Methods for enhancing exposure therapy using vagus nerve stimulation
View Patent ↗Disclosed is a method of enhancing exposure therapy comprising providing an exposure therapy to a patient and stimulating the patient's vagus nerve at the same time as the exposure therapy. Also disclosed is a post-traumatic stress disorder therapy method comprising providing an exposure event to a patient and stimulating the patient's vagus nerve during the exposure event. Also disclosed is a phobia disorder therapy method comprising providing an extinction event to a patient and stimulating the patient's vagus nerve during the extinction event. Also disclosed is an obsessive compulsive disorder therapy method comprising providing a therapy event to a patient and stimulating the patient's vagus nerve during the therapy event. Also disclosed is an addiction disorder therapy method comprising providing a therapy event to a patient and stimulating the patient's vagus nerve during the therapy event.
1. A method comprising:
obtaining access to a patient that is a mammal;
identifying a stimulus that evokes an identifiable reaction indicative of a psychological response to the stimulus in the patient;
providing an exposure therapy to the patient including presenting the stimulus to the patient;
electrically stimulating the patient's vagus nerve at the same time as the exposure therapy; and
obtaining data indicative of whether the identified stimulus evokes the reaction, wherein
the actions of providing an exposure therapy to the patient and stimulating the patient's vagus nerve at the same time as the exposure therapy are repeated at least until the identified stimulus evokes the reaction no more than about one-fifth of the time that the identified stimulus is presented to the patient.
2. The method of claim 1 , wherein said exposure therapy is a memory extinction therapy.
3. The method of claim 1 , wherein said exposure therapy is a post traumatic stress disorder therapy.
4. The method of claim 1 , wherein said patient's vagus nerve is stimulated using a constant current stimulation pulse.
5. The method of claim 1 , wherein said patient's vagus nerve is stimulated using a voltage controlled capacitive discharge stimulation pulse.
6. The method of claim 1 , wherein said exposure therapy contains sensory recreations of a traumatic event.
7. The method of claim 1 , wherein said exposure therapy is a phobic disorder therapy.
8. The method of claim 1 , wherein said exposure therapy is an obsessive compulsive disorder therapy.
9. The method of claim 1 , wherein said exposure therapy includes a trigger event that indicates a paired vagal nerve stimulation.
10. The method of claim 1 , wherein said exposure therapy is an addiction therapy.
11. The method of claim 1 , further comprising obtaining data indicative of the action of stimulating the patient's vagus nerve at the same time as the exposure therapy that results in consolidation of extension of patient determined undesirable memories of the patient at a rate greater than that which would be the case in the absence of the vagus nerve stimulation at the same time as the exposure therapy.
12. The method of claim 1 , wherein the method is a method of treating post traumatic stress disorder, and further comprising obtaining data indicative of the action of stimulating the patient's vagus nerve at the same time as the exposure therapy results in a subsequent decrease of a physically detectable reaction of the patient to a stimulus relative to that which would be the case in the absence of the stimulation of the vagus nerve at the same time as the exposure therapy.
13. The method of claim 1 , wherein the method is a method of treating post traumatic stress disorder, and further comprising obtaining data indicative of the action of stimulating the patient's vagus nerve at the same time as the exposure therapy results in, at least two weeks after the stimulation, a subsequent decrease of a physically detectable reaction of the patient to a stimulus relative to that which would be the case in the absence of the stimulation of the vagus nerve at the same time as the exposure therapy.
14. The method of claim 1 , further comprising:
identifying a stimulus induced anxiety of the patient; and
selecting an exposure therapy based on the identified stimulus induced anxiety of the patient, wherein the selected exposure therapy is the exposure therapy that occurs at the same time as the stimulation of the patient's vagus nerve.
15. The method of claim 14 , wherein:
the actions of providing an exposure therapy to a patient and stimulating the patient's vagus nerve at the same time as the exposure therapy are repeated until the identified anxiety of the patient is effectively reduced.
16. The method of claim 1 , further comprising:
identifying a feeling of the patient;
identifying a stimulus associated with the identified feeling; and
identifying a physically detectable reaction of the patient to the stimulus, wherein
the actions of providing an exposure therapy to a patient and stimulating the patient's vagus nerve at the same time as the exposure therapy are repeated until the physically detectable reaction of the patient to the stimulus is different.
17. The method of claim 1 , further comprising:
obtaining access to a mammal, wherein the mammal is the patient; and
during a first temporal period, identifying a stimulus that evokes an identifiable feeling in the mammal, wherein
the actions of providing an exposure therapy to the patient and stimulating the patient's vagus nerve at the same time as the exposure therapy are repeated during a second temporal period after the first temporal period until the identified stimulus evokes a percept that is different from that at the identification of the stimulus during the first temporal period.
18. The method of claim 1 , further comprising:
obtaining access to the patient; and
identifying a stimulus that evokes an identifiable feeling in the patient, wherein
the actions of providing an exposure therapy to the patient and stimulating the patient's vagus nerve at the same time as the exposure therapy are repeated until the identified stimulus evokes a percept that is different from that of the identified feeling.
19. The method of claim 18 , further comprising:
observing the patient to detect at least one of a physical reaction to the identified stimulus that is different from that of the identified feeling or a lack of physical reaction to the identified stimulus.
20. The method of claim 1 , further comprising:
implanting electrodes proximate the patient's vagus nerve, wherein
the stimulation of the patient's vagus nerve corresponds to the application of electrical current thereto from the electrodes.
21. The method of claim 1 , further comprising:
implanting cuff electrodes around the patient's vagus nerve, wherein
the stimulation of the patient's vagus nerve corresponds to the application of electrical current thereto from the electrodes.
22. The method of claim 1 , further comprising:
implanting bipolar platinum iridium cuff electrodes around the patient's vagus nerve, wherein
the stimulation of the patient's vagus nerve corresponds to the application of electrical current thereto from the electrodes.
23. The method of claim 20 , wherein:
the electrical current is less than about 0.8 milliamps alternating current.
24. The method of claim 20 , wherein:
the electrical current is less than about 0.8 milliamps alternating current at less than about 150 Hz.
25. The method of claim 20 , wherein:
the current of the electrical current is alternating current applied for less than about 30 seconds per application.
26. The method of claim 1 , further comprising:
identifying a stimulus that evokes a reaction in the patient indicative of a patient-identified undesirable reaction;
identifying an exposure therapy based on the identified stimulus;
repeating the action of stimulating the patient's vagus nerve at the same time as the exposure therapy, at least intermittently, until the stimulus evokes a reaction in the patient different from that of the reaction indicative of the patient-identified undesirable reaction, wherein the exposure therapy is the identified exposure therapy.
27. The method of claim 1 , further comprising:
identifying a stimulus that evokes a fear percept and sensing the evoked fear percept;
identifying an exposure therapy based on the identified stimulus;
repeating an extinction therapy a plurality of times until a sensed percept evoked by the identified stimulus is different from that of the evoked fear percept, wherein
the extinction therapy comprises providing the exposure therapy to the patient and stimulating the patient's vagus nerve at the same time as the exposure therapy.
28. The method of claim 1 , further comprising:
applying a stimulus to the patient that evokes a psychological percept;
sensing the evoked psychological percept;
identifying a parameter of the sensed evoked psychological percept;
identifying an exposure therapy based on the identified stimulus;
repeating an extinction therapy a plurality of times until an parameter of a percept evoked by the identified stimulus is different from the identified parameter of the sensed evoked psychological percept,
wherein the extinction therapy comprises providing the exposure therapy to the patient and stimulating the patient's vagus nerve at the same time as the exposure therapy.
29. A method, comprising:
(i) obtaining access to a patient;
(ii) identifying a stimulus that evokes an identifiable reaction indicative of a psychological response to the stimulus in the patient;
(iii) executing an extinction session including:
providing an exposure therapy to a patient by providing the stimulus to the patient; and
electrically stimulating the patient's vagus nerve at the same time as the exposure therapy;
(iv) observing the patient for a lack of reaction to the stimulus; and
(v) repeating method actions iii and iv until a lack of reaction to the stimulus is observed.
30. The method of claim 29 , wherein:
a temporal delay of at least a day is interposed between repetitions of method actions iii and iv.
31. A method, comprising:
(i) obtaining access to a patient;
(ii) identifying a stimulus that evokes an identifiable reaction indicative of a psychological response to the stimulus in the patient;
(iii) executing an extinction session including:
providing an exposure therapy to a patient by providing the stimulus to the patient; and
electrically stimulating the patient's vagus nerve at the same time as the exposure therapy;
(iv) observing the patient for a lack of reaction to the stimulus; and
(v) repeating method actions iii and iv until a consistent lack of reaction to the stimulus is observed.
32. The method of claim 31 , wherein:
a temporal delay of at least a day is interposed between repetitions of method actions iii and iv.