STIMULATION ELECTRODE SELECTION

• US 20100100153A1
• Filed: 09/21/2009
• Published: 04/22/2010
• Est. Priority Date: 10/16/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Stanslaski, Scott, Carlson, David, Marks, William J., Denison, Timothy J., Molnar, Gabriela C., Wu, Jianping, Jensen, Randy M.
• Granted Patent: US 8,428,733 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• 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 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Bioelectrical signals may be sensed within a brain of a patient with a plurality of sense electrode combinations. A stimulation electrode combination for delivering stimulation to the patient to manage a patient condition may be selected based on the frequency band characteristics of the sensed signals. In some examples, a stimulation electrode combination associated with the sense electrode combination that sensed a bioelectrical brain signal having a relatively highest relative beta band power level may be selected to deliver stimulation therapy to the patient. Other frequency bands characteristics may also be used to select the stimulation electrode combination.

Claims

1. A method comprising:

sensing a first bioelectrical signal in a brain of a patient with a first sense electrode combination;

sensing a second bioelectrical signal in the brain with a second sense electrode combination that is different than the first sense electrode combination;

determining a frequency domain characteristic of each of the first and second bioelectrical signals;

selecting at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals; and

selecting a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the selected at least one of the first or second sense electrode combinations.

2. The method of claim 1, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations having a higher power level in the frequency band.

3. The method of claim 2, wherein the frequency band comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

4. The method of claim 2, wherein the frequency domain characteristic comprises the power level in the frequency band relative to an overall power of the respective one of the first or second bioelectrical signals.

5. The method of claim 1, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations having a lower power level in the frequency band.

6. The method of claim 1, wherein the frequency domain characteristic comprises a ratio of power levels in one or more frequency bands, a correlation in change of power between one or more frequency bands or a pattern in the power level of one or more frequency bands over time.

7. The method of claim 1, further comprising determining a frequency band of interest, wherein determining the frequency domain characteristic comprises determining the frequency domain characteristic in the frequency band of interest.

8. The method of claim 7, wherein determining the frequency band of interest comprises:

sensing a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition;

sensing a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition;

generating a spectrogram of the third and fourth bioelectrical signals;

determining which frequency bands exhibited a change in power levels between the first and second time periods; and

selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

9. The method of claim 1, further comprising presenting a display to a user, wherein the display indicates the first and second sense electrode combinations and associated frequency domain characteristics.

10. The method of claim 1, wherein the first sense electrode combination is associated with a first stimulation electrode combination and the second sense electrode combination is associated with a second stimulation electrode combination, wherein selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient comprises selecting the first or second stimulation electrode combination associated with the selected at least one of the first or second sense electrode combinations.

11. The method of claim 10, further comprising determining a respective confidence score for the first and second sense electrode combinations, wherein the confidence score indicates a probability that delivery of stimulation via the first and second stimulation electrode combinations, respectively, will provide efficacious therapy for the patient.

12. The method of claim 1, wherein determining the frequency domain characteristic of each of the first and second bioelectrical signals comprises determining first and second frequency domain characteristics for each of the first and second bioelectrical signals.

13. The method of claim 12, wherein the first frequency domain characteristic comprises a first power level of the respective first or second bioelectrical brain signal in a first frequency band, and the second frequency domain characteristic comprises a second power level of the respective first or second bioelectrical brain signal in a second frequency band that is different than the first frequency band.

14. The method of claim 12, wherein the first frequency domain characteristic comprises a first average power level of the respective first or second bioelectrical brain signal in a frequency band over a first time period, and the second frequency domain characteristic comprises a second average power level of the respective first or second bioelectrical brain signal in the frequency band over a second time period.

15. The method of claim 14, wherein the first and second time periods are different.

16. The method of claim 14, wherein the first time period has a longer duration than the second time period.

17. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise substantially the same electrodes.

18. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise at least one different electrode.

19. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations is positioned within the brain of the patient to sense in a first part of the brain and the stimulation electrode combination is positioned to provide electrical stimulation to a second part of the brain of the patient that differs from the first part.

20. The method of claim 19, wherein the first and second parts of the brain partially overlap.

21. The method of claim 1, further comprising:

determining a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination; and

determining a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination,

wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals and the first and second electrical parameter values.

22. A system comprising:

a plurality of electrodes;

a sensing module that senses a first bioelectrical signal in a brain of a patient with a first sense electrode combination comprising a first subset of electrodes of the plurality of electrodes and senses a second bioelectrical signal in the brain with a second sense electrode combination that a second subset of electrodes of the plurality of electrodes different than the first subset of electrodes; and

a processor that determines a frequency domain characteristic of each of the first and second bioelectrical signals, selects at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals, and selects a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the selected at least one of the first or second sense electrode combinations.

23. The system of claim 22, further comprising a memory that stores a plurality of sense electrode combinations and associated stimulation electrode combinations.

24. The system of claim 23, wherein the memory stores at least one of the first and second bioelectrical signals or the frequency domain characteristic of each of the first and second bioelectrical signals.

25. The system of claim 23, wherein the first sense electrode combination is associated with a first stimulation electrode combination and the second sense electrode combination is associated with a second stimulation electrode combination in the memory, wherein the processor selects the stimulation electrode combination for delivering electrical stimulation to the brain of the patient by at least selecting the first or second stimulation electrode combinations associated with the selected at least one of the first or second sense electrode combinations.

26. The system of claim 23, wherein the processor determines a confidence score for each of the stored sense electrode combinations, wherein the confidence score indicates a probability that delivery of stimulation to the patient with the stimulation electrode combination associated with a respective sense electrode combination will provide efficacious therapy for the patient.

27. The system of claim 22, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein the processor selects at least one of the first or second electrode sense combinations by at least selecting the at least one of the first or second sense electrode combinations having a higher power level in the frequency band.

28. The system of claim 27, wherein the frequency band comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

29. The system of claim 27, wherein frequency domain characteristic comprises the power level in the frequency band relative to an overall power of the respective one of the first or second bioelectrical signals.

30. The system of claim 22, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein the processor selects the at least one of the first or second sense electrode combinations by at least selecting the at least one of the first or second sense electrode combinations having a lower power level in the frequency band.

31. The system of claim 22, wherein the frequency domain characteristic comprises a ratio of power levels in two or more frequency bands, a correlation in change of power between two or more frequency bands or a pattern in the power level of one or more frequency bands over time.

32. The system of claim 22, wherein the processor determines a frequency band of interest, the frequency domain characteristic comprises a power level in the frequency band of interest.

33. The system of claim 32, wherein the sensing module senses a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition and senses a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition, wherein the processor determines the frequency band of interest comprises by generating a spectrogram of the third and fourth bioelectrical signals, determining which frequency bands exhibited a change in power levels between the first and second time periods, and selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

34. The system of claim 22, further comprising a medical device programmer including a display, wherein the processor presents the first and second sense electrode combinations and respective frequency domain characteristics to a user via the display.

35. The system of claim 22, wherein the processor determines the frequency domain characteristic of each of the first and second bioelectrical signals by at least determining first and second frequency domain characteristics for each of the first and second bioelectrical signals.

36. The system of claim 35, wherein the first frequency domain characteristic comprises a first power level in a first frequency band, and the second frequency domain characteristic comprises a second power level in a second frequency band that is different than the first frequency band.

37. The system of claim 35, wherein the first frequency domain characteristic comprises a first average power level in a frequency band over a first time period, and the second frequency domain characteristic comprises a second average power level in the frequency band over a second time period.

38. The system of claim 37, wherein the first and second time periods are different.

39. The system of claim 37, wherein the first time period has a longer duration than the second time period.

40. The system of claim 22, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise at least one different electrode.

41. The system of claim 22, wherein the sensing module senses the first or second bioelectrical signal in a first part of the brain with the selected at least one of the first or second sense electrode combinations, respectively, and the stimulation electrode combination is positioned within the brain to provide electrical stimulation to a second part of the brain of the patient that differs from the first part.

42. The system of claim 41, wherein the first and second parts of the brain partially overlap.

43. The system of claim 41, wherein the first and second parts of the brain partially overlap.

44. The system of claim 22, wherein the processor determines a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination, and determines a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination, wherein the processor selects the at least one of the first or second sense electrode combinations by at least selecting the at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals and the first and second electrical parameter values.

45. A system comprising:

means for sensing a first bioelectrical signal in a brain of a patient with a first sense electrode combination;

means for sensing a second bioelectrical signal in the brain with a second sense electrode combination that is different than the first sense electrode combination;

means for determining frequency domain characteristics of the first and second bioelectrical signals;

means for selecting at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals; and

means for selecting a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the selected at least one of the first or second sense electrode combinations.

46. The system of claim 45, further comprising means for determining a frequency band of interest, wherein the means for determining the frequency domain characteristic comprises determining the frequency domain characteristic in the frequency band of interest.

47. The system of claim 45, further comprising means for presenting a display to a user, wherein the display indicates the first and second sense electrode combinations and associated frequency domain characteristics.

48. A method comprising:

controlling a stimulation module to deliver stimulation to a brain of a patient with a first stimulation electrode combination;

sensing a first bioelectrical signal in the brain of the patient with a first sense electrode combination that is associated with the first stimulation electrode combination;

determining a first frequency domain characteristic of the first bioelectrical signal;

sensing a second bioelectrical signal in the brain of the patient with a second sense electrode combination that is associated with a second stimulation electrode combination;

determining a second frequency domain characteristic of the second bioelectrical signal;

comparing the first and second frequency domain characteristics; and

controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison.

49. The method of claim 48, wherein the first frequency domain characteristic comprises a first power level in a frequency band of interest and the second frequency domain characteristic comprises a second power level in the frequency band of interest.

50. The method of claim 49, wherein the frequency band of interest comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

51. The method of claim 49, wherein the first frequency domain characteristic comprises the first power level in the frequency band of interest relative to a first overall power of the first bioelectrical signal and the second frequency domain characteristic comprises the second power level in the frequency band of interest relative to a second overall power of the second bioelectrical signal.

52. The method of claim 48, wherein comparing the first and second frequency domain characteristics comprises determining whether the first power level is greater than or equal to the second power level, and wherein controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison comprises controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination if the first power level is not greater than or equal to the second power level.

53. The method of claim 52, further comprising controlling the stimulation module to deliver stimulation to the brain of the patient with the first stimulation electrode combination if the first power level is greater than or equal to the second power level.

54. The method of claim 48, further comprising determining a frequency band of interest, wherein determining the first and second frequency domain characteristics comprises determining the first and second frequency domain characteristics in the frequency band of interest.

55. The method of claim 54, wherein determining the frequency band of interest comprises:

sensing a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition;

sensing a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition;

generating a spectrogram of the third and fourth bioelectrical signals; and

determining which frequency bands exhibited a change in power levels between the first and second time periods;

selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

56. The method of claim 48, further comprising:

determining a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination; and

determining a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination,

wherein controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination comprises controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison and the first and second electrical parameter values.

57. A system comprising:

a stimulation generator that delivers stimulation to a brain of a patient with a first stimulation electrode combination;

a sensing module that senses a first bioelectrical signal in the brain of the patient with a first sense electrode combination that is associated with the first stimulation electrode combination and senses a second bioelectrical signal in the brain of the patient with a second sense electrode combination that is associated with a second stimulation electrode combination; and

a processor that determines a first frequency domain characteristic of the first bioelectrical signal and a second frequency domain characteristic of the second bioelectrical signal, compares the first and second frequency domain characteristics, and controls the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison.

58. The system of claim 57, wherein the first frequency domain characteristic comprises a first power level in a frequency band of interest and the second frequency domain characteristic comprises a second power level in the frequency band of interest.

59. The system of claim 58, wherein the frequency band of interest comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

60. The system of claim 57, wherein the first frequency domain characteristic comprises the first power level in the frequency band of interest relative to a first overall power of the first bioelectrical signal and the second frequency domain characteristic comprises the second power level in the frequency band of interest relative to a second overall power of the second bioelectrical signal.

61. The system of claim 57, wherein the processor compares the first and second frequency domain characteristics by at least determining whether the first power level is greater than or equal to the second power level, and wherein the processor controls the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination if the first power level is not greater than or equal to the second power level.

62. The system of claim 61, wherein the processor controls the stimulation module to deliver stimulation to the brain of the patient with the first stimulation electrode combination if the first power level is greater than or equal to the second power level.

63. The system of claim 57, wherein the processor determines a frequency band of interest, the first and second frequency domain characteristic comprise power levels of the first and second bioelectrical signals, respectively, in the frequency band of interest.

64. The system of claim 63, wherein the sensing module senses a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition and senses a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition, wherein the processor determines the frequency band of interest comprises by generating a spectrogram of the third and fourth bioelectrical signals, determining which frequency bands exhibited a change in power levels between the first and second time periods, and selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

65. The system of claim 57, wherein the processor determines a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination and determines a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination, and wherein the processor controls the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison and the first and second electrical parameter values.

66. A system comprising:

means for controlling a stimulation module to deliver stimulation to a brain of a patient with a first stimulation electrode combination;

means for sensing a first bioelectrical signal in the brain of the patient with a first sense electrode combination that is associated with the first stimulation electrode combination;

means for determining a first frequency domain characteristic of the first bioelectrical signal;

means for sensing a second bioelectrical signal in the brain of the patient with a second sense electrode combination that is associated with a second stimulation electrode combination;

means for determining a second frequency domain characteristic of the second bioelectrical signal;

means for comparing the first and second frequency domain characteristics; and

means for controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison.

67. The system of claim 66, wherein the means for comparing the first and second frequency domain characteristics comprises means for determining whether the first power level is greater than or equal to the second power level, and wherein the means for controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination based on the comparison comprises means for controlling the stimulation module to deliver stimulation to the brain of the patient with the second stimulation electrode combination if the first power level is not greater than or equal to the second power level.

68. The system of claim 67, further comprising means for controlling the stimulation module to deliver stimulation to the brain of the patient with the first stimulation electrode combination if the first power level is greater than or equal to the second power level.