Therapy program selection based on patient state

• US 8,290,596 B2
• Filed: 09/25/2008
• Issued: 10/16/2012
• Est. Priority Date: 09/26/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Wei, Xuan, Stone, Richard T., Denison, Timothy J., Molnar, Gregory F.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/238,025
• Publication Number:
  US 20090105785A1
• Time in Patent Office: 1,482 Days
• Field of Search: 607/45, 600/378
• US Class Current: 607/45
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation

Abstract

A therapy program is selected based on a patient state, where the patient state comprises at least one of a movement state, sleep state or speech state. In this way, therapy delivery is tailored to the patient state, which may include specific patient symptoms. The therapy program is selected from a plurality of stored therapy programs that comprise therapy programs associated with a respective one at least two of the movement, sleep, and speech states. Techniques for determining a patient state include receiving volitional patient input or detecting biosignals generated within the patient'"'"'s brain. The biosignals are nonsymptomatic and may be incidental to the movement, sleep, and speech states or generated in response to volitional patient input.

Claims

1. A method comprising:

with a processor, determining a patient state of a patient based on received information, wherein the patient state comprises at least one of a movement state, a sleep state or a speech state;

with the processor, selecting a therapy program or instruction for modifying a baseline therapy program from a plurality of stored therapy programs or instructions for modifying the baseline therapy program based on the determined patient state, wherein the plurality of stored therapy programs or instructions comprises;

a first therapy program or instruction associated with the speech state, and

a second therapy program or instruction associated with at least one of the movement state or the sleep state,

wherein selecting the therapy program or instruction based on the determined patient state comprises selecting the first therapy program or instruction in response to determining the patient is in the speech state and selecting the second therapy program or instruction in response to determining the patient is in at least one of the movement state or the sleep state; and

controlling a medical device to deliver deep brain stimulation therapy to the patient based on the selected therapy program or instruction.

2. The method of claim 1, wherein determining the patient state comprises receiving an indication of the patient state from the patient, the received information comprising the indication.

3. The method of claim 2, wherein receiving an indication from the patient comprises receiving input from the patient indicating the patient state via at least one of an accelerometer, a patient programmer or a voice detector.

4. The method of claim 2, wherein receiving an indication from the patient comprises detecting at least one biosignal from a brain of the patient that results from a volitional patient input.

5. The method of claim 4, wherein detecting at least one biosignal from the brain of the patient comprises:

detecting a bioelectrical signal from the brain of the patient via one or more electrodes; and

processing the bioelectrical signal to determine whether the bioelectrical signal includes the biosignal.

6. The method of claim 5, wherein processing the bioelectrical signal comprises evaluating one or more frequency characteristics of the bioelectrical signal.

7. The method of claim 6, wherein the one or more frequency characteristics comprise a strength of the electrical signal within one or more frequency bands.

8. The method of claim 7, wherein the one or more frequency characteristics comprise relative strengths between two or more frequency bands.

9. The method of claim 1, wherein determining the patient state comprises:

receiving, from a sensing module, a bioelectrical signal from a brain of the patient, the received information comprising the bioelectrical signal; and

determining whether the bioelectrical signal indicates the patient is in the movement state, speech state or sleep state.

10. The method of claim 9, wherein the bioelectrical signal comprises at least one of an electroencephalogram (EEG) signal, electromyogram (EMG) signal, electrocorticogram (ECoG) signal, a field potential or a single cell recording of the brain of the patient.

11. The method of claim 1, wherein selecting the therapy program or instruction comprises determining an activity level or posture of the patient and selecting the therapy program or instruction based on the determined activity level or posture.

12. A system comprising:

a memory that stores a plurality of therapy programs for deep brain stimulation therapy or instructions for modifying a baseline therapy program for deep brain stimulation therapy, and associates each therapy program or instruction with a patient state, the patient state comprising at least one of a movement state, a sleep state or a speech state, wherein the plurality of therapy programs or instructions comprises;

a first therapy program or instruction associated with the speech state, and

a second therapy program or instruction associated with at least one of the movement state or the sleep state; and

a processor that determines the patient state of a patient and selects a therapy program or instruction from the plurality of therapy programs or instructions stored by the memory based on the determined patient state, wherein the processor selects the first therapy program in response to determining the patient is in the speech state and selects the second therapy program in response to determining the patient is in at least one of the movement state or the sleep state.

13. The system of claim 12, wherein the processor receives input from a patient indicating the determined patient state.

14. The system of claim 13, further comprising a medical device programmer comprising a user interface, wherein the medical device programmer is configured to receive input from a patient indicating the determined patient state and transmit an indication of the determined patient state to the processor.

15. The system of claim 12, further comprising a biosignal detection module that monitors a bioelectrical signal from a brain of a patient, wherein at least one of the biosignal detection module or the processor determines whether the bioelectrical signal indicates the patient is in the movement state, speech state or sleep state based on the bioelectrical signal from the brain.

16. The system of claim 15, wherein the bioelectrical signal comprises at least one of an electroencephalogram (EEG) signal, electromyogram (EMG) signal, electrocorticogram (ECoG) signal, a field potential or a single cell recording of the brain of the patient.

17. The system of claim 15, wherein the bioelectrical signal is generated by volitional input by the patient.

18. The system of claim 15, wherein the at least one of the biosignal detection module or the processor evaluates one or more frequency characteristics of the bioelectrical signal to determine whether the bioelectrical signal indicates the patient is in the movement state, speech state or sleep state.

19. The system of claim 12, wherein the movement state comprises at least one of intending to initiate movement, initiating movement, attempting to initiate movement or moving, the speech state comprises at least one of intending to initiate speech, initiating speech, attempting to initiate speech or speaking, and the sleep state comprises at least one of intending to initiate sleep, initiating sleep, attempting to initiate sleep or sleeping.

20. The system of claim 12, further comprises a motion sensor, wherein the processor receives input from the motion sensor, determines an activity level or posture of a patient, and selects the therapy program or instruction based on the determined activity level or posture.

21. The system of claim 12, further comprising a therapy module, wherein the processor controls the therapy module to deliver deep brain stimulation therapy to a patient based on the selected therapy program or instruction.

22. A non-transitory computer-readable medium comprising instructions that, when executed by a processor, cause the processor to:

determine a patient state of a patient based on received information, wherein the patient state comprises at least one of a movement state, sleep state or speech state;

select a therapy program or instruction for modifying a baseline therapy program from a plurality of therapy programs or instructions for modifying the baseline therapy program stored by a memory based on the determined patient state, wherein the plurality of stored therapy programs or instructions comprises;

a first therapy program or instruction associated with the speech state, and

a second therapy program or instruction associated with at least one of the movement state or the sleep state,

wherein the instructions, when executed by the processor, cause the processor to select the therapy program or instruction based on the determined patient state by at least selecting the first therapy program or instruction in response to determining the patient is in the speech state and selecting the second therapy program or instruction in response to determining the patient is in at least one of the movement state or the sleep state; and

control a medical device to deliver deep brain stimulation therapy to the patient based on the selected therapy program or instruction.

23. A system comprising:

means for determining a patient state of a patient, wherein the patient state comprises at least one of a movement state, sleep state or speech state; and

means for selecting a therapy program for deep brain stimulation or instruction for modifying a baseline therapy program for deep brain stimulation from a plurality of stored therapy programs or instructions for modifying the baseline therapy program based on the determined patient state, wherein the plurality of stored programs or instructions comprises;

a first therapy program or instruction associated with the speech state, and

a second therapy program or instruction associated with at least one of the movement state or the sleep state, and

wherein the means for selecting selects the therapy program or instruction by at least selecting the first therapy program or instruction in response to determining the patient is in the speech state and selecting the second therapy program or instruction in response determining the patient is in at least one of the movement state or the sleep state.

24. The system of claim 23, wherein the means for determining the patient state comprises means for receiving input from the patient indicating the patient state.

25. The system of claim 23, wherein the means for determining the patient state comprises means for determining the patient state based on biosignals detected within a brain of the patient.

26. The system of claim 23, further comprising means for delivering deep brain stimulation therapy to the patient according to the selected therapy program or instruction.

27. A method comprising:

with a processor, determining whether a patient is in a movement state;

with the processor, determining whether the patient is in a speech state;

with the processor, selecting, from a plurality of stored therapy programs or instructions for modifying a baseline therapy program, a first therapy program or a first instruction for modifying the baseline therapy program if the patient is in the movement state and selecting, from the plurality of stored therapy programs or instructions for modifying a baseline therapy program, a second therapy program different than the first therapy program or a second instruction different than the first instruction for modifying the baseline therapy program if the patient is in the speech state; and

controlling a medical device to deliver deep brain stimulation therapy to the patient based on the selected therapy program or instruction for modifying the baseline therapy program.

28. The method of claim 27, wherein determining whether the patient is in the movement state and determining whether the patient is in the speech state comprises receiving input from the patient indicating whether the patient is in the movement state or the speech state.

29. The method of claim 27, wherein determining whether the patient is in the movement state and determining whether the patient is in the speech state comprises sensing a bioelectrical signal within a brain of the patient and determining whether the bioelectrical signal indicates the patient is in the movement state or the speech state.