AUTOMATED PROGRAMMING OF ELECTRICAL STIMULATION ELECTRODES USING POST-IMPLANT IMAGING

• US 20090198306A1
• Filed: 01/23/2009
• Published: 08/06/2009
• Est. Priority Date: 01/31/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Dewing, Wende L.
• Granted Patent: US 8,862,240 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: G06T 2207/10116 X-ray image
• CPC Class Codes: G06T 2207/30052 Implant; Prosthesis
• CPC Class Codes: G06T 2207/30196 Human being; Person
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/73 using feature-based methods

Abstract

In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Claims

1. A method comprising:

obtaining an analysis of an electronic image of an electrical stimulation lead implanted within a patient, wherein the lead includes one or more electrodes; and

automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the analysis.

2. The method of claim 1, wherein the adjustment includes an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via the lead.

3. The method of claim 1, wherein the adjustment includes an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via the lead.

4. The method of claim 1, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, the method further comprising:

determining a configuration of the leads based on the analysis,

wherein automatically generating an adjustment comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the configuration of the leads.

5. The method of claim 4, wherein the configuration includes types of at least some of the leads, orientations of at least some the leads within the patient, and relative positions of at least some of the electrodes.

6. The method of claim 5, wherein the configuration further includes at least one of a shape and surface area of at least some of the electrodes.

7. The method of claim 4, wherein the configuration includes relative positions of at least some of the electrodes, and wherein automatically generating an adjustment comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the relative positions of at least some of the electrodes.

8. The method of claim 4, wherein analyzing comprises analyzing a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and automatically generating an adjustment comprises automatically generating the adjustment based on a difference between the first and second images.

9. The method of claim 1, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, and wherein analyzing comprises analyzing a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, the method further comprising automatically generating an indication of lead migration based on a difference between the first and second images.

10. The method of claim 1, further comprising:

analyzing a first electronic image of an electrical stimulation lead implanted within a patient when the patient is in a first posture;

analyzing a second electronic image of an electrical stimulation lead implanted within a patient when the patient is in a second posture;

automatically generating adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the first posture based on the analysis of the first image; and

automatically generating adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the second posture based on the analysis of the second image.

11. The method of claim 1, further comprising:

determining a relationship of at least some of the electrodes relative to one or more anatomical structures within the patient based on the analysis; and

automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the analysis and the determined relationship.

12. The method of claim 1, wherein automatically generating an adjustment comprises automatically generating an initial setting of one or more electrical stimulation therapy parameters.

13. The method of claim 1, wherein automatically generating an adjustment comprises automatically modifying one or more existing electrical stimulation therapy parameters.

14. The method of claim 1, further comprising automatically applying the adjustment to electrical stimulation therapy delivered via the lead.

15. The method of claim 1, further comprising applying the adjustment upon user approval.

16. The method of claim 1, further comprising automatically generating a programming search sequence for electrode combinations for delivery of electrical stimulation therapy based on the analysis, wherein automatically generating an adjustment to electrical stimulation therapy comprises automatically generating the adjustment to electrical stimulation therapy based on the generated programming search sequence.

17. The method of claim 1, further comprising automatically inhibiting selection of particular electrode combinations for delivery of electrical stimulation therapy based on the analysis, wherein automatically generating an adjustment to electrical stimulation therapy comprises automatically generating the adjustment to electrical stimulation therapy based on the inhibited selection of particular electrode combinations.

18. The method of claim 1, further comprising determining one or more inter-electrode distances based upon the analysis, and wherein automatically generating an adjustment to electrical stimulation therapy delivered via the lead comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the one or more inter-electrode distances.

19. The method of claim 1, further comprising determining one or more electrode sizes based upon the analysis, and wherein automatically generating an adjustment to electrical stimulation therapy delivered via the lead comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the one or more electrode sizes.

20. The method of claim 1, further comprising determining one or more inter-electrode sizes based upon the analysis, and wherein automatically generating an adjustment to electrical stimulation therapy delivered via the lead comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the one or more inter-electrode sizes.

21. A device comprising:

an image analysis interface that obtains an analysis of an electronic image of an electrical stimulation lead implanted within a patient, wherein the lead includes one or more electrodes; and

a programming unit that automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the analysis.

22. The device of claim 21, wherein the adjustment includes an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via the lead.

23. The device of claim 21, wherein the adjustment includes an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via the lead.

24. The device of claim 21, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, wherein the image analysis interface obtains a configuration of the leads based on the analysis, wherein the programming unit automatically generates an adjustment comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the configuration of the leads.

25. The device of claim 24, wherein the configuration includes types of at least some of the leads, orientations of at least some the leads within the patient, and relative positions of at least some of the electrodes.

26. The device of claim 25, wherein the configuration further includes at least one of a shape and surface area of at least some of the electrodes.

27. The device of claim 24, wherein the configuration includes relative positions of at least some of the electrodes, and wherein the programming unit automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the relative positions of at least some of the electrodes.

28. The device of claim 24, wherein the analysis comprises analysis of a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and the programming unit automatically generates the adjustment based on a difference between the first and second images.

29. The device of claim 21, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, the analysis comprises analysis of a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and the programming unit automatically generates an indication of lead migration based on a difference between the first and second images.

30. The device of claim 21, wherein the analysis includes analysis of a first electronic image of an electrical stimulation lead implanted within a patient when the patient is in a first posture, and analysis of a second electronic image of an electrical stimulation lead implanted within a patient when the patient is in a second posture, and wherein the programming unit automatically generates adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the first posture based on the analysis of the first image, and automatically generates adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the second posture based on the analysis of the second image.

31. The device of claim 21, wherein the interface obtains a determination of a relationship of at least some of the electrodes relative to one or more anatomical structures within the patient, and the programming unit automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the analysis and the determined relationship.

32. The device of claim 21, wherein automatically generation of an adjustment comprises automatically generation of an initial setting of one or more electrical stimulation therapy parameters.

33. The device of claim 21, wherein automatically generation of an adjustment comprises automatic modification of one or more existing electrical stimulation therapy parameters.

34. The device of claim 21, wherein the programming unit automatically applies the adjustment to electrical stimulation therapy delivered via the lead.

35. The device of claim 21, wherein the programming unit applies the adjustment upon user approval.

36. The device of claim 21, wherein the programming unit automatically generates a programming search sequence for electrode combinations for delivery of electrical stimulation therapy based on the analysis, wherein the programming unit automatically generates an adjustment to electrical therapy based on the generated programming search sequence.

37. The device of claim 21, where in the programming unit automatically inhibits selection of particular electrode combinations for delivery of electrical stimulation therapy based on the analysis, wherein the programming unit automatically generating an adjustment to electrical stimulation therapy based on the inhibited selection of particular electrode combinations.

38. The device of claim 21, wherein the programming unit determines one or more inter-electrode distances based upon the analysis, and wherein the programming unit automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the one or more inter-electrode distances.

39. The device of claim 21, wherein the programming unit determines one or more electrode sizes based upon the analysis, and wherein the programming unit automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the one or more electrode sizes.

40. The device of claim 21, wherein the programming unit determines one or more inter-electrode sizes based upon the analysis, and wherein the programming unit automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the one or more inter-electrode sizes.

41. A system comprising:

an image capture device that obtains an electronic image of an electrical stimulation lead implanted within a patient, wherein the lead includes one or more electrodes;

an image analysis device that analyzes the electronic image of the electrical stimulation lead; and

a programming device that automatically generates an adjustment to electrical stimulation therapy delivered by an electrical stimulation device via the lead based on the analysis.

42. The system of claim 41, wherein the adjustment includes an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via the lead.

43. The system of claim 41, wherein the adjustment includes an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via the lead.

44. The system of claim 41, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, wherein the image analysis device determines a configuration of the leads based on the analysis, and wherein the programming device automatically generates the adjustment to electrical stimulation therapy delivered via the lead based on the configuration of the leads.

45. The system of claim 44, wherein the configuration includes types of at least some of the leads, orientations of at least some the leads within the patient, and relative positions of at least some of the electrodes.

46. The system of claim 44, wherein the configuration includes relative positions of at least some of the electrodes, and wherein the programming device automatically generates the adjustment to electrical stimulation therapy delivered via the lead based on the relative positions of at least some of the electrodes.

47. The system of claim 44, wherein the image analysis device analyzes a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and the programming device automatically generates the adjustment based on a difference between the first and second images.

48. The system of claim 41, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, the image analysis device analyzes a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and the programming device automatically generates an indication of lead migration based on a difference between the first and second images.

49. The system of claim 41, wherein the analysis device analyzes a first electronic image of an electrical stimulation lead implanted within a patient when the patient is in a first posture, and analyzes a second electronic image of an electrical stimulation lead implanted within a patient when the patient is in a second posture, and wherein the programming device automatically generates adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the first posture based on the analysis of the first image, and automatically generates adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the second posture based on the analysis of the second image.

50. The system of claim 41, wherein the image analysis device determines a relationship of at least some of the electrodes relative to one or more anatomical structures within the patient, and the programming device automatically generates an adjustment to electrical stimulation therapy delivered via the lead based on the analysis and the determined relationship.

51. A system comprising:

means for obtaining an analysis of an electronic image of an electrical stimulation lead implanted within a patient, wherein the lead includes one or more electrodes; and

means for automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the analysis.

52. The system of claim 51, wherein the adjustment includes an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via the lead.

53. The system of claim 51, wherein the adjustment includes an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via the lead.

54. The system of claim 51, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, the system further comprising:

means for determining a configuration of the leads based on the analysis,

wherein automatically generating an adjustment comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the configuration of the leads.

55. The system of claim 54, wherein the configuration includes types of at least some of the leads, orientations of at least some the leads within the patient, and relative positions of at least some of the electrodes.

56. The system of claim 55, wherein the configuration further includes at least one of a shape and surface area of at least some of the electrodes.

57. The system of claim 54, wherein the configuration includes relative positions of at least some of the electrodes, and wherein automatically generating an adjustment comprises automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the relative positions of at least some of the electrodes.

58. The system of claim 54, wherein the means for analyzing comprises means for analyzing a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, and the means for automatically generating an adjustment comprises means for automatically generating the adjustment based on a difference between the first and second images.

59. The system of claim 51, wherein the electronic image includes an electronic image of a plurality of electrical stimulation leads implanted within the patient, and

wherein the means for analyzing comprises means for analyzing a first electronic image of the electrical stimulation lead obtained at a first time relative to a second electronic image of the electrical stimulation lead obtained at a second time, the system further comprising means for automatically generating an indication of lead migration based on a difference between the first and second images.

60. The system of claim 59, further comprising:

means for analyzing a first electronic image of an electrical stimulation lead implanted within a patient when the patient is in a first posture;

means for analyzing a second electronic image of an electrical stimulation lead implanted within a patient when the patient is in a second posture;

means for automatically generating adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the first posture based on the analysis of the first image; and

means for automatically generating adjustments to electrical stimulation therapy configured for delivery via the lead when the patient is in the second posture based on the analysis of the second image.

61. The system of claim 59, further comprising:

means for determining a relationship of at least some of the electrodes relative to one or more anatomical structures within the patient based on the analysis; and

means for automatically generating an adjustment to electrical stimulation therapy delivered via the lead based on the analysis and the determined relationship.

62. A computer-readable medium comprising instructions to cause one or more processors to:

obtain an analysis of an electronic image of an electrical stimulation lead implanted within a patient, wherein the lead includes one or more electrode; and

automatically generate an adjustment to electrical stimulation therapy delivered via the lead based on the analysis.