Clinician programmer system and method for steering volumes of activation

• US 20110313487A1
• Filed: 08/23/2011
• Published: 12/22/2011
• Est. Priority Date: 05/15/2008
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: IntElect Medical, Inc. (Boston Scientific Corporation)
• Inventors: Kokones, Scott, Blum, David Arthur, Carlton, Keith, Sparks, Troy
• Granted Patent: US 8,855,773 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36128 Control systems
• 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
• CPC Class Codes: G06V 40/10 Human or animal bodies, e.g. vehicle occupants or pedestrians; Body parts, e.g. hands
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A system and method for selection of stimulation parameters for Deep Brain Stimulation (DBS) may include a processor that displays in a display device and in relation to a displayed model of a leadwire including model electrodes, a current field corresponding to a first stimulation parameter set, provides a user interface for receipt of user input representing a shift of the current field, in response to the user input, moves, in the display device, the current field with respect to the displayed model, determines a second stimulation parameter set that results in the moved current field, and outputs the second stimulation parameter set and/or sets a stimulation device with the second stimulation parameter set, where the stimulation device is configured for performing a stimulation using the leadwire in accordance with the second stimulation parameter set.

Claims

1. A computer-implemented surgical planning method, comprising:

prior to surgical insertion of a stimulation apparatus into a patient, providing, by a computer processor and relative to a patient-specific anatomical model, a representation of a target region for stimulation by the stimulation apparatus.

2. The method of claim 1, further comprising:

generating, by the processor, the anatomical model based on an anatomical image.

3. The method of claim 2, wherein the anatomical image includes at least one of a computed tomography (CT) image and a magnetic resonance (MR) image.

4. The method of claim 1, further comprising:

determining and outputting, by the processor, at least one of a burr hole location for insertion of the stimulation apparatus, an angle of entry of the stimulation apparatus into the patient at the burr hole, and a path of the stimulation apparatus from the burr hole to the target region.

5. The method of claim 1, wherein the anatomical model is a three-dimensional model.

6. The method of claim 1, wherein the anatomical model is a two-dimensional model.

7. The method of claim 1, wherein the providing of the target region representation includes receiving user-input of a plurality of points relative to the anatomical model.

8. The method of claim 1, further comprising:

receiving a click-and-drag input; and

responsive to the input, modifying the target region representation.

9. The method of claim 1, where the providing of the target region representation includes automatically determining the target region based on received input describing the patient.

10. The method of claim 1, wherein the input includes a patient disorder.

11. A computer-implemented surgical planning method, comprising:

prior to surgical insertion of a stimulation apparatus into a patient, determining and outputting, by a computer processor, patient-specific information including at least one of a patient-specific target region at which to provide a stimulation using the stimulation apparatus, a patient-specific burr hole location for insertion of the stimulation apparatus, a patient-specific angle of entry of the stimulation apparatus into the patient at the burr hole, and a patient-specific path of the stimulation apparatus from the burr hole to a target region at which to provide the stimulation.

12. The method of claim 11, wherein the patient-specific information is determined based on a patient-specific anatomical model.

13. The method of claim 11, wherein the patient-specific information is determined based on received input describing the patient.

14. A computer-implemented surgical planning method, comprising:

prior to surgical insertion of a stimulation apparatus into a patient;

automatically selecting, by a computer processor, a patient-specific implantation location of the stimulation apparatus and patient-specific stimulation settings of the stimulation apparatus for providing a therapeutic stimulation to an anatomical region of the patient; and

outputting the selected location and settings.

15. The method of claim 14, wherein the location and settings are determined based on a patient-specific anatomical model.

16. The method of claim 14, wherein the selecting includes simulating at least one volume of activation (VOA) relative to a patient-specific anatomical model, the VOA being an estimated volume of tissue activated by the stimulation apparatus.

17. The method of claim 14, wherein the outputting includes displaying a representation of the stimulation apparatus relative to a patient-specific anatomical model.

18. A computer-implemented method, comprising:

obtaining, by a computer processor, microelectrode recording (MER) data;

based on the MER data, at least one of (a) automatically selecting, by the processor, a stimulation apparatus to be inserted into a patient, (b) automatically selecting, by the processor, a position of the stimulation apparatus to be inserted into the patient, and (c) adjusting or generating, by the processor, a patient-specific anatomical model.

19. The method of claim 18, wherein the patient-specific anatomical model is adjusted or generated based on the MER data and is used for planning a surgery in which the stimulation apparatus is inserted into the patient.

20. A programmer for an implantable medical device comprising:

a processor that associates one or more implantable elements of an implantable medical device with one or more anatomical implant regions of a patient; and

a user interface that receives user input selecting one of the anatomical implant regions, and receives user input specifying one or more therapy parameters for the one or more implantable elements associated with the selected anatomical region.