Non-invasive treatment of neurodegenerative diseases

• US 10,265,523 B2
• Filed: 08/19/2014
• Issued: 04/23/2019
• Est. Priority Date: 03/20/2009
• Status: Active Grant

• Current Assignee: Electrocore, Llc
• Original Assignee: electroCore, Inc.
• Inventors: Simon, Bruce J., Errico, Joseph P., Raffle, John T.
• Primary Examiner(s): Tejani, Ankit D
• Application Number:
  US14/462,605
• Publication Number:
  US 20140357936A1
• Time in Patent Office: 1,708 Days
• Field of Search: None
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/40 Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 2/002 in combination with another treatment
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/02 using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence

Abstract

The present disclosure includes methods and devices for a non-invasive treatment of a neurodegenerative disease through a delivery of energy to a target nervous tissue, such as a vagus nerve of a patient. Such energy can be applied to the patient to generate an electrical impulse. The electrical impulse can be modulated to increase an activity of an anti-inflammatory cytokine in the patient to inhibit inflammation and treat the neurodegenerative disease. Such stimulation can bring about a reduction of neuro-inflammation in some patients suffering from one or more conditions, such as Alzheimer'"'"'s Disease, Parkinson'"'"'s Disease, Multiple Sclerosis, postoperative cognitive dysfunction, or postoperative delirium.

Claims

1. A method for treating a neurodegenerative disorder in a patient, the method comprising:

positioning a contact surface of a housing in contact with an outer skin surface of a neck of the patient, wherein the housing comprises an energy source configured to generate an electric current;

transmitting, via the contact surface, the electric current transcutaneously and non-invasively through the outer skin surface of the neck of the patient to generate an electrical impulse at or near a selected nerve within the patient; and

modulating the electric current such that the electrical impulse comprises bursts of pulses with each of the bursts comprising a frequency from about 5 Hz to about 100 Hz and with each of the pulses comprising a duration from about 50 microseconds to about 1000 microseconds and such that the electrical impulse is sufficient to increase an activity of an anti-inflammatory cytokine in the patient to inhibit an inflammation and thereby treat the neurodegenerative disorder.

2. The method of claim 1, wherein the electrical impulse is sufficient to stimulate a nerve fiber that controls or mediates an activity of a neurotrophic factor.

3. The method of claim 2, wherein the neurotrophic factor is a member of a transforming growth factor (TGF) beta superfamily of neurotrophic factors.

4. The method of claim 2, wherein the neurotrophic factor is a member of at least one of a nerve growth factor superfamily, a neurokine superfamily, or an insulin-like family of non-neuronal growth factors.

5. The method of claim 2, wherein the neurotrophic factor is a member of a same family as at least one of a nerve growth factor (NGF), a glial-cell-line-derived neurotrophic factor (GDNF), a brain-derived neurotrophic factor (BDNF), or a mesencephalic astrocyte-derived neurotrophic factor (MANF).

6. The method of claim 1, wherein the neurodegenerative disorder is selected from a group comprising at least one of Alzheimer'"'"'s disease, Parkinson'"'"'s disease, multiple sclerosis, postoperative cognitive dysfunction, or postoperative delirium.

7. The method of claim 1 wherein the selected nerve is a vagus nerve.

8. The method of claim 7 wherein the selected nerve is a right branch of the vagus nerve.

9. The method of claim 1, wherein the electrical impulse is sufficient to inhibit a release of a pro-inflammatory cytokine.

10. The method of claim 9 wherein the pro-inflammatory cytokine is tumor necrosis factor (TNF)-alpha.

11. The method of claim 1 wherein the selected nerve is at least approximately 1-2 cm below an outer skin surface of the patient.

12. The method of claim 1, wherein the electric current is modulated such that the patient has decreased measurable pain.

13. The method of claim 1, wherein the bursts comprise the pulses and at least one of the bursts corresponds to at least one of an up-cycle or a down-cycle of the electrical impulse.

14. An apparatus for applying an electric current to a target region within a patient with a neurodegenerative disorder, the apparatus comprising:

an enclosure having a contact surface; and

a power source housed within the enclosure and configured to generate the electric current that is sufficient to transmit an electrical impulse transcutaneously and non-invasively through an outer skin surface of a neck of the patient to a location at or near the target region when the contact surface is positioned against the outer skin surface of the neck of the patient, wherein the electrical impulse comprises bursts of pulses with each of the bursts comprising a frequency from about 5 Hz to about 100 Hz and with each of the pulses comprising a duration from about 50 microseconds to about 1000 microseconds and such that the electrical impulse is sufficient to modulate an activity of a selected nerve at or near the target region to increase an activity of an anti-inflammatory cytokine in the patient and thereby treat the neurodegenerative disorder.

15. The apparatus of claim 14, further comprising:

a conduction medium contained within the enclosure, wherein the electrical impulse passes through the conduction medium, the contact surface, and the outer skin surface of the patient.

16. The apparatus of claim 14, wherein the electrical impulse is sufficient to inhibit a release of a pro-inflammatory cytokine.

17. The apparatus of claim 16, wherein the pro-inflammatory cytokine is tumor necrosis factor (TNF)-alpha.

18. The apparatus of claim 14, wherein the anti-inflammatory cytokine is transforming growth factor (TGF)-beta.

19. The apparatus of claim 18, wherein the electrical impulse is sufficient to cause at least one of a retinoid or a component of a retinoic acid signaling system to bias a competence of the anti-inflammatory cytokine towards an anti-inflammation.

20. The apparatus of claim 14, wherein the electrical impulse is sufficient to enhance an anti-inflammatory activity of a neurotrophic factor.

21. The apparatus of claim 20, wherein the neurotrophic factor is a member of at least one of a transforming growth factor (TGF)-beta superfamily of neurotrophic factors, a nerve growth factor superfamily of neurotrophic factors, a neurokine superfamily of neurotrophic factors, or an insulin-like family of non-neuronal growth factors.

22. The apparatus of claim 14, wherein the selected nerve is a vagus nerve of the patient.

23. The apparatus of claim 14, wherein the neurodegenerative disorder comprises at least one of Alzheimer'"'"'s disease, Parkinson'"'"'s disease, multiple sclerosis, postoperative cognitive dysfunction, or postoperative.

24. The apparatus of claim 14, wherein the electrical impulse is sufficient to modulate the activity of the selected nerve at or near the target region of the patient with decreased measurable pain to the patient.

25. The apparatus of claim 14, wherein the bursts comprise the pulses and at least one of the bursts corresponds to at least one of an up-cycle or a down-cycle of the electrical impulse.

26. The method of claim 14, wherein the electric current is modulated such that the patient has decreased measurable pain.

27. The method of claim 14, wherein the bursts comprise the pulses and at least one of the bursts corresponds to at least one of an up-cycle or a down-cycle of the electrical impulse.

28. A method for treating a neurodegenerative disorder in a patient, the method comprising:

applying an electric current to an outer skin surface of a neck of the patient non-invasively sufficient to transmit the electric current transcutaneously and non-invasively through the outer skin surface of the neck of the patient and generate an electrical impulse at or near a selected nerve within the patient; and

modulating the electric current such that the electrical impulse comprises bursts of pulses with each of the bursts comprising a frequency from about 5 Hz to about 100 Hz and with each of the pulses comprising a duration from about 50 microseconds to about 1000 microseconds and such that the electrical impulse is sufficient to increase an activity of an anti-inflammatory cytokine in the patient to inhibit an inflammation and thereby treat the neurodegenerative disorder.

29. The method of claim 28, wherein the electrical current is generated by a power source housed in a housing, wherein the housing hosts a contact surface coupled to the power source, wherein the applying is via the contact surface, wherein the modulating is as the contact surface contacts the outer skin surface.

30. The method of claim 29, wherein the selected nerve is a vagus nerve.

31. The method of claim 30, wherein the housing houses a conduction medium electrically positioned between the power source and the contact surface, wherein the applying is through the conduction medium.