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

• US 20040073270A1
• Filed: 04/08/2003
• Published: 04/15/2004
• Est. Priority Date: 07/13/2000
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Northstar Neuroscience, Inc.
• Inventors: Firlik, Andrew D., Gliner, Bradford Evan, Balzer, Jeffrey
• Granted Patent: US 7,236,831 B2
• Time in Patent Office: Days
• US Class Current: 607/48
• 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 1/36082 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 present disclosure suggests methods of selecting a stimulation site for stimulating a patient'"'"'s brain or methods of effectuating a neural-function of a patient associated with an impaired body function. In one exemplary implementation, such a neural function may be effectuated by selecting a stimulation site, positioning at least a first electrode at the stimulation site, and applying an electrical potential to pass a current through the first electrode. If one aspect, this stimulation site may be selected by a) identifying a second body function that is a corollary to the impaired body function, and b) determining a corollary location of the patient'"'"'s brain that is associated with the second body function and is ipsilateral to the impaired body function.

Claims

1. A method of effectuating a neural-function of a patient that has been affected by damage to a first location of a first hemisphere of a brain of the patient, 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 second location of the brain in which a response neural activity occurs in reaction to the neural signal, the second location being in a second hemisphere of the brain that is contralateral to the first hemisphere;

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 a body part impaired by the damage to the first location.

3. The method of claim 1 wherein triggering a neural signal comprises applying an electrical stimulation to a body part impaired by the damage to the first location.

4. The method of claim 1 wherein selecting the stimulation site further comprises detecting a third location of the brain in which a response neural activity occurs in reaction to the neural signal, the third location being in the first hemisphere.

5. The method of claim 1 wherein selecting the stimulation site further comprises detecting a third location of the brain in which a response neural activity occurs in reaction to the neural signal, the third location being in the first hemisphere;

and selecting a site of the brain at least proximate the second location as the stimulation site.

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

identifying a second body function that is a corollary to the impaired body function, and

determining a corollary location of the patient'"'"'s brain that is associated with the second body function and is ipsilateral to the impaired body function.

7. The method of claim 6 wherein determining the corollary location comprises a) exercising the second body function, and b) detecting neural activity that occurs in response to the exercise of the second body function.

8. The method of claim 6 wherein the impaired body function comprises an impaired movement of a body part and the second body function comprises movement of a contralateral homotypic body part, and determining the corollary location comprises a) moving the homotypic body part, and b) detecting neural activity that occurs in response to the movement of the homotypic body part.

9. The method of claim 6 wherein the impaired body function comprises an impaired sensation in a body part and the second body function comprises sensation in a contralateral homotypic body part, and determining the corollary location comprises a) stimulating sensation in the homotypic body part, and b) detecting neural activity that occurs in response to the stimulation of the homotypic body part.

10. The method of claim 9 wherein stimulating sensation comprises applying an electrical stimulation to the homotypic body part.

11. The method of claim 6 wherein determining the corollary location comprises identifying an ipsilateral location of the patient'"'"'s brain at which neural activity associated with the second function is expected to occur.

12. The method of claim 11 wherein the ipsilateral location is identified using a spatial relationship with respect to at least one anatomical feature of the patient'"'"'s skull.

13. 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 or from an impaired body part, and

detecting a region of an ipsilateral hemisphere of the brain in which a response neural activity occurs in reaction to the neural signal, the ipsilateral hemisphere being ipsilateral to the impaired body part.

14. The method of claim 13 wherein triggering a neural signal comprises passively moving the impaired body part.

15. The method of claim 13 wherein triggering a neural signal comprises applying an electrical stimulation to the impaired body part.

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

selecting a stimulation site by a) identifying a second body function that is a corollary to the impaired body function, and b) determining a corollary location of the patient'"'"'s brain that is associated with the second body function and is ipsilateral to the impaired body function;

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

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

17. The method of claim 16 wherein determining the corollary location comprises a) exercising the second body function, and b) detecting neural activity that occurs in response to the exercise of the second body function.

18. The method of claim 16 wherein the impaired body function comprises an impaired movement of a body part and the second body function comprises movement of a contralateral homotypic body part, and determining the corollary location comprises a) moving the homotypic body part, and b) detecting neural activity that occurs in response to the movement of the homotypic body part.

19. The method of claim 16 wherein the impaired body function comprises an impaired sensation in a body part and the second body function comprises sensation in a contralateral homotypic body part, and determining the corollary location comprises a) stimulating sensation in the homotypic body part, and b) detecting neural activity that occurs in response to the stimulation of the homotypic body part.

20. The method of claim 19 wherein stimulating sensation comprises applying an electrical stimulation to the homotypic body part.

21. The method of claim 16 wherein determining the corollary location comprises identifying an ipsilateral location of the patient'"'"'s brain at which neural activity associated with the second function is expected to occur.

22. The method of claim 21 wherein the ipsilateral location is identified using a spatial relationship with respect to at least one anatomical feature of the patient'"'"'s skull.

31. The method of claim 21 wherein the location of the patient'"'"'s brain is identified using a spatial relationship with respect to at least one anatomical feature of the patient'"'"'s skull.

23. 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 an ipsilateral hemisphere of the brain in which a response neural activity occurs in reaction to the neural signal, the ipsilateral hemisphere being ipsilateral to the impaired body part;

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

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

24. The method of claim 23 wherein triggering a neural signal comprises passively moving the impaired body part.

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

26. 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 an ipsilateral region of the cortex of the patient where neural activity for motor control of the impaired body part is expected or determined to occur, the ipsilateral region being ipsilateral to the impaired body part;

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.

27. The method of claim 26 wherein applying an electrical stimulation therapy comprises applying electrical stimulation to a configuration of the electrodes at a sub-threshold level.

28. The method of claim 26 wherein applying an electrical stimulation to at least one configuration of electrodes comprises applying a supra-threshold level of stimulation.

29. The method of claim 26 wherein applying an electrical stimulation to at least one configuration of electrodes comprises applying a sub-threshold level of stimulation.

30. The method of claim 26 further comprising identifying the ipsilateral region prior to positioning the electrode assembly by identifying a location of the patient'"'"'s brain at which neural activity associated with the second function is expected to occur.

32. A method of effectuating a neural-function that has been affected by damage to a first region of a patient'"'"'s brain, comprising:

selecting a stimulation site by generating remotely from the first location an intended neural activity and determining a second region of the brain, contralateral to the first region, where the generated neural activity is present;

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

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