STIMULATION ELECTRODE SELECTION

• US 20110264165A1
• Filed: 04/27/2010
• Published: 10/27/2011
• Est. Priority Date: 04/27/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Molnar, Gabriela C., Csavoy, Andrew N.
• Granted Patent: US 9,814,885 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 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

One or more stimulation electrodes may be selected based on a bioelectrical signal sensed in a brain of a patient with a sense electrode combination that comprises at least one electrode and a physiological model that indicates one or more anatomical structures of the brain of the patient that are proximate the implanted at least one electrode. In some examples, the bioelectrical brain signal indicates which electrodes are located closest to a target tissue site. The physiological model can be generated based on a location of implanted at least one electrode within a patient and patient anatomy data, which can, for example, indicate one or more characteristics of patient tissue proximate to the implanted at least one electrode. In some example, the physiological model includes a therapy field model that represents a region of the tissue of the patient to which therapy is delivered via a selected set of electrodes.

Claims

1. A method comprising:

sensing a bioelectrical signal in a brain of a patient with a sense electrode combination that comprises at least one electrode;

accessing a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient; and

selecting a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the bioelectrical signal and the physiological model.

2. The method of claim 1, wherein the physiological model comprises at least one of an electrical field model that indicates where electrical stimulation propagates from the selected stimulation electrode combination, an activation field model that indicates neurons of the brain of the patient that will be activated by the electrical stimulation delivered by the selected stimulation electrode combination, or a voltage gradient or current density model that indicates a distribution of the electrical stimulation delivered via the selected stimulation electrode combination.

3. The method of claim 1, wherein the physiological model indicates one or more anatomical structures of the brain of the patient proximate the at least one electrode within the brain of the patient.

4. The method of claim 1, wherein accessing the physiological model comprises generating the physiological model, wherein generating the physiological model comprises:

determining a stereotactic coordinate of a lead comprising the at least one electrode within the brain of the patient;

determining one or more anatomical structures of the brain of the patient proximate the lead based on the stereotactic coordinate; and

generating the physiological model that indicates the one or more anatomical structures of the brain of the patient proximate the lead.

5. The method of claim 1, wherein sensing the bioelectrical signal comprises sensing a plurality of bioelectrical signals in the brain of the patient with respective sense electrode combinations, wherein each of the sense electrode combinations comprises at least one electrode, the method further comprising selecting one of the sense electrode combinations based on the sensed bioelectrical signals, wherein selecting the stimulation electrode combination comprises selecting the stimulation electrode combination based on the selected sense electrode combination and the physiological model.

6. The method of claim 5, wherein selecting one of the sense electrode combinations based on the sensed bioelectrical signals comprises:

determining a frequency domain characteristic for each of the plurality of bioelectrical signals;

determining a plurality of relative values of the frequency domain characteristic, wherein each of the plurality of relative values is based on at least two of the frequency domain characteristics; and

selecting at least one electrode of the plurality of electrodes for delivering stimulation to the patient based on the plurality of relative values.

7. The method of claim 5, wherein selecting one of the sense electrode combinations based on the sensed bioelectrical signals comprises:

comparing a pattern of the each of the sensed bioelectrical signals to a template; and

selecting one or more sense electrode combinations that correspond to sensed bioelectrical signals that substantially match the template.

8. The method of claim 5, wherein selecting one of the sense electrode combinations comprises selecting the sense electrode combination based on a variability of the respective sensed bioelectrical signal.

9. The method of claim 5, wherein selecting one of the sense electrode combinations comprises:

determining at least one of a mean, median, peak or lowest amplitude of each of the sensed bioelectrical signals; and

selecting the sense electrode combination based on the mean, median, peak or lowest amplitude of the respective sensed bioelectrical signal.

10. The method of claim 1, wherein selecting the stimulation electrode combination comprises:

selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the sense electrode combination; and

confirming the stimulation electrode combination based on the physiological model.

11. The method of claim 10, wherein confirming the stimulation electrode combination based on the physiological model comprises determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in a target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation-induced side effects.

12. The method of claim 11, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in the target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation-induced side effects comprises determining whether the therapy field at least partially overlaps with the target anatomical structure or the one or more anatomical structures of the brain associated with stimulation-induced side effects.

13. The method of claim 1, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein selecting the stimulation electrode combination comprises:

determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects; and

selecting the sense electrode combination as the stimulation electrode combination if the therapy field at least one of at least partially overlaps with a target anatomical structure of the brain of the patient or does not overlap with the one or more anatomical structures of the brain associated with stimulation-induced side effects.

14. The method of claim 1, wherein selecting the stimulation electrode combination comprises:

selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the physiological model; and

confirming the selected stimulation electrode combination based on the bioelectrical signal.

15. The method of claim 14, wherein confirming the selected stimulation electrode combination based on the bioelectrical signal comprises:

sensing the bioelectrical signal in the brain of the patient with the stimulation electrode combination selected based on the physiological model; and

determining whether the bioelectrical signal sensed via the stimulation electrode combination indicates the stimulation electrode combination is proximate a target stimulation site within the brain of the patient.

16. The method of claim 1, further comprising displaying the physiological model via a display of a device, and wherein selecting the stimulation electrode combination comprises, after displaying the physiological model, receiving user input selecting the stimulation electrode combination.

17. The method of claim 1, wherein the physiological model indicates one or more characteristics of tissue proximate electrodes of the sense electrode combination, the method further comprising displaying the physiological model via a display of a device, wherein selecting the stimulation electrode combination comprises, after displaying the physiological model, receiving user input selecting the sense electrode combination as the stimulation electrode combination.

18. A system comprising:

a sensing module that senses a bioelectrical signal in a brain of a patient with a sense electrode combination that comprises at least one electrode; and

a processor that accesses a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient and selects a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the bioelectrical signal and the physiological model.

19. The system of claim 18, wherein the physiological model comprises at least one of an electrical field model that indicates where electrical stimulation propagates from the stimulation electrode combination, an activation field model that indicates neurons of the brain of the patient that will be activated by the electrical stimulation delivered by the stimulation electrode combination, or a voltage gradient or current density model that indicates a distribution of the electrical stimulation delivered via the stimulation electrode combination.

20. The system of claim 18, wherein the physiological model indicates one or more anatomical structures of the brain of the patient proximate the at least one electrode within the brain of the patient.

21. The system of claim 18, wherein the processor generates the physiological model by at least determining a stereotactic coordinate of a lead comprising the at least one electrode within the brain of the patient and determining one or more anatomical structures of the brain of the patient proximate the lead based on the stereotactic coordinate, wherein the physiological model indicates the one or more anatomical structures of the brain of the patient proximate the at least one electrode.

22. The system of claim 18, wherein the sensing module senses a plurality of bioelectrical signals in the brain of the patient with respective sense electrode combinations, wherein each of the sense electrode combinations comprises at least one electrode, and the processor selects one of the sense electrode combinations based on the sensed bioelectrical signals, and selects the stimulation electrode combination by at least selecting the stimulation electrode combination based on the selected sense bioelectrical signal and the physiological model.

23. The system of claim 22, wherein the processor selects one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

determining a frequency domain characteristic for each of the plurality of bioelectrical signals;

determining a plurality of relative values of the frequency domain characteristic, wherein each of the plurality of relative values is based on at least two of the frequency domain characteristics; and

selecting at least one of the plurality of electrodes for delivering stimulation to the patient based on the plurality of relative values.

24. The system of claim 22, wherein the processor selects one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

comparing a pattern of the each of the sensed bioelectrical signals to a template; and

selecting one or more sense electrode combinations that correspond to sensed bioelectrical signals that substantially match the template.

25. The system of claim 22, wherein the processor selects one of the sense electrode combinations based on the sensed bioelectrical signals based on a variability of the respective sensed bioelectrical signal.

26. The system of claim 22, wherein the processor selects one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

determining at least one of a mean, median, peak or lowest amplitude of each of the sensed bioelectrical signals; and

selecting the sense electrode combination based on the mean, median, peak or lowest amplitude of the respective sensed bioelectrical signal.

27. The system of claim 18, wherein the processor selects the stimulation electrode combination by at least selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the sense electrode combination, and confirming the stimulation electrode combination based on the physiological model.

28. The system of claim 27, wherein the processor confirms the stimulation electrode combination based on the physiological model by at least determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in a target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation-induced side effects.

29. The system of claim 18, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein the processor selects the stimulation electrode combination by at least determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects, and selecting the sense electrode combination as the stimulation electrode combination if the therapy field at least one of at least partially overlaps with a target anatomical structure of the brain of the patient or does not overlap with the one or more anatomical structures of the brain associated with stimulation-induced side effects.

30. The system of claim 18, wherein the processor selects the stimulation electrode combination comprises by at least selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the physiological model, and confirming the selected stimulation electrode combination based on the bioelectrical signal.

31. The system of claim 30, wherein the processor confirms the selected stimulation electrode combination based on the bioelectrical signal by at least controlling the sensing module to sense the bioelectrical signal in the brain of the patient with the stimulation electrode combination selected based on the physiological model, and determining whether the bioelectrical signal sensed via the stimulation electrode combination indicates the stimulation electrode combination is proximate a target stimulation site within the brain of the patient.

32. The system of claim 18, further comprising a user interface comprising a display, wherein the processor displays the physiological model via the display, and selects the stimulation electrode combination based on user input received via the user interface after displaying the physiological model.

33. A system comprising:

means for sensing a bioelectrical signal in a brain of a patient with a sense electrode combination that comprises at least one electrode; and

means for selecting a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the bioelectrical signal and a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient.

34. The system of claim 33, wherein the physiological model comprises a therapy field that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein the means for selecting the stimulation electrode combination selects the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the sense electrode combination and confirms the stimulation electrode combination selection based on the physiological model by at least determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects.

35. The system of claim 33, wherein the means for selecting the stimulation electrode combination selects the stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the physiological model and confirms the selected stimulation electrode combination based on the bioelectrical signal.

36. A computer-readable medium comprising instructions that cause a programmable processor to:

receive, from a sensing module, a bioelectrical signal sensed by the sensing module in a brain of a patient with a sense electrode combination that comprises at least one electrode;

access a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient; and

select a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the bioelectrical signal and the physiological model.