Closed-loop feedback for steering stimulation energy within tissue

• US 20090118787A1
• Filed: 11/02/2007
• Published: 05/07/2009
• Est. Priority Date: 11/02/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Advanced Bionics Corporation (Sonova Holding AG)
• Inventors: Peterson, David K.L., Moffitt, Michael Adam, Meadows, Paul Milton
• Granted Patent: US 9,248,280 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/36189 using modulation techniques
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

Methods, systems, and external programmers provide therapy to a patient having a dysfunction. In one aspect, electrical energy is conveyed between electrodes to create a stimulation region in tissue adjacent the electrodes. Physiological information from the patient is acquired and analyzed, and a locus of the stimulation region is electronically displaced relative to the tissue based on the analysis of the acquired physiological information. In another aspect, electrical energy is delivered to tissue of the patient in accordance with one or more stimulation parameters. A cognitive brain signals is sensed and analyzed, and the stimulation parameter(s) are modified based on the analysis of the cognitive brain signal.

Claims

1. A method of providing therapy to a patient, comprising:

conveying electrical energy between electrodes to create a stimulation region in tissue adjacent the electrodes;

acquiring physiological information from the patient;

analyzing the physiological information; and

automatically displacing a locus of the stimulation region relative to the tissue based on the analysis of the acquired physiological information.

2. The method of claim 1, wherein the tissue is brain tissue.

3. The method of claim.2, wherein the brain tissue is cortical brain tissue.

4. The method of claim 1, wherein the patient suffers from a dysfunction, and the electrical energy is conveyed between the electrodes to change the status of the dysfunction.

5. The method of claim 4, wherein the dysfunction is a neurological disorder.

6. The method of claim 4, wherein the acquired physiological information is indicative of the changed status of the dysfunction.

7. The method of claim 1, wherein the acquired physiological information is indicative of a desire of the patient to displace the locus of the stimulation region.

8. The method of claim 1, wherein acquiring the physiological information comprises sensing electrical signals with at least one of the electrodes.

9. The method of claim 1, wherein acquiring the physiological information comprises sensing a non-cognitive based brain signal.

10. The method of claim 1, wherein acquiring the physiological information comprising sensing a cognitive based brain signal.

11. The method of claim 1, wherein acquiring the physiological information comprises sensing a physiological end-function.

12. The method of claim 1, wherein the locus of the stimulation region is automatically displaced in response to a change in the acquired physiological information.

13. The method of claim 1, wherein the electrical energy is conveyed between the electrodes in accordance with a single timing channel to create the stimulation region, and the locus of the stimulation region is automatically displaced by modifying an electrode combination for the single timing channel.

14. The method of claim 1, wherein the electrical energy is conveyed between the electrodes in accordance with a single timing channel to create the stimulation region, and the locus of the stimulation region is automatically displaced by shifting electrical current between at least two of the electrodes for the single timing channel.

15. The method of claim 1, wherein the electrical energy is conveyed between the electrodes in accordance with a plurality of timing channels to create the stimulation region, and the locus of the stimulation region is automatically displaced by modifying the relative magnitude of the electrical energy conveyed in accordance with the timing channels.

16. A neurostimulation system, comprising:

a plurality of electrical terminals configured for being electrically coupled to a plurality of electrodes;

output stimulation circuitry configured for conveying electrical energy between the electrodes, thereby creating a stimulation region in tissue of a patient when the electrodes are located adjacent the tissue;

monitoring circuitry configured for acquiring physiological information from the patient; and

control circuitry configured for analyzing the acquired physiological information from the monitoring circuitry and for controlling the output stimulation circuitry to displace a locus of the stimulation region relative to the tissue based on the analysis of the acquired physiological information.

17. The system of claim 16, wherein the output stimulation circuitry is configured for conveying the electrical energy between the electricals to change the status of a dysfunction suffered by the patient, and the acquired physiological information is indicative of the changed status of the dysfunction.

18. The system of claim 16, wherein the acquired physiological information is indicative of a desire of the patient to displace the locus of the stimulation region.

19. The system of claim 16, wherein the monitoring circuitry is configured for acquiring the physiological information by sensing electrical signals at the electrodes.

20. The system of claim 16, wherein the monitoring circuitry is configured for acquiring the physiological information by sensing a non-cognitive based brain signal.

21. The system of claim 16, wherein the monitoring circuitry is configured for acquiring the physiological information by sensing a cognitive based brain signal.

22. The system of claim 16, wherein the monitoring circuitry is configured for acquiring the physiological information by sensing a physiological end-function.

23. The system of claim 16, wherein the control circuitry is configured for automatically controlling the output stimulation circuitry to displace the locus of the stimulation region in response to a change in the acquired physiological information.

24. The system of claim 16, wherein the output stimulation circuitry is configured for conveying the electrical energy between the electrodes in accordance with a single timing channel to create the stimulation region, and the control circuitry is configured for controlling the output stimulation circuitry to displace the locus of the stimulation region by modifying an electrode combination for the single timing channel.

25. The system of claim 16, wherein the output stimulation circuitry is configured for conveying the electrical energy between the electrodes in accordance with a single timing channel to create the stimulation region, and the control circuitry is configured for controlling the output stimulation circuitry to displace the locus of the stimulation region by shifting electrical current between at least two of the electrodes for the single timing channel.

26. The system of claim 16, wherein the output stimulation circuitry is configured for conveying the electrical energy between the electrodes in accordance with a plurality of timing channels to create the stimulation region, and the control circuitry is configured for controlling the output stimulation circuitry to displace the locus of the stimulation region by modifying the relative magnitude of the electrical energy conveyed in accordance with the timing channels.

27. The system of claim 16, further comprising a case, wherein the electrical terminals and output stimulation circuitry are contained in the case to form a neurostimulator.

28. The system of claim 27, wherein the monitoring circuitry is contained within the case.

29. The system of claim 27, wherein the control circuitry is contained within the case.

30. The system of claim 27, wherein the neurostimulator is implantable.

31. An external programmer for a neurostimulator coupled to an array of electrodes between which electrical energy may be conveyed to create a stimulation region within tissue of a patient, comprising:

input circuitry configured for receiving physiological information from a patient;

processing circuitry configured for analyzing the physiological information and automatically generating a series of stimulation parameter sets based on the analysis of the physiological information, the series of stimulation parameter sets corresponding to different loci of the stimulation region relative to the tissue; and

output circuitry configured for transmitting the series of stimulation parameter sets to the neurostimulator.

32. The external programmer of claim 31, wherein the acquired physiological information is indicative of a changed status of a dysfunction suffered by the patient.

33. The external programmer of claim 31, wherein the acquired physiological information is indicative of a desire of the patient to displace the locus of the stimulation region.

34. The external programmer of claim 31, wherein the stimulation parameter sets define different electrode combinations for a single timing channel.

35. The external programmer of claim 31, wherein the stimulation parameter sets define different magnitudes for the electrical current at the same electrode for a single timing channel.

36. The external programmer of claim 31, wherein the stimulation parameter sets define different magnitudes for the electrical energy conveyed between the electrodes for one of a plurality of different timing channels.

37. The external programmer of claim 31, wherein the processing circuitry is configured for generating the stimulation parameter sets in response to changes in the acquired physiological information.

38. The external programmer of claim 31, wherein the output circuitry is telemetry circuitry.

39-64. -64. (canceled)