Systems and methods for providing targeted neural stimulation therapy to address neurological disorders, including neuropyschiatric and neuropyschological disorders

• US 8,538,537 B2
• Filed: 12/08/2008
• Issued: 09/17/2013
• Est. Priority Date: 12/07/2007
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Hulvershorn, Justin, Fowler, Brad, Gliner, Bradford Evan, Sloan, Leif R., Kopell, Brian, Soltysik, David Alan
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US12/330,437
• Publication Number:
  US 20090149898A1
• Time in Patent Office: 1,744 Days
• Field of Search: 607/2, 607/3, 607/45
• US Class Current: 607/45
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

Systems and methods for providing targeted neural stimulation therapy to address neurological disorders, including neuropsychiatric and neuropsychological disorders are disclosed. A method for treating a patient'"'"'s neurological disorder in accordance with a particular embodiment includes, in a patient identified as having at least one of a neuropsychological disorder and a neuropsychiatric disorder, implanting at least one stimulation electrode within the patient'"'"'s skull cavity, and outside a cortical surface of the patient'"'"'s brain. The electrode is implanted at a location in a range of about 15 mm to about 35 mm anterior to a precentral sulcus reference point that is positioned at the precentral sulcus and at the patient'"'"'s middle frontal gyrus. The method can further include treating the patient'"'"'s disorder by applying electrical stimulation to the patient via the at least one stimulation electrode.

Claims

1. A method for treating a patient'"'"'s neurological disorder, comprising:

in a patient identified as having at least one of a neuropsychological disorder and a neuropsychiatric disorder, implanting at least one stimulation electrode within the patient'"'"'s skull cavity, outside a cortical surface of the patient'"'"'s brain, and at a location in a range of about 15 mm to about 35 mm anterior to a precentral sulcus reference point that is positioned (a) at the precentral sulcus and (b) at the patient'"'"'s middle frontal gyrus; and

treating the patient'"'"'s disorder by applying electrical stimulation to the patient via the at least one stimulation electrode;

wherein;

the at least one stimulation electrode is one of a plurality of stimulation electrodes;

all of the active stimulation electrodes implanted within the patient'"'"'s skull cavity are implanted outside the cortical surface of the patient'"'"'s brain at the patient'"'"'s middle frontal gyrus;

the at least one electrode is the posterior-most electrode within the patient'"'"'s skull cavity and outside a cortical surface of the patient'"'"'s brain via which electrical stimulation is applied to the patient'"'"'s brain;

the at least one electrode is at least 18 mm anterior to the precentral sulcus reference point and is positioned superior to a linear or curvilinear line that at least bisects the middle frontal ayrus into a superior portion and an inferior portion; and

the precentral sulcus reference point is approximately at an intersection of the precentral sulcus and the linear or curvilinear line.

2. The method of claim 1 wherein implanting at least one electrode includes implanting a plurality of electrodes, with at least one of the plurality of electrodes positioned more than 35 mm anterior to the precentral sulcus reference point.

3. The method of claim 1 wherein implanting the at least one electrode includes implanting a plurality of electrodes aligned generally parallel to a linear or curvilinear line that at least bisects the middle frontal gyrus into a superior portion and an inferior portion.

4. The method of claim 1 wherein implanting the at least one electrode includes implanting a plurality of electrodes, and wherein all of the stimulation electrodes implanted within the patient'"'"'s skull cavity are implanted outside the cortical surface of the patient'"'"'s brain at the patient'"'"'s middle frontal gyrus.

5. The method of claim 1 wherein implanting the at least one electrode includes implanting a plurality of electrodes, and wherein all of the stimulation electrodes implanted within the patient'"'"'s skull cavity are implanted outside the cortical surface of the patient'"'"'s brain at least 15 mm anterior to the precentral sulcus reference point.

6. The method of claim 1 wherein all stimulation electrodes implanted within the patient'"'"'s skull cavity are implanted outside the cortical surface of the patient'"'"'s brain, and at a location in the range of about 15 mm to about 35 mm anterior to the precentral sulcus reference point.

7. The method of claim 1, further comprising directing the patient to engage in an adjunctive therapy as part of a treatment regimen that also includes the electrical stimulation.

8. The method of claim 7 wherein the adjunctive therapy includes at least one of a drug therapy, a behavioral therapy, a cognitive behavioral therapy, counseling, and biofeedback.

9. The method of claim 1 wherein implanting the electrode includes implanting the electrode at an epidural location.

10. The method of claim 1 wherein implanting the electrode includes implanting the electrode at a subdural location.

11. The method of claim 1 wherein the patient is diagnosed with a depressive disorder.

12. The method of claim 1 wherein the patient is diagnosed with a major depressive disorder.

13. The method of claim 1 wherein the patient is diagnosed with at least one of a mood disorder, bipolar disorder, obsessive-compulsive disorder (OCD), Tourette'"'"'s syndrome, schizophrenia, a dissociative disorder, an anxiety disorder, a phobic disorder, a post-traumatic stress disorder, a borderline personality disorder, ADHD, and craving.

14. A method for treating a patient'"'"'s neurological disorder, comprising:

in a patient identified as having at least one of a neuropsychological disorder and a neuropsychiatric disorder, preferentially directing electrical stimulation to a target location of the patient'"'"'s brain, the target location being in a range of about 15 mm to about 35 mm anterior to a precentral sulcus reference point that is positioned (a) at the precentral sulcus and (b) at the patient'"'"'s middle frontal gyrus, with the electrical stimulation being directed from at least one stimulation electrode positioned within the patient'"'"'s skull cavity and outside a cortical surface of the patient'"'"'s brain;

wherein;

the at least one stimulation electrode is one of a plurality of stimulation electrodes;

all of the stimulation electrodes within the patient'"'"'s skull cavity are outside the cortical surface of the patient'"'"'s brain at the patient'"'"'s middle frontal gyrus;

the at least one electrode is the posterior-most electrode within the patient'"'"'s skull cavity and outside a cortical surface of the patient'"'"'s brain via which electrical stimulation is applied to the patient'"'"'s brain;

the at least one electrode is at least 18 mm anterior to the precentral sulcus reference point and is positioned superior to a linear or curvilinear line that at least bisects the middle frontal gyrus into a superior portion and an inferior portion; and

the precentral sulcus reference point is approximately at an intersection of the precentral sulcus and the linear or curvilinear line.

15. The method of claim 14, further comprising directing the patient to engage in an adjunctive therapy as part of a treatment regimen that also includes the electrical stimulation.

16. The method of claim 15 wherein the adjunctive therapy includes at least one of a drug therapy, a behavioral therapy, a cognitive behavioral therapy, counseling, and biofeedback.

17. The method of claim 14 wherein the patient is diagnosed with a depressive disorder.

18. The method of claim 14 wherein the patient is diagnosed with at least one of a mood disorder, bipolar disorder, obsessive-compulsive disorder (OCD), Tourette'"'"'s syndrome, schizophrenia, a dissociative disorder, an anxiety disorder, a phobic disorder, a post-traumatic stress disorder, a borderline personality disorder, ADHD, and craving.