse trains to the patient entails operating an implanted neurostimulator to deliver pulse trains of electrical stimulation energy to the vagus nerve such that a respective pulse train results in respective directed neuro plasticity lasting no more than about 8 seconds.

6. The method of claim 1, wherein the action of applying a plurality of vagus nerve stimulation pulse trains to the patient further comprises sensing respective performances of the selected therapeutic motions and applying the pulse trains to the vagus nerve based on the sensed beginnings of the performances.

7. A method, comprising:

treating motor deficits via the actions of;

repetitively exposing a patient to a plurality of therapeutic motions;

pairing a respective vagus nerve stimulation pulse train of electrical;

and stimulation energy with a respective therapeutic motion of the plurality of therapeutic motions, thereby improving the patient'"'"'s motor deficits,

wherein the method further comprises;

determining that a key portion of a therapeutic motion of the performed therapeutic motions is occurring; and

applying a respective vagus nerve stimulation pulse train of the plurality of pulse trains based on the determined occurrence of the key portion, wherein

the key portion occurs after a beginning of the therapeutic motion.