Methods, systems, and devices for pairing vagus nerve stimulation with motor therapy in stroke patients

Patent metadata

Field	Value
Publication number	US-9522273-B2
Application number	US-201414538400-A
Country	US
Kind code	B2
Filing date	Nov 11, 2014
Priority date	Jul 2, 2008
Publication date	Dec 20, 2016
Grant date	Dec 20, 2016

Abstract

A method of treating motor deficits in a stroke patient, comprising assessing a patient's motor deficits, determining therapeutic goals for the patient, based on the patient's motor deficits, selecting therapeutic tasks based on the therapeutic goals, performing each of the selected therapeutic tasks repetitively, observing the performance of the therapeutic tasks, initiating the stimulation of the vagus nerve manually at approximately a predetermined moment during the performance of the therapeutic tasks, stimulating the vagus nerve of the patient during the performance of the selected therapeutic tasks, and improving the patient's motor deficits.

First claim

What is claimed is:

1. A method of improving motor deficits in a stroke patient, comprising:
selecting one or more therapeutic tasks;
observing repetitive performances by the patient of the selected therapeutic task;
stimulating a vagus nerve of the patient with an implanted neurostimulator that delivers pulse trains of electrical stimulation energy to the vagus nerve while the patient is performing a movement of the selected therapeutic task;
terminating the stimulation of the vagus nerve so that there is no stimulation between movement execution; and
improving the patient's motor deficits,
wherein the action of stimulating the vagus nerve of the patient further comprises determining respective beginnings of performances of the selected therapeutic task, and applying the pulse trains to the vagus nerve based on the determined beginnings of the performances, wherein the vagus nerve stimulation pulse trains begin after the beginning of the respective selected therapeutic tasks, wherein the vagus nerve stimulation pulse trains end prior to the end of the respective selected therapeutic tasks, and wherein the vagus nerve stimulation pulse train is not presented between performances of the selected therapeutic task.

2. The method of claim 1 , wherein the pulse trains are about 500 milliseconds in duration.

3. The method of claim 1 , wherein the pulse trains have an amplitude of about 0.8 milliamperes.

4. The method of claim 1 , wherein a therapeutic task level is selected for each therapeutic task and the therapeutic task level may be changed between the repetitive performances.

5. A method of improving motor deficits in a stroke patient, comprising:
assessing a stroke patient's motor deficits;
determining therapeutic goals for the patient, based on the patient's motor deficits;
selecting one or more therapeutic tasks based on the therapeutic goals;
observing repetitive performances by the patient of the selected therapeutic task;
artificially electrically stimulating the vagus nerve of the patient while the patient is performing a movement of the selected therapeutic task;
terminating the stimulation of the vagus nerve so that there is no stimulation between movement execution; and
improving the patient's motor deficits,
wherein the action of stimulating the vagus nerve of the patient further comprises determining respective beginnings of performances of the selected therapeutic task, and applying the pulse trains to the vagus nerve based on the determined beginnings of the performances, wherein the vagus nerve stimulation pulse trains begin after the beginning of the respective selected therapeutic tasks, wherein the vagus nerve stimulation pulse trains end prior to the end of the respective selected therapeutic tasks, and wherein the vagus nerve stimulation pulse train is not presented between performances of the selected therapeutic task.

6. The method of claim 5 , wherein the pulse trains are about 500 milliseconds in duration.

7. The method of claim 5 , wherein the pulse trains have an amplitude of about 0.8 milliamperes.

8. The method of claim 5 , wherein the motion is detected by detecting a change in color of an object by a camera.

9. A method of improving motor deficits in a stroke patient, comprising:
assessing a stroke patient's motor deficits;
determining therapeutic goals for the patient, based on the patient's motor deficits;
selecting one or more therapeutic tasks based on the therapeutic goals;
observing repetitive performances by the patient of the selected therapeutic task;
stimulating the vagus nerve of the patient with an implanted neurostimulator that delivers pulse trains of electrical stimulation energy to a vagus nerve while the patient is performing a movement of the selected therapeutic task;
terminating the stimulation of the vagus nerve; and
improving the patient's motor deficits,
wherein the action of stimulating the vagus nerve of the patient further comprises determining respective beginnings of performances of the selected therapeutic task, and applying the pulse trains to the vagus nerve based on the determined beginnings of the performances, wherein the vagus nerve stimulation pulse trains begin after the beginning of the respective selected therapeutic tasks, wherein the vagus nerve stimulation pulse trains end prior to the end of the respective selected therapeutic tasks, and wherein the vagus nerve stimulation pulse train is not presented between performances of the selected therapeutic task.

10. The method of claim 9 , wherein the pulse trains are about 500 milliseconds in duration.

11. The method of claim 9 , wherein the pulse trains have an amplitude of about 0.8 milliamperes.

12. The method of claim 9 , wherein the motion is detected by detecting a change in color of an object by a camera.

Assignees

• Microtransponder Inc
• Univ Texas

Inventors

• Kilgard Michael P
• Engineer Navzer
• Pierce David Michael
• Rennaker Robert L

Classifications

• A61N1/36103

  Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke · CPC title

• A61B5/1124

  Determining motor skills · CPC title

• A61N1/36132

  using patient feedback · CPC title

• A61N1/36067 Primary

  Movement disorders, e.g. tremor or Parkinson disease (stimulating motor muscle A61N1/36003) · CPC title

• A61N1/361

  Phantom sensations, e.g. tinnitus · CPC title