ANALYZING A STIMULATION PERIOD CHARACTERISTIC FOR PSYCHIATRIC DISORDER THERAPY DELIVERY

• US 20090264955A1
• Filed: 04/17/2009
• Published: 10/22/2009
• Est. Priority Date: 04/18/2008
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Stypulkowski, Paul H., Giftakis, Jonathon E., Denison, Timothy J., Rise, Mark T.
• Application Number:
  US12/425,859
• Publication Number:
  US 20090264955A1
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A characteristic of a stimulation period, which occurs during the delivery of stimulation therapy to a patient according to a therapy program, may be determined based on a physiological parameter of the patient. The stimulation period characteristic may include, for example, an amplitude or a trend in a physiological signal during the stimulation period or a power level or a ratio of power levels in frequency bands of the physiological signal. In some embodiments, stimulation period characteristics associated with a plurality of therapy programs may be used to compare the programs. In other embodiments, a stimulation period characteristic may be used to determine a mood state of the patient and, in some cases, modify a therapy program.

Claims

1. A method comprising:

delivering therapy to a patient according to a therapy program during a stimulation period, wherein the therapy program defines a value for at least one therapy parameter for managing a psychiatric condition of the patient;

monitoring a physiological signal of the patient during the stimulation period, wherein the physiological signal is indicative of a patient mood state;

automatically determining a characteristic of the stimulation period based on the monitored physiological signal;

determining a patient mood state based on the characteristic of the stimulation period; and

associating the patient mood state with the therapy program in a memory.

2. The method of claim 1, wherein the characteristic of the stimulation period comprises an amplitude of the physiological signal during the stimulation period, a trend in the physiological signal during the stimulation period, a power level in a frequency band of the physiological signal, a ratio of power levels in two or more frequency bands of the physiological signal during the stimulation period or a change in the physiological signal relative to a baseline state during the stimulation period.

3. The method of claim 1, wherein delivering the therapy to the patient comprises delivering electrical stimulation to a target tissue site within a brain of the patient.

4. The method of claim 1, wherein monitoring a physiological signal of the patient comprises monitoring at least one of a brain signal, heart rate, respiratory rate, electrodermal activity, facial electromyogram or thermal activity of the patient.

5. The method of claim 1, wherein delivering therapy to the patient comprises delivering therapy to the patient according to a plurality of therapy programs, monitoring the physiological signal of the patient comprises monitoring the physiological signal during the delivery of therapy according to each of the therapy programs, and automatically determining the characteristic of the stimulation period comprises automatically determining the characteristic of the stimulation period for each therapy program based on a respective monitored physiological signal, the method further comprising ordering the plurality of therapy programs based on the characteristics of the respective stimulation periods.

6. The method of claim 5, wherein the stimulation period characteristic comprises a first metric, the method further comprising, for each of the therapy programs:

determining a second metric comprising at least one of an efficacy rating, a mood indicator, an anxiety indicator, a patient energy level, a mood improvement rating, side effects rating, a washout period characteristic or a power usage rating; and

determining a composite metric including the first metric and the second metric.

7. The method of claim 6, wherein determining the composite metric comprises assigning weights to the first and second metrics.

8. The method of claim 6, wherein ordering the plurality of therapy programs based on the characteristics of the respective stimulation periods comprises ordering the plurality of therapy programs based on the composite metrics.

9. The method of claim 1, wherein determining the patient mood state based on the characteristic of the stimulation period comprises comparing the characteristic to a threshold value or comparing the characteristic to a trend template and determining the patient mood state based on the comparison, wherein the threshold value and trend templates are associated with the patient mood state.

10. The method of claim 1, further comprising modifying the therapy program value based on the determined patient mood state.

11. The method of claim 1, wherein determining the patient mood state based on the characteristic of the stimulation period comprises receiving input from the patient indicative of the patient mood state, and associating the patient mood state with the characteristic of the stimulation period in the memory.

12. The method of claim 11, further comprising associating the characteristic of the stimulation period with a mood state probability based on the information indicative of the patient mood state.

13. A system comprising:

a memory;

a sensor that generates a signal as a function of at least one physiological parameter indicative of a mood state of a patient;

a medical device that delivers therapy to the patient according to a therapy program to manage a psychiatric condition during a stimulation period, wherein the therapy program defines a value for at least one therapy parameter; and

a processor that monitors the signal during the stimulation period, automatically determines a characteristic of the stimulation period based on the signal, determines a patient mood state based on the characteristic of the stimulation period, and associates the patient mood state with the therapy program in the memory.

14. The system of claim 13, further comprising a medical device programmer, wherein the programmer comprises the processor.

15. The system of claim 13, wherein the medical device comprises the processor.

16. The system of claim 13, wherein the physiological parameter comprises at least one of a brain signal, heart rate, respiratory rate, electrodermal activity, facial electromyogram or thermal activity of the patient.

17. The system of claim 13, wherein the characteristic of the stimulation period comprises an amplitude of the physiological signal during the stimulation period, a trend in the physiological signal during the stimulation period, a power level in a frequency band of the physiological signal or a ratio of power levels in two or more frequency bands of the physiological signal during the stimulation period.

18. The system of claim 13, wherein the medical device delivers therapy to the patient according to a plurality of therapy programs, and for each of the therapy programs, the processor monitors the physiological parameter of the patient during the stimulation period and automatically determines the characteristic of the stimulation period, wherein the processor orders the plurality of therapy programs based on the characteristics of the respective stimulation periods.

19. The system of claim 18, wherein the characteristic of the stimulation period comprises a first metric, and the system further comprises a user input mechanism, wherein, for each of the therapy programs, the processor receives a second metric comprising at least one of an efficacy rating, a mood indicator, an anxiety indicator, a patient energy level, a mood improvement rating, side effects rating, or a power usage rating and determines a composite metric including the first and second metrics.

20. The system of claim 19, wherein the processor receives user input selecting at least one of the first, second or composite metrics, and the processor orders the plurality of therapy programs based on selected metric.

21. The system of claim 13, wherein the processor receives information indicative of a patient mood state and associates the patient mood state with the characteristic of the stimulation period in the memory.

22. The system of claim 13, wherein the processor determines the patient mood state by at least receiving input from the patient indicative of the patient mood state, wherein the patient mood state is associated with the characteristic of the stimulation period in the memory.

23. A system comprising:

a memory;

means for delivering therapy to a patient according to a therapy program during a stimulation period, wherein the therapy program defines a value for at least one therapy parameter for managing a psychiatric condition of the patient;

means for monitoring a physiological signal of the patient during the stimulation period, wherein the physiological signal is indicative of a patient mood state;

means for automatically determining a characteristic of the stimulation period based on the monitored physiological signal;

means for determining a patient mood state based on the characteristic of the stimulation period; and

means for associating the patient mood state with the therapy program in the memory

24. The system of claim 23, wherein the means for delivering therapy to the patient delivers therapy to the patient according to a plurality of therapy programs, the means for monitoring the physiological signal of the patient monitors the physiological signal during the delivery of therapy according to each of the therapy programs, and the means for automatically determining the characteristic of the stimulation period automatically determines the characteristic of the stimulation period for each therapy program based on a respective monitored physiological signal, the system further comprising means for ordering the plurality of therapy programs based on the characteristics of the respective stimulation periods.