Programming Adjustment for Brain Network Treatment

• US 20170120043A1
• Filed: 10/05/2016
• Published: 05/04/2017
• Est. Priority Date: 01/21/2005
• Status: Active Grant

• Current Assignee: Michael Sasha John
• Original Assignee: Michael Sasha John
• Inventors: John, Michael Sasha
• Granted Patent: US 11,389,661 B2
• Time in Patent Office: Days
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/10 Electroencephalographic signals
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body
• CPC Class Codes: A61N 5/0622 Optical stimulation for exciting neural tissue

Abstract

The present invention involves methods and systems for treatment of brain disorders using neuromodulation of brain networks. Implantation occurs by selecting sites which modulate the network in selected manners, or are modulated by a stimulus in a particular manner that is relevant to treatment of the network. The candidate locations within a brain region are evaluated in relation to how these are indirectly modulated by stimulation at a different brain region. Treatment of one or more brain networks associated with a brain disorder is realized with a consideration of network dynamics and coupling effects such as indirect stimulation of non-target regions. A brain modulation system (BMS) increases, decreases, or otherwise modulates network regional activity in a differential manner. Therapy and electrode locations are adjusted using sensed data and target implantation criteria related to the brain network model. Linking rules be derived during the implantation procedure and used in the subsequent adjusting of the therapy of regions of a brain network.

Claims

1. A method comprising:

defining, using a processor, a model of a network of connected brain structures of a patient, wherein the model of the network includes at least one value indicating a functional interaction between at least a first brain structure and a second brain structure;

sensing activity in at least the first brain structure, the activity occurring in response to at least one therapy selected from the group of an electrical, magnetic or drug therapy delivered to the second brain structure; and

,

adjusting, based on the sensed activity, at least one of;

the functional interaction between the first brain structure, or the second brain structure and the therapy delivered to the second brain structure.

2. The method of claim 1, wherein the functional interaction between the first and second brain structures is assessed for an individual patient.

3. The method of claim 2, wherein defining the model of the network comprises defining the model based on neuroimaging data including at least one from the group of:

functional magnetic resonance data of the patient, positron emission topography data of the patient, and electroencephalographic data of the patient.

4. The method of claim 1, wherein at least one of the functional interaction between, and the selection of, the first and second brain structures is associated with a disease-specific state or trait.

5. The method of claim 1, further including operating a clinician programmer to generate and display a graphical user interface that presents a high level model of a brain network and permits a user to select at least one characteristic of therapy delivered to one or more anatomical structures within the brain network by interacting with the user interface.

6. The method of claim 1, wherein adjusting the therapy delivered to the second brain structure based on sensed activity comprises adjusting the therapy to achieve a desired therapeutic effect as assessed by at least one treatment criterion.

7. The method of claim 1, wherein adjusting the functional relationship between the first brain structure and the second brain structure comprises adjusting the functional interaction in response to a sensed change in therapeutic outcome in response to delivery of the therapy as assessed by at least one treatment criterion.

8. The method of claim 1, wherein defining the model of a network of connected brain structures of the patient comprises accessing a stored normative network model data from a database based on a patient condition.

9. The method of claim 1, wherein adjusting the functional interaction between the first brain structure and the second brain structure comprises adjusting the functional relationship based on severity of at least one direct measure of pathology.

10. The method of claim 1, wherein the model further includes information related to correlation of stimulation in the second brain structure with at least one characteristic of a mood, anxiety, or other psychiatric or neurological disorder, or side-effect associated with stimulation related unwanted interactions.

11. A system comprising:

a sensor configured to sense activity in at least a first brain structure of a patient in response to therapy delivered to a second brain structure of the patient; and

a processor configured to;

define a model of a network of connected brain structures of the patient, wherein the model of the network includes at least one value indicating a functional interaction between the first brain structure and the second brain structure; and

adjust, based on the sensed activity, at least one of the functional interaction between the first brain structure and the second brain structure and the at least one therapy selected from the group of an electrical, magnetic or drug therapy delivered to the second brain structure.

12. The system of claim 11, wherein the functional interaction between the first and second brain structures is assessed for an individual patient.

13. The system of claim 12, wherein the processor is further configured to define the model of the network of connected brain structures based neuroimaging data including at least one from the group of:

functional magnetic resonance data of the patient, positron emission topography data of the patient, and electroencephalographic data of the patient.

14. The system of claim 11, wherein at least one of the functional interaction between, and the selection of, the first and second brain structures is associated with a disease-specific state or trait.

15. The system of claim 11, further including a clinician programmer configured to generate and display a graphical user interface that presents a high level model of a brain network and permits a user to select at least one characteristic of therapy delivered to one or more anatomical structures within the brain network by interacting with the user interface.

16. The system of claim 11, wherein the processor is further configured to adjust the therapy delivered to achieve a desired therapeutic effect as assessed by at least one treatment criterion.

17. The system of claim 11, wherein the processor is further configured to adjust the relationship between the first anatomical structure and the second anatomical structure in response to a sensed change in therapeutic outcome in response to the delivery of therapy.

18. The system of claim 11, further comprising a memory, the memory storing a plurality of model networks, wherein the processor is further configured to access at least one of the stored model networks based on a patient condition, and define the model of a network of interconnected anatomical structures based on the accessed stored model network.

19. The system of claim 11, wherein the processor is further configured to adjust the functional relationship between the first anatomical structure and the second anatomical structure based on disease progression.

20. A system comprising:

a processor configured to be operated to define a model of a network of connected brain structures of a patient, wherein the model of the network includes at least one value indicating a functional interaction between at least a first brain structure and a second brain structure;

the processor further configured for adjusting based on sensed activity, at least one of the functional interaction between the first brain structure and the second brain structure, and the therapy delivered to the second brain structure; and

a sensor for sensing activity in at least the first brain structure in response to at least one therapy selected from the group of an electrical, magnetic or drug therapy delivered to the second brain structure.