Stimulation electrode selection

• US 9,814,885 B2
• Filed: 04/27/2010
• Issued: 11/14/2017
• Est. Priority Date: 04/27/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Molnar, Gabriela C., Goetz, Steven M., Csavoy, Andrew N.
• Primary Examiner(s): Carey, Michael
• Assistant Examiner(s): Bays, Pamela M
• Application Number:
  US12/768,403
• Publication Number:
  US 20110264165A1
• Time in Patent Office: 2,758 Days
• Field of Search: 607 45, 607 46, 607 62
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• 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

One or more stimulation electrodes may be selected based on a bioelectrical signal sensed in a brain of a patient with a sense electrode combination that comprises at least one electrode and a physiological model that indicates one or more anatomical structures of the brain of the patient that are proximate the implanted at least one electrode. In some examples, the bioelectrical brain signal indicates which electrodes are located closest to a target tissue site. The physiological model can be generated based on a location of implanted at least one electrode within a patient and patient anatomy data, which can, for example, indicate one or more characteristics of patient tissue proximate to the implanted at least one electrode. In some example, the physiological model includes a therapy field model that represents a region of the tissue of the patient to which therapy is delivered via a selected set of electrodes.

Claims

1. A method comprising:

sensing a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

selecting one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site;

accessing a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient; and

selecting, based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination and the physiological model, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient.

2. The method of claim 1, wherein the physiological model comprises at least one of an electrical field model that indicates where electrical stimulation propagates from the selected stimulation electrode combination, an activation field model that indicates neurons of the brain of the patient that will be activated by the electrical stimulation delivered by the selected stimulation electrode combination, or a voltage gradient or current density model that indicates a distribution of the electrical stimulation delivered via the selected stimulation electrode combination.

3. The method of claim 1, wherein the physiological model indicates one or more anatomical structures of the brain of the patient proximate the at least one electrode within the brain of the patient.

4. The method of claim 1, wherein accessing the physiological model compromises:

generating the physiological model, wherein generating the physiological model compromises;

determining a stereotactic coordinate of a lead comprising the at least one electrode within the brain of the patient;

determining one or more anatomical structures of the brain of the patient proximate the lead based on the stereotactic coordinate; and

generating the physiological model that indicates the one or more anatomical structures of the brain of the patient proximate the lead.

5. The method of claim 1, wherein selecting one of the sense electrode combinations based on the sensed bioelectrical signals comprises:

determining a frequency domain characteristic for each bioelectrical signal of the plurality of bioelectrical signals, the signal characteristic comprising the frequency domain characteristic;

determining a plurality of relative values of the frequency domain characteristic, wherein each relative value of the plurality of relative values is based on at least two of the frequency domain characteristics; and

selecting at least one electrode of the plurality of electrodes for delivering stimulation to the patient based on the plurality of relative values.

6. The method of claim 1, wherein selecting one of the sense electrode combinations based on the sensed bioelectrical signals comprises:

comparing a pattern of the each of the sensed bioelectrical signals to a template, the signal characteristic comprising the pattern; and

selecting one or more sense electrode combinations that correspond to sensed bioelectrical signals that substantially match the template.

7. The method of claim 1, wherein selecting one of the sense electrode combinations comprises selecting the sense electrode combination based on a variability of the respective sensed bioelectrical signal, the signal characteristic comprising the variability.

8. The method of claim 1, wherein selecting one of the sense electrode combinations comprises:

determining at least one of a mean, median, peak or lowest amplitude of each of the sensed bioelectrical signals, the signal characteristic comprising the at least one of the mean, median, peak or lowest amplitude; and

selecting the sense electrode combination based on the mean, median, peak or lowest amplitude of the respective sensed bioelectrical signal.

9. The method of claim 1, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein selecting the stimulation electrode combination comprises:

determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects; and

selecting the sense electrode combination as the stimulation electrode combination in response to determining the therapy field at least one of at least partially overlaps with a target anatomical structure of the brain of the patient or does not overlap with the one or more anatomical structures of the brain associated with stimulation-induced side effects.

10. The method of claim 1, further comprising displaying the physiological model via a display of a device, and wherein selecting the stimulation electrode combination comprises, after displaying the physiological model, receiving user input selecting the stimulation electrode combination.

11. The method of claim 1, wherein the physiological model indicates one or more characteristics of tissue proximate electrodes of the sense electrode combination, the method further comprising displaying the physiological model via a display of a device, wherein selecting the stimulation electrode combination comprises, after displaying the physiological model, receiving user input selecting the sense electrode combination as the stimulation electrode combination.

12. A method comprising:

sensing a bioelectrical signal in a brain of a patient with a sense electrode combination that comprises at least one electrode;

accessing a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient;

selecting, based on a signal characteristic of the bioelectrical signal, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient, the signal characteristic indicating a location of the at least one electrode relative to a target tissue site; and

confirming the stimulation electrode combination based on the physiological model.

13. The method of claim 12, wherein confirming the stimulation electrode combination based on the physiological model comprises determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in a target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation-induced side effects.

14. The method of claim 13, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in the target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation-induced side effects comprises determining whether the therapy field at least partially overlaps with the target anatomical structure or the one or more anatomical structures of the brain associated with stimulation-induced side effects.

15. A method comprising:

sensing a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

selecting one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site;

accessing a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient;

selecting, based on the physiological model, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient; and

confirming the selected stimulation electrode combination based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination.

16. The method of claim 15, wherein confirming the selected stimulation electrode combination based on the bioelectrical signal comprises:

sensing the bioelectrical signal in the brain of the patient with the stimulation electrode combination selected based on the physiological model; and

determining whether the bioelectrical signal sensed via the stimulation electrode combination indicates the stimulation electrode combination is proximate a target stimulation site within the brain of the patient.

17. A system comprising:

a sensing module configured to sense a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode; and

a processor configured to select one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site, access a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, and select, based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination and the physiological model, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient.

18. The system of claim 17, wherein the physiological model comprises at least one of an electrical field model that indicates where electrical stimulation propagates from the stimulation electrode combination, an activation field model that indicates neurons of the brain of the patient that will be activated by the electrical stimulation delivered by the stimulation electrode combination, or a voltage gradient or current density model that indicates a distribution of the electrical stimulation delivered via the stimulation electrode combination.

19. The system of claim 17, wherein the physiological model indicates one or more anatomical structures of the brain of the patient proximate the at least one electrode within the brain of the patient.

20. The system of claim 17, wherein the processor is configured to generate the physiological model by at least determining a stereotactic coordinate of a lead comprising the at least one electrode within the brain of the patient and determining one or more anatomical structures of the brain of the patient proximate the lead based on the stereotactic coordinate, wherein the physiological model indicates the one or more anatomical structures of the brain of the patient proximate the at least one electrode.

21. The system of claim 17, wherein the processor is configured to select one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

determining a frequency domain characteristic for each bioelectrical signal of the plurality of bioelectrical signals, the signal characteristic comprising the frequency domain characteristic;

determining a plurality of relative values of the frequency domain characteristic, wherein each relative value of the plurality of relative values is based on at least two of the frequency domain characteristics; and

selecting at least one electrode of the plurality of electrodes for delivering stimulation to the patient based on the plurality of relative values.

22. The system of claim 17, wherein the processor is configured to select one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

comparing a pattern of the each of the sensed bioelectrical signals to a template, the signal characteristic comprising the pattern; and

selecting one or more sense electrode combinations that correspond to sensed bioelectrical signals that substantially match the template.

23. The system of claim 17, wherein the processor is configured to select one of the sense electrode combinations based on the sensed bioelectrical signals based on a variability of the respective sensed bioelectrical signal, the signal characteristic comprising the variability.

24. The system of claim 17, wherein the processor is configured to select one of the sense electrode combinations based on the sensed bioelectrical signals by at least:

determining at least one of a mean, median, peak or lowest amplitude of each of the sensed bioelectrical signals, the signal characteristic comprising the at least one of the mean, median, peak or lowest amplitude; and

selecting the sense electrode combination based on the mean, median, peak or lowest amplitude of the respective sensed bioelectrical signal.

25. The system of claim 17, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein the processor is configured to select the stimulation electrode combination by at least determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects, and selecting the sense electrode combination as the stimulation electrode combination if the therapy field at least one of at least partially overlaps with a target anatomical structure of the brain of the patient or does not overlap with the one or more anatomical structures of the brain associated with stimulation-induced side effects.

26. The system of claim 17, further comprising a user interface comprising a display, wherein the processor is configured to display the physiological model via the display, and select the stimulation electrode combination based on user input received via the user interface after displaying the physiological model.

27. A system comprising:

a sensing module configured to sense a bioelectrical signal in a brain of a patient with a sense electrode combination that comprises at least one electrode; and

a processor configured to access a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, select, based on a signal characteristic of the bioelectrical signal, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient, the signal characteristic indicating a location of the at least one electrode relative to a target tissue site, and confirm the stimulation electrode combination based on the physiological model.

28. The system of claim 27, wherein the processor is configured to confirm the stimulation electrode combination based on the physiological model by at least determining whether the electrical stimulation delivered to the brain of the patient via the stimulation electrode combination at least one of stimulates tissue in a target anatomical structure of the brain of the patient or stimulates one or more anatomical structures of the brain associated with stimulation induced side effects.

29. A system comprising:

a sensing module configured to sense a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode; and

a processor configured to select one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site, access a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, select, based on the physiological model, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient, and confirm the selected stimulation electrode combination based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination.

30. The system of claim 29, wherein the processor is configured to confirm the selected stimulation electrode combination based on the bioelectrical signal by at least controlling the sensing module to sense the bioelectrical signal in the brain of the patient with the stimulation electrode combination selected based on the physiological model, and determining whether the bioelectrical signal sensed via the stimulation electrode combination indicates the stimulation electrode combination is proximate a target stimulation site within the brain of the patient.

31. A system comprising:

means for sensing a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

means for selecting one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site; and

means for selecting, based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination and a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient.

32. A system comprising:

means for sensing a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

means for selecting one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site;

means for selecting, based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient, the signal characteristic indicating a location of the at least one electrode relative to a target tissue site; and

means for confirming the stimulation electrode combination selection based on a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, wherein the physiological model comprises a therapy field model that indicates where stimulation will propagate from electrodes of the stimulation electrode combination, and wherein the means for confirming confirms the sitmulation electrode combination by at least determining whether the therapy field at least partially overlaps with a target anatomical structure of the brain of the patient or one or more anatomical structures of the brain associated with stimulation-induced side effects.

33. A system comprising:

means for sensing a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

means for selecting one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site;

means for selecting, based on a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient, a electrode combination for delivering electrical stimulation to the brain of the patient; and

means for confirming the selected stimulation electrode combination based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination.

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

receive, from a sensing module, a plurality of bioelectrical signals in a brain of a patient with respective sense electrode combinations that each comprise at least one electrode;

select one of the sense electrode combinations based on a signal characteristic of each of the sensed bioelectrical signals, the signal characteristic indicating a location of the at least one electrode of the respective sense electrode combination relative to a target tissue site;

access a physiological model that indicates one or more characteristics of tissue proximate the at least one electrode within the brain of the patient; and

select, based on the signal characteristic of the bioelectrical signal sensed with the selected sense electrode combination and the physiological model, a stimulation electrode combination for delivering electrical stimulation to the brain of the patient.