Treatment of anxiety disorders by external application of ionizing radiation
View Patent ↗Medical systems, devices, and methods provide improved radiosurgical techniques for treatment of anxiety disorders (such as Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Panic Disorder, Social Phobia, Specific Phobia, and the like). Radiation can be directed from a radiation source outside the patient toward a target tissue deep within the patient's brain using a stereotactic radiosurgical platform, typically without having to impose the surgical trauma associated with accessing deep brain tissues. The target will often include at least a portion of the amygdala, with exemplary treatments being directed to targets that are limited to a sub-region of the amygdala. Rather than applying sufficient radiation to kill the neural tissue within the target, a cellularly sub-lethal dose of the radiation may be applied. Without imposing frank cell death throughout the target, the radiation can mitigate the anxiety disorder, obesity, or the like, often by modulating the level of neural activity within the target and in associated tissues.
1. A method for treating a psychiatric anxiety disorder of a patient, the disorder associated with a level of localized neuronal activity within a brain of the patient as well as deleterious anxiety by the patient, the method comprising:
identifying a portion of an amygdala on at least one side of the brain of the patient associated with the disorder; and
inducing glial cell changes in the identified portion of the amygdala without damaging surrounding neural tissues by transmitting a cellularly sub-lethal quantity of ionizing radiation from outside the patient selectively into the identified portion of the amygdala of the brain of the patient thereby altering the level of neuronal activity such that the anxiety of the patient is mitigated.
2. The method of claim 1 , wherein the portion of the amygdala is included within a basolateral complex of nuclei within the amygdala.
3. The method of claim 1 , wherein the portion of the amygdala is included within a centromedial nucleus of nuclei within the amygdala.
4. The method of claim 1 , wherein the portion of the amygdala is included within the central nuclei within the amygdala.
5. The method of claim 1 , wherein the portion comprises a sub region included within a limited portion of discrete tissue structures of the amygdala such that at least a region of a boundary of the portion is disposed within, and separate from, anatomical boundaries of the amygdala.
6. The method of claim 1 , wherein the ionizing radiation is transmitted from a radiation source as a plurality of radiation beams, and further comprising planning the radiation beams so that radiation outside the portion drops off sufficiently to inhibit collateral damage to adjacent neural tissues of the amygdala.
7. The method of claim 6 , wherein the portion has a volume of less than 1000 mm3.
8. The method of claim 1 , further comprising clinically determining that the disorder falls within an accepted psychiatric standard before transmitting the radiation, and verifying that the anxiety is mitigated per a clinical evaluation after transmitting the radiation.
9. The method of claim 8 , further comprising identifying or verifying the portion of the amygdala by imaging differing localized neuronal activity levels within regions of the amygdala of the patient.
10. The method of claim 1 , wherein the sub-lethal quantity of radiation comprises, during a single treatment, a dose in a range from about 50 Gy to about 100 Gy within the portion.
11. The method of claim 1 , wherein the disorder comprises Post-Traumatic Stress Disorder (PTSD).
12. The method of claim 1 , wherein said disorder comprises Generalized Anxiety Disorder (GAD).
13. The method of claim 1 , wherein said disorder comprises Panic Disorder.
14. The method of claim 1 , wherein said disorder comprises Social Phobia.
15. The method of claim 1 , wherein the anxiety disorder comprises Specific Phobia.
16. The method of claim 1 , wherein the glial cell changes in the identified portion of the amygdala comprise astrocytosis in the identified portion of the amygdala.
17. The method of claim 1 , wherein the glial cell changes in the identified portion of the amygdala comprise reduction in myelin sheathing extending from oligodendrocytes in the identified portion of the amygdala.
18. The method of claim 1 , wherein the glial cell changes in the identified portion of the amygdala comprise microglial increase in the identified portion of the amygdala.