Feedback method for deep brain stimulation with detection of generalized efference copy signals

Abstract

Disclosed is a method for improving cognitive function or for improving coordination of function across a patient's cortical regions. The method includes applying electrical stimulation to at least a portion of the patient's subcortical structures involved in the generation and control of generalized efference copy signals. Internally generated movement of the patient is then detected and, in response to such internally generated movement, application of electrical stimulation is controlled. The method of the present invention has a number of benefits, including increasing flexibility in identifying targets for stimulation, improving the probability of successfully treating brain injury, and permitting patient biofeedback and self-regulation.

1 . A system for treating cognitive function in a patient, said system comprising:
 an implantable multipolar electrode, wherein the poles of said multipolar electrode are positioned to contact individual subdivisions of the patient's intralaminar nuclei and   a pulse generator for controlling the multipolar electrode, wherein said pulse generator selectively stimulates and does not stimulate the poles of the multipolar electrode to allow customized stimulation and non-stimulation of subdivisions of the patient's intralaminar nuclei.   
   
   
       2 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei set forth in  FIGS. 2A-2E . 
   
   
       3 . The system according to  claim 2 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei at coordinates set forth in Table 1. 
   
   
       4 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate the patient's entire intralaminar nuclei. 
   
   
       5 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate the patient's entire intralaminar nuclei and other regions of the patient's brain. 
   
   
       6 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei without stimulating other regions of the patient's brain. 
   
   
       7 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate all subdivisions of the patient's intralaminar nuclei except for the patient's centromedian-parafasicularis or central lateral, or except both the patient's centromedian-parafasicularis and central lateral. 
   
   
       8 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate a subdivision of the patient's intralaminar nuclei selected from the group consisting of centromedian-parafasicularis, central lateral, paracentralis, paraventricularis, central medial, paralamellar, and combinations thereof. 
   
   
       9 . The system according to  claim 8 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate the paralamellar region's medial dorsal nucleus. 
   
   
       10 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei in one brain hemisphere. 
   
   
       11 . The system according to  claim 1 , wherein the poles of said multipolar electrode are positioned and said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei in both brain hemispheres. 
   
   
       12 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate a plurality of subdivisions of the patient's intralaminar nuclei completely in phase. 
   
   
       13 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate a plurality of subdivisions of the patient's intralaminar nuclei partially in phase. 
   
   
       14 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate a plurality of subdivisions of the patient's intralaminar nuclei completely out of phase. 
   
   
       15 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei at a frequency of 2-200 Hz. 
   
   
       16 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei at an amplitude of 0.1-10 volts. 
   
   
       17 . The system according to  claim 1 , wherein said pulse generator is controlled to stimulate subdivisions of the patient's intralaminar nuclei at a pulse width of 50-500 microseconds. 
   
   
       18 . The system according to  claim 1  further comprising:
 a voltage controller positioned in the system to provide a selected current amplitude or voltage to pulse waves generated by the pulse generator.