MOOD CIRCUIT MONITORING TO CONTROL THERAPY DELIVERY

• US 20100114237A1
• Filed: 10/29/2009
• Published: 05/06/2010
• Est. Priority Date: 10/31/2008
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Jensen, Randy M., Stypulkowski, Paul H., Giftakis, Jonathon E., Denison, Timothy J., Rise, Mark T., Carlson, David L., Stanslaski, Scott R.
• Application Number:
  US12/608,815
• Publication Number:
  US 20100114237A1
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4076 Diagnosing or monitoring particular conditions of the nervous system A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61M 2021/0072 with application of electrical currents
• CPC Class Codes: A61M 21/00 Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

Brain signals may be monitored at different locations of a mood circuit in order to determine a mood state of the patient. A relationship (e.g., a ratio) between frequency band characteristics of the monitored brain signals may be indicative of a particular mood state. In some examples, therapy parameter values that define the therapy delivered to the patient may be selected to maintain a target relationship (e.g., a target ratio) between the frequency band characteristics of the brain signals monitored within the mood circuit. In addition, in some examples, therapy delivery to the patient may be controlled based on the frequency band characteristics of brain signals sensed at different portions of the mood circuit.

Claims

1. A method comprising:

monitoring a first brain signal of a patient at a first location within the brain of the patient;

monitoring a second brain signal at a second location within the brain, wherein the first and second locations are part of a common mood circuit of the brain;

determining a mood state metric indicative of a relationship between a first frequency band characteristic of the first brain signal and a second frequency band characteristic of the second brain signal; and

controlling delivery of therapy to the patient to control a psychiatric disorder based on the mood state metric.

2. The method of claim 1, wherein controlling delivery of therapy comprises selecting one or more therapy parameter values for the therapy based on the mood state metric.

3. The method of claim 2, wherein selecting one or more therapy parameter values for the therapy based on the mood state metric comprises:

delivering the psychiatric disorder therapy to the patient according to a therapy program;

determining the mood state metric after delivering the psychiatric disorder therapy to the patient according to the therapy program;

comparing the mood state metric to a target value; and

storing the therapy program if the mood state metric is within a threshold range of the target value.

4. The method of claim 1, wherein the mood state metric comprises at least one of a ratio of the first frequency band characteristic to the second frequency band characteristic or a difference between the first frequency band characteristic and the second frequency band characteristic.

5. The method of claim 1, wherein the first and second frequency band characteristics comprises a power level within a selected frequency band.

6. The method of claim 1, wherein the first frequency band characteristic comprises a first power level within a first frequency band and the second frequency band characteristic comprises a second power level within a second frequency band that is different than the first frequency band.

7. The method of claim 1, further comprising determining a patient mood state determination based on the mood state metric.

8. The method of claim 7, wherein the patient mood state determination comprises a first patient mood state determination, the method further comprising:

determining a second patient mood state determination based on a secondary indicator that is different than the first and second brain signals;

comparing the first and second mood state determinations; and

generating a consistency determination based on the comparison.

9. The method of claim 8, wherein controlling the delivery of therapy comprises terminating delivery of the therapy if the consistency determination indicates that the first patient mood state determination is inconsistent with the second patient mood state determination.

10. The method of claim 8, wherein controlling the delivery of therapy comprises initiating delivery of the therapy to the patient if the consistency determination indicates that the first patient mood state determination is consistent with the second patient mood state determination.

11. The method of claim 8, wherein the secondary indicator of the patient mood state comprises at least one of patient activity level, cardiac activity, a respiratory rate, electrodermal activity, thermal activity, muscle activity, or user feedback.

12. The method of claim 1, wherein controlling the delivery of therapy to the patient comprises at least one of suspending therapy delivery to the patient or initiating therapy delivery to the patient.

13. The method of claim 1, wherein controlling the delivery of therapy to the patient comprises initiating therapy delivery to the patient, the method further comprising:

comparing the mood state metric to a target value; and

initiating therapy delivery to the patient if the mood state metric is not within a threshold range of the target value.

14. The method of claim 1, wherein controlling the delivery of therapy to the patient comprises:

comparing the mood state metric to a target value; and

adjusting one or more therapy parameter values of the psychiatric disorder therapy if the mood state metric is not within a threshold range of the target value.

15. The method of claim 1, further comprising monitoring a third brain signal at a third location along the mood circuit, wherein determining the mood state metric further comprises determining the mood state metric indicative of the relationship between at least one of the first or second frequency band characteristics and a third frequency band characteristic of the third brain signal.

16. The method of claim 1, wherein the first location and the second location are within different hemispheres of the brain.

17. The method of claim 1, wherein the mood state metric comprises a first mood state metric that indicates a first difference between the first and second frequency band characteristics, and determining the first mood state metric comprises determining the first mood state metric at a first time, and the method further comprises:

determining a second mood state metric indicative of a second difference between a third frequency band characteristic of the first brain signal and a fourth frequency band characteristic of the second brain signal at a second time that occurs prior to the first time;

delivering therapy to the patient according to a therapy program prior to determining the first mood state metric;

determining a gap state based on the first and second mood state metrics; and

associating the gap state with the therapy program in a memory.

18. A medical system comprising:

a therapy module that delivers a psychiatric disorder therapy to a patient;

a sensing module that monitors a first brain signal of a patient at a first location within the brain of the patient and monitors a second brain signal at a second location within the brain, wherein the first and second locations are part of a common mood circuit of the brain; and

a processor that determines a mood state metric indicative of a relationship between a first frequency band characteristic of the first brain signal and a second frequency band characteristic of the second brain signal, and controls the therapy module based on the mood state metric.

19. The medical system of claim 18, further comprising an implantable medical device comprising at least one of the therapy module, sensing module or the processor.

20. The medical system of claim 18, wherein the processor controls the therapy module by at least selecting one or more therapy parameter values with which the therapy module generates the psychiatric disorder therapy based on the mood state metric.

21. The medical system of claim 20, further comprising a memory, wherein the processor selects the one or more therapy parameter values by at least controlling the therapy module to deliver the psychiatric disorder therapy to the patient according to a therapy program, determining the mood state metric after the therapy module initiates delivery of the psychiatric disorder therapy to the patient according to the therapy program, comparing the mood state metric to a target value stored in the memory, and storing the therapy program in the memory if the mood state metric is within a threshold range of the target value.

22. The medical system of claim 18, wherein the mood state metric comprises at least one of a ratio of the first frequency band characteristic to the second frequency band characteristic or a difference between the first frequency band characteristic and the second frequency band characteristic.

23. The medical system of claim 18, wherein the first and second frequency band characteristics comprises a power level within a selected frequency band.

24. The medical system of claim 18, wherein the first frequency band characteristic comprises a first power level within a first frequency band and the second frequency band characteristic comprises a second power level within a second frequency band that is different than the first frequency band.

25. The medical system of claim 18, wherein the processor determines a patient mood state determination based on the mood state metric.

26. The medical system of claim 25, further comprises a memory, wherein the processor determines the patient mood state determination by referencing the memory to determine the patient mood state that is associated with the mood state metric in the memory.

27. The medical system of claim 25, wherein the patient mood state determination comprises a first patient mood state determination, and wherein the processor determines a second patient mood state determination based on a secondary indicator that is different than the first and second brain signals, compares the first and second mood state determinations, and generates a consistency determination based on the comparison.

28. The medical system of claim 27, wherein the secondary indicator comprises at least one of a patient activity level, cardiac activity, a respiratory rate, electrodermal activity, thermal activity, muscle activity or user input indicating a mood state of the patient.

29. The medical system of claim 18, wherein the processor controls the therapy module based on the mood state metric by at least controlling the therapy module to suspend therapy delivery to the patient.

30. The medical system of claim 18, wherein the processor controls the therapy module based on the mood state metric by at least comparing the mood state metric to a target value, and initiating therapy delivery to the patient if the mood state metric is not within a threshold range of the target value.

31. The medical system of claim 18, wherein the processor controls the delivery of therapy by at least comparing the mood state metric to a target value, adjusting one or more therapy parameter values of the psychiatric disorder therapy if the mood state metric is not within a threshold range of the target value, and controlling the therapy module to deliver therapy to the patient according to the adjusted one or more therapy parameter values.

32. The medical system of claim 18, further comprising a memory, wherein the mood state metric comprises a first mood state metric that indicates a first difference between the first and second frequency band characteristics, and the processor determines the first mood state metric at a first time, determines a second mood state metric indicative of a second difference between a third frequency band characteristic of the first brain signal and a fourth frequency band characteristic of the second brain signal at a second time that occurs prior to the first time, controls the therapy module to deliver therapy to the patient according to a therapy program prior to the determination of the first mood state metric, determines a gap state based on the first and second mood state metrics, and associates the gap state with the therapy program in the memory.

33. A medical system comprising:

means for delivering therapy to a patient to control a psychiatric disorder;

means for monitoring a first brain signal of the patient at a first location within the brain of the patient;

means for monitoring a second brain signal at a second location within the brain, wherein the first and second locations are part of a common mood circuit of the brain;

means for determining a mood state metric indicative of a relationship between a first frequency band characteristic of the first brain signal and a second frequency band characteristic of the second brain signal; and

means for controlling the means for delivering therapy based on the mood state metric.

34. The medical system of claim 33, wherein the means for controlling delivery of therapy comprises at least one of means for selecting one or more therapy parameter values for the therapy based on the mood state metric, means for controlling the means for delivering therapy to suspend therapy delivery to the patient, and means for controlling the means for delivering therapy to initiate therapy delivery to the patient

35. The medical system of claim 33, further comprising determining a patient mood state determination based on the mood state metric.

36. The medical system of claim 35, wherein the patient mood state determination comprises a first patient mood state determination, the system further comprising:

means for determining a second patient mood state determination based on a secondary indicator that is different than the first and second brain signals;

means for comparing the first and second mood state determinations; and

means for generating a consistency determination based on the comparison.