Methods for targeting deep brain sites to treat mood and/or anxiety disorders

Abstract

The present invention relates to a method of identifying a target such as within the subgenual area by measuring neuronal activity in response to a stimulus. Once the target is identified, it can be stimulated to treat a neurological disorder, such as a mood disorder or an anxiety disorder.

1 . A method of identifying a region of the brain comprising the steps of:
 presenting to the patient a stimulus to alter neuronal activity in a target area selected from the group consisting of subgenual area, internal capsule, anterior cingulate, nucleus accumbens or a combination thereof;   measuring neuronal activity by measuring the activity from at least one implanted electrode in response to the stimulus; and   analyzing the neuronal activity in which an alteration of the neuronal activity in response to the stimuli identifies the brain region within the target area.   
     
     
         2 . The method of  claim 1 , wherein the electrode is implanted in the subgenual area. 
     
     
         3 . The method of  claim 2 , wherein the electrode is implanted in the subgenual gyrus. 
     
     
         4 . The method of  claim 2 , wherein the electrode is implanted in Brodmann area 25. 
     
     
         5 . The method of  claim 2 , wherein the electrode is implanted about 20 mm to about 40 mm anterior to the anterior commisure. 
     
     
         6 . The method of  claim 1  further comprising measuring a physiological response to confirm the identified brain region within the target area. 
     
     
         7 . The method of  claim 6 , wherein the physiological response is measured by PET, MEG, EEG, or fMRI. 
     
     
         8 . The method of  claim 6 , wherein the physiological response changes in local pH, ionic concentrations, concentration of neurotransmitters, temperature, metabolic rate markers, rate of discharge, pattern of discharge, interspike interval, bursting index, oscillatory behavior, or local field potentials. 
     
     
         9 . The method of  claim 1  further comprising the step of stimulating the identified brain region to alter the neuronal activity thereby treating a neurological disease. 
     
     
         10 . The method of  claim 9 , wherein the disease is a mood and/or anxiety disorder. 
     
     
         11 . The method of  claim 10 , wherein the mood and/or anxiety disorder is depression. 
     
     
         12 . The method of  claim 11 , wherein the mood and/or anxiety disorder is obsessive-compulsive disorder. 
     
     
         13 . A method of improving at least one symptom in an individual suspected of having a mood and/or anxiety disorder, comprising:
 measuring neuronal activity by measuring the activity from at least one implanted electrode, wherein the neuronal activity is in response to an emotional stimuli;   analyzing the neuronal activity in which an alteration of the neuronal activity in identifies a pathological region; and   stimulating the identified pathological region, thereby improving at least one symptom in the individual.   
     
     
         14 . The method of  claim 14 , wherein the electrode is implanted in the subgenual area. 
     
     
         15 . The method of  claim 15 , wherein the electrode is implanted about 20 to about 40 mm anterior to the anterior commisure. 
     
     
         16 . A method of treating depression in a patient, comprising:
 identifying an approximate location of the subgenual area of the patient utilizing neuronal activity evoked by emotional stimuli;   implanting a stimulation lead within the patient such that at least one electrode of the lead is near or adjacent to the identified location;   generating electrical pulses using an implantable pulse generator (IPG) that is implanted within the patient;   conducting the electrical pulses from the IPG through a stimulation lead; and   applying the electrical pulses to stimulate neural tissue of the subgenual area of the patient utilizing the at least one electrode of the stimulation lead, wherein the applying the electrical pulses effectively treats the depression of the patient.   
     
     
         17 . The method of  claim 16 , wherein after implantation the at least one electrode is positioned at about 20 mm to about 40 mm anterior to the anterior commisure. 
     
     
         18 . The method of  claim 16 , wherein after implantation the at least one electrode is positioned at about 20 mm to about 40 mm anterior to the anterior commisure, about 0 to about 15 mm the midline and about 3 mm to about 10 mm from the medial border of the gyrus. 
     
     
         19 . The method of  claim 16 , wherein after implantation the at least one electrode is positioned at about 20 mm to about 40 mm anterior to the anterior commisure, and about 5 mm to about 7 mm from the medial border of the gyrus.