Stimulation electrode selection

• US 8,428,733 B2
• Filed: 09/21/2009
• Issued: 04/23/2013
• Est. Priority Date: 10/16/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Carlson, David L., Jensen, Randy M., Denison, Timothy J., Wu, Jianping, Molnar, Gabriela C., Stanslaski, Scott R., Marks, William J. Jr.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/563,845
• Publication Number:
  US 20100100153A1
• Time in Patent Office: 1,310 Days
• Field of Search: 607/48, 600544-545
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Bioelectrical signals may be sensed within a brain of a patient with a plurality of sense electrode combinations. A stimulation electrode combination for delivering stimulation to the patient to manage a patient condition may be selected based on the frequency band characteristics of the sensed signals. In some examples, a stimulation electrode combination associated with the sense electrode combination that sensed a bioelectrical brain signal having a relatively highest relative beta band power level may be selected to deliver stimulation therapy to the patient. Other frequency bands characteristics may also be used to select the stimulation electrode combination.

Claims

1. A method comprising:

receiving a first bioelectrical signal sensed by a sensing module in a brain of a patient with a first sense electrode combination;

receiving a second bioelectrical signal sensed by the sensing module in the brain with a second sense electrode combination that is different than the first sense electrode combination;

determining a frequency domain characteristic of each of the first and second bioelectrical signals;

selecting at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals;

selecting a stimulation electrode combination based on the selected at least one of the first or second sense electrode combinations; and

controlling a medical device to deliver electrical stimulation to the brain of the patient via the selected stimulation electrode combination.

2. The method of claim 1, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations having a higher power level in the frequency band.

3. The method of claim 2, wherein the frequency band comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

4. The method of claim 1, wherein the frequency domain characteristic comprises the power level in the frequency band relative to an overall power of the respective one of the first or second bioelectrical signals.

5. The method of claim 1, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations having a lower power level in the frequency band.

6. The method of claim 1, wherein the frequency domain characteristic comprises a ratio of power levels in one or more frequency bands, a correlation in change of power between one or more frequency bands or a pattern in the power level of one or more frequency bands over time.

7. The method of claim 1, further comprising determining a frequency band of interest, wherein determining the frequency domain characteristic comprises determining the frequency domain characteristic in the frequency band of interest.

8. The method of claim 7, wherein determining the frequency band of interest comprises:

controlling the sensing module to sense a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition;

controlling the sensing module to sense a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition;

generating a spectrogram of the third and fourth bioelectrical signals;

determining which frequency bands exhibited a change in power levels between the first and second time periods; and

selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

9. The method of claim 1, further comprising presenting a display to a user, wherein the display indicates the first and second sense electrode combinations and associated frequency domain characteristics.

10. The method of claim 1, wherein the first sense electrode combination is associated with a first stimulation electrode combination and the second sense electrode combination is associated with a second stimulation electrode combination, wherein selecting the stimulation electrode combination for delivering electrical stimulation to the brain of the patient comprises selecting the first or second stimulation electrode combination associated with the selected at least one of the first or second sense electrode combinations.

11. The method of claim 10, further comprising determining a respective confidence score for the first and second sense electrode combinations, wherein the confidence score indicates a probability that delivery of stimulation via the first and second stimulation electrode combinations, respectively, will provide efficacious therapy for the patient.

12. The method of claim 1, wherein determining the frequency domain characteristic of each of the first and second bioelectrical signals comprises determining first and second frequency domain characteristics for each of the first and second bioelectrical signals.

13. The method of claim 12, wherein the first frequency domain characteristic comprises a first power level of the respective first or second bioelectrical brain signal in a first frequency band, and the second frequency domain characteristic comprises a second power level of the respective first or second bioelectrical brain signal in a second frequency band that is different than the first frequency band.

14. The method of claim 12, wherein the first frequency domain characteristic comprises a first average power level of the respective first or second bioelectrical brain signal in a frequency band over a first time period, and the second frequency domain characteristic comprises a second average power level of the respective first or second bioelectrical brain signal in the frequency band over a second time period.

15. The method of claim 14, wherein the first and second time periods are different.

16. The method of claim 14, wherein the first time period has a longer duration than the second time period.

17. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise substantially the same electrodes.

18. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise at least one different electrode.

19. The method of claim 1, wherein the selected at least one of the first or second sense electrode combinations is positioned within the brain of the patient to sense in a first part of the brain and the stimulation electrode combination is positioned to provide electrical stimulation to a second part of the brain of the patient that differs from the first part.

20. The method of claim 19, wherein the first and second parts of the brain partially overlap.

21. The method of claim 1, further comprising:

determining a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination; and

determining a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination,

wherein selecting the at least one of the first or second sense electrode combinations comprises selecting the at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals and the first and second electrical parameter values.

22. A system comprising:

a plurality of electrodes;

a sensing module configured to sense a first bioelectrical signal in a brain of a patient with a first sense electrode combination comprising a first subset of electrodes of the plurality of electrodes and sense a second bioelectrical signal in the brain with a second sense electrode combination comprising a second subset of electrodes of the plurality of electrodes different than the first subset of electrodes; and

a processor configured to determine a frequency domain characteristic of each of the first and second bioelectrical signals, select at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals, and select a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the selected at least one of the first or second sense electrode combinations.

23. The system of claim 22, further comprising a memory that stores a plurality of sense electrode combinations and associated stimulation electrode combinations.

24. The system of claim 23, wherein the memory stores at least one of the first and second bioelectrical signals or the frequency domain characteristic of each of the first and second bioelectrical signals.

25. The system of claim 23, wherein the first sense electrode combination is associated with a first stimulation electrode combination and the second sense electrode combination is associated with a second stimulation electrode combination in the memory, wherein the processor is configured to select the stimulation electrode combination for delivering electrical stimulation to the brain of the patient by at least selecting the first or second stimulation electrode combinations associated with the selected at least one of the first or second sense electrode combinations.

26. The system of claim 23, wherein the processor is configured to determine a confidence score for each of the stored sense electrode combinations, wherein the confidence score indicates a probability that delivery of stimulation to the patient with the stimulation electrode combination associated with a respective sense electrode combination will provide efficacious therapy for the patient.

27. The system of claim 22, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein the processor is configured to select at least one of the first or second electrode sense combinations by at least selecting the at least one of the first or second sense electrode combinations having a higher power level in the frequency band.

28. The system of claim 27, wherein the frequency band comprises a beta band that comprises a frequency in a range of about 10 Hertz to about 35 Hertz.

29. The system of claim 27, wherein frequency domain characteristic comprises the power level in the frequency band relative to an overall power of the respective one of the first or second bioelectrical signals.

30. The system of claim 22, wherein the frequency domain characteristic comprises a power level within a frequency band of the first and second bioelectrical signals, and wherein the processor is configured to select the at least one of the first or second sense electrode combinations by at least selecting the at least one of the first or second sense electrode combinations having a lower power level in the frequency band.

31. The system of claim 22, wherein the frequency domain characteristic comprises a ratio of power levels in two or more frequency bands, a correlation in change of power between two or more frequency bands or a pattern in the power level of one or more frequency bands over time.

32. The system of claim 22, wherein the processor is configured to determine a frequency band of interest, the frequency domain characteristic comprising a power level in the frequency band of interest.

33. The system of claim 32, wherein the sensing module is configured to sense a third bioelectrical signal in the brain of the patient during a first time period in which the patient is not receiving therapy to manage a patient condition and sense a fourth bioelectrical signal in the brain of the patient during a second time period in which the patient is receiving the therapy to manage the patient condition, wherein the processor is configured to determine the frequency band of interest comprises by generating a spectrogram of the third and fourth bioelectrical signals, determining which frequency bands exhibited a change in power levels between the first and second time periods, and selecting at least one of the frequency bands that exhibited a change in power levels between the first and second time periods as the frequency band of interest.

34. The system of claim 22, further comprising a medical device programmer including a display, wherein the processor is configured to present the first and second sense electrode combinations and respective frequency domain characteristics to a user via the display.

35. The system of claim 22, wherein the processor is configured to determine the frequency domain characteristic of each of the first and second bioelectrical signals by at least determining first and second frequency domain characteristics for each of the first and second bioelectrical signals.

36. The system of claim 35, wherein the first frequency domain characteristic comprises a first power level in a first frequency band, and the second frequency domain characteristic comprises a second power level in a second frequency band that is different than the first frequency band.

37. The system of claim 35, wherein the first frequency domain characteristic comprises a first average power level in a frequency band over a first time period, and the second frequency domain characteristic comprises a second average power level in the frequency band over a second time period.

38. The system of claim 37, wherein the first and second time periods are different.

39. The system of claim 37, wherein the first time period has a longer duration than the second time period.

40. The system of claim 22, wherein the selected at least one of the first or second sense electrode combinations and the stimulation electrode combination comprise at least one different electrode.

41. The system of claim 22, wherein the sensing module is configured to sense the first or second bioelectrical signal in a first part of the brain with the selected at least one of the first or second sense electrode combinations, respectively, and the stimulation electrode combination is positioned within the brain to provide electrical stimulation to a second part of the brain of the patient that differs from the first part.

42. The system of claim 41, wherein the first and second parts of the brain partially overlap.

43. The system of claim 41, wherein the first and second parts of the brain partially overlap.

44. The system of claim 22, wherein the processor is configured to determine a first electrical parameter value indicative of a first impedance of a first electrical path including electrodes of the first sense electrode combination, and determine a second electrical parameter value indicative of a second impedance of a second electrical path including electrodes of the second sense electrode combination, wherein the processor is configured to select the at least one of the first or second sense electrode combinations by at least selecting the at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals and the first and second electrical parameter values.

45. A system comprising:

means for sensing a first bioelectrical signal in a brain of a patient with a first sense electrode combination;

means for sensing a second bioelectrical signal in the brain with a second sense electrode combination that is different than the first sense electrode combination;

means for determining frequency domain characteristics of the first and second bioelectrical signals;

means for selecting at least one of the first or second sense electrode combinations based on the frequency domain characteristics of the first and second bioelectrical signals; and

means for selecting a stimulation electrode combination for delivering electrical stimulation to the brain of the patient based on the selected at least one of the first or second sense electrode combinations.

46. The system of claim 45, further comprising means for determining a frequency band of interest, wherein the means for determining the frequency domain characteristic comprises determining the frequency domain characteristic in the frequency band of interest.

47. The system of claim 45, further comprising means for presenting a display to a user, wherein the display indicates the first and second sense electrode combinations and associated frequency domain characteristics.