Source: http://www.google.com/patents/US7756584?dq=5359317
Timestamp: 2015-01-30 11:07:51
Document Index: 751515590

Matched Legal Cases: ['art.\n3', 'art.\n5', 'art.\n6', 'art.\n7', 'art.\n13', 'art.\n15', 'art.\n16', 'art.\n18', 'art.\n20', 'art.\n24', 'art.\n32', 'art.\n34', 'Application No. 60', 'Application No. 60']

Patent US7756584 - Methods and apparatus for effectuating a lasting change in a neural-function ... - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsThe following disclosure is drawn to methods of electrically stimulating areas of the brain in which neuroplasticity are 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...http://www.google.com/patents/US7756584?utm_source=gb-gplus-sharePatent US7756584 - Methods and apparatus for effectuating a lasting change in a neural-function of a patientAdvanced Patent SearchPublication numberUS7756584 B2Publication typeGrantApplication numberUS 10/260,720Publication dateJul 13, 2010Filing dateSep 27, 2002Priority dateJul 13, 2000Fee statusPaidAlso published asUS8073546, US20030130706, US20110004270Publication number10260720, 260720, US 7756584 B2, US 7756584B2, US-B2-7756584, US7756584 B2, US7756584B2InventorsW. Douglas Sheffield, Andrew D. Firlik, Katrina S. FirlikOriginal AssigneeAdvanced Neuromodulation Systems, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (104), Non-Patent Citations (180), Referenced by (1), Classifications (27), Legal Events (4) External Links: USPTO, USPTO Assignment, EspacenetMethods and apparatus for effectuating a lasting change in a neural-function of a patientUS 7756584 B2Abstract The following disclosure is drawn to methods of electrically stimulating areas of the brain in which neuroplasticity are 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. The disclosure provides methods of identify the location in which neuroplasticity is occurring, not occurring or expected to occur.
selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal from an impaired body part affected by neural dysfunction of the patient's brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region;
2. The method of claim 1 wherein moving the impaired body part comprises passively moving the impaired body part.
3. The method of claim 1 wherein moving the impaired body part 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 stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.
5. The method of claim 1 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.
6. The method of claim 1 wherein moving the impaired body part includes directly contacting and moving the impaired body part.
7. The method of claim 1 wherein detecting a region of the brain includes detecting a region of the brain using fMRI.
8. The method of claim 1 wherein applying an electrical potential includes applying an electrical potential at a level that raises a resting potential of neurons at the stimulation site to a subthreshold level.
9. The method of claim 8 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 10%-95% of a difference between an unstimulated resting potential and a threshold potential for the neurons.
10. The method of claim 8 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 60%-80% of a difference between an unstimulated resting potential and a threshold potential for the neurons.
11. A method of effectuating a neural-function of a patient, comprising:
selecting a stimulation site by (a) generating an intended neural activity by triggering a neural signal from an impaired body part affected by neural dysfunction of the patient's brain, wherein triggering a neural signal includes moving, stimulating, or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region; and
applying an electrical signal directly to the stimulation site effective to carry out the neural function.
12. The method of claim 11 wherein moving the impaired body part comprises passively moving the impaired body part.
13. The method of claim 11 wherein moving the impaired body part 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.
14. The method of claim 11 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.
15. The method of claim 11 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.
16. A method of effectuating a neural-function of a patient, comprising:
selecting a stimulation site by (a) activating a neural signal from an impaired body part affected by neural dysfunction of the patient's brain, wherein activating a neural signal includes moving, stimulating, or moving and stimulating the impaired body part, (b) detecting a cortical region where a response to neural activity occurs in the brain of the patient in reaction to the neural signal associated with the impaired body part, the detected cortical region being at a cortical location of the brain different than a normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region; and
applying an electrical stimulation directly to the stimulation site.
17. The method of claim 16 wherein moving the impaired body part comprises passively moving the impaired body part.
18. The method of claim 16 wherein moving the impaired body part 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.
19. The method of claim 16 wherein stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.
20. The method of claim 16 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.
selecting a signal delivery site by a process that comprises:
applying a signal directly to a portion of the patient's body external to the patient's brain to trigger a neural signal from an impaired body part affected by neural dysfunction of the patient's brain;
detecting a cortical region of the brain in which a response to neural activity occurs in response to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part; and
selecting the signal delivery site to be within the detected cortical region; and
passing an electrical current through the signal delivery site.
22. The method 21 of claim wherein applying a signal includes applying an electrical signal.
23. The method of claim 21 wherein applying a signal directly to a portion of the patient's body includes applying a signal directly to the impaired body part.
24. The method of claim 21 wherein detecting a region of the brain includes detecting a region of the brain using fMRI.
25. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential at a level that raises a resting potential of neurons at the stimulation site to a subthreshold level.
26. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 10%-95% of a difference between an unstimulated resting potential and a threshold potential for the neurons.
27. The method of claim 21 wherein applying an electrical potential includes applying an electrical potential to achieve a change in a resting potential of neurons at the stimulation site of approximately 60%-80% of a difference between an unstimulated resting potential and a threshold potential for the neurons.
28. A method of effectuating a neural-function of a patient, comprising:
selecting a stimulation site by (a) triggering a neural signal from an impaired body part affected by neural dysfunction of the patient's brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, the detected cortical region being at a cortical location of the brain different than a dysfunctional, normal cortical location of the brain where neural activity typically occurs to carry out a function of the impaired body part, and (c) selecting the stimulation site to be within the detected cortical region;
positioning at least a first electrode within the patient's skull, external to a cortical surface of the brain at the stimulation site; and
29. The method of claim 28 wherein selecting a stimulation site includes selecting a stimulation site on a patent-specific basis.
30. A method of effectuating a neural-function of a patient, comprising:
selecting one or more stimulation sites by (a) triggering a neural signal from an impaired body part affected by neural dysfunction of the patient's brain, wherein triggering a neural signal includes moving, stimulating or moving and stimulating the impaired body part, (b) detecting a cortical region of the brain in which a response to neural activity occurs in reaction to the neural signal, and (c) selecting the patient's brain stimulation sites to be located within the patient's skull, within the detected cortical region, and on a cortical surface of the brain;
positioning at least a first electrode at the one or more stimulation sites; and
31. The method of claim 30 wherein moving the impaired body part comprises passively moving the impaired body part.
32. The method of claim 30 wherein moving the impaired body part 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 stimulating the impaired body part comprises applying an electrical stimulation to the impaired body part.
34. The method of claim 30 wherein stimulating the impaired body part comprises applying an electrical stimulation to a nerve of the impaired body part.
CROSS-REFERENCE TO RELATED APPLICATION(S) This application claims the benefit of U.S. Application No. 60/325,872 filed on Sep. 28, 2001, and is a continuation-in-part of U.S. application Ser. No. 09/802,808, filed on Mar. 8, 2001 now U.S. Pat. No. 7,010,351, which claims the benefit of U.S. Provisional Application No. 60/217,981, filed Jul. 13, 2000; both of which are incorporated by reference herein in their entirety.
BACKGROUND A wide variety of mental and physical processes are known to be controlled or are influenced by neural activity in particular regions of the brain. In some areas of the brain, such as in the sensory or motor cortices, the organization of the brain resembles a map of the human body; this is referred to as the �somatotopic organization of the brain.� There are several other areas of the brain that appear to have distinct functions that are located in specific regions of the brain in most individuals. For example, areas of the occipital lobes relate to vision, regions of the left inferior frontal lobes relate to language in the majority of people, and regions of the cerebral cortex appear to be consistently involved with conscious awareness, memory, and intellect. This type of location-specific functional organization of the brain, in which discrete locations of the brain are functional organization of the brain, in which discrete locations of the brain are statistically likely to control particular mental or physical functions in normal individuals, is herein referred to as the �functional organization of the brain.�
Independent studies have also demonstrated that TMS is able to produce a lasting change in neural activity within the cortex that occurs for a period of time after terminating the TMS treatment (�neuroplasticity�). For example, Ziemann et al., Modulation of Plasticity in Human Motor Cortex after Forearm Ischemic Nerve Block, 18 J Neuroscience 1115 (February 1998), disclose that TMS at subthreshold levels (e.g., levels at which movement was not induced) in neuro-block models that mimic amputation was able to modify the lasting changes in neural activity that normally accompany amputation. Similarly, Pascual-Leone et al. (submitted for publication) disclose that applying TMS over the contralateral motor cortex in normal subjects who underwent immobilization of a hand in a cast for 5 days can prevent the decreased motor cortex excitability normally associated with immobilization. Other researchers have proposed that the ability of TMS to produce desired changes in the cortex may someday be harnessed to enhance neuro-rehabilitation after a brain injury, such as stroke, but there are no published studies to date.
King discloses implanting the electrodes in contact with the surface of the cortex to create paresthesia, which is a sensation of vibration or �buzzing� in a patient. More specifically, King discloses inducing paresthesia in large areas by applying electrical stimulation to a higher element of the central nervous system (e.g., the cortex). As such, King discloses placing the electrodes against particular regions of the brain to induce the desired paresthesia. The purpose of creating paresthesia over a body region is to create a distracting stimulus that effectively reduces perception of pain in the body region. Thus, King appears to require stimulation above activation levels.
The passive movement of the impaired body part is expected to provide a good indication of the location in the cortex where the brain is performing neural activity that controls the impaired body part. Passively moving the impaired body part produces neural signals that travel through the spinal cord to the cortex. The neural signals then produce neural activity at a site in the brain that is associated with the function of the impaired body part; it is this neural activity that defines the �intended neural activity.� The site of the intended neural activity generated by the passive movement of the impaired body part correlates well with active movement of the impaired body part. Thus, by passively moving an impaired body part and monitoring the intended neural activity that occurs in response to the passive motion, the location of the intended neural activity defines the stimulation site for applying an electrical therapy or another type of therapy.
The embodiment of the diagnostic procedure 102 shown in FIG. 4B that electrically stimulates the impaired muscles is expected to provide highly accurate results. One reason for this is that the electrical current can be applied to only certain muscles without having to involve other muscles. As a result, it is expected that there will be less �noise� in the image of the neural activity. Such a reduction in noise will accordingly likely produce a more accurate indication of where the intended neural activity is occurring in the brain.
The embodiment of the diagnostic procedure 102 shown in FIG. 4C is also expected to be useful for providing an accurate image of the intended neural activity in the cortex. By stimulating the nerves instead of passively moving the impaired body part, this embodiment is also expected to reduce the �noise� of neural activity in the brain correlated with the impaired body part. Additionally, stimulating the nerves in the impaired body part may provide an even more precise image of the response neural activity in the brain because it directly involves the nervous system without having to involve other features of the impaired body part.
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