Neural stimulation system and method responsive to collateral neural activity

• US 20030074032A1
• Filed: 10/15/2002
• Published: 04/17/2003
• Est. Priority Date: 10/15/2001
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Gliner, Bradford Evan
• Granted Patent: US 7,831,305 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61B 5/1104 induced by stimuli or drugs; A61B5/1102 takes precedence; investigating medicinal preparations G01N33/15
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

A neural stimulation system responsive to collateral neural activity that may arise in association with a neural stimulation procedure includes a stimulation interface configured to deliver stimulation signals to a target neural population, a monitoring interface positioned to receive signals corresponding to a neural activity within the target neural population, a stimulus unit coupled to deliver stimulation singals to the stimulation interface, and a sensing unit coupled to the monitoring device and the stimulus unit. The neural stimulation procedure may be directed toward rehabilitating, restoring, and/or enhancing one or more neural functions by facilitating and/or effectuating a neuroplastic change or reorganization; and/or affecting a neurological condition that exists on a continuous or essentially continuous basis absent the stimulation procedure. The sensing unit determines whether evidence of an collateral neural activity exists, whereupon the stimulus unit attempts to abate the collateral neural activity.

Claims

1. A neural stimulation method comprising:

applying a first stimulation signal to a target neural population within a patient, the first stimulation signal being selected to affect a patient perception of pain, rehabilitate a functional deficit exhibited by the patient, and/or enhance a functional capability of the patient;

monitoring a parameter associated with a collateral neural activity using a sensing unit and a monitoring interface; and

responding to a state of the parameter indicative of collateral neural activity.

2. The method of claim 1, wherein applying the first stimulation signal induces the collateral neural activity.

3. The method of claim 1, wherein responding to an indication of collateral neural activity comprises discontinuing application of the first stimulation signal.

4. The method of claim 1, wherein responding to an indication of collateral neural activity comprises applying a second stimulation signal to the patient.

5. The method of claim 4, wherein the second stimulation signal is applied to the target neural population and/or a neural population adjacent to a portion of the target neural population.

6. The method of claim 1, wherein monitoring a parameter associated with the collateral neural activity comprises monitoring an electrophysiological signal of the patient.

7. The method of claim 1, wherein monitoring a parameter associated with the collateral neural activity comprises monitoring an EEG signal, a cerebral bloodflow signal, an EMG signal, an accelerometer signal, a motion sensor signal, and/or a neural imaging signal.

8. The method of claim 1, wherein applying the first stimulation signal occurs while a behavioral therapy is being performed on the patient.

9. The method of claim 1, further comprising:

interrupting application of the first stimulation signal; and

resuming application of the first stimulation signal when the monitored parameter indicates that the collateral neural activity is absent.

10. A neural stimulation method comprising:

applying a first stimulation signal to a target neural population within a patient, the first stimulation signal directed toward altering a neural condition that exists within the patient on at least an essentially continuous basis in the absence of the first stimulation signal;

automatically determining whether collateral neural activity exists; and

responding to collateral neural activity when it is determined to exist.

11. The method of claim 10, wherein applying the first stimulation induces the collateral neural activity.

12. The method of claim 10, wherein responding to the collateral neural activity comprises discontinuing application of the first stimulation signal.

13. The method of claim 10, wherein responding to the collateral neural activity comprises applying a second stimulation signal to the patient.

14. The method of claim 13, wherein the second stimulation signal is applied to the target neural population and/or a neural population adjacent to a portion of the target neural population.

15. The method of claim 10, wherein the determining whether collateral neural activity exists comprises monitoring an electrophysiological signal and/or a patient behavior.

16. The method of claim 10, wherein the determining whether collateral neural activity exists comprises monitoring an EEG signal, a cerebral bloodflow signal, an EMG signal, an accelerometer signal, a motion sensor signal, and/or a neural imaging signal.

17. The method of claim 10, wherein applying the first stimulation signal occurs while the patient is performing a behavioral therapy.

18. The method of claim 10, further comprising:

interrupting application of the first stimulation signal; and

resuming application of the first stimulation signal in the event that evidence of the collateral neural activity is absent.

19. A neural stimulation method comprising:

applying a first stimulation signal to a target neural population within a patient while the patient performs a behavioral therapy;

monitoring a parameter indicative of whether collateral neural activity exists; and

attempting to abate the collateral neural activity in the event that evidence of the collateral neural activity exists.

20. The method of claim 19, wherein the first stimulation signal is directed toward one from the group of rehabilitating a functional deficit exhibited by the patient and enhancing a functional capability of the patient.

21. The method of claim 19, wherein the collateral neural activity arises in association with application of the first stimulation signal to the patient.

22. The method of claim 19, wherein attempting to abate the collateral neural activity comprises discontinuing application of the first stimulation signal.

23. The method of claim 19, wherein attempting to abate the collateral neural activity comprises applying a second stimulation signal to the patient.

24. The method of claim 23, wherein the second stimulation signal is applied to at least one of the target neural population and a neural population adjacent to a portion of the target neural population.

25. The method of claim 19, wherein monitoring the parameter comprises monitoring at least one of an electrophysiological signal and a patient behavior.

26. The method of claim 19, wherein monitoring the parameter comprises monitoring at least one of an EEG signal, a cerebral bloodflow signal, an EMG signal, an accelerometer signal, a motion sensor signal, and a neural imaging signal.

27. The method of claim 19, further comprising:

interrupting application of the first stimulation signal; and

resuming application of the first stimulation signal in the event that evidence of the collateral neural activity is absent.

28. A neural stimulation system comprising:

a first set of electrodes configured to be positioned upon a target neural population corresponding to a site at which neuroplasticity is occurring, a site at which neuroplasticity is expected to occur, and/or a site associated with neuropathic pain;

a monitoring device to receive signals corresponding to a neural activity within a portion of the target neural population;

a stimulus unit coupled to deliver stimuli to the first set of electrodes; and

a sensing unit coupled receive signals from the monitoring device.

29. The neural stimulation system of claim 28, wherein the sensing unit is further coupled to the stimulus unit.

30. The neural stimulation system of claim 28, wherein the first set of electrodes and a portion of the stimulus unit are configured for implantation into the patient.

31. The neural stimulation system of claim 28, wherein the first set of electrodes, the monitoring device, and a portion of the stimulus unit are configured for implantation into a patient.

32. The neural stimulation system of claim 28, wherein the first set of electrodes, the monitoring device, a portion of the stimulus unit, and a portion of the sensing unit are configured for implantation into a patient.

33. The neural stimulation system of claim 28, further comprising a substrate that carries the first set of electrodes and the monitoring device.

34. The neural stimulation system of claim 28, wherein the monitoring device comprises one from the group of a second set of electrodes and a cerebral bloodflow monitor.

35. An implantable stimulation and monitoring device comprising:

a substrate;

an electrode carried by the substrate; and

a cerebral bloodflow monitor carried by the substrate.

36. A neural stimulation system comprising:

an electrode configuration positioned to deliver a stimulation signal to a target neural population corresponding to one from the group of a site at which neuroplasticity is occurring, a site at which neuroplasticity is expected to occur, and a site associated with a neurological disorder that is present on an essentially continuous basis in the absence of the stimulation signal;

a monitoring device positioned to receive signals corresponding to a neural activity within a portion of the target neural population;

a pulse system coupled to the electrode configuration, the pulse system delivering the stimulation signal to the electrode configuration;

a controller coupled to the pulse system, the controller including a computer operable medium containing instructions that generate command signals that define a set of parameters corresponding to the stimulation signal and selectively enable operation of the pulse system; and

a sensing unit coupled to the monitoring device, the sensing unit including a computer operable medium containing instructions that detect evidence of an collateral neural activity and generate a notification signal in the event that evidence of the collateral neural activity exists.

37. The neural stimulation system of claim 36, wherein the controller is further coupled to the sensing unit and the computer operable medium within the controller further contains instructions for attempting to abate the collateral neural activity in response to the notification signal.