# US 2014/0155677 A1 · Treatment of Anxiety Disorders by External Application of Ionizing Radiation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0155677 A1 - Document ID: US20140155677A1 - Status: Published application - Kind: A1 - Application number: 13/900,131 - Filed: 2013-05-22 - Published: 2014-06-05 - Earliest claimed: 2012-05-24 - Inventors: M. Bret Schneider; John R. Adler, JR. - Web page: https://patentgrep.com/patent/US20140155677A1 ## CPC - A61N 5/1031: {using a specific method of dose optimization} - A61N 5/1039: {using functional images, e.g. PET or MRI} - A61N 5/1049: {for verifying the position of the patient with respect to the radiation beam} - A61N 5/1084: {for delivering multiple intersecting beams at the same time, e.g. gamma knives} - A61N 5/0618: {Psychological treatment} - A61N 5/1042: {with spatial modulation of the radiation beam within the treatment head} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract 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. ## Claims ### Claim 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 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 so as to alter the level of neuronal activity such that the anxiety of the patient is mitigated. ### Claim 2 (depends on 1) The method of claim 1, wherein the portion of the amygdala is included within a basolateral complex of nuclei within the amygdala. ### Claim 3 (depends on 1) The method of claim 1, wherein the portion of the amygdala is included within a centromedial nucleus of nuclei within the amygdala. ### Claim 4 (depends on 1) The method of claim 1, wherein the portion of the amygdala is included within the central nuclei within the amygdala. ### Claim 5 (depends on 1) 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. ### Claim 6 (depends on 1) 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. ### Claim 7 (depends on 6) The method of claim 6, wherein the portion has a volume of less than 1000 mm3. ### Claim 8 (depends on 1) 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. ### Claim 9 (depends on 8) 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. ### Claim 10 (depends on 1) 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. ### Claim 11 (depends on 1) The method of claim 1, wherein the disorder comprises Post-Traumatic Stress Disorder (PTSD). ### Claim 12 (depends on 1) The method of claim 1, wherein said disorder comprises Generalized Anxiety Disorder (GAD). ### Claim 13 (depends on 1) The method of claim 1, wherein said disorder comprises Panic Disorder. ### Claim 14 (depends on 1) The method of claim 1, wherein said disorder comprises Social Phobia. ### Claim 15 (depends on 1) The method of claim 1, wherein the anxiety disorder comprises Specific Phobia. ### Claim 16 A method for treating chronic post-traumatic stress disorder (PTSD) of a patient, the method comprising: transmitting a cellularly sub-lethal quantity of ionizing radiation from outside the patient, through a plurality of intermediate tissues, and selectively into an amygdala of a brain of the patient so as to alter neuronal activity, without surgically accessing the amygdala, such that the PTSD is clinically mitigated. ### Claim 17 A system for treating a psychiatric anxiety disorder of a patient, the disorder associated with a level of neuronal activity within a brain of the patient and provoking deleterious anxiety of the patient, the system comprising: a source for transmitting ionizing radiation; and a processing system coupled to the source, the processing system configured to effect transmission of a plurality of beams of the radiation from the source selectively into an amygdala within the brain of the patient so that the radiation within the amygdala is cellularly sub-lethal and is sufficient to alter the level of neuronal activity such that the anxiety associated with the disorder is clinically mitigated. ### Claim 18 (depends on 17) The system of claim 17, wherein the processing system comprises software, the software comprising tangible media with non-volatile machine-readable code embodying instructions for planning transmission of the plurality of beams in response to input command signals received by an input, wherein the processing system transmits signals per the software so as to effect a desired positioning of the radiation beams relative to the brain of the patient. ### Claim 19 (depends on 17) The system of claim 17, wherein the portion of the amygdala is included within a basolateral complex of nuclei within the amygdala. ### Claim 20 (depends on 17) The system of claim 17, wherein the portion of the amygdala is included within a centromedial nucleus of nuclei within the amygdala. ### Claim 21 (depends on 17) The system of claim 17, wherein the portion of the amygdala is included within the central nuclei within the amygdala. ### Claim 22 (depends on 17) The system of claim 17, 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. ### Claim 23 (depends on 17) The system of claim 17, wherein the software is configured to plan the radiation beams so that radiation outside the portion drops off sufficiently to inhibit collateral damage to adjacent neural tissues of the amygdala. ### Claim 24 (depends on 17) The system of claim 17, wherein the portion has a volume of about 1000 cc or less. ### Claim 25 (depends on 17) The system of claim 17, further comprising collimating at least some of the radiation beams to a beam cross-sectional size of less than 5 mm. ### Claim 26 (depends on 17) The system of claim 17, further comprising an imaging system coupled to the processor, the imaging system configured for imaging differing localized neuronal activity levels within regions of the amygdala of the patient. ### Claim 27 (depends on 17) The system of claim 17, 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. ### Claim 28 (depends on 17) The system of claim 17, wherein the disorder comprises Post-Traumatic Stress Disorder (PTSD). ### Claim 29 (depends on 17) The system of claim 17, wherein said disorder comprises Generalized Anxiety Disorder (GAD). ### Claim 30 (depends on 17) The system of claim 17, wherein said disorder comprises Panic Disorder. ### Claim 31 (depends on 17) The system of claim 17, wherein said disorder comprises Social Phobia. ### Claim 32 (depends on 17) The system of claim 17, wherein the anxiety disorder comprises Specific Phobia. ### Claim 33 A system for treating chronic post-traumatic stress disorder (PTSD) of a patient, the system comprising: a source for transmitting ionizing radiation; and a processing system coupled to the source, the processing system configured to effect transmission of a plurality of beams of the radiation from the source from outside the patient, through a plurality of intermediate tissues, and selectively into an amygdala of a brain of the patient so as to alter neuronal activity, without surgically accessing the amygdala, such that the PTSD is clinically mitigated.