Reversing cognitive-motor impairments in patients having a neuro-degenerative disease using a computational modeling approach to deep brain stimulation programming

• US 9,776,003 B2
• Filed: 05/06/2016
• Issued: 10/03/2017
• Est. Priority Date: 12/02/2009
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Alberts, Jay L., McIntyre, Cameron C.
• Primary Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US15/148,996
• Publication Number:
  US 20160250473A1
• Time in Patent Office: 515 Days
• 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 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/36135 using physiological parameters

Abstract

A system and method may provide for conducting a stimulation of anatomic regions to treat a neuromotor, neurocognitive or neuromotor and neurocognitive disorder, according to which stimulation, motor regions are stimulated, while creep of current to non-motor regions is minimized. Stimulation parameters may be selected based on tests of motor function, tests of cognitive function, and tests of a combination of motor and cognitive functions.

Claims

1. A method for treating a neurological disorder that results in abnormal motor function, the method comprising:

determining, by a computer processor, an estimated volume of tissue activated (VTA) using a set of stimulation parameters, wherein the estimated VTA comprises at least a portion of at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus and the estimated VTA comprises less than 10% of non-motor anatomical-neural regions of a subthalamic nucleus;

providing the set of stimulation parameters to a deep brain stimulation device comprising a leadwire and a plurality of electrodes disposed along the leadwire; and

stimulating the portion of the at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus using the deep brain stimulation device and the set of stimulation parameters.

2. The method of claim 1, further comprising obtaining, by the computer processor, a target volume of tissue activated (VTA), wherein the target VTA comprises less than 10% of the non-motor anatomical-neural regions of the subthalamic nucleus, wherein the target VTA comprises at least a portion of at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus.

3. The method of claim 2, wherein obtaining the target VTA comprises receiving, by the computer processor, a drawing of the target VTA from a user.

4. The method of claim 2, wherein determining the estimated VTA comprises determining the estimated VTA so that the estimated VTA closely matches the target VTA.

5. The method of claim 4, wherein determining the estimated VTA to closely match the target VTA comprises determining the estimated VTA so that the estimated VTA does not extend beyond a perimeter of the target VTA.

6. The method of claim 1, further comprising displaying the estimated VTA overlaid on a representation of a brain and the leadwire.

7. The method of claim 1, further comprising conducting at least one cognitive function test or motor function test during or after the stimulation.

8. The method of claim 7, further comprising modifying the set of stimulation parameters based on results of the at least one cognitive function test or motor function test.

9. The method of claim 8, wherein the results are used for modification of stimulation parameters to reduce creep of current to non-motor anatomic regions.

10. The method of claim 8, wherein the at least one cognitive function test or motor function test comprises an n-back test.

11. The method of claim 8, wherein the at least one cognitive function test or motor function test is a force-maintenance task.

12. The method of claim 1, wherein the estimated VTA comprises less than 10% of the globus pallidus.

13. A system for treating a neurological disorder that results in abnormal motor function, the system comprising:

a deep brain stimulation device configured and arranged for implantation in a patient and for providing electrical stimulation to the patient, the deep brain stimulation device comprising a leadwire and electrodes disposed along the leadwire; and

a computer processor configured and arranged to perform actions, the actions comprising;

determine an estimated volume of tissue activated (VTA) using a set of stimulation parameters, wherein the estimated VTA comprises at least a portion of at least one of the zona incerta, lenticular fasciculus, or motor region of a globus pallidus and the estimated VTA comprises less than 10% of non-motor anatomical-neural regions of a subthalamic nucleus; and

provide the set of stimulation parameters to the deep brain stimulation device for stimulating the portion of the at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus using the deep brain stimulation device and the set of stimulation parameters.

14. The system of claim 13, wherein the actions further comprise

obtain a target volume of tissue activated (VTA), wherein the target VTA comprises less than 10% of the non-motor anatomical-neural regions of the subthalamic nucleus, wherein the target VTA comprises at least a portion of at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus.

15. The system of claim 14, wherein the action of obtain the target VTA comprises receive a drawing of the target VTA from a user.

16. The system of claim 14, wherein the action of determine the estimated VTA comprises determine the estimated VTA so that the estimated VTA closely matches the target VTA.

17. The system of claim 16, wherein the action of determine the estimated VTA to closely match the target VTA comprises determine the estimated VTA so that the estimated VTA does not extend beyond a perimeter of the target VTA.

18. The system of claim 13, wherein the system further comprises a display coupled to the computer processor and the actions further comprise

display, on the display, the estimated VTA overlaid on a representation of a brain and the leadwire.

19. The system of claim 13, wherein the actions further comprise

conduct at least one cognitive function test or motor function test during or after the stimulation.

20. A system for treating a neurological disorder that results in abnormal motor function, the system comprising:

a deep brain stimulation device configured and arranged for implantation in a patient and for providing electrical stimulation to the patient, the deep brain stimulation device comprising a leadwire and electrodes disposed along the leadwire; and

a computer processor configured and arranged to perform actions, the actions comprising;

determine an estimated volume of tissue activated (VTA) using a set of stimulation parameters, wherein the estimated VTA comprises at least a portion of at least one of a zona incerta, a lenticular fasciculus, or motor region of a globus pallidus and the estimated VTA comprises less than 10% of the globus pallidus; and

provide the set of stimulation parameters to the deep brain stimulation device for stimulating the portion of the at least one of the zona incerta, lenticular fasciculus, or motor region of the globus pallidus using the deep brain stimulation device and the set of stimulation parameters.