Stimulation electrode selection

• US 9,042,990 B2
• Filed: 01/22/2014
• Issued: 05/26/2015
• 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): Stice, Paula J
• Application Number:
  US14/161,389
• Publication Number:
  US 20140135870A1
• Time in Patent Office: 489 Days
• Field of Search: 607/45
• 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, by a processor of a therapy system, a plurality of bioelectrical signals, wherein each of the bioelectrical signals is sensed within a patient by a sensing module with a respective sense electrode combination of a plurality of sense electrode combinations, each of the sense electrode combinations being associated with a respective one of a plurality of stimulation electrode combinations;

for each of the sense electrode combinations, generating, by the processor, an indicator based on the bioelectrical signal sensed with the respective sense electrode combination, wherein the indicator indicates a possibility that electrical stimulation delivered by a medical device with the stimulation electrode combination associated with the sense electrode combination will provide efficacious therapy to the patient, and wherein generating the indicator comprises comparing a characteristic of the bioelectrical signal sensed with the respective sense electrode combination with stored information; and

presenting, via a display, indications of the sense electrode combinations and the respective indicators.

2. The method of claim 1, wherein generating the indicator comprises generating, for each of the sense electrode combinations, the indicator based on a frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination.

3. The method of claim 2, wherein generating the indicator comprises generating the indictor based on a weighted average of beta band power levels of the bioelectrical signal sensed with the respective sense electrode combination.

4. The method of claim 2, wherein generating the indicator based on the frequency domain characteristic comprises:

determining the frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination; and

comparing the frequency domain characteristic to stored information, wherein the stored information is based on at least one of bioelectrical signals sensed within other patients or bioelectrical signals previously sensed within the patient.

5. The method of claim 1, wherein the stored information indicates, for each stored bioelectrical brain signal of a plurality of stored bioelectrical brain signals, an outcome of electrical stimulation therapy delivered via a stimulation electrode combination associated with the stored bioelectrical brain signal.

6. The method of claim 1, wherein generating the indicator comprises generating a confidence score that indicates whether the stimulation electrode combination associated with the sense electrode combination will provide efficacious stimulation therapy to the patient.

7. The method of claim 6, wherein generating the confidence score comprises comparing the characteristic of the bioelectrical signal with the stored information, the stored information indicating at least one of efficacious or inefficacious stimulation electrode combinations determined based on testing of the stimulation electrode combinations on a group of patients.

8. The method of claim 6, wherein generating the confidence score comprises comparing the characteristic of the bioelectrical signal with the stored information, the stored information indicating at least one of efficacious or inefficacious stimulation electrode combinations for the patient, and the stored information being based on previous testing of the stimulation electrode combinations on the patient.

9. The method of claim 6, wherein generating the confidence score comprises comparing the characteristic of the bioelectrical signal with the stored information, the stored information associating a probability of efficacious stimulation with the respective sense electrode combination.

10. The method of claim 9, wherein the probability of efficacious stimulation is based on historical data from one or more other patients.

11. The method of claim 9, wherein the probability of efficacious stimulation is based on a frequency domain characteristic of the bioelectrical brain signal sensed with the respective sense electrode combination.

12. The method of claim 9, wherein the stored information associates a relatively high probability of efficacious stimulation with the stimulation electrode combination associated with a sense electrode combination with which a bioelectrical brain signal exhibiting a relative beta band power level at or above a threshold value was sensed.

13. The method of claim 9, further comprising generating the probability of efficacious stimulation for a sense electrode combination, wherein generating the probability of efficacious stimulation comprises:

determining the frequency domain characteristic of a bioelectrical brain signal sensed via the sense electrode combination;

determining an efficacy score associated with the frequency domain characteristic in a memory; and

generating the probability of efficacious stimulation based on the efficacy score.

14. The method of claim 13, wherein the efficacy score indicates at least one of an extent to which symptoms are mitigated or a rating of the severity of side effects from electrical stimulation delivered via the stimulation electrode combination associated with the sense electrode combination.

15. The method of claim 1, further comprising selecting, by the processor, at least one of the stimulation electrode combinations based on the generated indicators.

16. The method of claim 15, further comprising controlling the medical device to deliver electrical stimulation to the patient via the at least one of the stimulation electrode combinations selected based on the generated indicators.

17. The method of claim 1, wherein at least one of the sense electrode combinations includes at least one of a partial ring electrode or a segmented electrode.

18. The method of claim 1, wherein at least one of the sense electrode combinations includes a ring electrode.

19. A system comprising:

a memory; and

a processor configured to receive a plurality of bioelectrical signals, wherein each of the bioelectrical signals is sensed within a patient by a sensing module with a respective sense electrode combination of a plurality of sense electrode combinations, each of the sense electrode combinations being associated with a respective one of a plurality of stimulation electrode combinations, and, for each of the sense electrode combinations, generate an indicator based on the bioelectrical signal sensed with the respective sense electrode combination, wherein the indicator indicates a possibility that electrical stimulation delivered by a medical device with the stimulation electrode combination associated with the sense electrode combination will provide efficacious therapy to the patient, wherein the processor is configured to store the indicators in the memory, and wherein the processor is configured to generate the indicator by at least comparing a characteristic of the bioelectrical signal sensed with the respective sense electrode combination with information stored by the memory.

20. The system of claim 19, further comprising a display, wherein the processor is configured to present, via the display, a list of the sense electrode combinations and the respective indicators.

21. The system of claim 19, wherein the processor is configured to generate the indicator based on a frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination.

22. The system of claim 21, wherein the frequency domain characteristic comprises a weighted average of beta band power levels of the bioelectrical signal sensed with the respective sense electrode combination.

23. The system of claim 21, wherein the processor is configured to generate the indicator by at least determining the frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination, and comparing the frequency domain characteristic to the information stored by the memory, wherein the information is based on at least one of bioelectrical signals sensed within other patients or bioelectrical signals previously sensed within the patient.

24. The system of claim 19, wherein the information stored by the memory indicates, for each stored bioelectrical brain signal of a plurality of stored bioelectrical brain signals, an outcome of electrical stimulation therapy delivered via a stimulation electrode combination associated with the stored bioelectrical brain signal.

25. The system of claim 19, wherein the processor is configured to generate the indicator by at least generating, for each of the sense electrode combinations, a confidence score that indicates whether the stimulation electrode combination associated with the respective sense electrode combination will provide efficacious stimulation therapy to the patient.

26. The system of claim 25, wherein the processor is configured to generate the confidence score by at least comparing the characteristic of the bioelectrical signal sensed with the respective sense electrode combination with the information stored by the memory, the information indicating at least one of efficacious or inefficacious stimulation electrode combinations determined based on testing of the stimulation electrode combinations on a group of patients.

27. The system of claim 25, wherein the processor is configured to generate the confidence score by at least comparing the characteristic of the bioelectrical signal sensed with the respective sense electrode combination with the information stored by the memory, the information associating a probability of efficacious stimulation with the sense electrode combination.

28. The system of claim 27, wherein the probability of efficacious stimulation is based on historical data from one or more other patients.

29. The system of claim 27, wherein the probability of efficacious stimulation is based on a frequency domain characteristic of the bioelectrical brain signal sensed with the respective sense electrode combination.

30. The system of claim 27, wherein the information associates a relatively high probability of efficacious stimulation with the stimulation electrode combination associated with a sense electrode combination with which a bioelectrical brain signal exhibiting a relative beta band power level at or above a threshold value was sensed.

31. The system of claim 27, wherein the processor is further configured to generate the probability of efficacious stimulation for a sense electrode combination by at least:

determining the frequency domain characteristic of the bioelectrical brain signal sensed via the sense electrode combination;

determining an efficacy score associated with the frequency domain characteristic in a memory; and

generating the probability of efficacious stimulation based on the efficacy score.

32. The system of claim 31, wherein the efficacy score indicates at least one of an extent to which symptoms are mitigated or a rating of the severity of side effects from electrical stimulation delivered via the stimulation electrode combination associated with the sense electrode combination.

33. The system of claim 25, wherein the processor is configured to generate the confidence score by at least comparing the characteristic of the bioelectrical signal sensed with the respective sense electrode combination with the information stored by the memory, the information indicating at least one of efficacious or inefficacious stimulation electrode combinations for the patient, and the information being based on previous testing of the stimulation electrode combinations on the patient.

34. The system of claim 19, wherein the processor is further configured to select at least one of the stimulation electrode combinations based on the generated indicators.

35. The system of claim 34, further comprising the medical device, wherein the processor is configured to control the medical device to deliver electrical stimulation to the patient via the at least one of the stimulation electrode combinations selected based on the generated indicators.

36. The system of claim 19, wherein at least one of the sense electrode combinations includes at least one of a partial ring electrode or a segmented electrode.

37. The system of claim 19, wherein at least one of the sense electrode combinations includes a ring electrode.

38. A system comprising:

means for receiving a plurality of bioelectrical signals, wherein each of the bioelectrical signals is sensed within a patient by a sensing module with a respective sense electrode combination of a plurality of sense electrode combinations, each of the sense electrode combinations being associated with a respective one of a plurality of stimulation electrode combinations; and

means for generating, for each of the sense electrode combinations, an indicator based on the bioelectrical signal sensed with the respective sense electrode combination by at least comparing a characteristic of the bioelectrical signal sensed with the respective sense electrode combination with stored information, wherein the indicator indicates a possibility that electrical stimulation delivered by a medical device with the stimulation electrode combination associated with the sense electrode combination will provide efficacious therapy to the patient.

39. The system of claim 38, wherein the means for generating the indicator generates the indicator by at least determining a frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination and comparing the frequency domain characteristic to stored information, wherein the stored information is based on at least one of bioelectrical signals sensed within other patients or bioelectrical signals previously sensed within the patient.

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

receive a plurality of bioelectrical signals, wherein each of the bioelectrical signals is sensed within a patient by a sensing module with a respective sense electrode combination of a plurality of sense electrode combinations, each of the sense electrode combinations being associated with a respective one of a plurality of stimulation electrode combinations; and

for each of the sense electrode combinations, generate an indicator based on the bioelectrical signal sensed with the respective sense electrode combination by at least comparing a characteristic of the bioelectrical signal with stored information, wherein the indicator indicates a possibility that electrical stimulation delivered by a medical device with the stimulation electrode combination associated with the sense electrode combination will provide efficacious therapy to the patient.

41. The computer-readable medium of claim 40, further comprising instructions that, when executed by the processor, cause the processor to generate the indicator by at least:

determining a frequency domain characteristic of the bioelectrical signal sensed with the respective sense electrode combination; and

comparing the frequency domain characteristic to stored information, wherein the stored information is based on at least one of bioelectrical signals sensed within other patients or bioelectrical signals previously sensed within the patient.