Radiosurgical Neuromodulation Devices, Systems, and Methods for Treatment of Behavioral Disorders by External Application of Ionizing Radiation

Abstract

Radiosurgical techniques and systems treat behavioral disorders (such as depression, Obsessive-Compulsive Disorder (“OCD”), addiction, hyperphagia, and the like) by directing radiation from outside the patient toward a target tissue within the patient's brain, typically without imposing surgical trauma. The target will often be included in a neural circuit associated with the behavioral disorder. A cellularly sub-lethal dose of the radiation may be applied and the radiation can mitigate the behavioral disorder, obesity, or the like, by modulating the level of neural activity within the target and in associated tissues. Hypersensitive and/or hyperactive neuronal tissue may be targeted, with the radiation downwardly modulating hyperactive neuronal activity. By down-regulating the activity of a target that normally exerts negative feedback or a limiting effect on a relevant neural circuit, the activity of the circuit may be increased.

1 - 15 . (canceled) 
     
     
         16 . A non-transitory computer-readable storage medium comprising a set of computer executable instructions for treating a psychiatric behavioral disorder or hyperphagia of a patient, the behavioral disorder or hyperphagia associated with a level of neuronal activity in a neural circuit within a brain of the patient and provoking deleterious behavior by the patient associated with the behavioral disorder or hyperphagia, wherein the execution of the instructions by a computer processor causes the processor to carry out the steps of:
 receiving a treatment plan for selectively neuromodulating a target within the brain of the patient;   transmitting a quantity of ionizing radiation from outside the patient selectively into the target per the treatment plan wherein a transformed neuronal activity of the target induces a desired change of neuronal activity in the neural circuit such that the provoked behavior associated with the behavioral disorder or hyperphagia is reduced.   
     
     
         17 . The non-transitory computer-readable storage medium of  claim 16 , wherein the transmitted quantity of ionizing radiation comprises a cellularly sub-lethal dose of ionizing radiation at the target. 
     
     
         18 . The non-transitory computer-readable storage medium of  claim 16 , wherein the treatment plan comprises a plurality of ionizing radiation beams which intersect at the target. 
     
     
         19 . The non-transitory computer-readable storage medium of  claim 16 , wherein the execution of the instructions further causes the processor to carry out the step of receiving pre-treatment examination data of the patient, the pre-treatment examination data acquired by a PET, SPECT, or fMRI system. 
     
     
         20 . The non-transitory computer-readable storage medium of  claim 16 , wherein the psychiatric behavioral disorder comprises at least one of OCD, depression, and an addiction; and
 wherein the target comprises at least one of an anterior limb of an internal capsule; a ventral PFC, a dorsal anterior cingulate; a region of an insula; a genu of the anterior cingulate; an arcuate nucleus of a medial hypothalamus; an anterior cingulate cortex; an orbitofrontal cortex; a medial prefrontal cortex; a dorsal anterior cingulate; a nucleus accumbens; a neural circuit connection between the ventral tegmentum and the nucleus accumbens; a lateral nucleus of a hypothalamus; a rostral anterior cingulate; a subgenual cingulate of the brain; and a bilateral nuclei of the hypothalamus.   
     
     
         21 . A system for treating a psychiatric behavioral disorder or hyperphagia of a patient, the behavioral disorder or hyperphagia associated with a level of neuronal activity in a neural circuit within a brain of the patient and provoking deleterious behavior by the patient associated with the behavioral disorder or hyperphagia, the system comprising:
 an input module for receiving a treatment plan for selectively neuromodulating a target within the brain of the patient;   a radiation source for transmitting ionizing radiation; and   a processing system coupled with the input module and the radiation source, the processing system configured to selectively transmit a quantity of ionizing radiation from the radiation source into the target per a received treatment plan, wherein a transformed neuronal activity of the target induces a desired change of neuronal activity in the neural circuit such that the provoked behavior associated with the behavioral disorder or hyperphagia is reduced.   
     
     
         22 . The system of  claim 21  further comprising a PET, SPECT, or fMRI system coupled with the processing system. 
     
     
         23 . The system of  claim 21 , wherein the radiation source is configured to transmit ionizing radiation beams with a cross-sectional size of less than 5 mm. 
     
     
         24 . The system of  claim 21 , wherein the radiation source is configured to transmit a cellularly sub-lethal dose of ionizing radiation at the target.