Site specific deep brain stimulation for enhancement of memory
The various embodiments described herein include methods, devices, and systems for enhancement of memory. In one aspect, a method includes: (1) implanting intracranial electrodes in a patient, wherein the electrodes are placed selectively at a specific brain site; (2) determining a threshold for eliciting an after-discharge threshold of the patient, and (3) stimulating the electrodes with current set below the after-discharge threshold while the patient is in a particular phase of sleep so as to enhance memory of the patient.
1. A method of site-specific deep brain stimulation for enhancement of memory, the method comprising:
implanting intracranial electrodes in a patient, wherein each of the electrodes is placed selectively at a respective specific brain site in an entorhinal or hippocampal region;
determining an individualized after-discharge threshold for eliciting an after-discharge response in the patient; and
enhancing memory of the patient by stimulating the electrodes with current set below the individualized after-discharge threshold while the patient is in a particular phase of sleep.
2. The method of claim 1 , further comprising real time electroencephalographic (EEG) feedback to optimize therapeutic efficacy of the stimulating.
3. The method of claim 2 , wherein the real time EEG feedback includes evaluating theta rhythm at one or more electrode contacts.
4. The method of claim 3 , wherein the real time EEG feedback includes identifying phase resetting of the theta rhythm.
5. The method of claim 1 , wherein implanting the electrodes includes implanting at least one hippocampal electrode.
6. The method of claim 1 , wherein at least one of the electrodes is implanted at a respective specific brain site in the entorhinal region, which includes the entorhinal cortex and/or the perforant path.
7. The method of claim 1 , wherein each of the electrodes is placed selectively in white and/or gray matter of the respective specific brain site.
8. The method of claim 1 , wherein the stimulating current is in the range of 1.0 mA-2.0 mA and the stimulating is on-demand.
9. The method of claim 1 , wherein the patient is an Alzheimer's patient or a patient with minimal cognitive impairment (MCI) or a patient with epilepsy.
10. A method of site-specific deep brain stimulation for enhancement of memory, the method comprising:
implanting intracranial electrodes in a patient, wherein each of the electrodes is placed selectively at a respective specific brain site in an entorhinal or hippocampal region;
determining an individualized after-discharge threshold for eliciting an after-discharge response in the patient; and
enhancing memory of information processing for the patient through on-demand timed stimulation of the electrodes below the individualized after-discharge threshold at a specific stage of the information processing.
11. The method of claim 10 , further comprising real time electroencephalographic (EEG) feedback to optimize therapeutic efficacy.
12. The method of claim 11 , wherein the real time EEG feedback includes evaluating theta rhythm at one or more electrode contacts.
13. The method of claim 12 , wherein the real time EEG feedback includes identifying phase resetting of the theta rhythm.
14. The method of claim 10 , wherein the stage of information processing is a stage of learning.
15. The method of claim 10 , wherein the stage of information processing is a stage of retrieval of information, recall of information, and/or consolidation of information.
16. The method of claim 10 , wherein the stimulation is at an entorhinal region, which includes the entorhinal cortex and the perforant path.
17. The method of claim 10 , wherein each of the electrodes is placed selectively in white and/or gray matter of the respective specific brain site.
18. The method of claim 10 , wherein the patient is an Alzheimer's patient or a patient with minimal cognitive impairment (MCI) or a patient with epilepsy.
19. A method of site-specific deep brain stimulation for enhancement of memory of a patient with epilepsy, the method comprising:
accessing intracranial electrodes implanted in a medial temporal lobe of the patient, wherein each electrode is selectively placed at a respective specific brain site within an entorhinal or hippocampal region;
determining an individualized after-discharge threshold for eliciting an after-discharge response in the patient; and
enhancing memory of the patient through on-demand timed stimulation of one or more contacts of the electrodes below the individualized after-discharge threshold.
20. The method of claim 19 , wherein at least one electrode is selectively placed at a respective specific brain site selected for determining epileptogenic zone or area of seizure-onset for the patient and/or for treatment of the epilepsy.