Methods and systems for treating neurological movement disorders

• US 9,604,056 B2
• Filed: 03/21/2016
• Issued: 03/28/2017
• Est. Priority Date: 10/31/2012
• Status: Active Grant

• Current Assignee: Dept of Veterans' Affairs (Commonwealth of Australia), US Department of Veterans Affairs (Government of the United States of America), Regents of the University of California (University of California)
• Original Assignee: The United States of America-Department of Veterans Affairs, Regents of the University of California (University of California)
• Inventors: Starr, Philip A., de Hemptinne, Coralie, Ostrem, Jill, Swann, Nicole
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US15/076,303
• Publication Number:
  US 20160263380A1
• Time in Patent Office: 372 Days
• US Class Current: 1/1
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36139 with automatic adjustment

Abstract

The present disclosure provides methods for reducing the clinical presentations of a neurological movement disorder in a subject. Aspects of the methods include measuring cortical local field potentials (LFPs) from the subject'"'"'s brain, calculating a modulation index related to brain synchronization from the LFPs, and administering deep brain stimulation to the subject if the calculated modulation index is outside of a threshold range. Also provided are devices, systems, and kits that may be used in practicing the subject methods.

Claims

1. A method for reducing clinical presentation of a neurological movement disorder in a subject, the method comprising:

(i) measuring field potentials from a primary motor cortex of the subject'"'"'s brain using at least one non-brain penetrating electrode;

(ii) calculating, with a processor, a modulation index for synchronization of brain rhythms in the measured field potentials, wherein the synchronization of brain rhythms in the measured field potentials comprises synchronization of phase of beta rhythm and amplitude of gamma activity; and

(iii) administering a deep brain stimulus to the subject when the calculated modulation index is outside of a predefined threshold range,

wherein steps (i)-(iii) are continued in a manner effective to reduce the clinical presentation of the neurological movement disorder.

2. The method according to claim 1, wherein administering the deep brain stimulus to the subject comprises stimulating the subject'"'"'s thalamus, basal ganglia, or both.

3. The method according to claim 1, wherein administering the deep brain stimulus to the subject comprises stimulating the subject'"'"'s subthalamic nucleus, globus pallidus, or both.

4. The method according to claim 1, further comprising placing a stimulation electrode array in the subject'"'"'s brain.

5. The method according to claim 1, further comprising placing the at least one non-brain penetrating electrode on the surface of primary motor cortex of the subject'"'"'s brain.

6. The method according to claim 1, further comprising placing the at least one non-brain penetrating electrode at a position corresponding to an arm area of primary motor cortex Ml.

7. The method according to claim 1, wherein calculating the modulation index comprises calculating a Kullback-Liebler-based modulation index, a mean vector length modulation index, or applying a phase-amplitude coupling palette method.

8. The method according to claim 1, further comprising administering a pharmacological agent to the subject when the calculated modulation index is outside of the predefined threshold range.

9. The method according to claim 1, wherein the subject is human.

10. The method according to claim 9, wherein the neurological movement disorder comprises Parkinson'"'"'s disease.

11. The method according to claim 9, wherein the neurological movement disorder comprises dystonia.

12. The method according to claim 1, wherein the measuring field potentials is by electrocorticography (ECoG).

13. The method according to claim 1, wherein the measuring field potentials is by electroencephalography (EEG).

14. The method according to claim 1, wherein the field potentials are measured during movement preparation, during movement execution, or during rest.

15. The method according to claim 1, wherein the predefined threshold range is tailored for the subject.

16. The method of claim 1, wherein the method comprises administering a first deep brain stimulus to the subject prior to step (i);

and step (iii) comprises administering a second deep brain stimulus to the subject when the calculated modulation index is outside of a predefined threshold range.

19. The method of claim 16, wherein a parameter of the first deep brain stimulus differs from the parameter of the second brain stimulus, wherein the parameter is selected from the group consisting of contact choice, amplitude, and frequency.

17. A system for reducing clinical presentations of a neurological movement disorder in a subject, the system comprising:

a pulse generator configured to administer deep brain stimulation to a subject;

a non-brain penetrating electrode adapted to record field potentials from a primary motor cortex of the subject;

a processor in electronic communication with the pulse generator and the non-brain penetrating electrode, the processor programmed to;

calculate a modulation index for synchronization of brain rhythms, wherein synchronization of brain rhythms comprises synchronization of phase of beta rhythm and amplitude of gamma activity; and

administer the deep brain stimulation to the subject via the pulse generator when the calculated modulation index is outside of a predefined threshold range.

18. The system according to claim 17, wherein the processor changes a parameter of the pulse generator when the calculated modulation index is outside of a predefined threshold range.