Positioning system for neurological procedures in the brain

• US 20040049121A1
• Filed: 09/06/2002
• Published: 03/11/2004
• Est. Priority Date: 09/06/2002
• Status: Abandoned Application

• Current Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Yaron, Uri
• Application Number:
  US10/236,437
• Publication Number:
  US 20040049121A1
• Time in Patent Office: Days
• US Class Current: 600/544
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/501 for diagnosis of the head, e.g. neuroimaging or craniography
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition

Abstract

Apparatus for use in a brain of a subject is provided, including an instrument, adapted to be inserted into the brain. A set of one or more electrodes, coupled to the instrument, are adapted to sense electrical activity of the brain and to transmit an electrical activity signal responsive thereto. A location sensor, adapted to be coupled to the instrument transmits a location signal indicative of a location of the instrument. A control unit, analyzes the electrical activity signal and the location signal. The control unit determines, responsive to the analysis, a position of the instrument with respect to an image of the brain, and electrophysiological information regarding tissue at the position.

Claims

1. Apparatus for use in a brain of a subject, comprising:

an instrument, adapted to be inserted into the brain;

a set of one or more electrodes, adapted to be coupled to the instrument, and adapted to sense electrical activity of the brain and to transmit an electrical activity signal responsive thereto;

a location sensor, adapted to be coupled to the instrument and to transmit a location signal indicative of a location of the instrument; and

a control unit, adapted to analyze the electrical activity signal and the location signal, and adapted to determine, responsive to the analysis, a position of the instrument with respect to an image of the brain, and electrophysiological information regarding tissue at the position.

2. Apparatus according to claim 1, wherein the instrument is adapted to be guided to a target location in the brain responsive to the electrophysiological information and the determined position of the instrument.

3. Apparatus according to claim 1, wherein the control unit is adapted to create an electrical map indicating at least two physiological regions of the brain, responsive to the electrical activity signal and the location signal.

4. Apparatus according to claim 1, wherein the location sensor is adapted to transmit the location signal by wireless communication.

5. Apparatus according to claim 1, wherein at least one of the electrodes is adapted to be coupled to a distal tip of the instrument.

6. Apparatus according to claim 1, wherein the location sensor is adapted to be coupled near a distal tip of the instrument.

7. Apparatus according to claim 1, wherein the location sensor is adapted to be coupled to a proximal end of the instrument.

8. Apparatus according to claim 1, wherein the instrument is adapted to facilitate a fetal neural implant, responsive to the control unit determining the electrophysiological information regarding the tissue at the position.

9. Apparatus according to claim 1, wherein the control unit is adapted to determine the position of the instrument with respect to an image of the brain acquired prior to insertion of the instrument into the brain.

10. Apparatus according to claim 1, wherein the control unit is adapted to determine the position of the instrument with respect to an image of the brain acquired while the instrument is in the brain.

11. Apparatus according to claim 1, wherein the image of the brain includes a CT scan, and wherein the control unit is adapted to determine the position of the instrument with respect to the CT scan.

12. Apparatus according to claim 1, wherein the image of the brain includes an MRI image, and wherein the control unit is adapted to determine the position of the instrument with respect to the MRI image.

13. Apparatus according to claim 1, wherein the control unit is adapted to register one or more identifiable anatomical features in the image, and to correlate the position of the instrument with the image responsive to the registration.

14. Apparatus according to claim 1, wherein the instrument comprises a delivery element, adapted to deliver a pharmaceutical at a target location responsive to the electrical signal and the location signal.

15. Apparatus according to claim 1, wherein the location sensor comprises an electromagnetic transducer.

16. Apparatus according to claim 15, comprising one or more external electromagnetic radiators, adapted to be located at respective positions external to the subject and to transmit energy towards the location sensor.

17. Apparatus according to claim 1, wherein the location sensor comprises an ultrasound transducer.

18. Apparatus according to claim 17, comprising one or more external ultrasound transducers, adapted to be located at respective positions external to the subject, and to transmit ultrasound energy towards the location sensor.

19. Apparatus according to claim 1, comprising a diagnostic element coupled to the instrument.

20. Apparatus according to claim 1, wherein the instrument comprises a catheter.

21. Apparatus according to claim 20, wherein the catheter comprises a vascular catheter, adapted to be guided responsive to the location signal to a target location in the brain, through cerebral vasculature of the subject.

22. Apparatus according to claim 20, wherein the catheter is adapted to be guided responsive to the location signal to a target location in the brain through a venous circulation of the brain and subsequently through tissue of the brain.

23. Apparatus according to claim 1, comprising a stereotactic frame which is adapted to be fixed to a head of the subject, wherein the control unit determines the position of the instrument with respect to the frame.

24. Apparatus according to claim 1, comprising a current-driving electrode, adapted to be placed by the instrument at a target location of the brain and to apply a therapeutic current to the target location.

25. Apparatus according to claim 24, wherein the control unit is adapted to drive the current-driving electrode to apply the therapeutic current.

26. Apparatus according to claim 24, wherein the current-driving electrode is adapted to apply Deep Brain Stimulation therapy to the target location.

27. Apparatus according to claim 24, wherein the current-driving electrode is adapted to apply current configured for treatment of a motor disorder.

28. Apparatus according to claim 24, wherein the current-driving electrode is adapted to apply current configured for treatment of a mental disorder.

29. Apparatus according to claim 24, wherein the current-driving electrode is adapted to apply current configured for performing ablation at the target location.

30. Apparatus according to claim 29, wherein the current-driving electrode is adapted to apply current configured for performing thalamotomy at the target location.

31. Apparatus according to claim 29, wherein the current-driving electrode is adapted to apply current configured for performing pallidotomy at the target location.

32. Apparatus according to claim 24, wherein the current-driving electrode is adapted for long-term implantation in the brain.

33. A method for performing a medical procedure in a brain of a subject, comprising:

inserting an instrument into the brain;

sensing electrical activity of the brain in a vicinity of an electrical-activity sensing site on the instrument, and transmitting an electrical activity signal responsive thereto;

sensing, at a location-sensing site on the instrument, a location of the instrument, and transmitting a location signal responsive thereto;

determining, responsive to the location signal, a position of the instrument with respect to an image of the brain; and

determining, responsive to the electrical activity signal and the determination of the position, electrophysiological information regarding tissue at the position.

34. A method according to claim 33, including guiding the instrument to a target location in the brain responsive to the electrophysiological information and the determined position of the instrument.

35. A method according to claim 33, including creating an electrical map indicating at least two physiological regions of the brain, responsive to the electrical activity signal and the location signal.

36. A method according to claim 33, wherein transmitting the location signal includes transmitting the location signal by wireless communication.

37. A method according to claim 33, wherein transmitting the location signal includes sensing the location of the instrument near a distal tip of the instrument.

38. A method according to claim 33, including performing a fetal neural implant in a vicinity of the tissue, responsive to determining the electrophysiological information regarding the tissue.

39. A method according to claim 33, wherein determining the position of the instrument includes determining the position with respect to an image of the brain acquired prior to insertion of the instrument into the brain.

40. A method according to claim 33, wherein determining the position of the instrument includes determining the position with respect to an image of the brain acquired while the instrument is in the brain.

41. A method according to claim 33, wherein determining the position of the instrument includes determining the position with respect to a CT scan.

42. A method according to claim 33, wherein determining the position of the instrument includes determining the position with respect to an MRI image.

43. A method according to claim 33, wherein determining the position of the instrument includes registering one or more identifiable anatomical features in the image, and correlating the position of the instrument with the image responsive to the registration.

44. A method according to claim 33, including delivering a pharmaceutical in a vicinity of the tissue responsive to determining the electrophysiological information regarding the tissue.

45. A method according to claim 33, wherein sensing the location includes sensing an electromagnetic field in a vicinity of the location-sensing site.

46. A method according to claim 45, including radiating electromagnetic energy from a source external to the subject towards the location-sensing site.

47. A method according to claim 33, wherein sensing the location includes sensing ultrasound energy in a vicinity of the location-sensing site.

48. A method according to claim 47, including radiating ultrasound energy from a source external to the subject towards the location-sensing site.

49. A method according to claim 33, including facilitating a diagnostic procedure in a vicinity of the tissue, responsive to determining the electrophysiological information regarding the tissue.

50. A method according to claim 33, wherein inserting the instrument includes guiding a vascular catheter to a target location in the brain through cerebral vasculature of the subject, responsive to determining the position of the instrument.

51. A method according to claim 50, wherein guiding the catheter includes guiding the catheter to a target location in the brain through a venous circulation of the brain and subsequently through tissue of the brain.

52. A method according to claim 33, wherein determining the position of the instrument includes determining the position of the instrument with respect to a stereotactic frame which is fixed to a head of the subject.

53. A method according to claim 33, including applying a therapeutic current to a target location of the brain, responsive to determining the electrophysiological information.

54. A method according to claim 53, wherein applying the therapeutic current includes driving the current from a source located external to the subject.

55. A method according to claim 53, wherein applying the therapeutic current includes configuring the therapeutic current for application of Deep Brain Stimulation therapy to the target location.

56. A method according to claim 53, wherein applying the therapeutic current includes configuring the therapeutic current for treatment of a motor disorder.

57. A method according to claim 53, wherein applying the therapeutic current includes configuring the therapeutic current for treatment of a mental disorder.

58. A method according to claim 53, wherein applying the therapeutic current includes configuring the therapeutic current for performing ablation at the target location.

59. A method according to claim 58, wherein configuring the current includes configuring the current for performing thalamotomy at the target location.

60. A method according to claim 58, wherein configuring the current includes configuring the current for performing pallidotomy at the target location.

61. A method according to claim 53, wherein applying the therapeutic current includes driving the therapeutic current from a current-driving electrode implanted in the brain.