Probabilistic neurological disorder treatment

• US 8,209,018 B2
• Filed: 04/28/2006
• Issued: 06/26/2012
• Est. Priority Date: 03/10/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Osorio, Ivan, Frei, Mark G.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): PORTER, JR, GARY A
• Application Number:
  US11/380,752
• Publication Number:
  US 20070213785A1
• Time in Patent Office: 2,251 Days
• Field of Search: 600/544, 600/545, 607/45
• US Class Current: 607/45
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• 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
• CPC Class Codes: A61N 1/361 Phantom sensations, e.g. tinnitus
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Disclosed are probabilistic approaches to patient evaluation, warning and treatment of a neurological disorder. Disclosed techniques estimate probability distribution functions or cumulative distribution functions, determined by relying on representative historical profiles, comprising information in short and/or long timescales obtained at times that may be intermittent or temporally discontinuous from each other or from other events of interest. The patient may thereby be treated based on the determined probability information.

Claims

1. A method for treating a patient with a neurological disorder, comprising:

using one or more processors to determine a probability of a seizure occurring in the patient at a selected time point as a function of historical data comprising

a set of reference time points,

a relative time elapsed from one of the reference time points to the selected time point, and

seizure activity observed at one or more moments when the relative time had elapsed from one or more of the reference time points, and

treating the patient based on the determined probability, wherein treating the patient comprises at least one of evaluating the patient, diagnosing the neurological disorder of the patient, comparing therapies for the patient, alerting the patient, alerting a caregiver, dosing the patient with an implantable medical device, and stimulating the patient with the implantable medical device.

2. The method of claim 1, wherein the probability of a seizure occurring in the patient is determined according to a probability function P_E as follows:

3. The method of claim 1, wherein the reference time points each correspond to a respective therapy delivery.

4. The method of claim 1, wherein the reference time points each correspond to a time of a respective day.

5. The method of claim 1, wherein the reference time points each correspond to a respective seizure.

6. The method of claim 1, wherein the set of reference time points is generated from two or more temporally discontinuous recording time periods.

7. The method of claim 1, further comprising determining, based on the determined probability, a therapeutic carry-over effect persisting beyond cessation of a past delivered therapy and delivering a subsequent therapy based on the determined therapeutic carry-over effect.

8. The method of claim 7, further comprising providing event detection-contingent therapy in response to detecting at least one of a pre-seizure state and a seizure state.

9. The method of claim 1, further comprising determining, based on the determined probability, a therapeutic carry-over effect persisting beyond cessation of a past delivered therapy and delivering a subsequent series of therapies based on the determined therapeutic carry-over effect.

10. A method for treating a patient with a neurological disorder, comprising:

using one or more processors to determine a probability of a seizure occurring in the patient after a delivered therapy, the determined probability being a function of historical data comprising

a set of reference time points correlated to respective past delivered therapies,

a relative time elapsed from one of the reference time points, and

a number of seizures occurring at one or more moments when the relative time had elapsed from one or more of the reference time points;

determining a therapeutic carry-over effect based on the determined probability, the therapeutic carry-over effect persisting beyond cessation of the delivered therapy; and

treating the patient based on the determined probability, comprising delivering a subsequent therapy based on the determined therapeutic carry-over effect.

11. An apparatus for treating a patient with a neurological disorder, comprising:

a signal monitoring element for sensing patient activity and outputting a corresponding signal;

a treatment delivery element for delivering treatment to the patient; and

one or more processors configured to

determine a probability of a seizure occurring in the patient at a selected time point as a function of historical data comprising

a set of reference time points,

a relative time elapsed from one of the reference time points to the selected time point, and

seizure activity observed at one or more moments when the relative time had elapsed from one or more of the reference time points, and

control treating the patient based on the determined probability, wherein treating the patient comprises at least one of evaluating the patient, diagnosing the neurological disorder of the patient, comparing therapies for the patient, alerting the patient, alerting a caregiver, dosing the patient, and stimulating the patient.

12. The apparatus of claim 11, wherein the probability of a seizure occurring in the patient is determined according to a probability function P_E as follows:

13. The apparatus of claim 11, wherein the reference time points each correspond to a respective therapy delivery.

14. The apparatus of claim 11, wherein the reference time points each correspond to a time of a respective day.

15. The apparatus of claim 11, wherein the reference time points each correspond to a respective seizure.

16. The apparatus of claim 11, wherein the set of reference time points is generated from two or more temporally discontinuous recording time periods.

17. The apparatus of claim 11, wherein the one or more processors are further configured to determine, based on the determined probability, a therapeutic carry-over effect persisting beyond cessation of a past delivered therapy and control delivering a subsequent therapy based on the determined therapeutic carry-over effect.

18. The apparatus of claim 17, wherein the one or more processors are further configured to control event detection-contingent therapy in response to detecting at least one of a pre-seizure state and a seizure state.

19. The apparatus of claim 11, wherein the one or more processors are further configured to determine, based on the determined probability, a therapeutic carry-over effect persisting beyond cessation of a past delivered therapy and control delivering a subsequent series of therapies based on the determined therapeutic carry-over effect.

20. An apparatus for treating a patient with a neurological disorder, comprising:

a signal monitoring element for sensing patient activity and outputting a corresponding signal;

a treatment delivery element for delivering treatment to the patient; and

one or more processors configured to

determine a probability of a seizure occurring in the patient after a delivered therapy, the determined probability being a function of historical data comprising

a set of reference time points,

a relative time elapsed from one of the reference time points to the selected time point, and

seizure activity observed at one or more moments when the relative time had elapsed from one or more of the reference time points,

determine a therapeutic carry-over effect based on the determined probability, the therapeutic carry-over effect persisting beyond cessation of the delivered therapy, and

control treating the patient based on the determined probability, the treating the patient comprising delivering a subsequent therapy based on the determined therapeutic carry-over effect.