Closed loop neuromodulation for suppression of epileptic activity

• US 7,006,872 B2
• Filed: 03/13/2003
• Issued: 02/28/2006
• Est. Priority Date: 04/27/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gielen, Frans L. H., Wadman, Wytse J.
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/388,926
• Publication Number:
  US 20030181955A1
• Time in Patent Office: 1,083 Days
• Field of Search: 607/45, 607/66, 607/72, 600/544, 600/554
• US Class Current: 607/45
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/383 Somatosensory stimuli, e.g. electric stimulation
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A system and method for predicting the likelihood of occurrence of an impending neurological episode. Electrical stimuli are delivered to a structure of the brain. Response field potentials evoked by the stimuli are sensed. Analysis of these field potentials allows for predictions as to the occurrence of an impending, but not yet occurring, neurological disorder. In one example, a measurement of change in response pulses is used to determine a level of interconnectivity in the structures of the brain. The level of functional interconnectivity is used in predicting the occurrence of the neurological event. An example of such a neurological event includes an epileptic seizure.

Claims

1. A method comprising:

delivering electrical stimuli having a pulse pattern to a structure of a brain, wherein delivering stimuli having the pulse pattern includes delivering a first stimulus and a second stimulus to the structure;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal and wherein sensing response field potentials includes measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus; and

storing the sensed signal in memory.

2. The method of claim 1, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 2000 milliseconds.

3. The method of claim 1, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 1000 milliseconds.

4. The method of claim 1, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 2000 milliseconds.

5. The method of claim 1, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 1000 milliseconds.

6. The method of claim 1, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

7. The method of claim 1, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

8. The method of claim 1, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

9. The method of claim 1, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

10. The method of claim 1, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minute.

11. A method comprising:

delivering electrical stimuli to a structure of a brain wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or efferent fiber system in the structure of the brain;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal; and

storing the sensed signal in memory.

12. A method comprising:

implanting one or more electrodes in a structure of a brain wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain;

delivering electrical stimuli having a first pulse pattern to the structure through the electrodes, wherein the first pulse pattern includes pairs of two or more electrical stimuli;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal; and

storing the sensed signal in memory.

13. A method comprising:

implanting one or more electrodes in a structure of a brain wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain;

delivering electrical stimuli having a first pulse pattern to the structure through the electrodes, wherein delivering stimuli having the first pulse pattern includes delivering a first stimulus and a second stimulus to the structure;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal; and

storing the sensed signal in memory, wherein sensing response field potentials includes measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

14. The method of claim 13, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 2000 milliseconds.

15. The method of claim 13, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 5 to 1000 mIlliseconds.

16. The method of claim 13, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 2000 milliseconds.

17. The method of claim 13, wherein delivering the first stimulus and the second stimulus includes delaying delivery of the second stimulus relative the first stimulus by a time interval of 100 to 1000 milliseconds.

18. The method of claim 13, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

19. The method of claim 13, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

20. The method of claim 13, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

21. The method of claim 13, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

22. The method of claim 13, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 1 minute.

23. A method comprising:

implanting one or more electrodes in a structure of a brain wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain;

delivering electrical stimuli to the structure through the electrodes, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or an efferent fiber system in the structure of the brain;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are presented in a sensed signal; and

storing the sensed signal in memory.

24. A system comprising:

one or more electrodes implantable in a structure of a brain;

a signal processor/generator coupled to the electrodes, wherein the signal generator includes;

an electrical pulse generator to deliver electrical stimuli to the brain via the electrodes implanted in the structure of the brain;

a memory means for receiving from the electrodes a sensed signal representing the response field potentials to the electrical stimuli, the memory to store the sensed signal; and

wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 second to 30 minutes.

25. A system comprising:

one or more electrodes implantable in a structure of a brain;

a signal processor/generator coupled to the electrodes, wherein the signal generator includes;

an electrical pulse generator to deliver electrical stimuli to the brain via the electrodes implanted in the structure of the brain;

a memory means for receiving from the electrodes a sensed signal representing the response field potentials to the electrical stimuli, the memory to store the sensed signal; and

wherein the electrical pulse generator repeatedly delivers the first pulse pattern at a repetition frequency of 1 minute to 10 minutes.

26. A system comprising:

means for delivering electrical stimuli to a structure of a brain including means for delivering stimuli having a pulse pattern to the structure;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for staring the sensed response field potentials; and

wherein the means for delivering stimuli having the pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

27. A system comprising:

means for implanting one or more electrodes in a structure of a brain;

means for delivering electrical stimuli to the structure through the electrodes wherein the means for delivering stimuli includes means for delivering stimuli having a first pulse pattern;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for storing the response field potentials; and

wherein the means for delivering stimuli having the first pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

28. A system comprising:

one or more electrode means implantable in a structure of a brain;

a signal processor/generator means coupled to the electrode means, wherein the signal generator means includes;

an electrical pulse generator means to deliver electrical stimuli having a first pulse pattern

to the brain via the electrode means implanted in the structure of the brain;

a storage means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the storage means receives response field potentials through the electrode means and stores the response field potentials; and

wherein the electrical pulse generator means delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal processor means measures changes in the response field potentials to the second stimulus as compared to the response field potentials to the first stimulus.

29. A method comprising:

delivering electrical stimuli to a structure of a brain;

sensing response field potentials evoked by the stimuli delivered to the structure wherein the sensed response field potentials are represented in a sensed signal;

analyzing the sensed response field potentials to predict the likelihood of occurrence of a neurological disorder; and

storing the sensed signal in memory.

30. The method of claim 29, wherein the storing the sensed signal comprises storing a raw sensed signal.

31. The method of claim 29, wherein delivering stimuli to the structure includes delivering stimuli having a pulse pattern to the structure.

32. The method of claim 31, wherein delivering stimuli having the pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

33. The method of claim 32, wherein sensing response field potentials include sensing the response field potentials from a first location and a section location within the brain, and wherein measuring the change includes:

measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

34. The method of claim 33, wherein analyzing the sensed response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

35. The method of claim 33, wherein analyzing the sensed response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

36. The method of claim 32, including delivering a therapy forte neurological disorder when the change in the response field potentials exceeds a threshold value.

37. The method of claim 36, wherein delivering the therapy includes delivering therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

38. The method of claim 29, wherein analyzing the sensed response field potentials includes analyzing the sensed response field potentials pulses to predict the likelihood of occurrence of an epileptic seizure.

39. The method of claim 29, wherein delivering stimuli to the structure includes delivering a predetermined number of stimuli to the structure.

40. The method of claim 29, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or efferent fiber system in the structure of the brain.

41. A method comprising:

implanting one or more electrodes in a structure of a brain;

delivering electrical stimuli to the structure through the electrodes;

sensing response field potentials evoked by the stimuli delivered to the structure;

processing the response field potentials to predict the likelihood of occurrence of a neurological disorder based on the sensed response field potentials; and

storing the sensed response field potentials in memory.

42. The method of claim 41, wherein implanting the electrodes includes positioning each of the electrodes in communication with a predetermined site in a brain.

43. The method of claim 42, wherein positioning includes selecting the predetermined site from the group consisting of the sub thalamic nucleus, the hippocampus, the medial thalanus and the temporal lobe.

44. The method of claim 41, wherein implanting one or more electrodes includes implanting a lead that includes the one or more electrodes in the structure of the brain.

45. The method of claim 41, wherein sensing response field potentials includes sensing response field potentials with the one or more electrodes.

46. The method of claim 41, wherein sensing response field potentials includes sensing field potentials generated in the brain structure.

47. The method of claim 41, where delivering stimuli includes delivering stimuli having a first pulse pattern.

48. The method of claim 47, wherein the first pulse pattern includes pairs of two or more electrical stimuli.

49. The method of claim 47 wherein delivering stimuli having the first pulse pattern includes delivering a first stimulus and a second stimulus to the structure, and sensing response field potentials includes measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

50. The method of claim 49, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 minute to 30 minutes.

51. The method of claim 49, including repeating the delivery of the first pulse pattern at a repetition frequency of 1 second to 10 minutes.

52. The method of claim 49, wherein sensing response field potentials include sensing the response field potentials from a first location and a section location within the brain;

and wherein measuring the change includes;

measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

53. The method of claim 52, wherein processing the response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

54. The method of claim 52, wherein processing the response field potentials includes indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

55. The method of claim 49, including delivering a therapy for the neurological disorder when the change in the response field potential exceeds a threshold value.

56. The method of claim 55, wherein delivering the therapy includes delivering therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

57. The method of claim 41, wherein processing the response field potentials includes identifying the occurrence of an epileptic seizure based on the sensed response field potentials.

58. The method of claim 41, wherein delivering stimuli to the structure includes delivering the stimuli to an afferent fiber or an efferent fiber system in the structure of the brain.

59. A system comprising:

one or more electrodes implantable in a structure of a brain;

a signal processor/generator coupled to the electrodes, wherein the signal generator includes;

an electrical pulse generator to deliver electrical stimuli to the brain via the electrodes implanted in the structure of the brain;

a signal analyzer to receive via the electrodes response field potentials to the electrical stimuli delivered with the electrical pulse generator, where the signal analyzer receives response field potentials through the electrodes and predicts the likelihood of the occurrence of a neurological disorder based on the sensed response field potentials; and

a memory to receive from the electrodes a sensed signal representing the response field potentials to the electrical stimuli, the memory to store the sensed signal.

60. The system of claim 59 wherein the sensed signal stored in memory comprises a raw sensed signal.

61. The system of claim 59, wherein the electrical pulse generator delivers stimuli having a first pulse pattern.

62. The system of claim 61, wherein the electrical pulse generator delivers pairs of two or more electrical stimuli.

63. The system of claim 61, wherein the electrical pulse generator delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal analyzer measures changes in the response field potentials to the second pulse as compared to the response field potentials to the first pulse.

64. The system of claim 63, wherein the signal analyzer measures the field potential of the response field potentials received from a first location and a section location within the brain, and determines a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

65. The system of claim 64, wherein the signal analyzer indicates a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

66. The system of claim 64, wherein the signal analyzer indicates a likely epileptic event when the level of functional interconnectivity has a negative slope.

67. The system of claim 63, wherein the electrical pulse generator delivers a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

68. The system of claim 67, wherein the electrical pulse generator delivers the therapy pulses at a high frequency to prevent the occurrence of the neurological disorder.

69. The system of claim 59, wherein the signal analyzer indicates the likelihood of an occurrence of an epileptic seizure based on the response field potentials.

70. The system of claim 59, wherein the system includes a lead having the one or more electrodes.

71. The system of claim 59, wherein the signal processor/generator is encased in an implantable housing.

72. A system comprising:

means for delivering electrical stimuli to a structure of a brain;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means for analyzing the sensed response field potentials to predict the likelihood of occurrence of a neurological disorder; and

means for storing the sensed response field potentials.

73. The system of claim 72 wherein the means for storing sensed response field potentials comprises means for storing raw sensed response field potentials.

74. The system of claim 72, wherein the means for delivering stimuli to the structure includes means for delivering stimuli having a pulse pattern to the structure.

75. The system of claim 74, wherein the means for delivering stimuli having the pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second stimulus as compared to the response field potential to the first stimulus.

76. The system of claim 75, wherein the means for sensing response field potentials include means for sensing the response field potentials from a first location and a section location within the brain, and wherein the means for measuring the change includes:

means for measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the tint and second location; and

means for determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

77. The system of claim 76, wherein the means for analyzing the sensed response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity exceeds predetermined threshold value.

78. The system of claim 76, wherein the means for analyzing the sensed response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

79. The system of claim 75, including means for delivering a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

80. The system of claim 72, wherein the means for analyzing the sensed response field potentials includes means for analyzing the sensed response field potentials pulses to predict the likelihood of occurrence of an epileptic seizure.

81. A system comprising:

means for implanting one or more electrodes in a structure of a brain;

means for delivering electrical stimuli to the structure through the electrodes;

means for sensing response field potentials evoked by the stimuli delivered to the structure;

means far processing the response field potentials to predict the likelihood of occurrence of a neurological disorder based on the sensed response field potentials; and

means for storing the response field potentials.

82. The system of claim 81 wherein the means for storing the response field potentials comprises means for storing raw response field potentials.

83. The system of claim 81, wherein means for implanting one or more electrodes includes means for implanting a lead that includes the one or more electrodes in the structure of the brain.

84. The system of claim 81, where the means for delivering stimuli includes means for delivering stimuli having a first pulse pattern.

85. The system of claim 84, wherein the means for delivering stimuli having the first pulse pattern includes means for delivering a first stimulus and a second stimulus to the structure, and the means for sensing response field potentials includes means for measuring a change in a response field potential to the second pulse as compared to the response field potential to the first pulse.

86. The system of claim 85, wherein the means for sensing response field potentials include means for sensing the response field potentials from a first location and a section location within the brain;

and wherein the means for measuring the change includes;

means for measuring a field potential evoked by the first stimulus and the field potential evoked by the second stimulus at the first and second location; and

means for determining a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

87. The system of claim 86, wherein the means for processing the response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

88. The system of claim 86, wherein the means for processing the response field potentials includes means for indicating a likely epileptic event when the level of functional interconnectivity has a negative slope.

89. The system of claim 85, including means for delivering a therapy for the neurological disorder when the change in die response field potential exceeds a threshold value.

90. The system of claim 81, wherein the means for processing the response field potentials includes means for identifying the occurrence of an epileptic seizure based on the sensed response field potentials.

91. A system comprising:

one or more electrode means implantable in a structure of a brain;

a signal processor/generator means coupled to the electrode means, wherein the signal generator means includes;

an electrical pulse generator means to deliver electrical stimuli to the brain via the electrode means implanted in the structure of the brain;

a signal analyzer means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the signal analyzer means receives response field potentials through the electrode means and predicts the likelihood of the occurrence of a neurological disorder based on the sensed response field potentials; and

a storage means to receive via the electrode means response field potentials to the electrical stimuli delivered with the electrical pulse generator means, where the storage means receives response field potentials trough the electrode means and stores the response field potentials.

92. The system of claim 91 wherein the storage means stores raw response field potentials.

93. The system of claim 91, wherein the electrical pulse generator means delivers stimuli having a first pulse pattern.

94. The system of claim 93, wherein the electrical pulse generator means delivers the first pulse pattern that includes a first stimulus and a second stimulus, and the signal analyzer means measures changes in the response field potentials to the second pulse as compared to the response field potentials to the first pulse.

95. The system of claim 94, wherein the signal analyzer means measures the field potential of the response field potentials received from a first location and a section location within the brain, and determines a level of functional interconnectivity from a ratio of the response field potentials measured at the first and second locations.

96. The system of claim 95, wherein the signal analyzer means indicates a likely epileptic event when the level of functional interconnectivity exceeds a predetermined threshold value.

97. The system of claim 95, wherein the signal analyzer means indicates a likely epileptic event when the level of functional interconnectivity has a negative slope.

98. The system of claim 94, wherein the electrical pulse generator means delivers a therapy for the neurological disorder when the change in the response field potentials exceeds a threshold value.

99. The system of claim 91, wherein the signal analyzer means indicates the likelihood of an occurrence of an epileptic seizure based on the response field potentials.

100. The system of claim 91, wherein the system includes lead means having the one or more electrodes.

101. The system of claim 91, wherein the signal processor/generator means is encased in an implantable housing means.