Method and apparatus for event-triggered reinforcement of a favorable brain state

• US 8,954,152 B2
• Filed: 05/13/2013
• Issued: 02/10/2015
• Est. Priority Date: 09/22/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gupta, Rahul, Molnar, Gabriela C., Nelson, Dwight E.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US13/892,401
• Publication Number:
  US 20130245714A1
• Time in Patent Office: 638 Days
• Field of Search: 607/45, 607/48, 607/62
• US Class Current: 607/45
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/6868 Brain
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset

Abstract

Methods and apparatuses are disclosed for potentiating a favorable brain state that is associated with relief in symptoms of a brain condition. Techniques include monitoring one or more brain signals and detecting an episode of a favorable brain state based on the one or more brain signals, the favorable brain state associated with a decrease in one or more symptoms of a brain condition of the patient. Then, in response to the detection of the favorable brain state episode, electrical stimulation that potentiates the favorable brain state is delivered to the brain of the patient, the electrical stimulation delivered within a window of time opened for detection of each favorable brain state episode.

Claims

1. A method of treating a patient with a brain condition, comprising:

monitoring, via a sensor, a signal of the brain of the patient;

detecting, based on the brain signal, a brain state of the patient, the brain state of the patient being indicative of one or more areas of the brain being activated when the patient is experiencing the brain state; and

delivering, via a therapy module, electrical stimulation that potentiates the brain state by targeting one or more of the activated areas of the brain, the electrical stimulation being delivered only within a window of time that opens in response to detection of the brain state, the window of time extending no greater than 250 milliseconds from occurrence of the brain state.

2. The method of claim 1, wherein detecting the brain state comprises identifying the brain state from among multiple predetermined brain states associated with the brain condition.

3. The method of claim 2, wherein the brain state is identified by comparing a pattern of the brain signal to patterns respectively associated with each of the multiple predetermined brain states associated with the brain condition.

4. The method of claim 1, further comprising:

determining the patient is in a brain state associated with reduced symptoms of the brain condition; and

storing a pattern of the brain signal monitored while the patient is in the brain state associated with reduced symptoms of the brain condition as one of the multiple predetermined brain states.

5. The method of claim 4, wherein determining the patient is in a brain state associated with reduced symptoms of the brain condition comprises receiving input from the patient.

6. The method of claim 1, wherein the brain state is associated with a decrease in one or more symptoms of the brain condition.

7. The method of claim 1, wherein detecting the brain state comprises recognizing one or more patterns in one or more brain signals that correspond to one or more stored biomarkers of the brain state.

8. The method of claim 1, wherein detecting the brain state comprises detecting a power level of a frequency band of the brain signal crossing a threshold.

9. The method of claim 1, wherein detecting the brain state comprises detecting the brain transitioning from one brain state to a different brain state.

10. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation to increase the potentiation effect of the electrical stimulation on the brain state.

11. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation based on increasing one or both of frequency and duration of occurrence of the brain state.

12. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation based on increasing an amplitude of the brain signal.

13. The method of claim 1, further comprising:

identifying one or more brain signal biomarkers of the patient as indicative of the brain state; and

storing the one or more brain signal biomarkers in memory, wherein detecting the brain state comprises recognizing presence of at least one of the biomarkers in the brain signal.

14. The method of claim 1, wherein the electrical stimulation comprises only one or two pulses delivered within the window of time which is opened for each detection of occurrence of the brain state.

15. The method of claim 1, wherein delivery of the electrical stimulation is timed to coincide with a particular phase of the brain signal that indicates the brain state.

16. The method of claim 1, wherein:

detecting the brain state comprises detecting a plurality of brain state events; and

delivering the electrical stimulation comprises delivering one or more pulses to the brain for each of the plurality of detected brain state events.

17. The method of claim 1, wherein the window of time spans from the beginning of occurrence of the brain state and extends no greater than 100 milliseconds from the end of occurrence of the brain state.

18. The method of claim 1, wherein the brain signal comprises one or more local field potential signals sensed from implanted electrodes.

37. The method of claim 1,

wherein monitoring, via the sensor, the signal of the brain of the patient includes monitoring the signal of the brain of the patient via electrodes implanted within the brain of the patient, and

wherein delivering, via the therapy module, the electrical stimulation that potentiates the brain state includes delivering the electrical stimulation that potentiates the brain state via the same electrodes implanted within the brain of the patient used for monitoring the signal of the brain of the patient.

38. The method of claim 1, wherein delivering the electrical stimulation that potentiates the brain state by targeting one or more of the activated areas of the brain includes treating the targeted activated areas of the brain remotely by delivering the electrical stimulation to an associated brain area.

39. The method of claim 1, wherein delivering the electrical stimulation that potentiates the brain state by targeting one or more of the activated areas of the brain includes delivering the electrical stimulation to reinforce brain signals within the activated areas of the brain.

19. A system comprising:

a sensor configured to receive a signal indicative of a brain state of a patient;

a stimulation generator configured to generate electrical stimulation; and

control circuitry configured to detect the brain state based on the signal, the brain state of the patient being indicative of one or more areas of the brain being activated when the patient is experiencing the brain state, and control delivery of the electrical stimulation to potentiate the brain state by targeting one or more of the activated areas of the brain, the electrical stimulation being delivered only within a window of time that opens in response to detection of the brain state, the window of time extending no greater than 250 milliseconds from occurrence of the brain state.

20. The system of claim 19, wherein the brain signal comprises one or more brain signals, and wherein the control circuitry is configured to detect the brain state by recognizing one or more patterns in the one or more brain signals that correspond to one or more biomarkers indicative of the brain state.

21. The system of claim 19, wherein the control circuitry is configured to detect the brain state based on a power level of a frequency band of the brain signal crossing a threshold.

22. The system of claim 19, wherein the control circuitry is configured to detect the brain state based on the brain state transitioning from one brain state to a different brain state.

23. The system of claim 19, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing the potentiation effect of the electrical stimulation on the brain state.

24. The system of claim 19, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing one or both of frequency and duration of occurrence of the brain state.

25. The system of claim 19, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing the amplitude of the brain signal.

26. The system of claim 19, wherein the control circuitry is configured to identify one or more brain signal biomarkers of the patient as indicative of the brain state and store the one or more brain signal biomarkers in memory, wherein the control circuitry is configured to detect the brain state by recognizing presence of the one or more biomarkers in the one or more brain signals.

27. The system of claim 26, wherein the control circuitry is configured to identify the one or more brain signal biomarkers of the patient based on input from the patient.

28. The system of claim 27, wherein the input from the patient is input that indicates an improvement of a brain condition of the patient associated with the brain state.

29. The system of claim 19, wherein the electrical stimulation comprises only one or two pulses delivered within the window of time which is opened for each detection of the brain state.

30. The system of claim 19, wherein the control circuitry is configured to time delivery of the electrical stimulation to coincide with a particular phase of the brain signal.

31. The system of claim 19, wherein the window of time spans from the beginning of occurrence of the brain state and extends no greater than 100 milliseconds from the end of occurrence of the brain state.

32. The system of claim 19, wherein the sensor comprises an implantable brain electrode and the brain signal comprise one or more local field potential signals.

33. The system of claim 19, wherein the control circuitry is configured to detect the brain state by identifying the brain state from among multiple predetermined brain states associated with a brain condition of the patient.

34. The system of claim 33, wherein control circuitry is configured to detect the brain state by comparing a pattern of the brain signal to patterns respectively associated with each of the multiple predetermined brain states associated with the brain condition.

35. A system, comprising:

means for monitoring a brain signal from the brain of a patient;

means for detecting a brain state based on the brain signal, the brain state of the patient being indicative of one or more areas of the brain being activated when the patient is experiencing the brain state; and

means for delivering electrical stimulation that potentiates the brain state by targeting one or more of the activated areas of the brain, the electrical stimulation being delivered only within a window of time that opens in response to detection of the brain state, the window of time extending no greater than 250 milliseconds from occurrence of the brain state.

36. A physically embodied computer-readable medium comprising instructions that cause a processor to:

monitor a brain signal;

detect a brain state based on the brain signal, the brain state being indicative of one or more areas of the brain being activated when a patient is experiencing the brain state; and

deliver electrical stimulation to potentiate the brain state by targeting one or more of the activated areas of the brain, the electrical stimulation being delivered only within a window of time that opens in response to detection of the brain state and that extends no greater than 250 milliseconds from occurrence of the brain state.