System and method to define target volume for stimulation in brain

• US 8,644,946 B2
• Filed: 12/04/2009
• Issued: 02/04/2014
• Est. Priority Date: 12/04/2008
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Butson, Christopher R., McIntyre, Cameron C.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, Jon Eric C
• Application Number:
  US13/128,785
• Publication Number:
  US 20110218818A1
• Time in Patent Office: 1,523 Days
• Field of Search: 607/59, 600/407, 600/408, 600/410
• US Class Current: 607/59
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients

Abstract

One embodiment provides a computer-implemented method that includes storing a volume of tissue activation (VTA) data structure that is derived from analysis of a plurality of patients. Patient data is received for a given patient, the patient data representing an assessment of a patient condition. The VTA data structure is evaluated relative to the patient data to determine a target VTA for achieving a desired therapeutic effect for the given patient.

Claims

1. A computer-implemented method comprising:

storing in a memory device a volume of tissue activation (VTA) data structure that is derived from analysis of a plurality of patients;

receiving, by a computer processor, patient data for a given patient, the patient data representing an assessment of a patient condition; and

evaluating, by the computer processor, the VTA data structure relative to the patient data to determine a target VTA for achieving a desired therapeutic effect for the given patient;

wherein the VTA data structure comprises a plurality of statistical atlases, each of the plurality of statistical atlases comprising data that statistically characterizes a therapeutic effect for a plurality of VTAs acquired for the plurality of patients, and the plurality of statistical atlases are hierarchically organized according to one or more categories and a plurality of subcategories.

2. The method of claim 1, wherein the target VTA has a boundary defined in a three-dimensional coordinate system for the patient.

3. The method of claim 1, further comprising determining at least one of a structural parameter and a stimulation parameter that can provide a design VTA that substantially matches the target VTA.

4. The method of claim 3, wherein the structural parameter comprises electrode design parameter data and the stimulation parameter comprises electrical stimulation parameter data.

5. The method of claim 4, further comprising selecting an electrode design according to the electrode design parameter data.

6. The method of claim 5, further comprising programming an implantable pulse generator according to the electrical stimulation parameter data for the selected electrode design such that application of the respective electrical stimulation data to an implanted electrode structure results in stimulation of tissue that substantially achieves the target VTA for the given patient.

7. The method of claim 3, further comprising searching through a plurality of VTAs by adjusting the at least one of a structural parameter and a stimulation parameter to determine the design VTA that best matches the target VTA for achieving the desired therapeutic effect.

8. The method of claim 7, further comprising scoring each of the plurality of VTAs as a prospective design VTA to provide a score that characterizes an amount of overlap between each prospective design VTA and the target VTA.

9. The method of claim 8, wherein the target VTA has a boundary defined in a three-dimensional coordinate system for the patient the scoring, the method further comprising applying a penalty to the scoring according to a spread of the design volume of tissue activation that extends outside the boundary of the target VTA.

10. The method of claim 9, wherein the score is determined according to:

Score=(VTA_{in target}/VTA_target)*(1−

VTA_{out target}/Xvolume),

where;

VTA_{in target} corresponds to the portion of the design VTA that resides within the target VTA,

VTA_{out target} corresponds to the portion of the design VTA that resides out target outside of the target VTA, and

Xvolume defines the penalty for stimulation spread outside of the target VTA.

11. The method of claim 3, further comprising morphing the design VTA to fit the corresponding anatomical region of the given patient and storing data representing the morphed design VTA to provide patient-specific data corresponding to the design VTA.

12. The method of claim 1, wherein the data in the VTA data structure further comprises stimulation parameters associated with each of the plurality of VTAs.

13. The method of claim 1, wherein the data in the VTA data structure further comprises at least one clinical score associated with each of the plurality of VTAs.

14. The method of claim 1, wherein each of the statistical atlases further comprises a statistical representation of data that identifies a likelihood of desirable therapeutic effects associated with providing stimulation for each of the plurality of VTAs.

15. The method of claim 14, wherein each of the statistical atlases further comprises statistical information corresponding to negative or undesirable therapeutic effects associated with providing stimulation for each of the respective VTAs.

16. The method of claim 1, further comprising updating the VTA data structure in response to acquiring clinical data for at least one additional patient.

17. The method of claim 1, wherein the one or more categories and the plurality of subcategories are based on at least one of symptoms and diseases.

18. A system for determining a volume of tissue activation for achieving a desired therapeutic effect for a given patient, the system comprising:

a volume of tissue activation (VTA) data structure stored in memory, the VTA data structure being derived from analysis anatomical and electrical data acquired for a plurality of patients;

patient data stored in the memory, the patient data representing an assessment of a patient condition for the given patient; and

a processor programmed to execute instructions for;

evaluating the VTA data structure relative to the patient data to determine a target VTA for achieving a desired therapeutic effect for the given patient; and

determining at least one of a structural parameter and a stimulation parameter that can provide a design VTA for the given patient that substantially matches the target VTA;

wherein the VTA data structure comprises a plurality of statistical atlases, each of the plurality of statistical atlases comprising data that statistically characterizes a therapeutic effect for a plurality of VTAs acquired for the plurality of patients, and the plurality of statistical atlases are hierarchically organized according to one or more categories and a plurality of subcategories.

19. The system of claim 18, further comprising an interface configured for communicatively coupling the system to a stimulation device, the processor being programmed to program the stimulation device according to the stimulation parameter to achieve a desired therapeutic effect for the given patient.

20. The system of claim 18, wherein the processor is programmed to employ an optimization algorithm programmed to search through a plurality of VTAs in the VTA data structure by adjusting the at least one of a structural parameter and a stimulation parameter to determine the design VTA that best matches the target VTA for achieving the desired therapeutic effect.

21. The system of claim 18, wherein the one or more categories and the plurality of subcategories are based on at least one of symptoms and diseases.