Using physiological sensor data with an implantable medical device

• US 20070100378A1
• Filed: 10/28/2005
• Published: 05/03/2007
• Est. Priority Date: 10/28/2005
• Status: Active Grant

• Current Assignee: LivaNova USA, Inc. (LivaNova Plc)
• Original Assignee: Cyberonics, Inc
• Inventors: Maschino, Steven
• Granted Patent: US 7,957,796 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method, system, and apparatus for providing an electrical neurostimulation therapy to a neural structure of a patient'"'"'s body using an implantable medical device (IMD). A first electrical signal is provided using the implantable medical device. A first electrical signal is applied to the neural structure. An implanted sensor is provided. A physiological parameter is sensed using the implanted sensor. The physiological parameter is selected from the group consisting of a neurotransmitter parameter, a neurotransmitter breakdown product parameter, a neuropeptide parameter, and a glucocorticoid (GC) parameter. The first electrical signal is modified based upon the sensed physiological parameter to generate a second electrical signal. The second electrical signal is applied to the neural structure.

Claims

1. A method for providing an electrical neurostimulation therapy to a neural structure of a patient'"'"'s body using an implantable medical device (IMD), comprising:

providing a first electrical signal using said implantable medical device;

applying said first electrical signal to said neural structure;

providing an implanted sensor;

sensing a physiological parameter using said implanted sensor, wherein said physiological parameter is selected from the group consisting of a neurotransmitter parameter, a neurotransmitter breakdown product parameter, a neuropeptide parameter, and a glucocorticoid (GC) parameter;

modifying said first electrical signal based upon said sensed physiological parameter to generate a second electrical signal; and

applying said second electrical signal to said neural structure.

2. The method of claim 1, wherein said neurotransmitter parameter is selected from the group consisting of a norepinephrine concentration, a serotonin concentration and a dopamine concentration.

3. The method of claim 1, wherein sensing said physiological parameter comprises sensing at least one of a metabolite, a nucleotide parameter, a neuromodulator parameter, a neuromodulator breakdown product parameter, a peptide parameter, a ligand parameter, an amino acid parameter, a hormone parameter, an enzyme parameter, a parameter of a bloodbome substance, a medication parameter, and a drug level in a portion of a patient'"'"'s body.

4. The method of claim 3, wherein said neurotransmitter parameter comprises at least one of a dopamine parameter, a serotonin parameter, an acetylcholine parameter, a catecholamine parameter, and a nicotinic parameter.

5. The method of claim 3, wherein said peptide parameter comprises at least one of a substance P parameter, a neuropeptide Y parameter, a neurokines parameter, a cytokines parameter, a interleukins parameter, and a lymphokines parameter.

6. The method of claim 3, wherein said enzyme parameter comprises at least one of an adrenoceptor protein kinase parameter, a choline acetyltransferase parameter, and an acetylcholinesterase parameter.

7. The method of claim 3, wherein said hormone parameter comprises at least one of a glucocorticoid (GC) parameter, a serum cortisol parameter, a cortisol parameter, prostaglandin parameter, a cholecystokinin (CCK) parameter, a orexins parameter, a galinin parameter, a corticotrophin releasing hormone (CRH) parameter, and an adrenocorticotropic hormone (ACTH).

8. The method of claim 3, wherein the said amino acid parameter comprises at least one of a glutamate parameter, a gamma-aminobutyric acid (GABA) parameter, and a glycine parameter.

9. The method of claim 3, wherein said nucleotide parameter comprises at least one of a adenosine triphosphate (ATP) parameter and a guanosine triphosphate (GTP) parameter.

10. The method of claim 1, wherein modifying said first electrical signal based upon said sensed physiological parameter comprises modifying at least one of a current magnitude, a pulse width, a frequency, a polarity, an on-time, and an off-time.

11. The method of claim 1, further comprising

comparing said sensed physiological parameter with a predetermined threshold;

and

modifying said first electrical signal based upon said comparing step.

12. A method for providing an electrical neurostimulation therapy to a neural structure using an implantable medical device (IMD), comprising:

providing a first electrical signal comprising a first signal parameter selected from the group consisting of a current magnitude, a pulse width, a pulse period, a frequency, an on-time and an off-time;

applying said first electrical signal to a target portion of a patient'"'"'s body to treat a disorder using an electrode operatively coupled to said implantable medical device;

providing a sensor;

sensing a physiological parameter using said sensor, wherein said physiological parameter is selected from the group consisting of a neurotransmitter parameter, a neurotransmitter breakdown product parameter, a metabolite, a nucleotide parameter, a neuromodulator parameter, a neuromodulator breakdown product parameter, a peptide parameter, an enzyme parameter, a ligand parameter, a norepinephrine parameter, a glucocorticoid (GC) parameter, an amino acid parameter, a hormone parameter, a parameter of a bloodbome substance, a medication parameter, and a drug level in a portion of a patient'"'"'s body;

modifying said first signal parameter based upon said sensed physiological parameter to generate a second electrical signal; and

applying said second electrical signal to said target portion of a patient'"'"'s body.

13. The method of claim 12, wherein:

said neurotransmitter parameter comprises at least one of a dopamine parameter, a serotonin parameter, an acetylcholine parameter, a catecholamine parameter, and a nicotinic parameter;

said peptide parameter comprises at least one of a substance P parameter, a neuropeptide Y parameter, a neurokines parameter, a cytokines parameter, a interleukins parameter, and a lymphokines parameter;

said enzyme parameter comprises at least one of an adrenoceptor protein kinase parameter, a choline acetyltransferase parameter, and an acetylcholinesterase parameter;

said hormone parameter comprises at least one of a glucocorticoid (GC) parameter, a serum cortisol parameter, a cortisol parameter, prostaglandin parameter, a cholecystokinin (CCK) parameter, a orexins parameter, a galinin parameter, a corticotrophin releasing hormone (CRH) parameter, and an adrenocorticotropic hormone (ACTH);

said amino acid parameter comprises at least one of a glutamate parameter, a gamma-aminobutyric acid (GABA) parameter, and a glycine parameter; and

said nucleotide parameter comprises at least one of an adenosine triphosphate (ATP) parameter and a guanosine triphosphate (GTP) parameter;

14. The method of claim 12, wherein applying said first stimulation signal to said portion of a patient'"'"'s body comprises applying said first stimulation to a vagus nerve, the spinal column, the brain stem, a trigeminal nerve, a hypoglossal nerve, and an accessory nerve.

15. The method of claim 12, wherein providing said first stimulation signal to a portion of said patient'"'"'s body to treat a disorder comprises providing said first stimulation to treat at least one of depression, epilepsy, an eating disorder, diabetes, and a heart rhythm disorder.

17. The implantable medical system of claim 15, wherein said sensor is implanted in at least one of a spinal column, the brain stem, the brain, a cranial nerve, a neural tissue, and a gastrointestinal tract of said patient'"'"'s body.

19. The implantable medical system of claim 17, wherein said IMD further comprises:

a stimulation unit operatively coupled to said controller, said stimulation unit to provide said first and said second stimulation signals;

a sensor interface to provide communications with said sensor;

a sensor data processing unit to process data from said sensor, said sensor data processing unit comprising a comparator to compare said physiological data with an corresponding predetermined data, said sensor data processing unit also to correlate said compared value to said first stimulation; and

a communication unit to provide communication with said external unit.

16. An implantable medical system for providing an electrical neurostimulation therapy to a neural structure of a patient'"'"'s body using an implantable medical device (IMD), comprising:

an implantable medical device (IMD) for providing a first electrical signal to a portion of a neural structure to treat a disorder;

an electrode operatively coupled to said IMD, said electrode to deliver said first electrical signal from said IMD to said neural structure; and

a sensor operatively coupled to said IMD, said sensor to sense a physiological parameter, wherein said physiological parameter is selected from the group consisting of a neurotransmitter parameter, a neurotransmitter breakdown product parameter, a neuropeptide parameter, a norepinephrine parameter, and a glucocorticoid (GC) parameter; and

wherein said IMD comprises a controller to change a parameter of said first signal selected from the group consisting of a pulse width, a frequency, a polarity, and an amplitude, based upon said sensed physiological parameter to generate a second electrical signal, and to apply said second electrical signal to said neural structure.

18. The implantable medical system of claim 16, further comprising an external unit, said external unit to provide communications with said IMD.

20. A sensor to provide physiological data to an implantable medical device (IMD) to perform an adaptive stimulation process, said sensor to acquire data indicative of a neurotransmitter parameter in a patient'"'"'s body, said neurotransmitter parameter selected from the group consisting of a neurotransmitter level, a neurotransmitter breakdown product level, a neuropeptide level, a ligand level, an amino acid level, and a change in a glucocorticoid (GC) level in said patient'"'"'s body.

21. The sensor of claim 20, further comprising:

a sensor controller to control an operation performed by said sensor;

a sensing unit to acquire said physiological data;

an analog-to-digital converter to convert an analog format of said physiological data to a digital format of said physiological data; and

a sensor interface to provide communication between said sensor and said IMD.

22. The sensor of claim 20, wherein said sensing unit comprises at least one of:

a neurotransmitter sensor circuit to acquire data relating to an indication of a neurotransmitter level in a target portion of said patient'"'"'s body,

23. The sensor of claim 20 wherein said neurotransmitter level is selected from the group consisting of a norepinephrine concentration, a serotonin concentration and a dopamine concentration.

24. The sensor of claim 20, wherein said chemical data comprises information relating to at least one of a serum cortisol level, a cortisol level, a neuropeptide Y level, an acetylcholine level, a prostaglandins level, a catecholamine level, an adrenoceptorc-protein kinas level, aglutamate level, a nicotinic level, a GABA A level, a GABA B level, a neurokine-a level, a neurokine-3 level, a choline acteytransferanse level, a acetylcholinesterase level, a cytokines level, a cholecystokinin (CCK) level, an orexins level, a galinin level, a medication level, and/or a drug level.

25. The sensor of claim 20, further comprising a sensing element selected from the group consisting of a carbon nanotube array and a microdialysis probe.

26. The sensor of claim 20, wherein said sensor is implanted in at least one of a spinal column, brain stem, brain, a cranial nerve, a volume of neural tissue, and a gastro-intestinal tract of said patient'"'"'s body.