System and methods of deep brain stimulation for post-operation patients

• US 7,957,808 B2
• Filed: 01/16/2007
• Issued: 06/07/2011
• Est. Priority Date: 01/13/2006
• Status: Active Grant

• Current Assignee: Vanderbilt University
• Original Assignee: Vanderbilt University
• Inventors: D'Haese, Pierre-Francois Dominique, Konrad, Peter E., Dawant, Benoit M.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): GHAND, JENNIFER LEIGH-STEWAR
• Application Number:
  US11/653,599
• Publication Number:
  US 20070185544A1
• Time in Patent Office: 1,603 Days
• Field of Search: 382/128, 382/131, 600/378, 600/437, 600/439, 600/440, 600/544, 607/45, 607/116, 607/139
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A method for programming a deep brain stimulator implanted in a target region of a brain of a living subject. In one embodiment, the method comprises the steps of creating an efficacy atlas; acquiring a position of each electrode contact of the at least one electrode; mapping the acquired position of each electrode contact of the at least one electrode onto a corresponding position in the efficacy atlas so as to determine the efficacy of stimulation at the acquired position; and selecting one or more electrode contacts having the highest efficacy for stimulation.

Claims

1. A method for programming a deep brain stimulator implanted in a target region of a brain of a living subject for optimal stimulation, wherein the deep brain stimulator comprises at least one electrode having a plurality of electrode contacts spaced apart from each other, and wherein any portion of the brain of the living subject is identifiable by a set of corresponding spatial coordinates, comprising the steps of:

(a) creating an efficacy atlas in which any spatial coordinates for a position in a target region of the brain of the living subject are related to a position with corresponding atlas coordinates in the efficacy atlas, and each position in the atlas coordinates of the efficacy atlas is associated with an efficacy of stimulation at a corresponding position in the spatial coordinates of the brain of the living subject;

(b) acquiring a position of each electrode contact of the at least one electrode in the spatial coordinates of the brain of the living subject;

(c) mapping the acquired position of each electrode contact of the at least one electrode in the spatial coordinates of the brain of the living subject onto a corresponding position in the efficacy atlas so as to determine the efficacy of stimulation at the acquired position in the spatial coordinates of the brain of the living subject; and

(d) selecting one or more electrode contacts having the highest efficacy for stimulation,

wherein the efficacy of stimulation at a position in the spatial coordinates of the brain of the living subject is

proportional to a percent of loss of rigidity, L^R,

proportional to a therapeutic window that equals to the difference between a voltage, V, applied to the position for achieving the loss of rigidity and a voltage, V^SE, applied to the position for which side effects occur, and

inversely proportional to the voltage V,

wherein the efficacy of stimulation at a position is corresponding to the probability of the stimulation to be clinically effective at the position, and

wherein the creating step (a) comprises the steps of;

(i) obtaining stimulation data corresponding to a target region in which a deep brain stimulator is implanted from a database, wherein the stimulation data comprise M×

N sets of intra-operatively acquired stimulation signals, {V_ij, L_ij^R, V_ij^SE}, and their corresponding stimulation positions, {x_j, y_j, z_j}, wherein i=1, 2, . . . , M, M being a positive integer and the number of a population of living subjects from which the stimulation signals are acquired and stored in the database, and j=1, 2, . . . , N, N being a positive integer and the number of positions at which the stimulation takes place for each of the population of living subjects, and wherein V_ij, L_ij^R, V_ij^SE are a stimulation voltage, a percent of loss of rigidity caused by the stimulation voltage, and a voltage for which side effects occur, respectively, at the j-th stimulation position of the i-th living subject;

(ii) choosing a local efficacy of stimulation, E_ij, at the j-th stimulation position (x_j, y_j, z_j) for the i-th living subject with a Gaussian curve, F_ij, in the form of;

2. The method of claim 1, wherein the efficacy atlas comprises at least one stimulation map having at least one stimulation region corresponding to the target region of the brain of the living subject for optimal stimulation.

3. The method of claim 1, wherein the database comprises an electrophysiological atlas containing electrophysiological information acquired from each of the population of living subjects and related to atlas coordinates of the electrophysiological atlas.

4. The method of claim 3, wherein the atlas coordinates of the efficacy atlas are substantially coincident with the atlas coordinates of the electrophysiological atlas.

5. The method of claim 3, wherein the electrophysiological information comprises at least intra-operative information for each of the population of living subjects.

6. The method of claim 5, wherein the intra-operative information comprises at least specific information associated with at least one stimulation electrode, wherein the specific information includes voltages applied to the at least one stimulation electrode, a response of a living subject undergoing treatment to the stimulation, differences in voltage between disappearance of symptoms and appearance of side effects, and a position of the at least one stimulation electrode.

7. The method of claim 6, wherein the response of the living subject undergoing treatment to the stimulation includes loss of rigidity, location where the loss of rigidity is observed, appearance of side effects, and/or location affected by the side effects.

8. The method of claim 5, wherein the intra-operative information comprises at least specific information associated with a deep brain stimulator having at least one electrode, wherein the specific information includes a position of each electrode contact of the at least one electrode, and a voltage, frequency and pulse width of stimulation at the position.

9. The method of claim 8, wherein the acquiring step comprises the step of obtaining the position of each electrode contact of the at least one electrode from the database.

10. The method of claim 1, wherein the acquiring step comprises the step of acquiring the position of each electrode contact of the at least one electrode post-operatively from the target region of the brain of the living subject in which the deep brain stimulator is implanted.

11. The method of claim 1, wherein the mapping step is performed with a non-rigid registration algorithm.

12. A method for programming a deep brain stimulator implanted in a target region of a brain of a living subject for optimal stimulation, wherein the deep brain stimulator comprises at least one electrode having a plurality of electrode contacts, comprising the step of:

(a) creating an efficacy atlas in which a position in atlas coordinates of the efficacy atlas is related to a corresponding position in spatial coordinates of the brain of the living subject, and each position in atlas coordinates of the efficacy atlas is associated with an efficacy of stimulation at a corresponding position in spatial coordinates of the brain of the living subject, comprising the steps of;

(i) obtaining stimulation data corresponding to a target region in which a deep brain stimulator is implanted from a database, wherein the stimulation data comprise M×

N sets of intra-operatively acquired stimulation signals, {V_ij, L_ij^R, V_ij^SE}, and their corresponding stimulation positions, {x_j, y_j, z_j}, wherein i=1, 2, . . . , M, M being a positive integer and the number of a population of living subjects from which the stimulation signals are acquired and stored in the database, and j=1, 2, . . . , N, N being a positive integer and the number of positions at which the stimulation takes place for each of the population of living subjects, and wherein V_ij, L_ij^R, V_ij^SE are a stimulation voltage, a percent of loss of rigidity caused by the stimulation voltage, and a voltage for which side effects occur, respectively, at the j-th stimulation position of the i-th living subject;

(ii) choosing a local efficacy of stimulation, E_ij, at the j-th stimulation position (x_j, y_j, z_j) for the i-th living subject with a Gaussian curve, F_ij, in the form of;

13. The method of claim 12, wherein the efficacy atlas comprises at least one stimulation map having at least one stimulation region related to the target region of the brain of the living subject for optimal stimulation.

14. The method of claim 12, wherein the database comprises an electrophysiological atlas containing electrophysiological information acquired from each of the population of living subjects and related to atlas coordinates of the electrophysiological atlas.

15. The method of claim 12, wherein the atlas coordinates of the efficacy atlas are is substantially coincident with the atlas coordinates of the electrophysiological atlas.

16. The method of claim 12, further comprising the steps of:

(b) mapping a position of each electrode contact of the at least one electrode in the spatial coordinates of the brain of the living subject onto a corresponding position in the atlas coordinates of the efficacy atlas so as to determine the efficacy of stimulation at the acquired position in the spatial coordinates of the brain of the living subject; and

(c) selecting one or more electrode contacts having the highest efficacy for stimulation.

17. The method of claim 16, wherein the mapping step is performed with a non-rigid registration algorithm.