CA2432810A1 - Method of treating depression, mood disorders and anxiety disorders by brian infusion - Google Patents

Method of treating depression, mood disorders and anxiety disorders by brian infusion Download PDF

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Publication number
CA2432810A1
CA2432810A1 CA 2432810 CA2432810A CA2432810A1 CA 2432810 A1 CA2432810 A1 CA 2432810A1 CA 2432810 CA2432810 CA 2432810 CA 2432810 A CA2432810 A CA 2432810A CA 2432810 A1 CA2432810 A1 CA 2432810A1
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CA
Canada
Prior art keywords
depression
site
stimulation
drugs
signal generator
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
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CA 2432810
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French (fr)
Inventor
Andres M. Lozano
Helen S. Mayberg
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Advanced Neuromodulation Systems Inc
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Individual
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Filing date
Publication date
Priority to CA 2432810 priority Critical patent/CA2432810A1/en
Application filed by Individual filed Critical Individual
Priority to PCT/US2004/019470 priority patent/WO2004112894A1/en
Priority to EP04755566A priority patent/EP1638646A1/en
Priority to US10/872,277 priority patent/US7346395B2/en
Priority to EP20100010744 priority patent/EP2277588A3/en
Priority to AU2004249234A priority patent/AU2004249234B2/en
Priority to US10/872,271 priority patent/US20050033379A1/en
Publication of CA2432810A1 publication Critical patent/CA2432810A1/en
Priority to US11/469,669 priority patent/US7653433B2/en
Priority to AU2009200605A priority patent/AU2009200605B2/en
Priority to US12/686,030 priority patent/US8190264B2/en
Priority to US13/478,646 priority patent/US8467878B2/en
Priority to US13/913,189 priority patent/US9026218B2/en
Priority to US14/703,725 priority patent/US9474852B2/en
Abandoned legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M5/14244—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
    • A61M5/14276—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body specially adapted for implantation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0526—Head electrodes
    • A61N1/0529—Electrodes for brain stimulation
    • A61N1/0534—Electrodes for deep brain stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36082—Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
    • A61N1/36096—Mood disorders, e.g. depression, anxiety or panic disorder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128—Control systems
    • A61N1/36146—Control systems specified by the stimulation parameters
    • A61N1/36182—Direction of the electrical field, e.g. with sleeve around stimulating electrode
    • A61N1/36185—Selection of the electrode configuration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/24—Antidepressants

Abstract

In one aspect there is provided a method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, as well as an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:
surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site preferably selected from the group consisting of the Subcallosal Cingulate area 25, the Subcaudate area, and the orbitofrontal cortex areas in brain tissue, which site when electrically stimulated, reduces symptoms of depression, mood disorders and anxiety disorders;
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site preferably selected from the group consisting of the Subcallosal Cingulate area 25 and the orbitofrontal cortex areas in the brain tissue, which site when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression, mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site while the signal generator is stimulating the stimulation site, whereby depression, mood disorders and anxiety disorders are treated.

Description

METHOD OIa' TREATING DEPRESSION, MOOD
DISORDERS AND AN~;IET~' DISORDERS B~ BRAIN INFUSION
FIELD OF THE INVENTION
This invention relates to nerve tissue stimulation for treating depression, anxiety disorders and mood disorders, and more particularly to treating nerve tissue at a particular predetermined stimulation site in brain tissue.
BACKGROUND OF THE INVENTION
Persons with depression can be treated with oral medications, such as for example, monoarnine oxidase inhibitors, such as phenelzine, serotonin uptake blockers like trazodone and fluoxetine and trycyclinc compounds like imipramine. Lithium salts are used to terminate manic episodes and prophylactically to prevent reaccurance. .Antipsychotic drugs can be used in combination with tricyclics for cases of depression when psychosis is present.
USP 5,599,560 - Siuciak discloses the use of neurotrophins to treat depression. USP
4,596,807 and USP 4,698,342 - COSBY teaches the use of the serotonin precursor tryptophan. USP 4,912,126 - Owen discloses the use of 3(H)-indolones. USP
4,980,174 -Sgan describes implanting monoamine producing living cells into the central nervous system to treat depressive patients.
The use of biofeedback to the user of the asymmetry between the brain waves measured at two locations as a means of treating depression is disclosed in USP 5,280,793 -Rosenfeld.
Electrical stimulation of the nervous system has been proposed as a therapeutic treatment of depression. USP 5,470,846 - Sandyk disclosed the use of transcranial pulsed magnetic fields to treat depression. USP 5,299,569 - Werneke et. al. discloses electrical stimulation of the vagus nerve and USP 5,540,734 - Zabara teaches stimulation of the trigeminal or glossopharyngeal nerves for psychiatric illness such as depression.
USP 6,176,242 - Rise discloses techniques using one or more drugs, electrical stimulation or both to treat depression or manic depression by means of an implantable signal generator and electrode and/or an implantable pump and catheter. A catheter is surgically implanted in selected sites in the brain to infuse the drugs, and one or more electrodes are surgically implanted in the brain at selected sites to provide electrical stimulation.
However, despite the aforesaid available treatments, there are patients with major depression that remain treatment refractory and chronically disabled. For these severely ill and disabled patients, novel therapies are required.
SUMMARY OF THE INVENTION
The present invention is of value for the treatment by Subgenual deep brain stimulation or focal drug delivery of human patients suffering from depression, mood disorders and anxiety disorders as grouped in defined areas understood and accepted to the persons skilled in the art, as follows.
I. Mood Disorders, severe refractory 5 A. Major Depressive Disorder (unipolar~
B. Bipolar Disorder I, depressive phase C. Bipolar Disorder II, depressive phase D. Depression associated with Neurological Disorders 1. Parkinson's disease 2. Stroke II. Anxiety Disorders, severe refractory A. Obsessive Compulsive Disorder B. Generalized Anxiety Disorder C. Panic Disorder The present invention relates to nerve electrical and/or drug stimulation techniques described in aforesaid USP 6,176,242, but applied to novel areas of the brain not considered in the prior art to play a role in depression. Functional imaging studies have implicated specific cortical areas functioning abnormally in depression. Such imaging studies have pointed to abnormal function in a circuit involving particularly Brodmann area 25 of the brain, an area know as the sub-genual cingulate area.

We have found that neurosurgical intervention that blocks the pathological activity of Brodmann area 25 in patients suffering from depression has helped to alleviate their depression. Such interventions include, applying chronic electrical stimulation, herein termed "deep brain stimulation" or DBS, as is currently practiced to treat a number of disorders like Parkinson's disease or the local delivery of neuroactive substances to disrupt or block the pathological activity stemming from or coursing through this area.
Accordingly, the invention provides in one aspect a method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, as well as an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site selected from the group consisting of the Subcallosal Cingulate area 25, the subcaudate area, and the orbitofrontal cortex areas in brain tissue, which site when electrically stimulated, reduces symptoms of depression;
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site selected from the group consisting of the Subcallosal Cingulate area 25, the subcaudate area, and the orbitofrontal cortex areas in the brain tissue, which site when therapeutic dosages of the one or more dnzgs are infused thereto, reduces symptoms of depression;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site while the signal generator is stimulating the stimulation site, whereby depression, mood disorders and anxiety disorders is treated.
In a preferred aspect the invention provides a method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an 34 implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, as well as an electric signal generator and an implantabie electrode having a proximal end and a stimulation portion, the method comprising the steps of:
surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site in brain tissue, the stimulation site chosen as a location that, when electrically stimulated, reduces symptoms of depression, mood disorders and anxiety disorders;
surgically implanting the catheter so that the discharge portion Lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression, mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site while the signal generator 1 S is stimulating the stimulation site, whereby depression, mood disorders and anxiety disorders are treated;
wherein said stimulation site and said infusion site are selected from the Subcallosal Cingulate area 25, the subcaudate area, and the orbitofrontal cortex areas.
One form of the invention comprises a method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, the method comprising the steps of:
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression, mood disorders and anxiety disorders; and operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site, whereby the depression, mood disorders and anxiety disorders is treated;
wherein said infusion site is selected from the Subcallosal Cingulate area 25, the subcaudate area, and the orbitofrontal cortex areas.

Another form of the invention comprises a method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, the method comprising the steps of:
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression, mood disorders and anxiet)~ disorders; and operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site, whereby the depression, mood disorders and anxiety disorders is treated;
wherein said infusion site is selected from the Subcallosal Cingulate area 25 and the orbitofrontal cortex areas.
As analogously described in aforesaid USP 6,176,242 a preferred form of the present invention uses one or more drugs and/or electrical stimulation to treat a patient. The treatment is carried out by an implantable pump and a catheter having a proximal end coupled to the pump and having a discharge portion for infusing therapeutic dosages ofthe one or more drugs into a predetermined infusion site in brain tissue. Alternatively, encapsulated cells selected to secrete the appropriate substance or a drug eluting polymer may be implanted into a predetermined treatment site in brain tissue. The treatment also may be carried out by an implantable signal generator and an implantable electrode having a proximal end coupled to the signal generator and having a stimulation portion for electrically stimulating a predetermined stimulation site in the brain tissue. In one embodiment of the invention stimulation and/or infusion is carried out in a nearly continuous manner. In another form of the invention, the stimulation or infusion is initiated by the patient in response to undesirable symptoms associated with depression or mania.
In a further feature, the invention provides a method of treating depression, mood disorders and anxiety disorders by means of an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:

surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site selected from the group consisting of the Subcallosal Cinguiate area 25, the Subcaudate area, and the orbitofrontal cortex areas in the brain tissue, which site when electrically stimulated, reduces symptoms of depression, mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
whereby depression, mood disorders and anxiety disorders are treated.
In a yet further feature, the invention provides a method of treating mood disorders IO and anxiety disorders by means of an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, fhe method comprising the steps of surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site in the brain tissue, which site when electrically stimulated, reduces symptoms of mood disorders and anxiety disorders;
15 coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
whereby mood disorders and anxiety disorders are treated.
Another form of the invention uses a sensor in combination with the signal generator, one or more stimulating electrodes, pump and catheter to treat a neurological or psychiatric 20 disorder. .In this form of the invention, the sensor generates a sensor signal related to a condition resulting from the depressive or manic disorder. Control means responsive to the sensor signal regulate the signal generator and pump so that the neurological disorder is treated.
By using the foregoing techniques, the symptoms of depressive disorders can be 25 controlled to a degree unattainable by prior art methods or apparatus.
Drugs of use in the practise of the invention as hereinabove described may be selected from the group consisting of Anesthetic, GABA Agonist, G.ABA Antagonist, Dopamine Antagonist, Dopamie Agonist, Serotonin Antagonist, Serotonin Agonist, Glutamate Antagonist, Glutamate Agonist, Adrenergic Agonist and Adrenergic Antagonist.
3~
b BRIEF DESCRIPTION OF THE DRAWINGS
In order that the invention may be better understood, preferred embodiments will now be described by way of example only, with reference to the accompanying drawing wherein Fig. 1 is a coronal (front vertical) section of a human brain showing arrows directed to target areas; and I~ igs. 2A-2E are NMR scans through various planes of the brain.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
The following general procedures are followed in the treatment of a patient according to the invention.
Surgery:
Under local anesthesia, a stereotactic frame is first placed on the patient's head, followed by acquisition of an MRI (Magnetic Resonance Imaging) scan to localize the target region. Patients are then taken to the operating room where, under local anesthesia, two burr holes are placed at the hairline. Stereotactic coordinates are derived from the pre-op MRI.
Once the target sites have been identified, the following are delivered at target, including: 1) two mufti contact electrodes, such as the quadripolarpolar Medtronic electrodes (model 3387), one in each hemisphere; or 2) set of electrodes as hereinafter described; or 3) a multiport infusion catheter for drug delivery. The electrodes are connected to a stimulating pulse generator capable of stimulating from 0-IOOOHz, 0-I0.0 volts and 0-500 microseconds pulse widths in monopolar or multipolar configurations. In patients receiving a catheter far intraparenchymal delivery the surgery is similar except a catheter is delivered at target to allow focal drug infusions.
With the patient's participation, each electrode contact is stimulated and acute changes in behavior is assessed using self report and mood rating scales, such as POMS, PANAS, sadness, anxiety and general well being. Acute stimulation of this type is routinely used with microelectrode recording to identify the precise STN or globus pallidus DBS target for treatment of Parkinson's disease. In PD, the stereotypic changes in motor unit patterns to guide electrode placement. Acute reductions in motor symptoms are commonly observed with stimulation. The assessment of the variations in effects of transient stimulation in the acute setting help guide chronic stimulation parameters. Based on experiences with DBS in PD where acute changes in mood state have been observed, acute changes in behavior are seen with stimulation or focal drug delivery. As either positive or negative changes in mood might occur, the relationship between the specific stimulation site and the resulting behavior is carefully documented. Following the 15 minute testing session to help in optimal target selection and adjustment of the position of the electrode contacts or delivery ports, the incisions are closed and patients taken to the intensive care unit for recovery from surgery.
Analogous studies axe performed with drug infusions.
Stimulator Mapping with fMRI. Within I-2 days of surgery, fMRI scans are performed during successive stimulation of each electrode contact. This procedure defines the differential projection fields mediating acute changes in behavior initiated by a particular stimulation site. Even without acute changes in behavior, these maps allow discrimination of subtle differences in pathways served by stimulation of different white matter tracts within the stimulation field of each electrode. These results are also useful in guiding selection of the optimal site for chronic stimulation, particularly if changes with some but not all electrodes are seen in subgenual cingulate regions----the site of maximal change with both memory evoked sadness and medication-mediated remission of depression symptoms.
Analogous studies are performed with drug infusions.
Imaging is performed on a I.ST scanner using methods proven safe for pts with implanted electrodes and delivery catheters. Whole brain samples using spiral acquisition are repeated every 3.52 sacs. One cycle is 30 seconds of stimulation and 3t) seconds rest. A
block of 6 cycles is acquired for each of the 8 contacts in consecutive order.
'The electrodes are activated using a transcutaneous Lead connected to a pulse generator outside the imaging room. Pts are rate mood (pos/neg) on a 1-5 scale by bratton push and auditory prompt following each cycle. Analyses addresses differences ON vs OFF for each contact and changes over multiple cycles.
Analogous studies are performed with drug infusions, pacemaker implantation and drug pump implantation. At anytime after the surgery for implantation of the electrodes or drug delivery catheters but usually within °~ days post-op and after fMRI
mapping, pts undergoes a second procedure (~45 mins under general anesthesia) to connect the electrodes to a self contained subcutaneous pacemaker device placed below the clavicle and connected to the electrodes in the head After 2-3 days, the patients are discharged home on their regular antidepressant regime with the stimulator turned OFF. In patients receiving an intraparenchymal drug delivery catheter, the catheter is connected to an adjustable programmable pump able to deliver I-I O microliters per hour to the target.
DBS and drug delivery pump Programming. Patients return for pacemaker ~ programming. There are several parameters that are tested, namely, which electrode contact of 4 is to be stimulated, the polarity of stimulation, the frequency and pulse width of stimulation, etc. Electrode contacts that produced acute behavioral changes in the OR or decreased BOLD signal in Cg25 during fMRI are tried first with the goal being to find electrode settings that are well tolerated and free of side effects. The electrode programming I O is done as an outpatient basis and involves a series of trials over the course of a week. Once basic parameters are set, adjustments are made periodically until a stable program is established. Similar adjustment in dose is required in the case of patients requiring drug infusions.
I5 Clinical Followup. Once final stimulation parameters are established, psychiatric symptoms are monitored on a monthly basis. Clinical ratings are quanitified using Beck, Hamilton, CGI, and Quality of Life Scales Serial Neuropsychological Testing. A standardized battery is performed on the same day as 20 the PET studies. General cognitive performance and detailed frontal lobe functioning is assessed. The test battery has been designed to differentiate dorsolateral, superior medial, and ventrolateral/orbital frontal behaviors which is differentially affected by activation or disruption of the target areas with DBS or drug infusion. Serial testing allows differentiation between early surgical effects, chronic stimulation effects, and correlations with mood 25 change.
With reference to Fig. 1, this shows the position of the subgenual cingulated target area, Brodmann area 25 having coordinates derived from the Schaltenbrand and Wahren Atlas plate 3 coronal section through the brain are 6-7 mm from the midline (range 2-I4 mm), 29mm anterior to the mid-commissural point range 20-40) and 5 mm (range 0-10 mm) 30 below the intra-commissural line. Arrow 1 is the preferred target, Subcallosal cingulated area 25, area 25 arrows 2 Gyrus rectus, 3 Subcaudate area and 4 orbitofrontal cream, show alternate targets.

Fig. 2A is a T 1 MRI in the horizontal plane showing the tips (at arrows) on the implanted 4 contact electrodes positioned anterior to the anterior commisure .AC, approximately 7 mm from the midline and below the plane of the inter-commisural line, in a patient with depression.
S Fig. 2B is an axial Tl MRI in the horizontal plane of a patient with depression implanted with chronic deep brain stimulating electrodes to stimulate Brodmann area 25.
Fig. 2C is a Sagittal T1 weighted MRI, vertical through the nose, showing an implanted chronic deep brain stimulating electrode with 4 contacts to stimulate Brodmann area 25. The central dot shows a contact area 25.
Fig. 2D is a T1 weighted MRI Coronal view of a patient having scans of Figs.
2A and 2B showing right and left electrodes in the plane of the brain corresponding to the Schaltebrand and Warren atlas section plate 3 shown in Fig. 1. The central dot is at the midline.
Fig. 2E are T1 weighted MRI images of a second patient with bilateral electrodes implanted to stimulate area 25.
Results:
The surgical procedure was the insertion into and the chronic stimulation of the subgenual cingulated gyrus Broadmann Area 25 as shown in Fig. 1 with deep brain stimulating system. An MRI showing the position of the electrodes is shown in Fig. 2.
Alternatively, intraparenchymal drug delivery was used to change the function of this area.
The coordinates of this target derived from the Schaltenbrand and Wahren Atlas plate 3 (Fig.
1) are 6-7mm from the midline (range 2-l4mm), 29mm anterior to the mid-commissural point range 20-40) and Smm (range 0-10 mm) below the infra-commissural line.
Three different forms of electrodes or contact to best conform to thus anatomical site for optimal delivery of electrical stimulation could be used. One design is a single mufti contact electrode with eight contacts separated by 2%a mm each contract would have a span of approximately 2mm. Another design is an electrode with two 1 cm contacts with a 2 mm intervening gap. A third design is a 2 or 3 branched electrode/catheter to cover the white matter of the gyfus rectus, the subcaudate area and the subgenual cingulate area. Each one of these three pronged catheters/electrodes would have four contacts 1-2 mm contacts with a center to center separation of 2 of 2.5 mm and a span of 1.5 mm. Similar designs with catheters to infuse drugs with single outlet pore at the extremities of these types of catheters or along their shaft could also be designed.
With two patients operated on according to one embodiment according to the practise of the present invention, with acute intraoperative stimulation at the target site using parameters of 60-90 microseconds and 100-185 Hz and 6-10 volts, sensations of calm, tranquilty, peacefulness, increased energy and alertness, feel of a deep void and improved mood were induced. There was also a striking improvement in motor speed and in spontaneity of speech.
Acute effects of stimulation and functional MRI changes in downstream frontal lobe targets was useful in choosing the correct electrode contact and the correct stimulation parameters. Stimulation in and in the vicinity of AREA 25 leads to changes in the activation of Area 25 and downstream targets in the frontal lobe, cingulated and orbitofrontal cortex.
Although this disclosure has described and illustrated certain preferred embodiments of the invention, it is to be understood that the invention is not restricted to those particular embodiments. Rather, the invention includes all embodiments which are functional or mechanical equivalence of the specific embodiments and features that have been described and illustrated.

Claims (8)

1. A method of using one or more drugs to therapeutically treat depression, mood disorders and anxiety disorders by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, as well as an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:
surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site selected from the group consisting of the Subcallosal Cingulate area 25, the Subcaudate area, and the orbitofrontal cortex areas in brain tissue, which site when electrically stimulated, reduces syptoms of depression, mood disorders and anxiety disorders;
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site selected from the group consisting of the Subcallosal Cingulate area 25, the Subcaudate area, and the orbitofrontal cortex areas in the brain tissue, which site when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression, mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site while the signal generator is stimulating the stimulation site, whereby depression, mood disorders and anxiety disorders are treated.
2. A method of using one or more drugs to therapeutically treat depression and manic depression by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, as well as an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:
surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site in brain tissue, the stimulation site chosen as a location that, when electrically stimulated, reduces symptoms of depression and manic depression;

surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression and manic depression;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site while the signal generator is stimulating the stimulation site, whereby depression and manic depression are treated;
the improvement, wherein said stimulation site and said infusion site are selected from the Subcallosal Cingulate area 25 and the orbitofrontal cortex areas.
3. A method, as claimed in claim 1 or claim 2, wherein the one or more drugs is selected from the group consisting of Anesthetic, GABA Agonist, GABA Antagonist, Dopamine Antagonist, Dopamie Agonist, Serotonin Antagonist, Serotonin Agonist, Glutamate Antagonist, Glutamate Agonist, Adrenergic Agonist and Adrenergic Antagonist.
4. A method of using one or more drugs to therapeutically treat depression and manic depression by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, the method comprising the steps of:
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression and manic depression; and operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into the infusion site, whereby the depression and manic depression is treated;
the improvement, wherein said infusion site is selected from the Subcallosal Cingulate area 25 and the orbitofrontal cortex areas.
5. A method as claimed in claim 4 wherein the one or more drugs is selected from the group consisting of Anesthetic, GABA Agonist, GABA Antagonist, Dopamine Antagonist, Dopamie Agonist, Serotonin Antagonist, Serotonin Agonist, Glutamate Antagonist, Glutamate Agonist, Adrenergic Agonist and Adrenergic Antagonist.
6. A method of using one or more drugs to therapeutically treat depression and manic depression by means of an implantable pump and a catheter having a proximal end coupled to the pump and a discharge portion for infusing therapeutic dosages of the one or more drugs, the method comprising the steps of:
surgically implanting the catheter so that the discharge portion lies adjacent a predetermined infusion site in the brain tissue, the infusion site chosen as a location that, when therapeutic dosages of the one or more drugs are infused thereto, reduces symptoms of depression and manic depression; and operating the pump to discharge a predetermined dosage of the one or more drugs through the discharge portion of the catheter into tile infusion site, whereby the depression and manic depression is treated;
the improvement, wherein said infusion site is selected from the Subcallosal Cingulate area 25 and the orbitofrontal cortex areas.
7. A method of treating depression, mood disorders and anxiety disorders by means of an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site selected from the group consisting of the Subcallosal Cingulate area 25, the Subcaudate area, and the orbitofrontal cortex areas in the brain tissue, which site when electrically stimulated, reduces symptoms of depression, mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
whereby depression, mood disorders and anxiety disorders are treated.
8. A method of treating mood disorders and anxiety disorders by means of an electric signal generator and an implantable electrode having a proximal end and a stimulation portion, the method comprising the steps of:
surgically implanting the electrode so that the stimulation portion lies adjacent a predetermined stimulation site in the brain tissue, which site when electrically stimulated, reduces symptoms of mood disorders and anxiety disorders;
coupling the proximal end of the electrode to the signal generator;
operating the signal generator to stimulate the stimulation site;
whereby mood disorders and anxiety disorders are treated.
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CA 2432810 CA2432810A1 (en) 2003-06-19 2003-06-19 Method of treating depression, mood disorders and anxiety disorders by brian infusion
PCT/US2004/019470 WO2004112894A1 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
EP04755566A EP1638646A1 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US10/872,277 US7346395B2 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
EP20100010744 EP2277588A3 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
AU2004249234A AU2004249234B2 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US10/872,271 US20050033379A1 (en) 2003-06-19 2004-06-18 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US11/469,669 US7653433B2 (en) 2003-06-19 2006-09-01 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
AU2009200605A AU2009200605B2 (en) 2003-06-19 2009-02-17 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US12/686,030 US8190264B2 (en) 2003-06-19 2010-01-12 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US13/478,646 US8467878B2 (en) 2003-06-19 2012-05-23 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US13/913,189 US9026218B2 (en) 2003-06-19 2013-06-07 Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US14/703,725 US9474852B2 (en) 2003-06-19 2015-05-04 Method of treating depression, mood disorders and anxiety disorders using neuromodulation

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8195298B2 (en) 2008-02-15 2012-06-05 Andres M Lozano Method for treating neurological/psychiatric disorders with stimulation to the subcaudate area of the brain

Families Citing this family (133)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060217782A1 (en) * 1998-10-26 2006-09-28 Boveja Birinder R Method and system for cortical stimulation to provide adjunct (ADD-ON) therapy for stroke, tinnitus and other medical disorders using implantable and external components
US7062330B1 (en) * 1998-10-26 2006-06-13 Boveja Birinder R Electrical stimulation adjunct (Add-ON) therapy for urinary incontinence and urological disorders using implanted lead stimulus-receiver and an external pulse generator
US7305268B2 (en) 2000-07-13 2007-12-04 Northstar Neurscience, Inc. Systems and methods for automatically optimizing stimulus parameters and electrode configurations for neuro-stimulators
US6959215B2 (en) * 2002-12-09 2005-10-25 Northstar Neuroscience, Inc. Methods for treating essential tremor
WO2004052449A1 (en) * 2002-12-09 2004-06-24 Northstar Neuroscience, Inc. Methods for treating neurological language disorders
CA2432810A1 (en) * 2003-06-19 2004-12-19 Andres M. Lozano Method of treating depression, mood disorders and anxiety disorders by brian infusion
WO2005011805A2 (en) 2003-08-01 2005-02-10 Northstar Neuroscience, Inc. Apparatus and methods for applying neural stimulation to a patient
US9050469B1 (en) 2003-11-26 2015-06-09 Flint Hills Scientific, Llc Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals
US7422555B2 (en) * 2003-12-30 2008-09-09 Jacob Zabara Systems and methods for therapeutically treating neuro-psychiatric disorders and other illnesses
US7313442B2 (en) * 2004-04-30 2007-12-25 Advanced Neuromodulation Systems, Inc. Method of treating mood disorders and/or anxiety disorders by brain stimulation
US20050154425A1 (en) * 2004-08-19 2005-07-14 Boveja Birinder R. Method and system to provide therapy for neuropsychiatric disorders and cognitive impairments using gradient magnetic pulses to the brain and pulsed electrical stimulation to vagus nerve(s)
US7353065B2 (en) * 2004-09-14 2008-04-01 Neuropace, Inc. Responsive therapy for psychiatric disorders
US9352145B2 (en) * 2004-12-22 2016-05-31 Boston Scientific Neuromodulation Corporation Methods and systems for treating a psychotic disorder
US9079030B2 (en) 2004-12-22 2015-07-14 G. Blake Holloway Systems and methods for balancing and maintaining the health of the human autonomic nervous system
US20110307030A1 (en) * 2005-03-24 2011-12-15 Michael Sasha John Methods for Evaluating and Selecting Electrode Sites of a Brain Network to Treat Brain Disorders
US9314633B2 (en) 2008-01-25 2016-04-19 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US8565867B2 (en) 2005-01-28 2013-10-22 Cyberonics, Inc. Changeable electrode polarity stimulation by an implantable medical device
AU2006218642A1 (en) 2005-03-01 2006-09-08 Advanced Neuromodulation Systems, Inc. Method of treating depression, mood disorders and anxiety disorders using neuromodulation
US20060212090A1 (en) * 2005-03-01 2006-09-21 Functional Neuroscience Inc. Method of treating cognitive disorders using neuromodulation
US20070053996A1 (en) 2005-07-22 2007-03-08 Boyden Edward S Light-activated cation channel and uses thereof
US9274099B2 (en) 2005-07-22 2016-03-01 The Board Of Trustees Of The Leland Stanford Junior University Screening test drugs to identify their effects on cell membrane voltage-gated ion channel
US9238150B2 (en) * 2005-07-22 2016-01-19 The Board Of Trustees Of The Leland Stanford Junior University Optical tissue interface method and apparatus for stimulating cells
US8926959B2 (en) 2005-07-22 2015-01-06 The Board Of Trustees Of The Leland Stanford Junior University System for optical stimulation of target cells
US20070027499A1 (en) 2005-07-29 2007-02-01 Cyberonics, Inc. Neurostimulation device for treating mood disorders
US7729773B2 (en) * 2005-10-19 2010-06-01 Advanced Neuromodualation Systems, Inc. Neural stimulation and optical monitoring systems and methods
US20070088403A1 (en) * 2005-10-19 2007-04-19 Allen Wyler Methods and systems for establishing parameters for neural stimulation
US7684867B2 (en) * 2005-11-01 2010-03-23 Boston Scientific Neuromodulation Corporation Treatment of aphasia by electrical stimulation and/or drug infusion
US7606622B2 (en) * 2006-01-24 2009-10-20 Cardiac Pacemakers, Inc. Method and device for detecting and treating depression
US7801601B2 (en) 2006-01-27 2010-09-21 Cyberonics, Inc. Controlling neuromodulation using stimulus modalities
US20070179558A1 (en) * 2006-01-30 2007-08-02 Gliner Bradford E Systems and methods for varying electromagnetic and adjunctive neural therapies
ES2538726T3 (en) 2006-03-29 2015-06-23 Dignity Health Vagus nerve stimulation system
US7869885B2 (en) * 2006-04-28 2011-01-11 Cyberonics, Inc Threshold optimization for tissue stimulation therapy
US9352167B2 (en) * 2006-05-05 2016-05-31 Rio Grande Neurosciences, Inc. Enhanced spatial summation for deep-brain transcranial magnetic stimulation
WO2008003318A1 (en) * 2006-07-05 2008-01-10 Aarhus Universitet A research model system and a method for using electrical stimulation and/ chemical stimulation to induce depressive illness in research animals
US20080103548A1 (en) * 2006-08-02 2008-05-01 Northstar Neuroscience, Inc. Methods for treating neurological disorders, including neuropsychiatric and neuropsychological disorders, and associated systems
DK176782B1 (en) * 2006-08-04 2009-08-17 Innovision As Method for Compensating the Effect of Blood Soluble Gas Recirculation on Determination of Pulmonary Blood Flow in Repeat Inert Gas Repeat Tests
US7869867B2 (en) 2006-10-27 2011-01-11 Cyberonics, Inc. Implantable neurostimulator with refractory stimulation
US8280514B2 (en) 2006-10-31 2012-10-02 Advanced Neuromodulation Systems, Inc. Identifying areas of the brain by examining the neuronal signals
DE202007003577U1 (en) * 2006-12-01 2008-04-10 Liebherr-Hausgeräte Ochsenhausen GmbH Fridge and / or freezer
WO2008086470A1 (en) 2007-01-10 2008-07-17 The Board Of Trustees Of The Leland Stanford Junior University System for optical stimulation of target cells
US20080183068A1 (en) * 2007-01-25 2008-07-31 Warsaw Orthopedic, Inc. Integrated Visualization of Surgical Navigational and Neural Monitoring Information
US20080183188A1 (en) * 2007-01-25 2008-07-31 Warsaw Orthopedic, Inc. Integrated Surgical Navigational and Neuromonitoring System
US20080183074A1 (en) * 2007-01-25 2008-07-31 Warsaw Orthopedic, Inc. Method and apparatus for coordinated display of anatomical and neuromonitoring information
US8374673B2 (en) * 2007-01-25 2013-02-12 Warsaw Orthopedic, Inc. Integrated surgical navigational and neuromonitoring system having automated surgical assistance and control
US7987001B2 (en) * 2007-01-25 2011-07-26 Warsaw Orthopedic, Inc. Surgical navigational and neuromonitoring instrument
WO2008106694A2 (en) 2007-03-01 2008-09-04 The Board Of Trustees Of The Leland Stanford Junior University Systems, methods and compositions for optical stimulation of target cells
US7974701B2 (en) * 2007-04-27 2011-07-05 Cyberonics, Inc. Dosing limitation for an implantable medical device
EP2200649A4 (en) 2007-10-19 2012-09-26 Univ California Compositions and methods for ameliorating cns inflammation, psychosis, delirium, ptsd or ptss
US10434327B2 (en) 2007-10-31 2019-10-08 The Board Of Trustees Of The Leland Stanford Junior University Implantable optical stimulators
WO2009073891A1 (en) * 2007-12-07 2009-06-11 Northstar Neuroscience, Inc. Systems and methods for providing targeted neural stimulation therapy to address neurological disorders, including neuropyschiatric and neuropyschological disorders
US8571643B2 (en) 2010-09-16 2013-10-29 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8337404B2 (en) 2010-10-01 2012-12-25 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8382667B2 (en) 2010-10-01 2013-02-26 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US20090264955A1 (en) * 2008-04-18 2009-10-22 Medtronic, Inc. Analyzing a stimulation period characteristic for psychiatric disorder therapy delivery
US9333350B2 (en) * 2008-04-18 2016-05-10 Medtronic, Inc. Psychiatric disorder therapy control
WO2009129486A2 (en) * 2008-04-18 2009-10-22 Medtronic, Inc. Timing therapy evaluation trials
US10688303B2 (en) * 2008-04-18 2020-06-23 Medtronic, Inc. Therapy target selection for psychiatric disorder therapy
ES2608498T3 (en) 2008-04-23 2017-04-11 The Board Of Trustees Of The Leland Stanford Junior University Systems, methods and compositions for optical stimulation of target cells
US9560967B2 (en) 2008-04-24 2017-02-07 The Invention Science Fund I Llc Systems and apparatus for measuring a bioactive agent effect
US9649469B2 (en) 2008-04-24 2017-05-16 The Invention Science Fund I Llc Methods and systems for presenting a combination treatment
US9282927B2 (en) 2008-04-24 2016-03-15 Invention Science Fund I, Llc Methods and systems for modifying bioactive agent use
US9449150B2 (en) 2008-04-24 2016-09-20 The Invention Science Fund I, Llc Combination treatment selection methods and systems
US9662391B2 (en) 2008-04-24 2017-05-30 The Invention Science Fund I Llc Side effect ameliorating combination therapeutic products and systems
US8204603B2 (en) 2008-04-25 2012-06-19 Cyberonics, Inc. Blocking exogenous action potentials by an implantable medical device
US8315703B2 (en) * 2008-04-30 2012-11-20 Advanced Neuromodulation Systems, Inc. Methods for targeting deep brain sites to treat mood and/or anxiety disorders
US20090306750A1 (en) * 2008-06-06 2009-12-10 Neuropace, Inc. Lead Fixation Assembly and Methods of Using Same
SG191604A1 (en) 2008-06-17 2013-07-31 Univ Leland Stanford Junior Apparatus and methods for controlling cellular development
US9101759B2 (en) 2008-07-08 2015-08-11 The Board Of Trustees Of The Leland Stanford Junior University Materials and approaches for optical stimulation of the peripheral nervous system
EP3536376A1 (en) 2008-07-30 2019-09-11 Ecole Polytechnique Fédérale de Lausanne Apparatus for optimized stimulation of a neurological target
US8262714B2 (en) * 2008-08-05 2012-09-11 Advanced Neuromodulation Systems, Inc. Techniques for selecting signal delivery sites and other parameters for treating depression and other neurological disorders, and associated systems and methods
US8457747B2 (en) * 2008-10-20 2013-06-04 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
US8417344B2 (en) 2008-10-24 2013-04-09 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
JP5667987B2 (en) 2008-11-12 2015-02-12 エコーレ ポリテクニーク フェデラーレ デ ローザンヌ （イーピーエフエル） Micromachined nerve stimulation device
US20100191304A1 (en) 2009-01-23 2010-07-29 Scott Timothy L Implantable Medical Device for Providing Chronic Condition Therapy and Acute Condition Therapy Using Vagus Nerve Stimulation
US20100198281A1 (en) * 2009-01-30 2010-08-05 C.Y. Joseph Chang, MD, PA Methods for treating disorders of perceptual integration by brain modulation
US8396558B2 (en) * 2009-02-11 2013-03-12 University Of Maryland, Baltimore Methods for treating central pain syndrome and other pain related pathologies
US10232178B2 (en) * 2009-03-20 2019-03-19 Electrocore, Inc. Non-invasive magnetic or electrical nerve stimulation to treat or prevent dementia
US8239028B2 (en) * 2009-04-24 2012-08-07 Cyberonics, Inc. Use of cardiac parameters in methods and systems for treating a chronic medical condition
US8827912B2 (en) 2009-04-24 2014-09-09 Cyberonics, Inc. Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters
WO2011019918A1 (en) * 2009-08-12 2011-02-17 Fredric Schiffer Methods for treating psychiatric disorders using light energy
JP2013512062A (en) 2009-12-01 2013-04-11 エコーレ ポリテクニーク フェデラーレ デ ローザンヌ Microfabricated surface nerve stimulation device and methods of making and using the same
US20120290058A1 (en) * 2009-12-02 2012-11-15 United States Government Department Of Veterans Affairs Methods and systems for the treatment of anxiety disorders and disorders with psychotic features
US9549708B2 (en) 2010-04-01 2017-01-24 Ecole Polytechnique Federale De Lausanne Device for interacting with neurological tissue and methods of making and using the same
US8649871B2 (en) 2010-04-29 2014-02-11 Cyberonics, Inc. Validity test adaptive constraint modification for cardiac data used for detection of state changes
US8562536B2 (en) 2010-04-29 2013-10-22 Flint Hills Scientific, Llc Algorithm for detecting a seizure from cardiac data
US8831732B2 (en) 2010-04-29 2014-09-09 Cyberonics, Inc. Method, apparatus and system for validating and quantifying cardiac beat data quality
US8679009B2 (en) 2010-06-15 2014-03-25 Flint Hills Scientific, Llc Systems approach to comorbidity assessment
US20110319878A1 (en) * 2010-06-24 2011-12-29 Dimauro Thomas M Red Light Implants for Treating Postpartum Depression
US8641646B2 (en) 2010-07-30 2014-02-04 Cyberonics, Inc. Seizure detection using coordinate data
US8684921B2 (en) 2010-10-01 2014-04-01 Flint Hills Scientific Llc Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
US10086012B2 (en) 2010-11-05 2018-10-02 The Board Of Trustees Of The Leland Stanford Junior University Control and characterization of memory function
CN103313752B (en) 2010-11-05 2016-10-19 斯坦福大学托管董事会 Upper conversion for the light of light genetic method
WO2012061744A2 (en) 2010-11-05 2012-05-10 The Board Of Trustees Of The Leland Stanford Junior University Stabilized step function opsin proteins and methods of using the same
CN103492564B (en) 2010-11-05 2017-04-19 斯坦福大学托管董事会 Light-activated chimeric opsins and methods of using the same
US8696722B2 (en) 2010-11-22 2014-04-15 The Board Of Trustees Of The Leland Stanford Junior University Optogenetic magnetic resonance imaging
US9504390B2 (en) 2011-03-04 2016-11-29 Globalfoundries Inc. Detecting, assessing and managing a risk of death in epilepsy
US9498162B2 (en) 2011-04-25 2016-11-22 Cyberonics, Inc. Identifying seizures using heart data from two or more windows
US9402550B2 (en) 2011-04-29 2016-08-02 Cybertronics, Inc. Dynamic heart rate threshold for neurological event detection
WO2012173634A1 (en) * 2011-06-16 2012-12-20 Solace Lifesciences, Inc. Systems and methods for balancing and maintaining the health of the human autonomic nervous system
US9549677B2 (en) 2011-10-14 2017-01-24 Flint Hills Scientific, L.L.C. Seizure detection methods, apparatus, and systems using a wavelet transform maximum modulus algorithm
JP6406581B2 (en) 2011-12-16 2018-10-17 ザ ボード オブ トラスティーズ オブ ザ レランド スタンフォード ジュニア ユニバーシティー Opsin polypeptides and uses thereof
WO2013126521A1 (en) 2012-02-21 2013-08-29 The Board Of Trustees Of The Leland Stanford Junior University Compositions and methods for treating neurogenic disorders of the pelvic floor
US10448839B2 (en) 2012-04-23 2019-10-22 Livanova Usa, Inc. Methods, systems and apparatuses for detecting increased risk of sudden death
WO2013172981A1 (en) * 2012-05-16 2013-11-21 Beth Israel Deaconess Medical Center, Inc. Identifying individual target sites for transcranial magnetic stimulation applications
US10220211B2 (en) 2013-01-22 2019-03-05 Livanova Usa, Inc. Methods and systems to diagnose depression
US9446238B2 (en) 2013-01-25 2016-09-20 Andres M. Lozano Deep brain stimulation of the subcallosal cingulate area for treatment of refractory anorexia nervosa
JP6594854B2 (en) 2013-03-15 2019-10-23 ザ ボード オブ トラスティーズ オブ ザ レランド スタンフォード ジュニア ユニバーシティー Optogenetic control of behavioral state
EP2991491B1 (en) 2013-04-29 2019-12-25 The Board of Trustees of the Leland Stanford Junior University Devices, systems and methods for optogenetic modulation of action potentials in target cells
WO2015017543A2 (en) 2013-07-30 2015-02-05 Massachusetts Institute Of Technology Systems and methods for delivering chemical and electrical stimulation across one or more neural circuits
JP6621747B2 (en) 2013-08-14 2019-12-18 ザ ボード オブ トラスティーズ オブ ザ レランド スタンフォード ジュニア ユニバーシティー Compositions and methods for controlling pain
EP3476430B1 (en) 2014-05-16 2020-07-01 Aleva Neurotherapeutics SA Device for interacting with neurological tissue
US11311718B2 (en) 2014-05-16 2022-04-26 Aleva Neurotherapeutics Sa Device for interacting with neurological tissue and methods of making and using the same
US9403011B2 (en) 2014-08-27 2016-08-02 Aleva Neurotherapeutics Leadless neurostimulator
US9474894B2 (en) 2014-08-27 2016-10-25 Aleva Neurotherapeutics Deep brain stimulation lead
CA2962231A1 (en) 2014-09-23 2016-03-31 Icahn School Of Medicine At Mount Sinai Systems and methods for treating a psychiatric disorder
US10568516B2 (en) 2015-06-22 2020-02-25 The Board Of Trustees Of The Leland Stanford Junior University Methods and devices for imaging and/or optogenetic control of light-responsive neurons
EP3331434B1 (en) 2015-08-06 2020-06-17 Cyril Herry Method and device for modulating fear and/or anxiety
CN109069824B (en) 2016-02-02 2022-09-16 阿莱瓦神经治疗股份有限公司 Treatment of autoimmune diseases using deep brain stimulation
US11123565B1 (en) 2016-10-31 2021-09-21 Nevro Corp. Treatment of neurodegenerative disease with high frequency stimulation, and associated systems and methods
US11294165B2 (en) 2017-03-30 2022-04-05 The Board Of Trustees Of The Leland Stanford Junior University Modular, electro-optical device for increasing the imaging field of view using time-sequential capture
WO2018187785A1 (en) 2017-04-07 2018-10-11 The Regents Of The University Of California Method of neural intervention for the treatment of affective neuropsychiatric disorders
US11241575B1 (en) 2017-09-05 2022-02-08 Kelly C.R. Bijanki Anxiolysis without sedation: awake craniotomy facilitated by continuous direct stimulation of cingulum bundle
US11123549B1 (en) 2017-09-08 2021-09-21 Nevro Corp. Electrical therapy applied to the brain with increased efficacy and/or decreased undesirable side effects, and associated systems and methods
WO2019060298A1 (en) 2017-09-19 2019-03-28 Neuroenhancement Lab, LLC Method and apparatus for neuroenhancement
US11717686B2 (en) 2017-12-04 2023-08-08 Neuroenhancement Lab, LLC Method and apparatus for neuroenhancement to facilitate learning and performance
EP3731749A4 (en) 2017-12-31 2022-07-27 Neuroenhancement Lab, LLC System and method for neuroenhancement to enhance emotional response
US10702692B2 (en) 2018-03-02 2020-07-07 Aleva Neurotherapeutics Neurostimulation device
US11364361B2 (en) 2018-04-20 2022-06-21 Neuroenhancement Lab, LLC System and method for inducing sleep by transplanting mental states
WO2020056418A1 (en) 2018-09-14 2020-03-19 Neuroenhancement Lab, LLC System and method of improving sleep
US10835747B2 (en) 2018-09-24 2020-11-17 Vorso Corp. Auricular nerve stimulation to address patient disorders, and associated systems and methods
RU2714296C1 (en) * 2019-04-09 2020-02-13 Федеральное государственное бюджетное образовательное учреждение высшего образования "Алтайский государственный медицинский университет" Министерства здравоохранения Российской Федерации Method of treating patients with chronic insomnia
US11786694B2 (en) 2019-05-24 2023-10-17 NeuroLight, Inc. Device, method, and app for facilitating sleep
WO2022183273A1 (en) * 2021-03-03 2022-09-09 Whitewater West Industries, Ltd. Wave system and method

Family Cites Families (88)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3731681A (en) 1970-05-18 1973-05-08 Univ Minnesota Implantable indusion pump
US3653385A (en) 1970-10-20 1972-04-04 Charles Burton Production of focal brain lesions by inductive heating
US3951147A (en) 1975-04-07 1976-04-20 Metal Bellows Company Implantable infusate pump
US4692147A (en) 1980-04-02 1987-09-08 Medtronic, Inc. Drug administration device
US4883057A (en) 1984-05-09 1989-11-28 Research Foundation, The City University Of New York Cathodic electrochemical current arrangement with telemetric application
US4772263A (en) 1986-02-03 1988-09-20 Regents Of The University Of Minnesota Spring driven infusion pump
US5601835A (en) 1987-04-29 1997-02-11 Massachusetts Institute Of Technology Polymeric device for controlled drug delivery to the CNS
US4892538A (en) 1987-11-17 1990-01-09 Brown University Research Foundation In vivo delivery of neurotransmitters by implanted, encapsulated cells
US5458631A (en) 1989-01-06 1995-10-17 Xavier; Ravi Implantable catheter with electrical pulse nerve stimulators and drug delivery system
US5119832A (en) 1989-07-11 1992-06-09 Ravi Xavier Epidural catheter with nerve stimulators
US5125888A (en) 1990-01-10 1992-06-30 University Of Virginia Alumni Patents Foundation Magnetic stereotactic system for treatment delivery
US5342410A (en) * 1990-10-05 1994-08-30 Eric Braverman Apparatus and method for increasing the amplitude of P300 waves in the human brain
US5618531A (en) 1990-10-19 1997-04-08 New York University Method for increasing the viability of cells which are administered to the brain or spinal cord
US5263480A (en) 1991-02-01 1993-11-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5299569A (en) 1991-05-03 1994-04-05 Cyberonics, Inc. Treatment of neuropsychiatric disorders by nerve stimulation
US5423877A (en) 1992-05-04 1995-06-13 David C. Mackey Method and device for acute pain management by simultaneous spinal cord electrical stimulation and drug infusion
US5470846A (en) 1994-01-14 1995-11-28 Sandyk; Reuven Treatment of neurological and mental disorders
US6129685A (en) 1994-02-09 2000-10-10 The University Of Iowa Research Foundation Stereotactic hypothalamic obesity probe
US5853385A (en) 1994-08-26 1998-12-29 Cytotherapeutics, Inc. Encapsulated PC12 cell transplants for treatment of Parkinson's disease
US5540734A (en) 1994-09-28 1996-07-30 Zabara; Jacob Cranial nerve stimulation treatments using neurocybernetic prosthesis
US6132361A (en) 1994-11-28 2000-10-17 Neotonus, Inc. Transcranial brain stimulation
US6425852B1 (en) 1994-11-28 2002-07-30 Emory University Apparatus and method for transcranial magnetic brain stimulation, including the treatment of depression and the localization and characterization of speech arrest
US5735505A (en) 1995-04-03 1998-04-07 Data Connections, Inc. Cable pulley device and method
US5752911A (en) * 1995-04-27 1998-05-19 Canedo; Luis E. Electromagnetic method of treatment of epilepsy and apparatus
AU5545596A (en) 1995-04-28 1996-11-18 Medtronic, Inc. Intraparenchymal infusion catheter system
US7069634B1 (en) 1995-04-28 2006-07-04 Medtronic, Inc. Method for manufacturing a catheter
US5585118A (en) 1995-06-02 1996-12-17 Brigham And Women's Hospital Choline in the treatment of bipolar disorder
US5753505A (en) 1995-07-06 1998-05-19 Emory University Neuronal progenitor cells and uses thereof
US20020169485A1 (en) 1995-10-16 2002-11-14 Neuropace, Inc. Differential neurostimulation therapy driven by physiological context
US6463328B1 (en) 1996-02-02 2002-10-08 Michael Sasha John Adaptive brain stimulation method and system
US6051017A (en) 1996-02-20 2000-04-18 Advanced Bionics Corporation Implantable microstimulator and systems employing the same
US6036459A (en) 1996-04-04 2000-03-14 Medtronic, Inc. Occlusion compensator for implantable peristaltic pump
US5840069A (en) 1996-04-04 1998-11-24 Medtronic, Inc. Implantable peristaltic pump techniques
US6094598A (en) 1996-04-25 2000-07-25 Medtronics, Inc. Method of treating movement disorders by brain stimulation and drug infusion
US5683422A (en) 1996-04-25 1997-11-04 Medtronic, Inc. Method and apparatus for treating neurodegenerative disorders by electrical brain stimulation
US5716377A (en) 1996-04-25 1998-02-10 Medtronic, Inc. Method of treating movement disorders by brain stimulation
US5735814A (en) 1996-04-30 1998-04-07 Medtronic, Inc. Techniques of treating neurodegenerative disorders by brain infusion
US5711316A (en) 1996-04-30 1998-01-27 Medtronic, Inc. Method of treating movement disorders by brain infusion
US5713923A (en) 1996-05-13 1998-02-03 Medtronic, Inc. Techniques for treating epilepsy by brain stimulation and drug infusion
US5921245A (en) 1996-06-03 1999-07-13 O'donnell, Jr.; Francis E. Method for modification of anti-social behavior
US6609031B1 (en) 1996-06-07 2003-08-19 Advanced Neuromodulation Systems, Inc. Multiprogrammable tissue stimulator and method
US6015786A (en) 1997-02-25 2000-01-18 Celtrix Pharmaceuticals, Inc. Method for increasing sex steroid levels using IGF or IGF/IGFBP-3
US6025368A (en) * 1997-02-25 2000-02-15 Celtrix Pharmaceuticals, Inc. Method for treating the symptoms of chronic stress-related disorders using IGF
US6514937B1 (en) 1997-02-25 2003-02-04 Celtrix Pharmaceuticals, Inc. Method of treating psychological and metabolic disorders using IGF or IGF/IGFBP-3
US5873849A (en) 1997-04-24 1999-02-23 Ichor Medical Systems, Inc. Electrodes and electrode arrays for generating electroporation inducing electrical fields
US6042579A (en) 1997-04-30 2000-03-28 Medtronic, Inc. Techniques for treating neurodegenerative disorders by infusion of nerve growth factors into the brain
US5975085A (en) 1997-05-01 1999-11-02 Medtronic, Inc. Method of treating schizophrenia by brain stimulation and drug infusion
US6128537A (en) * 1997-05-01 2000-10-03 Medtronic, Inc Techniques for treating anxiety by brain stimulation and drug infusion
US20040092010A1 (en) 2002-04-15 2004-05-13 Ariel Ruiz I Altaba Method of proliferating and inducing brain stem cells to differentiate to neurons
US5938688A (en) 1997-10-22 1999-08-17 Cornell Research Foundation, Inc. Deep brain stimulation method
US6016449A (en) 1997-10-27 2000-01-18 Neuropace, Inc. System for treatment of neurological disorders
US6230049B1 (en) 1999-08-13 2001-05-08 Neuro Pace, Inc. Integrated system for EEG monitoring and electrical stimulation with a multiplicity of electrodes
US6597954B1 (en) 1997-10-27 2003-07-22 Neuropace, Inc. System and method for controlling epileptic seizures with spatially separated detection and stimulation electrodes
US6248126B1 (en) 1998-01-12 2001-06-19 The Johns Hopkins University Technique for using heat flow management to treat brain disorders
US6227203B1 (en) 1998-02-12 2001-05-08 Medtronic, Inc. Techniques for controlling abnormal involuntary movements by brain stimulation and drug infusion
AUPP398898A0 (en) * 1998-06-09 1998-07-02 University Of Queensland, The Diagnostic method and apparatus
US6735474B1 (en) 1998-07-06 2004-05-11 Advanced Bionics Corporation Implantable stimulator system and method for treatment of incontinence and pain
US6366813B1 (en) 1998-08-05 2002-04-02 Dilorenzo Daniel J. Apparatus and method for closed-loop intracranical stimulation for optimal control of neurological disease
SE520276C2 (en) 1999-01-25 2003-06-17 Elekta Ab Device for controlled tissue destruction
US6214016B1 (en) 1999-04-29 2001-04-10 Medtronic, Inc. Medical instrument positioning device internal to a catheter or lead and method of use
US6176242B1 (en) 1999-04-30 2001-01-23 Medtronic Inc Method of treating manic depression by brain infusion
US6353762B1 (en) 1999-04-30 2002-03-05 Medtronic, Inc. Techniques for selective activation of neurons in the brain, spinal cord parenchyma or peripheral nerve
US6161045A (en) 1999-06-01 2000-12-12 Neuropace, Inc. Method for determining stimulation parameters for the treatment of epileptic seizures
US6539263B1 (en) 1999-06-11 2003-03-25 Cornell Research Foundation, Inc. Feedback mechanism for deep brain stimulation
US6567696B2 (en) 2001-02-06 2003-05-20 Mediseb Ltd. Physiotherapeutic device
US6898455B2 (en) 1999-10-29 2005-05-24 The Mclean Hospital Corporation Method for providing optimal drug dosage
AU1943301A (en) 1999-12-02 2001-06-12 General Hospital Corporation, The Method and apparatus for measuring indices of brain activity
US6907280B2 (en) 1999-12-02 2005-06-14 The General Hospital Corporation Method and apparatus for objectively measuring pain, pain treatment and other related techniques
US6609030B1 (en) 2000-02-24 2003-08-19 Electrocore Techniques, Llc Method of treating psychiatric diseases by neuromodulation within the dorsomedial thalamus
US6708064B2 (en) 2000-02-24 2004-03-16 Ali R. Rezai Modulation of the brain to affect psychiatric disorders
US6418344B1 (en) * 2000-02-24 2002-07-09 Electrocore Techniques, Llc Method of treating psychiatric disorders by electrical stimulation within the orbitofrontal cerebral cortex
US6473639B1 (en) 2000-03-02 2002-10-29 Neuropace, Inc. Neurological event detection procedure using processed display channel based algorithms and devices incorporating these procedures
US6399574B1 (en) 2000-03-22 2002-06-04 University Of Utah Research Foundation Use of conantokins
US6353754B1 (en) 2000-04-24 2002-03-05 Neuropace, Inc. System for the creation of patient specific templates for epileptiform activity detection
US6782292B2 (en) * 2000-06-20 2004-08-24 Advanced Bionics Corporation System and method for treatment of mood and/or anxiety disorders by electrical brain stimulation and/or drug infusion
US7146217B2 (en) 2000-07-13 2006-12-05 Northstar Neuroscience, Inc. Methods and apparatus for effectuating a change in a neural-function of a patient
US6591138B1 (en) 2000-08-31 2003-07-08 Neuropace, Inc. Low frequency neurostimulator for the treatment of neurological disorders
US6871098B2 (en) 2000-10-30 2005-03-22 Medtronic, Inc. Method for treating obsessive-compulsive disorder with electrical stimulation of the brain internal capsule
AU2002218012A1 (en) 2000-11-14 2002-05-27 Joseph Manne Electromagnetically induced anesthesia and sensory stimulation
US6666845B2 (en) 2001-01-04 2003-12-23 Advanced Neuromodulation Systems, Inc. Implantable infusion pump
US6735475B1 (en) 2001-01-30 2004-05-11 Advanced Bionics Corporation Fully implantable miniature neurostimulator for stimulation as a therapy for headache and/or facial pain
US6620151B2 (en) 2001-03-01 2003-09-16 Advanced Neuromodulation Systems, Inc. Non-constant pressure infusion pump
WO2002082970A2 (en) 2001-04-06 2002-10-24 The Research Foundation Of The City University Of New York Diagnosis and treatment of neural disease and injury using microvoltammetry
US6592509B1 (en) 2002-02-04 2003-07-15 Thomas W. Hunter, Jr. Electromagnetic stimulator
US7110820B2 (en) 2002-02-05 2006-09-19 Tcheng Thomas K Responsive electrical stimulation for movement disorders
CA2432810A1 (en) 2003-06-19 2004-12-19 Andres M. Lozano Method of treating depression, mood disorders and anxiety disorders by brian infusion
US7993352B2 (en) * 2003-12-11 2011-08-09 Advanced Neuromodulation Systems, Inc. Electrical stimulation system and associated apparatus for securing an electrical stimulation lead in position in a person's brain
US7981119B2 (en) * 2003-12-11 2011-07-19 Advanced Neuromodulation Systems, Inc. Electrical stimulation system and associated apparatus for securing an electrical stimulation lead in position in a person's brain

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8195298B2 (en) 2008-02-15 2012-06-05 Andres M Lozano Method for treating neurological/psychiatric disorders with stimulation to the subcaudate area of the brain

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