Closed-loop feedback-driven neuromodulation

• US 20060293720A1
• Filed: 06/22/2005
• Published: 12/28/2006
• Est. Priority Date: 08/05/1998
• Status: Active Grant

• Current Assignee: LivaNova USA, Inc. (LivaNova Plc)
• Original Assignee: Cyberonics, Inc
• Inventors: DiLorenzo, Daniel John
• Granted Patent: US 8,762,065 B2
• Time in Patent Office: Days
• US Class Current: 607/42
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A neurological control system for modulating activity of any component or structure comprising the entirety or portion of the nervous system, or any structure interfaced thereto, generally referred to herein as a “nervous system component.” The neurological control system generates neural modulation signals delivered to a nervous system component through one or more neuromodulators, comprising intracranial (IC) stimulating electrodes and other actuators, in accordance with treatment parameters. Such treatment parameters may be derived from a neural response to previously delivered neural modulation signals sensed by one or more sensors, each configured to sense a particular characteristic indicative of a neurological or psychiatric condition.

Claims

1-50. -50. (canceled)

51. A method comprising:

monitoring EEG signals from the patient;

delivering a known stimulation current through the at least a first and second electrical component to stimulate a vagus nerve when the monitored EEG signals are indicative of an undesirable disease state;

measuring a voltage across the at least first and second electrical component; and

calculating an impedance across the at least first and second electrical component based on the known current and the measured voltage.

52. The method of claim 51, wherein calculating the impedance comprises dividing the measured voltage by a magnitude of the known stimulation current.

53. The method of claim 51, wherein monitoring the EEG signals comprises monitoring for epileptic activity.

54. The method of claim 51, wherein monitoring the EEG signals is performed with a neurological device that is adapted to be implantable in a patient.

55. The method of claim 51, wherein delivering the stimulation current comprises delivering a specified amount of the stimulation current regardless of the measured impedance across the at least first or second electrical component.

56. A method of monitoring a complex impedance across a first and second electrical components of a neurological device, comprising:

delivering a current-modulated waveform through a first and second electrical component;

measuring a resultant voltage potential waveform across the first and second electrical component;

calculating a magnitude of the measured voltage potential waveform;

calculating a phase shift of the measured voltage potential waveform; and

calculating the complex impedance between the first and second electrical component based on the calculated magnitudes and phase shift.

57. The method of claim 56, wherein the first and second electrical components are intracranial electrodes that are configured to deliver electrical stimulation to a patient'"'"'s brain.

58. The method of claim 56, wherein the neurological device is implanted in a patient, the method further comprising communicating the calculated complex impedance to a device external to the patient'"'"'s body.

59. A method comprising:

implanting a first and second electrode in a patient'"'"'s body;

coupling a control module to the first and second electrode, wherein the control module is configured to deliver electrical stimulation to a nervous system component through the first and second electrode to manage a patient'"'"'s neurological or psychiatric disorder;

monitoring impedance between the first and second electrode; and

providing an output to at least one of the patient and a health care provider of the monitored electrode impedance.

60. The method of claim 59, further comprising automatically adjusting at least one parameter of the electrical stimulation to compensate for the electrode impedance between the first and second electrode.

61. The method of claim 59, further comprising storing an impedance history information in the control module.

62. The method of claim 60, wherein the control module is implanted in the patient'"'"'s body, wherein providing an output to at least one of the patient and the health care provider comprises wirelessly transmitting a signal that is representative of the impedance history information from the implanted control module to a device that is external to the patient'"'"'s body.

63. The method of claim 59, wherein the first and second electrode are intracranial electrode that are in direct communication with a patient'"'"'s brain, wherein the electrical stimulation is delivered to the patient'"'"'s brain to manage seizures.

64. The method of claim 59, wherein the control module is adapted to monitor EEG signals from the patient and process the EEG signals to predict future symptomatology of the patient.

65. The method of claim 64, wherein the neurological disorder comprises epilepsy and the future symptomatology comprises future seizures.

66. The method of claim 64, wherein the electrical stimulation is delivered to the patient after the prediction of the future symptomatology.

67. The method of claim 64, wherein parameters of the electrical stimulation are based at least on part on the predicted future symptomatology.

68. The method of claim 59, wherein the nervous system component comprises a peripheral nerve, and wherein the first and second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage seizures.

69. The method of claim 68, wherein the peripheral nerve comprises a vagus nerve.

70. The method of claim 59, wherein the nervous system component comprises a peripheral nerve, wherein the plurality of electrodes are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage depression.

71. The method of claim 59, wherein the electrical stimulation comprises a current stimulation comprising known current parameters, wherein monitoring impedance between the first and second electrode comprises:

delivering the current stimulation through the first and second electrode;

measuring a voltage across the first and second electrode; and

calculating the impedance across the first and second electrode based on the known current parameters and the measured voltage.

72. The method of claim 59 wherein the electrical stimulation comprises charge-balanced biphasic waveforms.

73. A method comprising:

implanting a first and second electrode in a patient'"'"'s body;

coupling a control module to the first and second electrodes, wherein the control module is configured to deliver electrical stimulation to a nervous system component through the first and second electrodes to manage a patient'"'"'s neurological or psychiatric disorder;

monitoring for a change of impedance between the first and second electrodes; and

providing an output to at least one of the patient and a health care provider that is indicative of the change to the impedance between the first and second electrodes.

74. The method of claim 73 further comprising automatically adjusting at least one parameter of the electrical stimulation to compensate for the change of impedance between the first and second electrode.

75. The method of claim 73 further comprising storing an impedance history information in the control module.

76. The method of claim 75 wherein the control module is implanted in the patient'"'"'s body, wherein providing an output to at least one of the patient and the health care provider comprises wirelessly transmitting a signal that is representative of at least one of the impedance change and the impedance history information from the implanted control module to a device that is external to the patient'"'"'s body.

77. The method of claim 73 wherein the first and second electrode are intracranial electrode that are in direct communication with a patient'"'"'s brain, wherein the electrical stimulation is delivered to the patient'"'"'s brain to manage seizures.

78. The method of claim 73 wherein the control module is adapted to monitor EEG signals from the patient and process the EEG signals to predict future symptomatology of the patient.

79. The method of claim 78 wherein the neurological disorder comprises epilepsy and the future symptomatology comprises future seizures.

80. The method of claim 78 wherein the electrical stimulation is delivered to the patient after the prediction of the future symptomatology.

81. The method of claim 78 wherein parameters of the electrical stimulation are based at least on part on the predicted future symptomatology.

82. The method of claim 73 wherein the nervous system component comprises a peripheral nerve, and wherein the first and second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage seizures.

83. The method of claim 82 wherein the peripheral nerve comprises a vagus nerve.

84. The method of claim 73 wherein the nervous system component comprises a peripheral nerve, wherein the plurality of electrodes are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage depression.

85. The method of claim 73 wherein the electrical stimulation comprises a current stimulation comprising known current parameters, wherein monitoring impedance between the first and second electrode comprises:

delivering the current stimulation through the first and second electrode;

measuring a voltage across the first and second electrode; and

calculating the impedance across the first and second electrode based on the known current parameters and the measured voltage.

86. The method of claim 73 wherein the electrical stimulation comprises charge-balanced biphasic waveforms.