SYSTEM AND APPARATUS FOR EARLY DETECTION, PREVENTION, CONTAINMENT OR ABATEMENT OF SPREAD ABNORMAL BRAIN ACTIVITY

• US 20120265262A1
• Filed: 04/17/2012
• Published: 10/18/2012
• Est. Priority Date: 03/23/2009
• Status: Active Grant

• Current Assignee: Flint Hills Scientific, LLC
• Original Assignee: Flint Hills Scientific, LLC
• Inventors: OSORIO, Ivan
• Granted Patent: US 9,095,303 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• 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 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• 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 5/18 for vehicle drivers or machine operators
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/37 Intracranial electroencephalography [IC-EEG], e.g. electrocorticography [ECoG]
• CPC Class Codes: A61B 5/372 Analysis of electroencephalograms
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate

Abstract

A method, comprising detecting an epileptic event in a neural network, wherein the event occurs in a first node; identifying a second node; and applying a therapy to the second node or any connection. A method, comprising determining a first body index indicative of epileptic activity; monitoring a second body index; detecting an indication of activity spread, based upon at least the second body index; and taking a responsive action, such as delivering therapy, modifying therapy, logging the indication, or warning. A method, comprising detecting an epileptic event in a first node of a neural network; applying a first therapy to a first neural structure for treating the event; and applying a second therapy to a second neural structure of the patient based on an event spread proclivity to a third neural structure. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform a method.

Claims

1. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform a method, comprising:

detecting an epileptic event in a neural network within a brain of a patient, wherein said epileptic event occurs in a first node of said neural network;

identifying a second node of said neural network based at least in part on at least one coupling characteristic between said first node and said second node; and

applying a therapy to said second node or any connection to said second node of said neural network, in response to said detecting.

2. The non-transitive, computer-readable storage device of claim 1, wherein said applying said therapy is performed prior to the spread of said epileptic event to said second node.

3. The non-transitive, computer-readable storage device of claim 1, wherein said connection to said second node is said first node.

4. The non-transitive, computer-readable storage device of claim 1, wherein said neural network is a limbic system, and said first node and said second node are selected from an amygdala, a hippocampus, a dentate gyms, a subiculum, an entorhinal cortex, an anterior thalamic nucleus, a mammillary body, a cingulate gyms, an anterior commissure, a fornix, an arcuate fasciculus, a temporal stem, an orbito-frontal cortex, a locus coeruleus, a reticular thalamic nucleus, a caudate nucleus, a striate nucleus, or a ventral tegmental nucleus.

5. The non-transitive, computer-readable storage device of claim 1, wherein said coupling characteristic is selected from at least one of:

a rate of increase of seizure energy in one or more oscillation frequencies, an intensity of said epileptic event, a duration of said epileptic event, a length of fibers connecting said first node and second node, a number of synapses between said first node and said second node, a synaptic density between said first node and said second node, at least one conductivity property of fibers connecting said first node and said second node, a fiber density between said first node and said second node, a synaptic target within at least one of said first node or said second node, a functional hierarchy level of at least one of said first node or said second node, a clinical hierarchy level of at least one of said first node or said second node, a degree of epileptogenicity associated with at least one of said first and said second node, an anatomical location in said network of said first node, an anatomical location in said network of said second node, a degree of connectivity between the second node and the first node, a type of connectivity between the second node and the first node, a functional coupling level between the second node and at least one other network node, a plasticity of said neural network, an extent of network recruitment within said neural network, a functional role of the second node, a type of the first node, a type of the second node, a state of the first node, a state of the second node, a number of nodes impacted by said epileptic event, a magnitude of spread as a function of a type of the second node, a rate of spread as a function of a type of the second node, a type of subnetwork comprising at least one of said first node or said second node, a number of subnetworks comprising at least one of said first node or said second node, a magnitude of spread as a function of a type of a subnetwork comprising at least one of said first node or said second node, a rate of spread as a function of a type of a subnetwork comprising at least one of said first node or said second node, or a state of a subnetwork comprising at least one of said first node or said second node.

6. The non-transitive, computer-readable storage device of claim 1, wherein said coupling characteristic is selected from at least one of:

a time elapsed since a prior epileptic event, a seizure severity index of a prior epileptic event, a burden of a prior epileptic event, an impact of a prior epileptic event, a time elapsed since a therapy for a prior epileptic event, a type of a therapy for a prior epileptic event, a response to a therapy for a prior epileptic event, a physical and/or cognitive state of the patient at the time of said detecting, a time of day at the time of said detecting, an empirical estimation of epileptic event spread from the first node at the time of said detecting, or a history of epileptic event spread in at least one of said patient or a patient population with relevant characteristics similar to said patient.

7. The non-transitive, computer-readable storage device of claim 1, wherein said coupling characteristic is selected from at least one of:

an autonomic index indicative of a probability of epileptic event spread from the first node, a neurologic index indicative of a probability of epileptic event spread from the first node, a metabolic index indicative of a probability of epileptic event spread from the first node, an endocrine index indicative of a probability of epileptic event spread from the first node, a tissue stress marker index indicative of a probability of epileptic event spread from the first node, a physical fitness index indicative of a probability of epileptic event spread from the first node, a body integrity index indicative of a probability of epileptic event spread from the first node, a quality of life index indicative of a probability of epileptic event spread from the first node, a seizure burden index indicative of a probability of epileptic event spread from the first node, or a number of indices indicative of a probability of epileptic event spread from the first node.

8. The non-transitive, computer-readable storage device of claim 1, wherein applying said therapy is further based upon detecting an indication of said epileptic event spreading or having spread to said second node.

9. The non-transitive, computer-readable storage device of claim 1, wherein said therapy is an electrical therapy, a thermal therapy, a drug therapy, an endosomatic therapy, a supportive therapy, an optical therapy, an acoustic therapy, or two or more thereof.

10. The non-transitive, computer-readable storage device of claim 1, further comprising:

applying a therapy to a neural structure outside said neural network, in response to detecting said epileptic event.

11. The non-transitive, computer-readable storage device of claim 10, wherein said neural structure is selected from a cranial nerve, a spinal cord, or a peripheral nerve.

12. The non-transitive, computer-readable storage device of claim 1, wherein said neural network comprises a sensory network of said brain, a motor network of said brain, or a cognitive network of said brain.

13. The non-transitive, computer-readable storage device of claim 1, further comprising:

determining at least one seizure spread characteristic indicative of a spread of said epileptic event from said first node, wherein said characteristic comprises at least one of

a result of at least one of a cognitive test, an awareness test, a responsiveness test, and a chemical assay administered to said patient;

or

a change in at least one of an autonomic index, a neurologic index, a metabolic index, an endocrine index, a tissue stress marker index, a physical fitness index, a body integrity index, a quality of life index, or a seizure burden index;

wherein identifying said second node is based at least in part on said at least one seizure spread characteristic.

14. The non-transitive, computer-readable storage device of claim 1, further comprising:

determining at least one seizure spread characteristic indicative of a spread of said epileptic event from said first node, wherein said characteristic comprises at least one of

a result of at least one of a cognitive test, an awareness test, a responsiveness test, and a chemical assay administered to said patient;

or

a change in at least one of an autonomic index, a neurologic index, a metabolic index, an endocrine index, a tissue stress marker index, a physical fitness index, a body integrity index, a quality of life index, or a seizure burden index;

identifying at least one pathway from said first node to said second node, based at least in part on said determining said at least one seizure spread characteristic; and

applying a therapy to said pathway.

15. The non-transitive, computer-readable storage device of claim 1, wherein the method further comprises:

determining a spread quotient relating to said epileptic event, said spread quotient comprising information relating to at least one or more of a probability of a spread of said epileptic activity, a speed of said spread of said epileptic activity, a location of said epileptic activity, a direction of said spread of said epileptic event, an intensity of said epileptic activity, and an extent of network recruitment;

wherein applying said therapy to said second node of said neural network is based at least in part upon said spread quotient.

16. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform a method, comprising:

determining a first body index indicative of an epileptic activity in a patient;

monitoring a second body index different from the first body index, in response to said determining;

detecting an indication of epileptic activity spread in a brain of the patient, based upon at least said second body index; and

taking a responsive action in response to said detecting, wherein said responsive action is selected from delivering a therapy to at least one neural structure of said patient, modifying a therapy to at least one neural structure of said patient, logging said indication of spread, or warning said patient, a caregiver, or a medical professional of said indication of spread.

17. The non-transitive, computer-readable storage device of claim 16, wherein said first body index is a non-electrocortical neurologic index, and said second body index is a non-neurologic index.

18. The non-transitive, computer-readable storage device of claim 16, wherein said second body index is derived from the same body signal as the first body index.

19. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform a method, comprising:

detecting an epileptic event in a first node of a neural network in the brain of a patient;

applying a first therapy to a first neural structure of said patient for treating said epileptic event; and

applying a second therapy to a second neural structure of said patient based on a proclivity of a spread of said epileptic event to a third neural structure of said patient.

20. The non-transitive, computer-readable storage device of claim 19, wherein said first neural structure comprises said first node of said neural network.

21. The non-transitive, computer-readable storage device of claim 19, wherein said proclivity of said spread is previously determined.

22. The non-transitive, computer-readable storage device of claim 19, wherein said proclivity is estimated based at least in part on at least one of:

a rate of increase of seizure energy in one or more oscillation frequencies, an intensity of said epileptic event, a duration of said epileptic event, a length of fibers connecting said first node and second node, a number of synapses between said first node and said second node, a synaptic density between said first node and said second node, at least one conductivity property of fibers connecting said first node and said second node, a fiber density between said first node and said second node, a synaptic target within at least one of said first node or said second node, a functional hierarchy level of at least one of said first node or said second node, a clinical hierarchy level of at least one of said first node or said second node, a degree of epileptogenicity associated with at least one of said first and said second node, an anatomical location in said network of said first node, an anatomical location in said network of said second node, a degree of connectivity between the second node and the first node, a type of connectivity between the second node and the first node, a functional coupling level between the second node and at least one other network node, a plasticity of said neural network, an extent of network recruitment within said neural network, a functional role of the second node, a type of the first node, a type of the second node, a state of the first node, a state of the second node, a number of nodes impacted by said epileptic event, a magnitude of spread as a function of a type of the second node, a rate of spread as a function of a type of the second node, a type of subnetwork comprising at least one of said first node or said second node, a number of subnetworks comprising at least one of said first node or said second node, a magnitude of spread as a function of a type of a subnetwork comprising at least one of said first node or said second node, a rate of spread as a function of a type of a subnetwork comprising at least one of said first node or said second node, or a state of a subnetwork comprising at least one of said first node or said second node.

23. The non-transitive, computer-readable storage device of claim 19, wherein said proclivity is estimated based at least in part on at least one of:

a time elapsed since a prior epileptic event, a seizure severity index of a prior epileptic event, a burden of a prior epileptic event, an impact of a prior epileptic event, a time elapsed since a therapy for a prior epileptic event, a type of therapy for a prior epileptic event, a response to a therapy for a prior epileptic event, a physical and/or cognitive state of the patient at the time of said detecting, a time of day at the time of said detecting, an empirical estimation of epileptic event spread from said first node at the time of said detecting, or a history of epileptic event spread in at least one of said patient or a patient population with relevant characteristics similar to said patient.

24. The non-transitive, computer-readable storage device of claim 19, wherein said proclivity is estimated based at least in part on at least one of:

an autonomic index indicative of a probability of epileptic event spread from the first node, a neurologic index indicative of a probability of epileptic event spread from the first node, a metabolic index indicative of a probability of epileptic event spread from the first node, an endocrine index indicative of a probability of epileptic event spread from the first node, a tissue stress marker index indicative of a probability of epileptic event spread from the first node, a physical fitness index indicative of a probability of epileptic event spread from the first node, a body integrity index indicative of a probability of epileptic event spread from the first node, a quality of life index indicative of a probability of epileptic event spread from the first node, or a seizure burden index indicative of a probability of epileptic event spread from the first node.