Patent Application
20170087377
Field of the Invention
The present invention relates to a system and device for transnasal delivery of low level light. In particular, the present invention is directed to a system and device for transnasal delivery via the sphenoidal sinus of low level light to the substantia nigra in the treatment of Parkinson's disease.
Description of Related Art
Low level light therapy, also known as phototherapy or photobiomodulation, has been a recognized treatment of many diseases and disorders of the human body including those of the brain. Heretofore, photobiomodulation of the substantia nigra, an anatomical structure inside the brain stem, for the treatment of Parkinson's required a suitable access path through the brain to position the optical light source at a desired location in the brain proximate the target tissue of the substantia nigra. Such previously recognized access paths were directed through the frontal lobe of the brain thus requiring brain surgery.
The intranasal delivery of red light for the treatment of Alzheimer's disease by illuminating diseased brain cells is disclosed in U.S. Pat. No. 7,351,253, assigned to Codman & Shurtleff and herein incorporated by reference in its entirety. Positioning the distal end of the optical fiber within the nasal cavity allows for illumination of red light to the olfactory bulb via the substantially permeable cribriform plate portion of the nasal cavity in the treatment of brain cells affected by Alzheimer's disease. In accordance with the patented procedure used in the treatment of Alzheimer's disease, the distal end of the optical fiber at all times remains only within the nasal cavity. Accordingly, only that amount of irradiated light able to permeate through the cribriform plate portion of the nasal cavity is able to enter the brain. As expressly recognized in the patented invention, the irradiated red light generated by the optical fiber is only able to penetrate the gray matter to a depth of up to a centimeter. Accordingly, using the patented device a sufficient amount of irradiated light would not be able to reach deep into the brain to illuminate substantia nigra required in the treatment of Parkinson's disease. It is therefore desirable to develop a photobiomodulation system and method that does not require brain surgery through the frontal lobe but, nevertheless, transnasally irradiates via the sphenoidal sinus the substantia nigra whereby a sufficient amount of irradiated light is able to penetrate deeper in the brain as required for treatment of Parkinson's disease.
An aspect of the present invention is directed to a system and method for photobiomodulation of the substantia nigra via intranasal delivery (i.e., delivery via the sphenoid sinus) in the treatment of Parkinson's disease without the need for surgical intervention into the brain (i.e., no need to access the brain via the front lobe or any other surgical intervention into the brain). The only surgery that typically may be required is Ear, Nose and Throat (ENT) surgery for enlarging/dilating/widening of the natural paranasal ostium sinus used in conventional sinusitis treatment procedures performed under general or local anesthesia. During access surgery, due to anatomic variation from patient to patient in those patients with relatively thick bone in the area behind the sphenoidal sinus, it may be advantageous to precisely decorticate such bone (without violating or damaging the dura) in order to reduce light absorption by the bone.
Another aspect of the present invention is directed to a system and method for photobiomodulation of the substantia nigra via the sphenoid sinus in the treatment of Parkinson's disease that eliminates the need for an implanted device.
Still another aspect of the present invention is directed to a system and method for photobiomodulation of the substantia nigra via the sphenoid sinus in the treatment of Parkinson's disease that occurs with repeated treatments performed in an outpatient setting, and may be performed under local anesthesia at relative low cost (without the need for an inpatient setting under general anesthesia).
In particular, the present claimed invention is directed to a transnasal delivery method for treating or preventing Parkinson's disease using photobiomodulation. An optical system is provided that includes a light source and an optical fiber. The optical system is advanced through the nasal cavity until a distal end of the optical fiber is positioned within the nasal cavity. Then the light source is activated to irradiate substantia nigra brain tissue with an effective amount of light in the treatment or prevention of Parkinson's disease.
While another aspect of the present claimed invention is directed to a transnasal delivery method for treating or preventing Parkinson's disease using photobiomodulation. An optical system is provided that includes a light source. The optical system is advanced through the nasal cavity until a distal end of the light source is positioned within the nasal cavity. Then the light source is activated to irradiate substantia nigra brain tissue with an effective amount of light in the treatment or prevention of Parkinson's disease.
The foregoing and other features of the present invention will be more readily apparent from the following detailed description and drawings of illustrative of the invention wherein like reference numbers refer to similar elements throughout the several views and in which:
The present invention is directed to a system and method for transmission of low level light (preferably in the wave length range of approximately 650 nm-approximately 1000 nm, most preferably, between approximately 670 nm-approximately 810 nm) delivered transnasally via the sphenoidal sinus to the substantia nigra for photobiomodulation of brain cells in the specific treatment of Parkinson's disease. The present inventive system and method does not require brain surgery on the frontal lobe or any other portion of the brain. Furthermore, the present invention system and method for transnasal photobiomodulation in the treatment of Parkinson's disease wherein the irradiated light does not cross the cribriform plate or irradiate the olfactory bulb.
Initial ENT surgery is preferably employed to permanently enlarge or widen the sinus ostium thereby facilitating access of the distal end of the present inventive optical system (including the distal end of the optical fiber, the frontal diffuser and the one or more lenses) inside the sphenoid sinus. This initial procedure is typically carried out in a medical facility under general or local anesthesia using any conventional methodology for enlarging/dilating/widening the paranasal sinus ostium. One exemplary conventional methodology for enlarging/dilating/widening a natural paranasal sinus ostium that has not been previously surgically altered is disclosed in U.S. Pat. Nos. 7,462,175 & 7,500,971 (assigned to Acclarent, Inc.), each of which is herein incorporated by reference in its entirety. Other systems and methods for enlarging/dilating/widening the natural, paranasal sinus ostium that has not been previously surgically altered are contemplated and within the intended scope of the present invention,
In one embodiment of the method of using the abovementioned set of devices, guide catheter 800 is introduced into the patient's body so that the distal end of the guide catheter 800 is in the vicinity of an anatomical opening (e.g., ostium) of an anatomical region (e.g., paranasal sinus). Thereafter, guidewire 820 is introduced through guide catheter 800 into the anatomical region (e.g., paranasal sinus). If necessary, guide catheter 800 may be removed and the smaller subselective catheter 806 may be introduced over guidewire 820 into the paranasal sinus and enlargement/widening/dilation of the ostium sinus is achieved by dilating the working device 812 (including dilating balloon 816). In another embodiment of a method of using the aforementioned set of devices, subselective catheter 806 may be introduced into a patient's body so that the distal end of the subselective catheter 806 is in the vicinity of an anatomical opening (e.g., an ostium) of an anatomical region (e.g., paranasal sinus). Then guide wire 820 is introduced through subselective catheter 806 into the anatomical region (e.g., paranasal sinus). Thereafter, subselective catheter 806 is removed. Larger guide catheter 800 is then introduced over guidewire 820. Working device 812 (including dilating balloon 816) is then introduced over guidewire 820 into the paranasal sinus and a diagnostic or therapeutic procedure is performed by working device 812. This last method embodiment enables a user to introduce a larger working device 812 in the anatomical region.
During access surgery, due to anatomic variation from patient to patient in those patients with relatively thick bone in the area behind the sphenoidal sinus, it may be advantageous to precisely decorticate such bone (without violating or damaging the dura) in order to reduce light absorption by the bone.
Once the paranasal sinus ostium has been enlarged/dilated/widened, any subsequent photobiomodulation treatment of the substantia nigra from inside the sphenoid sinus in accordance with the present invention advantageously may be performed in an outpatient setting under local anesthesia in relatively short period of time (e.g., approximately one hour). The present inventive optical system for the treatment of Parkinson's disease in accordance with the present invention may advantageously be introduced into the patient's sinus, on an as needed basis thereby eliminating the need for a permanently implanted device.
Once the optical fiber, light diffuser and one or more lenses have been introduced via the patient's sinus inside the sphenoidal sinus, the light exiting therefrom irradiates the target tissue of substantia nigra deep within the brain tissue. Specifically, during treatment, the irradiated light enters the bone and brain tissue via the sphenoidal sinus. The light that enters the bone and brain tissue is partially absorbed and scattered, whereby a portion thereof reaches the target tissue of the substantia nigra.
Measurements on human species indicate a fluence rate of between approximately 0.1 mW/cm2 and approximately 10 mW/cm2 at different locations inside the substantia nigra. The highest fluence levels have been detected in locations that are closest to the optical light source inside the sphenoidal sinus. Based on this experimental data, approximately 0.1%-approximately 1.0% of light energy emitted by the optical fiber and light diffuser reaches the substantia nigra. This measured fluence rate in the target tissue of the substantia nigra is within the range of energy densities found to be efficient therapeutically for the treatment of Parkinson's disease using photobiomodulation. Moreover, the maximum fluence rate in the tissue closest to the optical fiber light source is within a safe range in which there is no, or de minimis, detrimental effects to the illuminated tissue.
Irrigation of the sphenoidal sinus simultaneously with that of the light treatment and/or during pauses between intermittent light treatments may be required to dissipate heat in order to protect proximate tissues, such as the sphenoidal mucosa from damage.
Numerical simulation of light propagation in tissue (similar to the simulation used to create the experimental data shown in
By way of illustrative example, the present invention is shown and described with the optical, system including a light source, an optical fiber, a diffuser and an optical homogenizer. It is, however, contemplated and within the intended scope of the present invention to eliminate the diffuser and optical homogenizer from the optical system. Furthermore, so long as a light source, of sufficient power and wavelength as described herein, is itself able to be advanced so that its distal end is disposed entirely within the sphenoidal sinus then the optical fiber may also be eliminated from the optical system.
Thus, while there have been shown, described, and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions, substitutions, and changes in the form and details of the devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, it is expressly intended that all combinations of those elements and/or steps that perform substantially the same function, in substantially the same way, to achieve the same results be within the scope of the invention. Substitutions of elements from one described embodiment to another are also fully intended and contemplated. It is also to be understood that the drawings are not necessarily drawn to scale, but that they are merely conceptual in nature. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.
Every issued patent, pending patent application, publication; journal article, book or any other reference cited herein is each incorporated by reference in their entirety.
