Systems, methods and devices for paired plasticity

Abstract

Systems, methods and devices for paired training include timing controls so that training and neural stimulation can be provided simultaneously. Paired trainings may include therapies, rehabilitation and performance enhancement training. Stimulations of nerves such as the vagus nerve that affect subcortical regions such as the nucleus basalis, locus coeruleus or amygdala induce plasticity in the brain, enhancing the effects of a variety of therapies, such as those used to treat tinnitus, stroke, traumatic brain injury, post-traumatic stress disorder, speech deficit or language deficit.

What is claimed is: 
     
         1 . A method of treating a speech deficit in a patient, the method comprising:
 providing a neurostimulator to the patient to stimulate a vagus nerve of the patient electrically;   initiating stimulation of the patient's vagus nerve with the neurostimulator before a beginning of speech therapy; and   controlling the stimulation so that the stimulation overlaps an initial interval in a duration of a performance of the speech therapy thereby reducing the speech deficit.   
     
     
         2 . The method of  claim 1 , wherein:
 the neurostimulator provides a series of electrical pulse trains.   
     
     
         3 . The method of  claim 1 , wherein:
 the neurostimulator provides a programmed sequence of electrical pulse trains.   
     
     
         4 . The method of  claim 1 , wherein:
 the neurostimulator provides an electrical pulse train in response to a received signal.   
     
     
         5 . The method of  claim 1 , wherein:
 the patient's vagus nerve is also stimulated after the performance of the speech therapy.   
     
     
         6 . A method of treating a speech deficit in a patient, the method comprising:
 instructing the patient to perform speech therapy; and   at least one of electrically, chemically, magnetically, optically or mechanically stimulating a vagus nerve of the patient in a coordinated manner so that stimulation of the vagus nerve overlaps an initial interval in a duration of a performance of the speech therapy by the patient thereby reducing the speech deficit.   
     
     
         7 . The method of  claim 6 , wherein:
 the patient's vagus nerve is stimulated by a series of electrical pulse trains.   
     
     
         8 . The method of  claim 6 , wherein:
 the patient's vagus nerve is stimulated by a programmed sequence of electrical pulse trains.   
     
     
         9 . The method of  claim 6 , wherein:
 the patient's vagus nerve is stimulated by an electrical pulse train in response to a received signal.   
     
     
         10 . The method of  claim 6 , wherein the coordinated manner includes:
 initiating stimulation of the patient's vagus nerve before a beginning of a performance of the speech therapy by the patient; and   continuing the stimulation of the vagus nerve through and after the beginning of the performance of the speech therapy so that the stimulation overlaps the initial interval in a duration of the speech therapy.   
     
     
         11 . The method of  claim 6 , wherein:
 the patient's vagus nerve is also stimulated after the performance of the speech therapy.   
     
     
         12 . A method of treating a speech deficit in a patient, the method comprising:
 providing speech therapy to the patient which includes a pairing event;   applying at least one of electrical, chemical, magnetic, optical or mechanical vagus nerve stimulation in temporal proximity before a beginning of the pairing event; and   applying the vagus nerve stimulation so that the vagus nerve stimulation not only precedes but overlaps an initial interval of in a duration of the pairing event thereby reducing the speech deficit.   
     
     
         13 . The method of  claim 12 , wherein:
 the vagus nerve stimulation is a series of electrical pulse trains.   
     
     
         14 . The method of  claim 12 , wherein:
 the vagus nerve stimulation is a programmed sequence of electrical pulse trains.   
     
     
         15 . The method of  claim 12 , wherein:
 the vagus nerve stimulation is an electrical pulse train in response to a received signal.   
     
     
         16 . The method of  claim 12 , wherein:
 the vagus nerve stimulation begins after a performance of the speech therapy by the patient.   
     
     
         17 . A method of treating a speech deficit in a patient, the method comprising:
 indirectly inducing release of neuromodulators in nucleus basalis or locus coeruleus of the patient by initiating at least one of electrical, chemical, magnetic, optical or mechanical stimulation of a vagus nerve of the patient before performance of speech therapy by the patient begins; and   continuing the stimulation of the vagus nerve after the performance of speech therapy by the patient begins so that the stimulation of the vagus nerve overlaps an initial interval in a duration of a performance of the speech therapy thereby reducing the speech deficit.   
     
     
         18 . The method of  claim 17 , wherein:
 the patient's vagus nerve is stimulated by an electrical pulse train.   
     
     
         19 . The method of  claim 17 , wherein:
 the patient's vagus nerve is stimulated after the performance of the speech therapy.   
     
     
         20 . A method of treating a speech deficit in a patient comprising:
 instructing the patient to perform speech therapy which includes a pairing event; and   indirectly inducing release of neuromodulators in nucleus basalis or locus coeruleus of the patient by at least one of electrically, chemically, magnetically, optically or mechanically stimulating a vagus nerve of the patient in a coordinated manner so that stimulation of the vagus nerve overlaps an initial interval in a duration of the pairing event thereby reducing the patient's speech deficit.   
     
     
         21 . The method of  claim 20 , wherein:
 the patient's vagus nerve is stimulated by a series of electrical pulse trains.   
     
     
         22 . The method of  claim 20 , wherein the coordinated manner includes:
 initiating stimulation of the patient's vagus nerve before a beginning of a performance of the pairing event by the patient; and   continuing the stimulation of the vagus nerve through and after the beginning of the stimulation so that the stimulation overlaps the initial interval in a duration of the pairing event.   
     
     
         23 . The method of  claim 20 , wherein:
 the patient's vagus nerve is stimulated after performance of the speech therapy by the patient.   
     
     
         24 . A method of treating a patient afflicted with at least one of a speech deficit or a language deficit, the method comprising:
 instructing the patient to engage in speech therapy during a training period of training performed by the patient;   stimulating a vagus nerve (VNS) of the patient during a stimulation period; and   controlling the stimulation period to elapse during the training period resulting in synergism of the VNS and the training performed by the patient which reduces the speech deficit.   
     
     
         25 . The method of  claim 24 , wherein the VNS includes:
 electrically stimulating the vagus nerve.   
     
     
         26 . The method of  claim 24 , wherein the VNS includes:
 optically stimulating the vagus nerve.   
     
     
         27 . The method of  claim 24 , wherein:
 the VNS induces plasticity in a motor cortex of the patient, which improves a speaking ability of the patient.