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

Abstract

Methods and apparatus for treating an impaired neural function in a brain of a patient. In one embodiment, a method for treating a neural function in a brain of a patient includes determining a therapy period during which a plurality of therapy sessions are to be performed to recover functional ability corresponding to the neural function. The method continues by identifying a stimulation site in or on the brain of the patient associated with the neural function, and positioning an electrode at least proximate to the identified stimulation site. The patient is then treated by providing electrical stimulation treatments to the stimulation site. The treatment can comprise delivering electrical stimulation signals to the electrode during the therapy sessions. After expiration of the therapy period, the method includes preventing electrical stimulation signals from being delivered to the stimulation site.

1 - 28 . (Cancelled)  
     
     
         29 . A method for effectuating a neural-function affected by a stroke, comprising: 
 determining a therapy period during which at least one therapy session is to be performed to recover and/or develop the neural-function affected by the stroke;    identifying a stimulation site at the cortex associated with the neural-function affected by the stroke;    applying electrical stimulation to the stimulation site at the cortex; and    preventing the electrical stimulation from being delivered to the stimulation site at the cortex.    
     
     
         30 . The method of  claim 29  wherein determining the therapy period comprises setting a limiting module to terminate stimulation after a period from approximately one day to not more than one year.  
     
     
         31 . The method of  claim 29  wherein determining the therapy period comprises setting a limiting module to terminate stimulation after a period from approximately one day to not more than one month.  
     
     
         32 . The method of  claim 29  wherein determining the therapy period comprises setting a limiting module to terminate stimulation after a period from approximately one day to not more than one week.  
     
     
         33 . The method of  claim 29  wherein preventing the electrical stimulation from being delivered to the stimulation site comprises setting a limiting module to terminate stimulation after a predetermined number of therapy sessions.  
     
     
         34 . The method of  claim 29  wherein the electrical stimulation is applied by a stimulation apparatus having a housing implanted in the patient, a power supply in the housing, and a pulse generator in the housing, and wherein preventing the electrical stimulation from being delivered to the stimulation site comprises activating a switch that prevents electrical pulses from being sent to an electrode array.  
     
     
         35 . The method of  claim 34  wherein activating the switch comprises activating a hardware switch in the stimulation apparatus.  
     
     
         36 . The method of  claim 34  wherein activating the switch comprises activating a software switch.  
     
     
         37 . A method for recovering a neural-function affected by a stroke, comprising: 
 applying electrical stimulation to a cortical stimulation site selected to promote recovery of the affected neural-function in accordance with a predetermined therapy plan having a defined therapy period, the cortical stimulation site being at least proximate to the cortex; and    precluding the electrical stimulation from being applied to the cortical stimulation site after expiration of the therapy period.    
     
     
         38 . The method of  claim 37 , further comprising determining the therapy period by setting a limiting module to terminate stimulation after a period from approximately one day to not more than one year.  
     
     
         39 . The method of  claim 37 , further comprising determining the therapy period by setting a limiting module to terminate stimulation after a period from approximately one day to not more than one month.  
     
     
         40 . The method of  claim 37 , further comprising determining the therapy period by setting a limiting module to terminate stimulation after a period from approximately one day to not more than one week.  
     
     
         41 . The method of  claim 37  wherein precluding the electrical stimulation from being delivered to the stimulation site comprises setting a limiting module to terminate stimulation after a predetermined number of therapy sessions.  
     
     
         42 . The method of  claim 37  wherein the electrical stimulation is applied by a stimulation apparatus having a housing implanted in the patient, a power supply in the housing, and a pulse generator in the housing, and wherein precluding the electrical stimulation from being delivered to the stimulation site comprises activating a switch that prevents electrical pulses from being sent to an electrode array.  
     
     
         43 . The method of  claim 42  wherein activating the switch comprises activating a hardware switch in the stimulation apparatus.  
     
     
         44 . The method of  claim 42  wherein activating the switch comprises activating a software switch.  
     
     
         45 . A method for recovering a neural-function impaired by a stroke, comprising: 
 implanting an electrode at a cortical stimulation site selected to promote recovery of the impaired neural-function, the cortical stimulation site being at least proximate to the cortex;    applying electrical stimulation to the cortical stimulation site in accordance with a predetermined therapy plan having a defined therapy period;    performing an adjuctive therapy related to a body part affected by the stroke; and    precluding the electrical stimulation from being applied to the cortical stimulation site after expiration of the therapy period.    
     
     
         46 . The method of  claim 45  wherein the adjunctive therapy comprises electrically stimulating the body part.  
     
     
         47 . The method of  claim 45  wherein the adjunctive therapy comprises electrically stimulation the body part while electrically stimulating the cortical stimulation site.  
     
     
         48 . The method of  claim 45  wherein the adjuctive therapy comprises moving the body part.  
     
     
         49 . The method of  claim 45  wherein the adjuctive therapy comprises moving the body part while electrically stimulating the cortical stimulation site.  
     
     
         50 . The method of  claim 45  wherein implanting the electrode comprises placing the electrode proximate to the dura mater at the cortex.  
     
     
         51 . The method of  claim 45  wherein implanting the electrode comprises placing the electrode in contact with the dura mater at the cortex.  
     
     
         52 . The method of  claim 45  wherein implanting the electrode comprises placing the electrode proximate to the pia mater at the cortex.  
     
     
         53 . The method of  claim 45  wherein implanting the electrode comprises placing the electrode in contact with the pia mater at the cortex.  
     
     
         54 . The method of  claim 45  wherein implanting the electrode comprises positioning the electrode at the supplementary motor cortex anterior to a location of the stroke.  
     
     
         55 . The method of  claim 45  wherein electrically stimulating the cortical stimulation site comprises passing an anodic current through the electrode.  
     
     
         56 . The method of  claim 45  wherein electrically stimulating the cortical stimulation site comprises passing a cathodic current through the electrode.  
     
     
         57 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a voltage of approximately 50 mV to 5V directly to the cortex at the cortical stimulation site.  
     
     
         58 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a voltage effective to raise an expected resting potential of a population of neurons at the stimulation site by at least approximately 10% of a difference between the expected resting potential and an action potential for the population of neurons.  
     
     
         59 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a voltage effective to raise an expected resting potential of a population of neurons at the stimulation site by at least approximately 60% of a difference between the expected resting potential and an action potential for the population of neurons.  
     
     
         60 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a voltage effective to raise an expected resting potential of a population of neurons at the stimulation site by at least approximately 10-80% of a difference between the expected resting potential and an action potential for the population of neurons.  
     
     
         61 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a frequency of approximately 40-200 HZ.  
     
     
         62 . The method of  claim 45  wherein applying electrical stimulation comprises applying a signal having a frequency of approximately 50 HZ.