METHOD AND DEVICE FOR DETECTING AND TREATING DEPRESSION

• US 20070173901A1
• Filed: 01/24/2006
• Published: 07/26/2007
• Est. Priority Date: 01/24/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Reeve, Helen
• Granted Patent: US 7,606,622 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A system is described for detecting and/or treating depression that may be incorporated into an implantable device such as a cardiac rhythm management device. The device may determine that depression is present by analysis of heart rate variability measured using the cardiac sensing channels of the device and/or by detection of blood-borne factors that are associated with depression. If depression is detected, the device may be configured to automatically delivery therapy such as neuromodulation and/or drug delivery.

Claims

1. An implantable device, comprising:

a sensing channel for collecting values of one or more depression parameters that are correlated with depression in a patient;

circuitry for detecting depression based upon the one or more collected depression parameters; and

,

circuitry for causing delivery of anti-depressive therapy when depression is detected.

2. The device of claim 1 further comprising:

a neural channel for delivering neural stimulation; and

,

wherein the circuitry for causing delivery of anti-depressive therapy causes delivery of neural stimulation when depression is detected.

3. The device of claim 1 further comprising:

a delivery device for delivering a dose of medication; and

,

wherein the circuitry for causing delivery of anti-depressive therapy causes delivery of medication when depression is detected.

4. The device of claim 1 further comprising:

a sensing channel for generating an electrogram signal representing electrical activity in a cardiac chamber;

circuitry to measure heart rate and to compute a heart rate variability parameter; and

,

wherein the one or more depression parameters includes the computed heart rate variability parameter.

5. The device of claim 1 further comprising:

circuitry for measuring and collecting time intervals between successive intrinsic beats, referred to as a BB interval, and storing the collected intervals as a discrete BB interval signal, filtering the BB interval signal into defined high and low frequency bands, and determining the signal power of the BB interval signal in each of the low and high frequency bands, referred to LF and HF, respectively; and

,

circuitry for computing a heart rate variability parameter as an LF/HF ratio.

6. The device of claim 1 further comprising:

one or more chemical sensing channels for generating a signal indicative of the concentration of a specific blood-borne marker associated with depression; and

,

wherein the one or more depression parameters includes one or more marker concentrations.

7. The device of claim 1 further comprising:

a neural channel for measuring neural activity at a particular site; and

,

wherein the one or more depression parameters includes the measured neural activity.

8. The device of claim 1 further comprising:

a neural stimulation/sensing channel implemented as a separately implantable satellite unit;

means for allowing the circuitry for detecting depression and the circuitry for causing delivery of anti-depressive therapy to communicate wirelessly with the satellite unit.

9. The device of claim 1 further comprising:

circuitry for mapping a plurality of depression parameters into a depression index; and

,

wherein the circuitry for detecting depression compares the depression index with a specified threshold value.

10. The device of claim 7 wherein the depression index is a weighted sum or average of a number of different parameters associated with depression.

11. A method for treating depression, comprising:

collecting values of one or more depression parameters that are correlated with depression in a patient via one or more sensing channels of an implantable device;

detecting depression based upon the one or more collected depression parameters; and

,

delivering anti-depressive therapy from the implantable device when depression is detected.

12. The method of claim 11 further comprising delivering of neural stimulation when depression is detected.

13. The method of claim 11 further comprising delivering medication from the implantable device when depression is detected.

14. The method of claim 11 further comprising:

generating an electrogram signal representing electrical activity in a cardiac chamber;

measuring heart rate and to compute a heart rate variability parameter; and

,

wherein the one or more depression parameters includes the computed heart rate variability parameter.

15. The method of claim 11 further comprising:

measuring and collecting time intervals between successive intrinsic beats, referred to as a BB interval, and storing the collected intervals as a discrete BB interval signal, filtering the BB interval signal into defined high and low frequency bands, and determining the signal power of the BB interval signal in each of the low and high frequency bands, referred to LF and HF, respectively; and

,

computing a heart rate variability parameter as an LF/HF ratio.

16. The method of claim 11 further comprising:

generating a signal indicative of the concentration of a specific blood-borne marker associated with depression; and

,

wherein the one or more depression parameters includes one or more marker concentrations.

17. The method of claim 11 further comprising:

measuring neural activity at a particular site; and

,

wherein the one or more depression parameters includes the measured neural activity.

18. The method of claim 11 further comprising transmitting an alarm message over a network when depression is detected.

19. The method of claim 11 further comprising:

mapping a plurality of depression parameters into a depression index; and

,

comparing the depression index with a specified threshold value in order to detect depression.

20. The method of claim 17 wherein the depression index is a weighted sum or average of a number of different parameters associated with depression.