Closed loop neuromodulation for suppression of epileptic activity

• US 20030181955A1
• Filed: 03/13/2003
• Published: 09/25/2003
• Est. Priority Date: 04/27/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gielen, Frans L. H., Wadman, Wytse J.
• Granted Patent: US 7,006,872 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A system and method for predicting the likelihood of occurrence of an impending neurological episode. Electrical stimuli are delivered to a structure of the brain. Response field potentials evoked by the stimuli are sensed. Analysis of these field potentials allows for predictions as to the occurrence of an impending, but not yet occurring, neurological disorder. In one example, a measurement of change in response pulses is used to determine a level of interconnectivity in the structures of the brain. The level of functional interconnectivity is used in predicting the occurrence of the neurological event. An example of such a neurological event includes an epileptic seizure.

Claims

1. A method comprising:

delivering electrical stimuli to a structure of a brain;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal; and

storing the sensed signal in memory.

2. The method of claim 1, wherein the sensed signal stored in memory comprises raw response field potential data evoked by the stimuli.

3. The method of claim 1, wherein delivering stimuli to the structure includes delivering stimuli having a pulse pattern to the structure.

4. The method of claim 3, wherein delivering stimuli having the pulse pattern includes pairs of two or more electrical stimuli.

5. The method of claim 3, wherein delivering stimuli having the pulse pattern includes selecting the pulse pattern based on the structure to which the stimuli are delivered.

6. The method of claim 3, wherein delivering stimuli having the pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

7. The method of claim 6, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 2000 milliseconds.

8. The method of claim 6, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 1000 milliseconds.

9. The method of claim 6, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 2000 milliseconds.

10. The method of claim 6, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 1000 milliseconds.

11. The method of claim 6, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

12. The method of claim 6, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

13. The method of claim 6, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

14. The method of claim 6, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

15. The method of claim 6, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 1 minute.

16. The method of claim 1, wherein delivering stimuli to the structure includes delivering a predetermined number of stimuli to the structure.

17. The method of claim 1, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or efferent fiber system in the structure of the brain.

18. A method comprising:

implanting one or more electrodes in a structure of a brain;

delivering electrical stimuli to the structure through the electrodes;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal;

storing the sensed signal in memory.

19. The method of claim 18, wherein the sensed signal stored in memory comprises raw response field potential data evoked by the stimuli.

20. The method of claim 18, wherein implanting the electrodes includes positioning each of the electrodes in communication with a predetermined site in a brain.

21. The method of claim 20, wherein positioning includes selecting the predetermined site from the group consisting of the sub thalamic nucleus, the hippocampus, the medial thalamus and the temporal lobe.

22. The method of claim 18, wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain.

23. The method of claim 18, wherein sensing response field potentials includes sensing response field potentials with the one or more electrodes.

24. The method of claim 18, wherein sensing response field potentials includes sensing field potentials generated in the brain structure.

25. The method of claim 18, where delivering stimuli includes delivering stimuli having a first pulse pattern.

26. The method of claim 25, wherein the first pulse pattern includes pairs of two or more electrical stimuli.

27. The method of claim 25, wherein delivering stimuli having the first pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

28. The method of claim 27, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 2000 milliseconds.

29. The method of claim 27, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 1000 milliseconds.

30. The method of claim 27, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 2000 milliseconds.

31. The method of claim 27, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 1000 milliseconds.

32. The method of claim 27, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

33. The method of claim 27, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

34. The method of claim 27, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

35. The method of claim 27, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

36. The method of claim 27, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 1 minute.

37. The method of claim 18, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or an efferent fiber system in the structure of the brain.

38. A system comprising:

one or more electrodes implantable in a structure of a brain;

a signal processor/generator coupled to the electrodes, wherein the signal generator includes;

an electrical pulse generator to deliver electrical stimuli to the brain via the electrodes implanted in the structure of the brain; and

a memory to receive from the electrodes a sensed signal representing the response field potentials to the electrical stimuli, the memory to store the sensed signal.

39. The system of claim 38 wherein the memory stores raw sensed signal data.

40. The system of claim 38, wherein the electrical pulse generator delivers stimuli having a first pulse pattern.

41. The system of claim 40, wherein the electrical pulse generator delivers pairs of two or more electrical stimuli.

42. The system of claim 40, wherein the electrical pulse generator delivers the first pulse pattern that includes a first stimulus and a second stimulus.

43. The system of claim 42, wherein the electrical pulse generator delays delivery of the second stimulus relative the first stimulus by a time interval of 5 to 2000 milliseconds.

44. The system of claim 43, wherein the electrical pulse generator delays delivery of the second stimulus relative the first stimulus by a time interval of 5 to 1000 milliseconds.

45. The system of claim 44, wherein the electrical pulse generator delays delivery of the second stimulus relative the first stimulus by a time interval of 100 to 2000 milliseconds.

46. The system of claim 45, wherein the electrical pulse generator delays delivery of the second stimulus relative the first stimulus by a time interval of 100 to 1000 milliseconds.

47. The system of claim 42, wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

48. The system of claim 42, wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

49. The system of claim 42, wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

50. The system of claim 42, wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

51. The system of claim 42, wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 second to 1 minute.

52. The system of claim 38, wherein the system includes a lead having the one or more electrodes.

53. The system of claim 38, wherein the signal processor/generator is encased in an implantable housing.

54. A system comprising:

means for delivering electrical stimuli to a structure of a brain;

means for sensing response field potentials evoked by the stimuli delivered to the structure; and

means for storing the sensed response field potentials.

55. The system of claim 54 wherein the means for storing the sensed response field potentials comprises means for storing raw sensed response field potentials.

56. The system of claim 54, wherein the means for delivering stimuli to the structure includes means for delivering stimuli having a pulse pattern to the structure.

57. The system of claim 56, wherein the means for delivering stimuli having the pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

58. A system comprising:

means for implanting one or more electrodes in a structure of a brain;

means for delivering electrical stimuli to the structure through the electrodes;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for storing the response field potentials.

59. The system of claim 58 wherein the means for storing the response field potentials comprises means for storing raw response field potentials.

60. The system of claim 58, wherein means for implanting one or more electrodes includes means for implanting a lead that includes the one or more electrodes in the structure of the brain.

61. The system of claim 58, where the means for delivering stimuli includes means for delivering stimuli having a first pulse pattern.

62. The system of claim 61, wherein the means for delivering stimuli having the first pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

63. A system comprising:

one or more electrode means implantable in a structure of a brain;

a signal processor/generator means coupled to the electrode means, wherein the signal generator means includes;

an electrical pulse generator means to deliver electrical stimuli to the brain via the electrode means implanted in the structure of the brain; and

a storage means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the storage means receives response field potentials through the electrode means and stores the response field potentials.

64. The system of claim 63 wherein the storage means stores raw response field potentials.

65. The system of claim 63, wherein the electrical pulse generator means delivers stimuli having a first pulse pattern.

66. The system of claim 65, wherein the electrical pulse generator means delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal analyzer means measures changes in the response field potentials to the second pulse as compared to the response field potentials to the first pulse.

67. The system of claim 63, wherein the system includes lead means having the one or more electrodes.

68. The system of claim 63, wherein the signal processor/generator means is encased in an implantable housing means.

69. A method comprising:

delivering electrical stimuli to a structure of a brain;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal;

analyzing the sensed response field potentials to predict the likelihood of occurrence of a neurological disorder; and

storing the sensed signal in memory.

70. The method of claim 69 wherein the storing the sensed signal comprises storing a raw sensed signal.

71. The method of claim 69, wherein delivering stimuli to the structure includes delivering stimuli having a pulse pattern to the structure.

72. The method of claim 71, wherein delivering stimuli having the pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

73. The method of claim 72, wherein sensing response field potentials include sensing the response field potentials from a first location and a section location within the brain, and wherein measuring the change includes:

measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

74. The method of claim 73, wherein analyzing the sensed response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

75. The method of claim 73, wherein analyzing the sensed response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

76. The method of claim 72, including delivering a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

77. The method of claim 76, wherein delivering the therapy includes delivering therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

78. The method of claim 69, wherein analyzing the sensed response field potentials includes analyzing the sensed response field potentials pulses to predict the likelihood of occurrence of an epileptic seizure.

79. The method of claim 69, wherein delivering stimuli to the structure includes delivering a predetermined number of stimuli to the structure.

80. The method of claim 69, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or efferent fiber system in the structure of the brain.

81. A method comprising:

implanting one or more electrodes in a structure of a brain;

delivering electrical stimuli to the structure through the electrodes;

sensing response field potentials evoked by the stimuli delivered to the structure;

processing the response field potentials to predict the likelihood of occurrence of a neurological disorder based on the sensed response field potentials; and

storing the sensed response field potentials in memory.

83. The method of claim 81, wherein implanting the electrodes includes positioning each of the electrodes in communication with a predetermined site in a brain.

84. The method of claim 83, wherein positioning includes selecting the predetermined site from the group consisting of the sub thalamic nucleus, the hippocampus, the medial thalamus and the temporal lobe.

85. The method of claim 81, wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain.

86. The method of claim 81, wherein sensing response field potentials includes sensing response field potentials with the one or more electrodes.

87. The method of claim 81, wherein sensing response field potentials includes sensing field potentials generated in the brain structure.

88. The method of claim 81, where delivering stimuli includes delivering stimuli having a first pulse pattern.

89. The method of claim 88, wherein the first pulse pattern includes pairs of two or more electrical stimuli.

90. The method of claim 88 wherein delivering stimuli having the first pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

91. The method of claim 90, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

92. The method of claim 90, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

93. The method of claim 90, wherein sensing response field potentials include sensing the response field potentials from a first location and a section location within the brain;

and wherein measuring the change includes;

measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

94. The method of claim 93, wherein processing the response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

95. The method of claim 93, wherein processing the response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

96. The method of claim 90, including delivering a therapy for the neurological disorder when the change in the response field potential exceeds a threshold value.

97. The method of claim 96, wherein delivering the therapy includes delivering therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

98. The method of claim 81, wherein processing the response field potentials includes identifying the occurrence of an epileptic seizure based on the sensed response field potentials.

99. The method of claim 81, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or an efferent fiber system in the structure of the brain.

82. A method comprising:

implanting one or more electrodes in a structure of a brain;

delivering electrical stimuli to the structure through the electrodes;

sensing response field potentials evoked by the stimuli delivered to the structure;

processing the response field potentials to predict the likelihood of occurrence of a neurological disorder based on the sensed response field potentials, wherein the processing the response field potentials results in processed information; and

storing the processed information in memory.

100. A system comprising:

one or more electrodes implantable in a structure of a brain;

a signal processor/generator coupled to the electrodes, wherein the signal generator includes;

an electrical pulse generator to deliver electrical stimuli to the brain via the electrodes implanted in the structure of the brain;

a signal analyzer to receive via the electrodes response field potentials to the electrical stimuli delivered with the electrical pulse generator, where the signal analyzer receives response field potentials through the electrodes and predicts the likelihood of the occurrence of a neurological disorder based on the sensed response field potentials; and

a memory to receive from the electrodes a sensed signal representing the response field potentials to the electrical stimuli, the memory to store the sensed signal.

101. The system of claim 100 wherein the sensed signal stored in memory comprises a raw sensed signal.

102. The system of claim 100, wherein the electrical pulse generator delivers stimuli having a first pulse pattern.

103. The system of claim 102, wherein the electrical pulse generator delivers pairs of two or more electrical stimuli.

104. The system of claim 102, wherein the electrical pulse generator delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal analyzer measures changes in the response field potentials to the second pulse as compared to the response field potentials to the first pulse.

105. The system of claim 104, wherein the signal analyzer measures the field potential of the response field potentials received from a first location and a section location within the brain, and determines a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

106. The system of claim 105, wherein the signal analyzer indicates a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

107. The system of claim 105, wherein the signal analyzer indicates a likely epileptic event when the level of functional interconnectivity has a negative slope.

108. The system of claim 104, wherein the electrical pulse generator delivers a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

109. The system of claim 108, wherein the electrical pulse generator delivers the therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

110. The system of claim 100, wherein the signal analyzer indicates the likelihood of an occurrence of an epileptic seizure based on the response field potentials.

111. The system of claim 100, wherein the system includes a lead having the one or more electrodes.

112. The system of claim 100, wherein the signal processor/generator is encased in an implantable housing.

113. A system comprising:

means for delivering electrical stimuli to a structure of a brain;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for analyzing the sensed response field potentials to predict the likelihood of occurrence, of a neurological disorder; and

means for storing the sensed response field potentials.

114. The system of claim 113 wherein the means for storing sensed response field potentials comprises means for storing raw sensed response field potentials.

115. The system of claim 113, wherein the means for delivering stimuli to the structure includes means for delivering stimuli having a pulse pattern to the structure.

116. The system of claim 115, wherein the means for delivering stimuli having the pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

117. The system of claim 116, wherein the means for sensing response field potentials include means for sensing the response field potentials from a first location and a section location within the brain, and wherein the means for measuring the change includes:

means for measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

means for determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

118. The system of claim 117, wherein the means for analyzing the sensed response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

119. The system of claim 117, wherein the means for analyzing the sensed response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

120. The system of claim 116, including means for delivering a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

121. The system of claim 113, wherein the means for analyzing the sensed response field potentials includes means for analyzing the sensed response field potentials pulses to predict the likelihood of occurrence of an epileptic seizure.

122. A system comprising:

means for implanting one or more electrodes in a structure of a brain;

means for delivering electrical stimuli to the structure through the electrodes;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for processing the response field potentials to predict the likelihood of occurrence of a neurological disorder based on the sensed response field potentials; and

means for storing the response field potentials.

123. The system of claim 122 wherein the means for storing the response field potentials comprises means for storing raw response field potentials.

124. The system of claim 122, wherein means for implanting one or more electrodes includes means for implanting a lead that includes the one or more electrodes in the structure of the brain.

125. The system of claim 122, where the means for delivering stimuli includes means for delivering stimuli having a first pulse pattern.

126. The system of claim 125, wherein the means for delivering stimuli having the first pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

127. The system of claim 126, wherein the means for sensing response field potentials include means for sensing the response field potentials from a first location and a section location within the brain;

and wherein the means for measuring the change includes;

means for measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

means for determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

128. The system of claim 127, wherein the means for processing the response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

129. The system of claim 127, wherein the means for processing the response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

130. The system of claim 126, including means for delivering a therapy for the neurological disorder when the change in the response field potential exceeds a threshold value.

131. The system of claim 122, wherein the means for processing the response field potentials includes means for identifying the occurrence of an epileptic seizure based on the sensed response field potentials.

132. A system comprising:

one or more electrode means implantable in a structure of a brain;

a signal processor/generator means coupled to the electrode means, wherein the signal generator means includes;

an electrical pulse generator means to deliver electrical stimuli to the brain via the electrode means implanted in the structure of the brain;

a signal analyzer means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the signal analyzer means receives response field potentials through the electrode means and predicts the likelihood of the occurrence of a neurological disorder based on the sensed response field potentials; and

a storage means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the storage means receives response field potentials through the electrode means and stores the response field potentials.

133. The system of claim 132 wherein the storage means stores raw response field potentials.

134. The system of claim 132, wherein the electrical pulse generator means delivers stimuli having a first pulse pattern.

135. The system of claim 134, wherein the electrical pulse generator means delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal analyzer means measures changes in the response field potentials to the second pulse as compared to the response field potentials to the first pulse.

136. The system of claim 135, wherein the signal analyzer means measures the field potential of the response field potentials received from a first location and a section location within the brain, and determines a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

137. The system of claim 136, wherein the signal analyzer means indicates a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

138. The system of claim 136, wherein the signal analyzer means indicates a likely epileptic event when the level of functional interconnectivity has a negative slope.

139. The system of claim 135, wherein the electrical pulse generator means delivers a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

140. The system of claim 132, wherein the signal analyzer means indicates the likelihood of an occurrence of an epileptic seizure based on the response field potentials.

141. The system of claim 132, wherein the system includes lead means having the one or more electrodes.

142. The system of claim 132, wherein the signal processor/generator means is encased in an implantable housing means.