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

• US 7,577,481 B2
• Filed: 02/15/2006
• Issued: 08/18/2009
• Est. Priority Date: 07/13/2000
• Status: Expired due to Fees

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Firlik, Andrew D., Gliner, Bradford Evan, Levy, Alan J., Firlik, Katrina S., Balzer, Jeffrey, Morgan, Carlton B.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US11/355,038
• Publication Number:
  US 20060200206A1
• Time in Patent Office: 1,280 Days
• Field of Search: None
• US Class Current: 607/45
• 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 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/37514 Brain implants
• CPC Class Codes: A61N 1/37518 Anchoring of the implants, e.g. fixation
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

The following disclosure describes a method for intracranial electrical stimulation to treat or otherwise effectuate a change in neural-functions of a patient. Several embodiments 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 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 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).

Claims

1. A method for providing cortical stimulation to a patient, comprising:

performing a noninvasive neurofunctional localization procedure to determine a cortical location at which a patient-specific intrinsic neural activity occurs;

positioning a first electrode beneath the scalp at a cortical stimulation site corresponding to the cortical location;

positioning a second electrode at a location remote from the cortical stimulation site;

applying an electromagnetic signal to the patient using the first and second electrodes;

modulating a neuroplastic activity with the applied signal to affect a patient symptom; and

wherein the electrical signal has a parameter that varies in a pseudorandom manner.

2. A method for providing cortical stimulation to a patient, comprising:

performing a noninvasive neurofunctional localization procedure to determine a cortical location at which a patient-specific intrinsic neural activity occurs;

positioning a first electrode beneath the scalp at a cortical stimulation site corresponding to the cortical location;

positioning a second electrode at a location remote from the cortical stimulation site;

applying an electromagnetic signal to the patient using the first and second electrodes;

modulating a neuroplastic activity with the applied signal to affect a patient symptom; and

wherein modulating the neuroplastic activity includes decreasing the neuroplastic activity.

3. A method for providing cortical stimulation to a patient, comprising:

identifying a brain location at which a neuroplastic activity occurs or is expected to occur;

positioning an electrode beneath the scalp at a cortical stimulation site corresponding to the identified brain location;

applying an aperiodically varying electrical signal to the patient using the electrode; and

modulating the neuroplastic activity with the applied signal to affect a patient symptom.

4. The method of claim 3 wherein identifying a brain location includes identifying a brain location at which a patient-specific neuroplastic activity occurs.

5. The method of claim 3 wherein applying an aperiodically varying electrical signal includes applying a pseudorandomly varying signal.

6. The method of claim 3 wherein modulating the neuroplastic activity includes increasing the neuroplastic activity.

7. The method of claim 3 wherein modulating the neuroplastic activity includes decreasing the neuroplastic activity.

8. The method of claim 3 wherein identifying the brain location includes performing a neural function localization procedure while the patient is engaged in a task expected to facilitate detection of the neuroplastic activity.

9. A method for providing cortical stimulation to a patient, comprising:

identifying a cortical location at which an intrinsic neural activity occurs or is expected to occur to effectuate a first neural function;

applying a first electromagnetic signal to a cortical stimulation site corresponding to the cortical location at a level that triggers the first neural function as a result of the first signal alone;

applying a second electromagnetic signal to the cortical stimulation site at a level that fails to trigger the first neural function in the absence of additional neural input; and

engaging the patient in a behavioral activity that selectively generates a neural activity corresponding to a second neural function different than the first neural function, concurrent with applying the second electrical signal to the cortical stimulation site.

10. The method of claim 9 wherein the intrinsic neural activity is patient specific.

11. The method of claim 9 wherein at least one of the first and second signals is an electrical signal.

12. The method of claim 9 wherein at least one of the first and second signals is an electrical signal applied using an implanted electrode.

13. The method of claim 9 wherein the first neural function is subsumed by the second neural function.

14. The method of claim 9 wherein the signal is applied in a manner that is independent of the behavioral activity.

15. A method for providing cortical stimulation to a patient, comprising:

identifying a cortical location at which a patient-specific intrinsic neural activity occurs or is expected to occur to effectuate a first neural function;

applying an electromagnetic signal to a cortical stimulation site corresponding to the cortical location at a level that fails to trigger the first neural function in the absence of additional neural input;

engaging the patient in a behavioral activity that selectively generates neural activity corresponding to a second neural function, concurrent with applying the electrical signal to the cortical stimulation site.

16. The method of claim 15 wherein the second neural function is facilitated by the intrinsic neural activity.

17. The method of claim 15 wherein the first neural function is subsumed by the second neural function.

18. The method of claim 15 wherein the signal is applied in a manner that is independent of the behavioral activity.

19. The method of claim 15 wherein the first and second neural functions are different.

20. A method for treating a patient condition, comprising:

identifying a cortical location having a first neural population at which a patient-specific intrinsic neural activity corresponding to a first neural function occurs or is expected to occur;

determining a threshold level of a second neural population different than the first neural population;

based at least in part on the threshold level of the second neural population, applying an electromagnetic signal to the cortical location at a level below the threshold level of the second neural population; and

modulating a neuroplastic activity with the applied signal to affect a patient symptom.

21. The method of claim 20, further comprising concurrently with applying the electromagnetic signal, selectively generating a neural activity corresponding to a second neural function via a patient activity.

22. The method of claim 20 wherein applying an electromagnetic signal includes applying an electromagnetic signal in an aperiodic manner.

23. The method of claim 20 wherein applying an electromagnetic signal includes applying an electromagnetic signal in a pseudorandom manner.

24. The method of claim 20, further comprising engaging the patient in an adjunctive therapy concurrently with applying an electromagnetic signal.

25. The method of claim 20 wherein applying an electromagnetic signal includes applying an electrical signal.

26. The method of claim 20 wherein modulating a neuroplastic activity includes decreasing a neuroplastic activity.

27. The method of claim 20 wherein modulating a neuroplastic activity includes ineasing a neuroplastic activity.