Methods and apparatuses for treating neurological disorders by electrically stimulating cells implanted in the nervous system

• US 20050075679A1
• Filed: 05/07/2004
• Published: 04/07/2005
• Est. Priority Date: 09/30/2002
• Status: Abandoned Application

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Wyler, Allen, Firlik, Andrew D., Sheffield, W. Douglas, Gliner, Bradford E., Levy, Alan J., Balzer, Jeffrey
• Application Number:
  US10/842,052
• Publication Number:
  US 20050075679A1
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/3615 Intensity
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

Methods and apparatuses for treating neurological disorders by electrically stimulating cells implanted in the nervous system are disclosed. A method in accordance with one aspect of the invention includes preparing cells for implantation while the cells are in a first, at least partially undifferentiated state. The cells are then implanted at an implantation site within the patient'"'"'s skull cavity while in the first state, and at least one electrode is positioned to be in electrical communication with the implantation site. The patient'"'"'s neural dysfunction is at least partially corrected by differentiating the cells at least until the cells achieve a second state, with the cells in the second state having an increased level of differentiation and increased neurocharacteristics when compared to the cells in the first state. Differentiating the cells can include applying an electrical potential to the at least one electrode while the electrode is in electrical communication with the implantation site. In further aspects of the invention, the cells are implanted directly into the tissue without being carried by an electrically conductive substrate, and/or the electrode is removed from the patient without removing the implanted cells, for example, after stimulation has been completed.

Claims

1. A method for treating a neural disorder, comprising:

preparing cells for implantation, the cells being in a first, at least partially undifferentiated state;

implanting the cells at an implantation site within the skull cavity of a patient while the cells are in the first state;

positioning at least one electrode in electrical communication with the implantation site of the patient; and

at least partially correcting a neural dysfunction at least proximate to the implantation site by differentiating the cells at least until the cells achieve a second state, the cells in the second state having an increased level of differentiation and increased neural characteristics when compared to the cells in the first state, wherein differentiating the cells includes applying an electrical potential to the at least one electrode while the electrode is in electrical communication with the implantation site of the patient.

2. The method of claim 1 wherein implanting the cells includes implanting the cells directly into tissue of the patient without the cells being carried by an electrically conductive substrate.

3. The method of claim 1, further comprising removing the at least one electrode from the patient without removing the implanted cells.

4. The method of claim 1 wherein implanting the cells includes implanting the cells at at least one of an infarct region and a peri-infarct region of the nervous system.

5. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the basal ganglia of the patient.

6. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the motor cortex of the patient.

7. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the thalamus of the patient.

8. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the ventralis intermedius nucleus of the thalamus of the patient.

9. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the putamen of the patient.

10. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the globus pallidus of the patient.

11. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to the subthalamic nucleus of the patient.

12. The method of claim 1 wherein implanting the cells includes implanting the cells at least proximate to at least one of Broca'"'"'s area, Wernicke'"'"'s area, and neuronal connections extending between Broca'"'"'s area and Wernicke'"'"'s area.

13. The method of claim 1 wherein differentiating the cells includes at least partially reversing neural damage resulting from Huntington'"'"'s disease.

14. The method of claim 1 wherein differentiating the cells includes at least partially alleviating essential tremor motion.

15. The method of claim 1 wherein differentiating the cells includes at least partially alleviating a movement disorder.

16. The method of claim 1 wherein differentiating the cells includes at least partially reversing neural damage resulting from Parkinson'"'"'s disease.

17. The method of claim 1 wherein differentiating the cells includes at least partially reversing neural damage resulting from a stroke.

18. The method of claim 1, further comprising exposing the cells to growth factors.

19. The method of claim 1, further comprising exposing the cells to at least one of IGF and GDNF.

20. The method of claim 1 wherein applying an electrical potential to the at least one electrode includes applying the electrical potential before implanting the cells.

21. The method of claim 1 wherein applying an electrical potential to the at least one electrode includes applying the electrical potential after implanting the cells.

22. The method of claim 1, further comprising transporting a growth factor into the cells with a virus.

23. The method of claim 1 wherein positioning at least one electrode includes positioning at least one electrode proximate to a native cell and communicating with the implanted cells via the native cell.

24. The method of claim 1 wherein the cells are selected to include stem cells, precursor cells, and/or progenitor cells.

25. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes applying a voltage of from about ±

0.25V to about ±

10 V between the first electrode and the second electrode while the electrodes are at least proximate to the implantation site.

26. The method of claim 1 wherein applying an electrical potential includes generating electrical pulses at a rate of from about 2 to about 250 Hz.

27. The method of claim 1 wherein applying an electrical potential includes applying a current of from about 3 mA to about 10 mA.

28. The method of claim 1 wherein differentiating the cells includes applying an electrical potential to the at least one electrode at a first voltage until the cells develop action potentials and then applying an electrical potential to the at least one electrode at a second voltage less than the first voltage after the cells develop action potentials.

29. The method of claim 1 wherein differentiating the cells includes ceasing to apply an electrical potential to the at least one electrode after the cells develop increased action potentials.

30. The method of claim 1, further comprising ascertaining a threshold for generating action potentials for the cells at the implantation site, and wherein applying an electrical potential includes applying a subthreshold voltage less than the threshold for generating action potentials.

31. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises:

ascertaining a threshold for generating action potentials for the cells at the implantation site; and

positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes placing a subthreshold voltage between the first electrode and the second electrode, wherein the subthreshold voltage is approximately 10% to approximately 50% less than the threshold for generating an action potential.

32. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises:

ascertaining a threshold for generating electrophysiologic signals associated with a neural function; and

positioning a second electrode at least proximate to the implantation site of the nervous system, and wherein applying an electrical potential includes placing a subthreshold voltage between the first electrode and the second electrode, wherein the subthreshold voltage is less than the threshold for generating electrophysiologic signals.

33. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises:

ascertaining a threshold for generating electrophysiologic signals for the cells at the implantation site; and

positioning a second electrode at least proximate to the implantation site, wherein applying an electrical potential includes applying a subthreshold voltage between the first electrode and the second electrode, wherein the subthreshold voltage is from about 20% to about 50% less than the threshold for generating electrophysiologic signals.

34. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises:

ascertaining a threshold for eliciting a neural function; and

positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes placing a subthreshold voltage between the first electrode and the second electrode, wherein the subthreshold voltage is less than the threshold for eliciting the neural function.

35. The method of claim 1 wherein the at least one electrode includes a first electrode, and wherein the method further comprises:

ascertaining a threshold for eliciting a neural function; and

positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes placing a subthreshold voltage between the first electrode and the second electrode, wherein the subthreshold voltage is from about 30% to about 60% less than the threshold for eliciting the neural function.

36. The method of claim 1, further comprising identifying a stimulation site by generating remotely from the stimulation site an intended neural activity and determining the location of the brain where the generated neural activity is present.

37. The method of claim 1, further comprising implanting a pulse generator at least proximate to the implanted cells.

38. A method for treating a neural disorder, comprising:

identifying a site of the brain for implantation and stimulation;

preparing cells for implantation, the cells being in a first, at least partially undifferentiated state;

implanting the cells at the site while the cells are in the first state, the cells being unsupported by an electrically conductive substrate;

positioning at least one electrode in electrical communication with the site via native cells; and

at least partially correcting a neural dysfunction at least proximate to the implantation site by differentiating the cells at least until the cells achieve a second state, the cells in the second state having an increased level of differentiation and increased neural characteristics when compared to the cells in the first state, wherein differentiating the cells includes applying an electrical potential to the at least one electrode while the electrode is in electrical communication with the implantation site of the patient.

39. The method of claim 38, further comprising removing the at least one electrode from the patient without removing the implanted cells.

40. The method of claim 38, further comprising implanting a pulse generator at least proximate to the implanted cells.

41. The method of claim 38 wherein identifying the site includes stimulating a peripheral nerve of the patient and obtaining information corresponding to simultaneous activity in the patient'"'"'s brain.

42. The method of claim 38 wherein identifying the site includes directing the patient to engage in a language-based task and obtaining information corresponding to simultaneous activity in the patient'"'"'s brain.

43. A method for treating a neural disorder, comprising:

preparing fully differentiated neural cells for implantation;

implanting the cells at an implantation site within the skull cavity of a patient;

positioning at least one electrode at least proximate to the implantation site;

applying an electrical potential to the at least one electrode while the electrode is at least proximate to the implantation site of the nervous system; and

enhancing connections between native cells and the fully differentiated neural cells by directing an electrical current from the at least one electrode through the tissue surrounding the fully differentiated neural cells.

44. The method of claim 43 wherein implanting the fully differentiated neural cells includes implanting the cells directly into tissue of the patient without the cells being carried by an electrically conductive substrate.

45. The method of claim 43 wherein preparing fully differentiated neural cells includes applying an electrical stimulation to the cells while the cells are external to a patient.

46. The method of claim 43 wherein positioning at least one electrode includes positioning at least one electrode proximate to a native cell and communicating with the implanted cells via the native cell.

47. The method of claim 43 wherein the at least one electrode includes a first electrode, and wherein the method further comprises positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes applying a voltage of from about ±

0.25V to about ±

10 V between the first electrode and the second electrode while the electrodes are at least proximate to the implantation site.

48. The method of claim 43 wherein applying an electrical potential includes generating electrical pulses at a rate of from about 2 to about 250 Hz.

49. The method of claim 43 wherein applying an electrical potential includes applying a current of from about 3 mA to about 10 mA.

50. The method of claim 43, further comprising identifying a stimulation site by generating remotely from the stimulation site an intended neural activity and determining the location of the brain where the generated neural activity is present.

51. The method of claim 43, further comprising implanting a pulse generator at least proximate to the implanted cells.

52. The method of claim 43, further comprising identifying the implantation site.

53. A method for treating a neural disorder, comprising:

preparing fully differentiated neural cells for implantation;

implanting the cells at an implantation site within the skull cavity of a patient;

positioning at least one electrode at least proximate to the implantation site;

applying an electrical potential to the at least one electrode while the electrode is at least proximate to the implantation site of the nervous system; and

directing growth of the cells by directing an electrical current from the at least one electrode through the tissue surrounding the fully differentiated neural cells.

54. The method of claim 53 wherein positioning at least one electrode includes implanting a plurality of electrodes along a growth path, and wherein the method further comprises applying electrical potentials to the electrodes in a sequential manner along the growth path to direct the growth of the cells along the growth path.

55. The method of claim 53 wherein implanting the fully differentiated neural cells includes implanting the cells directly into tissue of the patient without the cells being carried by an electrically conductive substrate.

56. The method of claim 53 wherein preparing fully differentiated neural cells includes applying an electrical stimulation to the cells while the cells are external to a patient.

57. The method of claim 53 wherein positioning at least one electrode includes positioning at least one electrode proximate to a native cell and communicating with the implanted cells via the native cell.

58. The method of claim 53 wherein the at least one electrode includes a first electrode, and wherein the method further comprises positioning a second electrode at least proximate to the implantation site, and wherein applying an electrical potential includes applying a voltage of from about ±

0.25V to about ±

10 V between the first electrode and the second electrode while the electrodes are at least proximate to the implantation site.

59. The method of claim 53 wherein applying an electrical potential includes generating electrical pulses at a rate of from about 2 to about 250 Hz.

60. The method of claim 53 wherein applying an electrical potential includes applying a current of from about 3 mA to about 10 mA.

61. The method of claim 53, further comprising identifying a stimulation site by generating remotely from the stimulation site an intended neural activity and determining the location of the brain where the generated neural activity is present.

62. The method of claim 53, further comprising implanting a pulse generator at least proximate to the implanted cells.

63. The method of claim 53, further comprising identifying the implantation site.