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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
First Claim
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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 isproportional to a percent of loss of rigidity, LR,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, VSE, applied to the position for which side effects occur, andinversely 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, andwherein 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, {Vij, LijR, VijSE}, and their corresponding stimulation positions, {xj, yj, zj}, 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 Vij, LijR, VijSE 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, Eij, at the j-th stimulation position (xj, yj, zj) for the i-th living subject with a Gaussian curve, Fij, in the form of;

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