Brain stimulation models, systems, devices, and methods

• US 20080114233A1
• Filed: 01/14/2008
• Published: 05/15/2008
• Est. Priority Date: 07/07/2004
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: McIntyre, Cameron, Henderson, Jaimie, Hall, John, Butson, Christopher
• Granted Patent: US 7,860,548 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

This document discusses, among other things, brain stimulation models, systems, devices, and methods, such as for deep brain stimulation (DBS) or other electrical stimulation. A model computes a volume of influence region for a simulated electrical stimulation using certain stimulation parameters, such as amplitude, pulsewidth, frequency, pulse morphology, electrode contact selection or location, return path electrode selection, pulse polarity, etc. The model uses a non-uniform tissue conductivity. This accurately represents brain tissue, which has highly directionally conductive neuron pathways yielding a non-homogeneous and anisotropic tissue medium. In one example, the non-uniform tissue conductivity is obtained from diffusion tensor imaging (DTI) data. In one example, a second difference of an electric potential distribution is used to define a volume of activation (VOA) or similar volume of influence. In another example, a neuron or axon model is used to calculate the volume of influence without computing the second difference of the electric potential distribution.

Claims

1. A computer-assisted method comprising:

displaying volumetric imaging data representing an anatomic volume of a brain of a patient;

guiding an electrode into the anatomic volume represented by the imaging data;

displaying an actual first electrode location of the electrode in the anatomic volume;

using a computer model in calculating at least one volume of influence, wherein the volume of influence comprises a predicted volume of tissue affected by an electrical stimulation delivered by the displayed first electrode, and wherein calculating the volume of influence comprises at least one of;

i) calculating a second difference of a potential distribution to represent the volume of influence;

or

ii) calculating the volume of influence includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume; and

displaying the calculated volume of influence to a user.

2. The method of claim 1, in which the displaying the volumetric imaging data includes displaying the volumetric imaging data on a computer display along with a displayed indication of the first electrode location.

3. The method of claim 1, in which the displaying the volumetric imaging data includes displaying the volumetric imaging data on a computer display along with a displayed indication of the first electrode location, a displayed indication of an anatomic entry target location, and a displayed indication of a trajectory between the anatomic entry target location and the first electrode location.

4. The method of claim 1, in which the calculating the volume of influence near the first electrode location in the anatomic volume includes calculating a second difference of a potential distribution to represent the volume of influence.

5. The method of claim 1, in which the calculating the volume of influence near the first electrode location in the anatomic volume includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume.

6. The method of claim 1, further comprising:

moving the electrode from the first electrode location to a different second electrode location;

recalculating the volume of influence; and

displaying the recalculated volume of influence to the user.

7. A machine-accessible medium comprising instructions for:

displaying volumetric imaging data representing an anatomic volume of a brain of a patient;

receiving location information about an electrode that is guided into the anatomic volume represented by the imaging data;

displaying a first electrode location of the electrode in the anatomic volume;

using a computer model in calculating at least one volume of influence, wherein the volume of influence comprises a predicted volume of tissue affected by an electrical stimulation delivered by the displayed first electrode, and wherein calculating the volume of influence comprises at least one of;

i) calculating a second difference of a potential distribution to represent the volume of influence, or

ii) calculating the volume of influence includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume; and

displaying the calculated volume of influence to a user.

8. The machine-accessible medium of claim 7, in which the displaying the volumetric imaging data includes displaying the volumetric imaging data on a computer display along with a displayed indication of the first electrode location and a displayed indication of a trajectory between an anatomic entry target location and the first electrode location.

9. The machine-accessible medium of claim 7, in which the calculating the volume of influence near the first electrode location in the anatomic volume includes calculating a second difference of a potential distribution to represent the volume of influence.

10. The machine-accessible medium of claim 7, in which the calculating the volume of influence near the first electrode location in the anatomic volume includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume.

11. The machine-accessible medium of claim 7, further comprising instructions for:

recalculating the volume of activation at a second electrode location that is different from the first electrode location; and

displaying the recalculated volume of activation to the user.

12. A system comprising:

an imaging data storage circuit to store volumetric imaging data representing an anatomic volume of a brain of a patient;

an electrode position interface circuit to receive information about an electrode location of an electrode being inserted into the anatomic volume;

a processor circuit, coupled to the imaging data storage circuit and the electrode position interface circuit, the processor circuit including a computer model configured for calculating at least one volume of influence, wherein the volume of influence comprises a predicted volume of tissue affected by an electrical stimulation delivered by the an electrode, and wherein calculating the volume of influence comprises at least one of;

i) calculating a second difference of a potential distribution to represent the volume of influence, or

ii) calculating the volume of influence includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume; and

a display, coupled to the processor circuit, the display operable to display the electrode location and the calculated volume of influence near the electrode location.

13. The system of claim 12, in which the display is also operable to display the actual electrode location.

14. The system of claim 13, in which the display is also operable to display a trajectory between an anatomic entry location and the target electrode location.

15. The system of claim 12, in which the processor is operable to calculate a second difference of a potential distribution to represent the volume of influence.

16. The system of claim 12, in which the processor is operable to calculate the volume of influence near the first electrode location in the anatomic volume includes using an electric field model together with a multi-compartment neuron model oriented and positioned to represent at least one actual nerve pathway in the anatomic volume.

17. The system of claim 12, in which the processor circuit is operable to recalculate the volume of activation if the electrode is moved from the first electrode location to a different second electrode location, and in which the display is operable to display the recalculated volume of influence.