Methods and apparatus for effectuating a lasting change in a neural-function of a patient

• US 20030130706A1
• Filed: 09/27/2002
• Published: 07/10/2003
• Est. Priority Date: 07/13/2000
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Firlik, Andrew D., Sheffield, W. Douglas
• Granted Patent: US 7,756,584 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/361 Phantom sensations, e.g. tinnitus
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

The following disclosure describes several methods and apparatus for intracranial electrical stimulation to treat or otherwise effectuate a change in neural-functions of a patient. Several embodiments of methods in accordance with the invention are directed toward enhancing or otherwise inducing a lasting change in neural activity to effectuate a particular neural-function. Such lasting change in neural activity is defined as “neuroplasticity.” The methods in accordance with the invention can be used to treat brain damage (e.g., stroke, trauma, etc.), brain disease (e.g., Alzheimer'"'"'s, Pick'"'"'s, Parkinson'"'"'s, etc.), and/or brain disorders (e.g., epilepsy, depression, etc.). The methods in accordance with the invention can also be used to enhance neural-function of normal, healthy brains (e.g., learning, memory, etc.), or to control sensory functions (e.g., pain). Certain embodiments of methods in accordance with the invention electrically stimulate the brain at a stimulation site where neuroplasticity is occurring. The stimulation site may be different than the region in the brain where neural activity is typically present to perform the particular neural function according to the functional organization of the brain. In one embodiment in which neuroplasticity related to the neural-function occurs in the brain, the method can include identifying the location where such neuroplasticity is present. In an alternative embodiment in which neuroplasticity is not occurring in the brain, an alternative aspect is to induce neuroplasticity at a stimulation site where it is expected to occur. Several embodiments of these methods that are expected to produce a lasting effect on the intended neural activity at the stimulation site use electrical pulses that increase the resting membrane potential of neurons at the stimulation site to a subthreshold level.

Claims

1. A method of effectuating a neural-function of a patient associated with an impaired body part, comprising:

selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal in or from an impaired body part, and (b) detecting a region of the brain in which a response neural activity occurs in reaction to the neural signal;

positioning at least a first electrode at the stimulation site; and

applying an electrical potential to pass a current through the first electrode.

2. The method of claim 1 wherein triggering a neural signal comprises passively moving the impaired body part.

3. The method of claim 1 wherein triggering a neural signal comprises passively moving the impaired body part via attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

4. The method of claim 1 wherein triggering a neural signal comprises applying an electrical stimulation to the impaired body part.

5. The method of claim 1 wherein triggering a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.

6. A method of effectuating a neural-function of a patient associated with an impaired body part, comprising:

selecting a stimulation site by (a) inducing an electrical signal that is expected to generate a response in neural activity associated with the impaired body part, and (b) detecting a parameter related to the response in the neural activity;

positioning an electrode assembly at the stimulation site; and

applying an electrical stimulation to the electrode.

7. The method of claim 6 wherein inducing a neural signal comprises passively moving the impaired body part.

8. The method of claim 6 wherein inducing a neural signal comprises passively moving the impaired body part by attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

9. The method of claim 6 wherein inducing a neural signal comprises applying an electrical stimulation to the impaired body part.

10. The method of claim 6 wherein inducing a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.

11. A method of effectuating a neural-function of a patient associated with an impaired body part that is incapable of volitional control, comprising:

positioning an electrode assembly proximate to a region of the cortex of the patient where neural activity for motor control of the impaired body part is expected or determined to occur;

selecting a stimulation site in the region of the cortex by (a) applying an electrical stimulation to at least one configuration of electrodes, and (b) detecting the extent to which the applied electrical stimulation produces a response in the impaired body part; and

applying an electrical stimulation therapy to the selected body part via the electrode assembly.

12. The method of claim 11 wherein applying an electrical stimulation therapy comprises applying electrical stimulation to a configuration of the electrodes at a sub-threshold level.

13. The method of claim 11 wherein applying an electrical stimulation to at least one configuration of electrodes comprises applying a supra-threshold level of stimulation.

14. The method of claim 11 wherein applying an electrical stimulation to at least one configuration of electrodes comprises applying a sub-threshold level of stimulation.

15. A method of effectuating a neural-function of a patient associated with an impaired body part, comprising:

selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal in an impaired body part, and (b) detecting a region of the brain in which a response neural activity occurs in reaction to the neural signal;

applying an electrical signal directly to the stimulation site effective to carry out the neural function.

16. The method of claim 15 wherein triggering a neural signal comprises passively moving the impaired body part.

17. The method of claim 15 wherein triggering a neural signal comprises passively moving the impaired body part via attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

18. The method of claim 15 wherein triggering a neural signal comprises applying an electrical stimulation to the impaired body part.

19. The method of claim 15 wherein triggering a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.

20. A method of effectuating a neural-function of a patient associated with an impaired body part, comprising:

selecting a stimulation site by (a) inducing an electrical signal that is expected to generate a response in neural activity associated with the impaired body part, and (b) detecting a parameter related to the response in the neural activity; and

applying an electrical signal directly to the stimulation site effective to carry out the neural function.

21. The method of claim 20 wherein inducing a neural signal comprises passively moving the impaired body part.

22. The method of claim 20 wherein inducing a neural signal comprises passively moving the impaired body part via attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

23. The method of claim 20 wherein inducing a neural signal comprises applying an electrical stimulation to the impaired body part.

24. The method of claim 20 wherein inducing a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.

25. A method of selecting a stimulation site for applying an electrical stimulation to restore and/or enhance function of an impaired body part, comprising:

generating an intended neural activity by triggering a neural signal in an impaired body part; and

detecting a region of the brain where a response neural activity occurs in reaction to the neural signal.

26. The method of claim 25 wherein triggering a neural signal comprises passively moving the impaired body part.

27. The method of claim 25 wherein triggering a neural signal comprises passively moving the impaired body part by attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

28. The method of claim 25 wherein triggering a neural signal comprises applying an electrical stimulation to the impaired body part.

29. The method of claim 25 wherein triggering a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.

30. A method of selecting a stimulation site for applying an electrical stimulation to restore and/or enhance function of an impaired body part, comprising:

inducing an electrical signal that is expected to generate a response in neural activity associated with the impaired body part; and

detecting a parameter related to the response in the neural activity.

31. The method of claim 30 wherein inducing a neural signal comprises passively moving the impaired body part.

32. The method of claim 30 wherein inducing a neural signal comprises passively moving the impaired body part by attaching the impaired body part to a passive motion machine that moves the impaired body part through a defined motion.

33. The method of claim 30 wherein inducing a neural signal comprises applying an electrical stimulation to the impaired body part.

34. The method of claim 30 wherein inducing a neural signal comprises applying an electrical stimulation to a nerve of the impaired body part.