Deep brain stimulation for sleep and movement disorders

• US 9,770,204 B2
• Filed: 11/11/2009
• Issued: 09/26/2017
• Est. Priority Date: 11/11/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Wu, Jianping, Nelson, Dwight E., Su, Xin, Molnar, Gregory F.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/616,513
• Publication Number:
  US 20110112590A1
• Time in Patent Office: 2,876 Days
• Field of Search: 607 2, 607 45
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36078 Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

Delivery of electrical stimulation to the substantia nigra and the subthalamic nucleus of a brain of a patient are independently controlled in order to treat sleep and movement disorders. Electrical stimulation of the subthalamic nucleus may be effective in treating symptoms associated with a movement disorder, and electrical stimulation of the substantia nigra may be effective in treating symptoms associated with a sleep disorder. During a sleep state of the patient, a sleep stage of the patient may be determined, and an electrical stimulation device may be controlled based on the determined sleep stage. Electrical stimulation of the substantia nigra and subthalamic nucleus may be delivered at substantially the same time or at different times.

Claims

1. A method comprising, with one or more processors:

determining a sleep stage of a patient;

controlling an electrical stimulation device to deliver electrical stimulation to a substantia nigra of a brain of the patient based on the determined sleep stage; and

controlling the electrical stimulation device to deliver electrical stimulation to a subthalamic nucleus of the brain of the patient based on the determined sleep stage of the patient,

wherein delivery of electrical stimulation to the substantia nigra and delivery of electrical stimulation to the subthalamic nucleus are independently controlled by the one or more processors.

2. The method of claim 1, wherein determining a sleep stage of a patient comprises receiving a biosignal that is indicative of activity within a brain of the patient and determining the sleep stage based on the biosignal.

3. The method of claim 1, wherein determining a sleep stage of a patient comprises determining whether a patient is in at least one of Stage 1, rapid eye movement, Deep Sleep, or Stage 2 sleep stages.

4. The method of claim 3, wherein controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra of the patient comprises at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the substantia nigra if the patient is in at least one of the Stage 1 or rapid eye movement sleep stages, and wherein controlling the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus of the patient comprises at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the subthalamic nucleus if the patient is in the at least one of the Stage 1 or rapid eye movement sleep stages.

5. The method of claim 3, wherein controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra of the patient comprises at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the substantia nigra if the patient is in the Stage 2 sleep stage, and wherein controlling the electrical stimulation device to deliver electrical stimulation to a subthalamic nucleus of the patient comprises at least one of deactivating electrical stimulation, activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the subthalamic nucleus if the patient is in the Stage 2 sleep stage.

6. The method of claim 3, wherein controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra of the patient comprises at least one of deactivating electrical stimulation or decreasing the intensity of electrical stimulation delivered to the substantia nigra if the patient is in the Deep Sleep sleep stage, and wherein controlling the electrical stimulation device to deliver electrical stimulation to a subthalamic nucleus of the patient comprises at least one of deactivating electrical stimulation or decreasing the intensity of electrical stimulation delivered to the subthalamic nucleus if the patient is in the Deep Sleep sleep stage.

7. The method of claim 1, further comprising, with the one or more processors:

determining a movement state of the patient; and

controlling the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus of the patient based on the determined movement state of the patient.

8. The method of claim 1, wherein controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra comprises controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra according to a first therapy program and controlling the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus comprises controlling the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus according to a second therapy program that is different than the first therapy program.

9. The method of claim 8, wherein controlling the electrical stimulation device to deliver electrical stimulation to the substantia nigra and the subthalamic nucleus comprises controlling the electrical stimulation device to deliver electrical stimulation according to the first and second electrical stimulation therapy programs substantially simultaneously.

10. The method of claim 8, wherein the first and second electrical stimulation therapy programs are delivered alternatively.

11. The method of claim 8, wherein controlling the electrical stimulation device to deliver electrical stimulation according to at least one of the first or second therapy programs comprises modifying at least one therapy parameter value of at least one of the first or second therapy programs based on the determined sleep stage.

12. The method of claim 1, further comprising:

sensing, with a sensing module, a biosignal of the patient via an implanted electrode electrically coupled to the electrical stimulation device; and

determining, with the one or more processors, a location of the implanted electrode within the brain of the patient based on the biosignal.

13. A system comprising:

an electrical stimulation device; and

a processor that determines a sleep stage of a patient, controls the electrical stimulation device to deliver electrical stimulation to a substantia nigra of a brain of the patient based on the determined sleep stage, and controls the electrical stimulation device to deliver electrical stimulation to a subthalamic nucleus of the brain of the patient based on the determined sleep stage of the patient, wherein the processor independently controls the delivery of electrical stimulation to the substantia nigra and the subthalamic nucleus.

14. The system of claim 13, further comprising a sensing module that senses a biosignal that is indicative of activity within the brain of the patient, wherein the processor determines the sleep stage of the patient based on the biosignal.

15. The system of claim 13, wherein the sleep stage comprises at least one of Stage 1, rapid eye movement, Deep Sleep, or Stage 2 sleep stages.

16. The system of claim 15, wherein, if the patient is in at least one of the Stage 1 or rapid eye movement sleep stages, the processor controls the electrical stimulation device to deliver electrical stimulation to the substantia nigra by at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the substantia nigra, and wherein the processor controls the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus by at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the subthalamic nucleus.

17. The system of claim 15, wherein, if the patient is in the Stage 2 sleep stage, the processor controls the electrical stimulation device to deliver electrical stimulation to the substantia nigra by at least one of activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the substantia nigra, and wherein the processor controls the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus by at least one of deactivating electrical stimulation, activating electrical stimulation, increasing an intensity of electrical stimulation, or decreasing an intensity of electrical stimulation delivered to the subthalamic nucleus.

18. The system of claim 15, wherein, if the patient is in the Deep Sleep sleep stage, the processor controls the electrical stimulation device to deliver electrical stimulation to the substantia nigra by at least one of deactivating electrical stimulation or decreasing the intensity of electrical stimulation delivered to the substantia nigra, and wherein the processor controls the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus of the patient by at least one of deactivating electrical stimulation or decreasing the intensity of electrical stimulation delivered to the subthalamic nucleus.

19. The system of claim 13, wherein the processor determines a movement state of the patient and controls the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus of the patient based on the determined movement state of the patient.

20. The system of claim 13, wherein the processor controls the electrical stimulation device to deliver electrical stimulation to the substantia nigra according to a first therapy program and controls the electrical stimulation device to deliver electrical stimulation to the subthalamic nucleus according to a second therapy program that is different than the first therapy program.

21. The system of claim 20, wherein the processor controls the electrical stimulation device to substantially simultaneously deliver electrical stimulation to the substantia nigra and the subthalamic nucleus according to the first and second therapy programs, respectively.

22. The system of claim 20, wherein the processor controls the electrical stimulation device to alternatively deliver electrical stimulation to the substantia nigra and the subthalamic nucleus according to the first and second therapy programs, respectively.

23. The system of claim 13, further comprising a sensing module that senses a biosignal that is indicative of activity within a brain of the patient via an electrode electrically coupled to the electrical stimulation device, wherein the processor determines a location of the electrode within the brain of the patient based on the biosignal.

24. A non-transitory computer-readable medium comprising instructions that cause a programmable processor to:

determine a sleep stage of a patient based on a brain signal sensed within a brain of the patient;

control an electrical stimulation device to deliver electrical stimulation to a substantia nigra of the brain of the patient based on the determined sleep stage; and

control the electrical stimulation device to deliver electrical stimulation to a subthalamic nucleus of the brain of the patient based on the determined sleep stage of the patient, wherein the instructions cause the programmable processor to independently control the electrical stimulation to deliver stimulation to the substantia nigra and the subthalamic nucleus.

25. The non-transitory computer-readable medium of claim 24, further comprising instructions that cause the programmable processor to determine a location of an implanted electrode within the brain of the patient based on a biosignal sensed by a sensing module via the implanted electrode.

26. A system comprising:

means for generating and delivering electrical stimulation to a brain of a patient;

means for determining a sleep stage of a patient;

means for controlling the means for generating and delivering electrical stimulation to deliver electrical stimulation to a substantia nigra of the brain of the patient based on the determined sleep stage; and

means for controlling the means for generating and delivering electrical stimulation to deliver electrical stimulation to a subthalamic nucleus of the brain of the patient based on the determined sleep stage of the patient, wherein the means for controlling the means for generating and delivering electrical stimulation to deliver electrical stimulation to the subthalamic nucleus controls the delivery of electrical stimulation to the subthalamic nucleus independently of the delivery of electrical stimulation to the substantia nigra.

27. The system of claim 26, further comprising means for sensing a biosignal that is indicative of activity within a brain of the patient, wherein the means for determining the sleep stage of the patient determines the sleep stage based on the biosignal.

28. The system of claim 26, further comprising:

means for sensing a biosignal of the patient via an implanted electrode electrically coupled to the means for generating and delivering electrical stimulation to the brain of the patient; and

means for determining a location of the implanted electrode within the brain of the patient based on the biosignal.