Therapy for rapid eye movement behavior disorder (RBD)

• US 9,211,411 B2
• Filed: 08/17/2011
• Issued: 12/15/2015
• Est. Priority Date: 08/26/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Wu, Jianping, Nelson, Dwight E.
• Primary Examiner(s): Stice, Paula J
• Application Number:
  US13/211,904
• Publication Number:
  US 20120053508A1
• Time in Patent Office: 1,581 Days
• Field of Search: 607/48, 607/2
• US Class Current: 1/1
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/1104 induced by stimuli or drugs; A61B5/1102 takes precedence; investigating medicinal preparations G01N33/15
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/6868 Brain
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36078 Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00

Abstract

Examples for delivering electrical stimulation to a patient via a medical device to manage or treat rapid eye movement behavior disorder (RBD) are described. In one example, a method comprises determining a patient is in a rapid eye movement (REM) sleep stage, and delivering electrical stimulation therapy to the patient based on the determination that the patient is in the REM sleep stage, where the electrical stimulation therapy is delivered to inhibit movement of the patient during the REM sleep stage. In some examples, the electrical stimulation therapy may be delivered to the brain of the patient.

Claims

1. A method comprising:

determining a patient is in a rapid eye movement (REM) sleep stage; and

controlling a therapy module to deliver therapy to the patient based on the determination that the patient is in the REM sleep stage, wherein the therapy is configured to inhibit movement of the patient during the determined REM sleep stage;

detecting, while the therapy is being delivered to the patient during the determined REM sleep stage, at least one of the movement of the patient or the muscle tone of the patient via a sensing module; and

adjusting the therapy delivered to the patient via the therapy module based on the at least one of the movement of the patient or the muscle tone of the patient detected via the sensing module, wherein at least one of the determining, controlling, detecting, or adjusting is performed using one or more processors.

2. The method of claim 1, wherein determining the patient is in the REM sleep stage comprises:

sensing a biosignal that is indicative of activity within a brain of the patient; and

determining the REM sleep stage based on the sensed biosignal.

3. The method of claim 2, wherein the sensed biosignal comprises a bioelectrical brain signal generated from at least one of local field potentials (LFP) within a brain of the patient, an electroencephalogram (EEG) signal, or an electrocorticogram (ECoG) signal.

4. The method of claim 1, wherein the therapy comprises electrical stimulation therapy, and wherein adjusting the electrical stimulation therapy delivered to the patient comprises one of terminating the electrical stimulation or modifying one or more stimulation therapy parameters.

5. The method of claim 4, wherein the one or more stimulation therapy parameters comprise pulse rate, pulse width, pulse amplitude, electrode polarity, or electrode combination.

6. The method of claim 1, wherein controlling the therapy module to deliver the therapy to the patient comprises controlling the therapy module to deliver electrical stimulation therapy to a brain of the patient.

7. The method of claim 6, wherein controlling the therapy module to deliver the electrical stimulation therapy to the brain comprises controlling the therapy module to deliver electrical stimulation to at least one of a globus pallidus pars interna (GPi), subthalamic nucleus (STN), striatum, pallidum, or substantia nigra of the brain.

8. The method of claim 7, wherein controlling the therapy module to deliver the electrical stimulation therapy to the at least one of a globus pallidus pars interna (GPi), subthalamic nucleus (STN) striatum, pallidum, or substantia nigra comprises controlling the therapy module to deliver electrical stimulation having a frequency of between approximately 8 Hz and 30 Hz to the at least one of the globus pallidus pars interna (GPi), subthalamic nucleus (STN), striatum, pallidum, or substantia nigra of the brain.

9. The method of claim 6, wherein controlling the therapy module to deliver the electrical stimulation therapy to the brain comprises controlling the therapy module to deliver electrical stimulation to a midbrain nuclei of the brain.

10. The method of claim 9, wherein controlling the therapy module to deliver the electrical stimulation therapy to the midbrain nuclei comprises controlling the therapy module to deliver electrical stimulation having a frequency of between approximately 80 Hz and 200 Hz to the midbrain nuclei of the brain.

11. The method of claim 1, further comprising:

subsequently determining that the patient is not in the REM sleep stage; and

terminating the therapy delivered to the patient based on the determination that the patient is not in the REM sleep stage.

12. The method of claim 1, wherein controlling the therapy module to deliver the therapy to the patient comprises controlling the therapy module to deliver electrical stimulation therapy to the patient.

13. The method of claim 12, wherein controlling the therapy module to deliver the electrical stimulation therapy to the patient comprises at least one of initiating delivery of electrical stimulation or adjusting one or more stimulation therapy parameters of the stimulation therapy.

14. The method of claim 1, wherein controlling the therapy module to deliver the therapy to the patient comprises controlling the therapy module to deliver electrical stimulation to at least one of a brain, muscle, or spinal cord of the patient.

15. The method of claim 1, wherein controlling the therapy module to deliver the therapy to the patient comprises controlling the therapy module to deliver a therapeutic agent to the patient.

16. A system comprising:

means for determining a patient is in a rapid eye movement (REM) sleep stage; and

means for delivering therapy to the patient based on the determination that the patient is in the REM sleep stage by the means for determining, wherein the therapy is configured to inhibit movement of the patient during the determined REM sleep stage;

means for detecting, while the therapy is being delivered to the patient during the determined REM sleep stage, at least one of the movement of the patient or a muscle tone of the patient; and

means for adjusting the therapy delivered to the patient by the means for delivering based on the at least one of the movement of the patient or the muscle tone of the patient detected by the means for detecting.

17. A system comprising:

a sensing module configured to detect at least one of movement of a patient or muscle tone of the patient;

a therapy module; and

a processor configured to determine the patient is in a rapid eye movement (REM) sleep stage, control the therapy module to deliver therapy to the patient based on the determination, wherein the therapy is configured to inhibit movement of the patient during the determined REM sleep stage, detect, while the therapy is being delivered to the patient during the determined REM sleep stage, the at least one of the movement of the patient or the muscle tone of the patient via the sensing module, and adjust the therapy delivered to the patient via the therapy module based on the at least one of the movement of the patient or the muscle tone of the patient detected via the sensing module.

18. The system of claim 17, wherein the sensing module comprises a first sensing module, wherein the processor is configured to determine the patient is in the REM sleep stage by at least:

sensing, via a second sensing module, a biosignal that is indicative of activity within a brain of the patient; and

determining the REM sleep stage based on the sensed biosignal.

19. The system of claim 18, wherein the sensed biosignal comprises a bioelectrical brain signal generated from at least one of local field potentials (LFP) within a brain of the patient, an electroencephalogram (EEG) signal, or an electrocorticogram (ECoG) signal.

20. The system of claim 17, wherein the therapy delivered by the therapy module comprises electrical stimulation therapy, and wherein the processor is configured to adjust the electrical stimulation therapy delivered to the patient by at least one of terminating the electrical stimulation or modifying one or more stimulation therapy parameters.

21. The system of claim 20, wherein the one or more stimulation therapy parameters comprise pulse rate, pulse width, pulse amplitude, electrode polarity, or electrode combination.

22. The system of claim 17, wherein the processor is configured to control the therapy module to deliver therapy to the patient by at least controlling the therapy module to deliver electrical stimulation therapy to a brain of the patient.

23. The system of claim 22, wherein the processor is configured to control the therapy module to deliver the electrical stimulation therapy to the brain of the patient by at least controlling the therapy module to deliver electrical stimulation to at least one of a globus pallidus pars interna (GPi), subthalamic nucleus (STN), striatum, pallidum, or substantia nigra of the brain.

24. The system of claim 23, wherein the processor is configured to control the electrical stimulation delivered to the at least one of the globus pallidus pars interna (GPi), subthalamic nucleus (STN), striatum, pallidum, or substantia nigra of the brain to have a frequency of between approximately 8 Hz and 30 Hz.

25. The system of claim 22, wherein the processor is configured to control the therapy module to deliver electrical stimulation therapy to the brain of the patient by at least controlling the therapy module to deliver of electrical stimulation to a midbrain nuclei of the brain.

26. The system of claim 25, wherein the processor is configured to control the electrical stimulation delivered to the midbrain nuclei to have a frequency of between approximately 80 Hz and 200 Hz.

27. The system of claim 17, wherein the processor is configured to subsequently determine that the patient is not in the REM sleep stage, and terminate the therapy delivered to the patient based on the determination that the patient is not in the REM sleep stage.

28. The system of claim 17, wherein the processor is configured to control the therapy module to deliver the therapy by at least controlling the therapy module to deliver electrical stimulation therapy to the patient.

29. The system of claim 28, wherein the processor is configured to control the therapy module to deliver the electrical stimulation therapy to the patient by at least one of initiating delivery of electrical stimulation or adjusting one or more stimulation therapy parameters of the stimulation therapy.

30. The system of claim 17, wherein the processor is configured to control the therapy module to deliver therapy to the patient by at least controlling the therapy module to deliver electrical stimulation to at least one of a brain, muscle, or spinal cord of the patient.

31. The system of claim 17, wherein the processor is configured to control the therapy module to deliver therapy by at least controlling the therapy module to deliver a therapeutic agent to the patient.

32. The system of claim 17, wherein the therapy is configured to relax the muscle tone of the patient to inhibit the movement of the patient during the determined REM sleep stage.

33. The system of claim 17, wherein the processor is configured to detect the muscle tone of the patient via the sensing module while the therapy is being delivered to the patient during the determined REM sleep stage, and adjust the therapy delivered to the patient via the therapy module based on the detected muscle tone of the patient.

34. A system comprising:

a sensing module configured to detect at least one of movement of a patient or muscle tone of the patient;

a therapy module configured to deliver therapy to the patient; and

a processor configured to determine the patient is in a rapid eye movement (REM) sleep stage, control the therapy module to deliver the therapy to the patient based on the determination, wherein the therapy is configured to relax muscle tone of the patient to inhibit the movement of the patient during the determined REM sleep stage, detect, while the therapy is being delivered to the patient during the determined REM sleep stage, the at least one of the movement of the patient or the muscle tone of the patient via the sensing module, and adjust the therapy delivered to the patient via the therapy module based on the at least one of the movement of the patient or the muscle tone of the patient detected via the sensing module.