Closed-loop feedback-driven neuromodulation

• US 8,762,065 B2
• Filed: 06/22/2005
• Issued: 06/24/2014
• Est. Priority Date: 08/05/1998
• Status: Expired due to Fees

• Current Assignee: DiLorenzo Biomedical, LLC
• Original Assignee: Cyberonics, Inc
• Inventors: DiLorenzo, Daniel John
• Primary Examiner(s): SIMS, JASON M
• Application Number:
  US11/159,842
• Publication Number:
  US 20060293720A1
• Time in Patent Office: 3,289 Days
• Field of Search: None
• US Class Current: 702/19
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A neurological control system for modulating activity of any component or structure comprising the entirety or portion of the nervous system, or any structure interfaced thereto, generally referred to herein as a “nervous system component.” The neurological control system generates neural modulation signals delivered to a nervous system component through one or more neuromodulators, comprising intracranial (IC) stimulating electrodes and other actuators, in accordance with treatment parameters. Such treatment parameters may be derived from a neural response to previously delivered neural modulation signals sensed by one or more sensors, each configured to sense a particular characteristic indicative of a neurological or psychiatric condition.

Claims

1. A method of treating a patient'"'"'s neurological or psychiatric disorder, the method comprising:

using a control module coupled to a first electrode and a second electrode to deliver electrical stimulation to a nervous system component through the first electrode and the second electrode to treat the patient'"'"'s neurological or psychiatric disorder, said first electrode and said second electrode being implanted in the patient'"'"'s body;

monitoring impedance between the first electrode and the second electrode;

automatically adjusting at least one parameter of the electrical stimulation to compensate for a monitored change of electrode impedance between the first electrode and the second electrode; and

delivering a subsequent electrical stimulation with the at least one adjusted parameter to the nervous system component through the first electrode and the second electrode to treat the patient'"'"'s neurological or psychiatric disorder.

2. The method of claim 1, further comprising providing an output to at least one of the patient and a health care provider of the monitored electrode impedance.

3. The method of claim 1, further comprising storing an impedance history information in the control module.

4. The method of claim 2, wherein the control module is implanted in the patient'"'"'s body, and further comprising:

wirelessly transmitting a signal that is representative of the impedance history information from the implanted control module to a device that is external to the patient'"'"'s body; and

providing an output from the external to at least one of the patient and a health care provider that is representative of the impedance history information.

5. The method of claim 1, wherein the first electrode and second electrode are intracranial electrodes that are in direct communication with a patient'"'"'s brain, wherein the electrical stimulation is delivered to the patient'"'"'s brain to manage seizures.

6. The method of claim 1, wherein the control module is adapted to monitor EEG signals from the patient and process the EEG signals to predict future symptomatology of the patient.

7. The method of claim 6, wherein the neurological disorder comprises epilepsy and the future symptomatology comprises future seizures.

8. The method of claim 6, wherein the electrical stimulation is delivered to the patient after the prediction of the future symptomatology.

9. The method of claim 6, wherein parameters of the electrical stimulation are based at least on part on the predicted future symptomatology.

10. The method of claim 1, wherein the nervous system component comprises a peripheral nerve, and wherein the first electrode and second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage seizures.

11. The method of claim 10, wherein the peripheral nerve comprises a vagus nerve.

12. The method of claim 1, wherein the nervous system component comprises a peripheral nerve, wherein the first electrode and the second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage depression.

13. The method of claim 1, wherein the electrical stimulation comprises a current stimulation comprising known current parameters, wherein monitoring impedance between the first electrode and second electrode comprises:

measuring a voltage across the first electrode and second electrode; and

calculating the impedance across the first electrode and second electrode based on the known current parameters and the measured voltage.

14. The method of claim 1 wherein the electrical stimulation comprises charge-balanced biphasic waveforms.

15. A method of treating a patient'"'"'s neurological or psychiatric disorder, the method comprising:

using a control module coupled to a first electrode and a second electrode to deliver electrical stimulation to a nervous system component through the first electrode and the second electrode to treat the patient'"'"'s neurological or psychiatric disorder, said first electrode and said second electrode being implanted in the patient'"'"'s body;

monitoring for a change of impedance between the first electrode and the second electrode;

automatically adjusting at least one parameter of the electrical stimulation to compensate for the change of impedance between the first electrode and the second electrode; and

delivering a subsequent electrical stimulation with the at least one adjusted parameter to the nervous system component through the first electrode and the second electrode to treat the patient'"'"'s neurological or psychiatric disorder.

16. The method of claim 15 further comprising providing an output to at least one of the patient and a health care provider that is indicative of the change to the impedance between the first electrode and the second electrode.

17. The method of claim 15 further comprising storing an impedance history information in the control module.

18. The method of claim 17 wherein the control module is implanted in the patient'"'"'s body, and further comprising:

wirelessly transmitting a signal that is representative of at least one of the impedance change and the impedance history information from the implanted control module to a device that is external to the patient'"'"'s body; and

providing an output from the external to at least one of the patient and a health care provider that is representative of at least one of the impedance change and the impedance history information.

19. The method of claim 15 wherein the first electrode and the second electrode are intracranial electrodes that are in direct communication with a patient'"'"'s brain, wherein the electrical stimulation is delivered to the patient'"'"'s brain to manage seizures.

20. The method of claim 15 wherein the control module is adapted to monitor EEG signals from the patient and process the EEG signals to predict future symptomatology of the patient.

21. The method of claim 20 wherein the neurological disorder comprises epilepsy and the future symptomatology comprises future seizures.

22. The method of claim 20 wherein the electrical stimulation is delivered to the patient after the prediction of the future symptomatology.

23. The method of claim 20 wherein parameters of the electrical stimulation are based at least on part on the predicted future symptomatology.

24. The method of claim 15 wherein the nervous system component comprises a peripheral nerve, and wherein the first electrode and the second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage seizures.

25. The method of claim 24 wherein the peripheral nerve comprises a vagus nerve.

26. The method of claim 15 wherein the nervous system component comprises a peripheral nerve, wherein the first electrode and the second electrode are adapted to be coupled to the peripheral nerve and the electrical stimulation is delivered to the patient'"'"'s peripheral nerve to manage depression.

27. The method of claim 15 wherein the electrical stimulation comprises a current stimulation comprising known current parameters, wherein monitoring impedance between the first electrode and the second electrode comprises:

measuring a voltage across the first electrode and the second electrode; and

calculating the impedance across the first electrode and the second electrode based on the known current parameters and the measured voltage.

28. The method of claim 15 wherein the electrical stimulation comprises charge-balanced biphasic waveforms.