METHODS AND SYSTEMS FOR ESTABLISHING, ADJUSTING, AND/OR MODULATING PARAMETERS FOR NEURAL STIMULATION BASED ON FUNCTIONAL AND/OR STRUCTURAL MEASUREMENTS

• US 20100185256A1
• Filed: 01/16/2009
• Published: 07/22/2010
• Est. Priority Date: 01/16/2009
• Status: Abandoned Application

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories)
• Original Assignee: Northstar Neuroscience, Inc.
• Inventors: Hulvershorn, Justin
• Application Number:
  US12/355,727
• Publication Number:
  US 20100185256A1
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/361 Phantom sensations, e.g. tinnitus

Abstract

Methods and systems for establishing, adjusting, and/or modulating parameters for neural stimulation based, at least in part, on functional and/or structural measurements are disclosed. A method in accordance with one embodiment includes measuring a volume of functionally active neural tissue within a patient'"'"'s central nervous system both before and after affecting a target neural population of the patient with electromagnetic stimulation. The method further includes controlling at least one signal delivery parameter with which the electromagnetic stimulation is applied to the patient based, at least in part, on the measured difference in the volume of functionally active neural tissue.

Claims

1. A method for treating a patient, the method comprising:

measuring a volume of functionally active neural tissue within a patient'"'"'s central nervous system both before and after affecting a target neural population of the patient with electromagnetic signals; and

based at least in part on a measured difference in the volume of functionally active neural tissue, controlling at least one signal delivery parameter with which the electromagnetic signals are applied to the patient.

2. The method of claim 1 wherein controlling at least one signal delivery parameter comprises changing at least one signal delivery parameter.

3. The method of claim 1 wherein controlling at least one signal delivery parameter comprises changing a location at which the stimulation is applied.

4. The method of claim 1 wherein controlling at least one signal delivery parameter comprises changing at least one of a current, voltage, and waveform of a stimulation signal applied to the patient.

5. The method of claim 1 wherein controlling at least one signal delivery parameter comprises at least one of initiating, continuing, varying interrupting, resuming, and discontinuing the application of the electromagnetic stimulation to the target neural population.

6. The method of claim 1 wherein controlling at least one signal delivery parameter comprises discontinuing treatment if the volume of functionally active neural tissue within the patient'"'"'s central nervous system remains approximately constant or increases after affecting the target neural population.

7. The method of claim 1 wherein affecting a target neural population of the patient with electromagnetic stimulation comprises affecting the target neural population with a signal delivery device selected from at least one of the following (a) a non-invasive device that is not implanted in the patient'"'"'s body;

(b) an invasive device that includes at least one electrode implanted in the patient'"'"'s body; and

(c) a combination of non-invasive and invasive devices.

8. The method of claim 7 wherein controlling at least one signal delivery parameter comprises selecting a signal delivery device having a different configuration with which to affect the target neural population.

9. The method of claim 7 wherein affecting a target neural population with a non-invasive device comprises affecting the target neural population with at least one of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS).

10. The method of claim 1, further comprising directing the patient to engage in an adjunctive therapy.

11. The method of claim 10 wherein the adjunctive therapy is selected to include behavioral therapy.

12. The method of claim 10 wherein directing the patient to engage in an adjunctive therapy includes directing the patient to engage in an adjunctive therapy during a treatment session that also includes applying the electromagnetic stimulation.

13. The method of claim 1 wherein measuring a volume of functionally active neural tissue comprises using magnetic resonance (MRI) techniques.

14. The method of claim 1 wherein measuring a volume of functionally active neural tissue comprises using an electroencephalography (EEG).

15. The method of claim 1 wherein affecting a target neural population comprises applying electromagnetic stimulation from at least one electrode implanted within the patient'"'"'s skull.

16. The method of claim 1 wherein affecting a target neural population comprises applying electromagnetic stimulation from a location external to the patient'"'"'s skull.

17. The method of claim 1 wherein measuring a volume of functionally active neural tissue, affecting a target neural population, and controlling at least one signal delivery parameter are performed at least in part by a computer-readable medium.

18. The method of claim 1 wherein measuring a volume of functionally active neural tissue, affecting a target neural population, and controlling at least one signal delivery parameter are performed at least in part by a practitioner.

19. The method of claim 1, further comprising selecting one of more target neural populations to which the stimulation signals are provided.

20. The method of claim 19 wherein selecting one of more target neural populations comprises selecting the one or more target neural populations based, at least in part, on the regions of functionally active neural tissue within the patient'"'"'s central nervous system.

21. The method of claim 1 wherein measuring a volume of functionally active neural tissue and controlling at least one signal delivery parameter occur approximately in real time.

22. The method of claim 1 wherein measuring a volume of functionally active neural tissue before stimulation, measuring a volume of functionally active neural tissue after stimulation, and controlling at least one signal delivery parameter based at least in part on the volume difference occur sequentially.

23. A method for treating a patient, the method comprising:

affecting a target neural population of the patient by providing electromagnetic signals to the target neural population;

detecting and measuring functional consolidation within the patient'"'"'s central nervous system after providing the electromagnetic signals to the target neural population; and

based at least in part on the measured functional consolidation, controlling at least one signal delivery parameter in accordance with which the electromagnetic signals are applied to the target neural population.

24. The method of claim 23 wherein controlling at least one signal delivery parameter comprises changing at least one a current, voltage, and waveform of a stimulation signal applied to the patient.

25. The method of claim 23 wherein controlling at least one signal delivery parameter comprises discontinuing treatment if the volume of functional consolidation within the patient'"'"'s central nervous system remains approximately constant or increases after affecting the target neural population.

26. The method of claim 23 wherein affecting a target neural population of the patient comprises affecting the target neural population with a signal delivery device selected from at least one of the following (a) a non-invasive device that is not implanted in the patient'"'"'s body;

(b) an invasive device that includes at least one electrode implanted in the patient'"'"'s body; and

(c) a combination of non-invasive and invasive devices.

27. The method of claim 23 wherein detecting and measuring functional consolidation and controlling at least one signal delivery parameter occur approximately in real time.

28. A method for treating a patient, the method comprising:

applying electromagnetic stimulation to the patient'"'"'s brain to at least partially reduce a volume of functionally activated tissue within the brain;

determining a volume of functionally activated tissue using a functional MRI (fMRI) process after applying the electromagnetic stimulation; and

based at least in part on the results of the fMRI process, performing at least one of the following functions

(a) changing at least one parameter in accordance with which the electromagnetic stimulation is applied;

(b) ceasing to apply the electromagnetic stimulation; and

(c) maintaining stimulation parameters in accordance with which the electromagnetic stimulation is applied.

29. The method of claim 28 wherein changing at least one parameter in accordance with which the electromagnetic stimulation is applied comprises changing at least one of a current, voltage, and waveform of a stimulation signal applied to the patient.

30. The method of claim 28, further comprising directing the patient to engage in an adjunctive therapy during a treatment session that also includes applying the electromagnetic stimulation.

31. A method for treating a patient, the method comprising:

identifying one or more target neural populations of the patient'"'"'s central nervous system associated, at least in part, with a particular motor function in the patient;

applying first electromagnetic signals to the target neural population in accordance with a first set of signal delivery parameters to produce functional consolidation within the central nervous system; and

applying second electromagnetic signals in accordance with a second set of signal delivery parameters to the corresponding one or more target neural populations, wherein the second set of signal delivery parameters are based, at least in part, on a level of functional consolidation in the patient after applying the first electromagnetic signals.

32. The method of claim 31 wherein applying second electromagnetic signals in accordance with a second set of signal delivery parameters comprises applying second electromagnetic signals having at least one of a current, a voltage, and a waveform different than the first electromagnetic signals.

33. The method of claim 31 wherein applying second electromagnetic signals in accordance with a second set of signal delivery parameters comprises applying second electromagnetic signals at a location different from a location at which the first electromagnetic signals were applied.

34. The method of claim 31, further comprising discontinuing treatment if level of functional consolidation in the patient remains approximately constant or increases after applying first electromagnetic signals to the target neural population.

35. A method for treating a patient, the method comprising:

applying a first stimulus to a target neural population of a patient associated with a particular motor function and using a first set of stimulation parameters;

measuring a response to the first stimulus at least proximate to the patient'"'"'s central nervous system using a functional neuroimaging process; and

based at least in part on the results of the functional neuroimaging process, applying a second stimulus to the target neural population using a second set of stimulation parameters.

36. The method of claim 35 wherein measuring a response to the first stimulus comprises measuring a volume of functionally active neural tissue within the patient'"'"'s central nervous system after applying the first stimulus to the target neural population.

37. The method of claim 35 wherein applying a second stimulus to the target neural population using a second set of stimulation parameters comprises applying a second stimulus having at least one of a current, a voltage, and a waveform different than the first stimulus.