Method for Monitoring or Treating Nervous System Disorders

• US 20110105913A1
• Filed: 12/10/2010
• Published: 05/05/2011
• Est. Priority Date: 12/17/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Giftakis, Jonathon E., Graves, Nina M.
• Granted Patent: US 8,744,562 B2
• Time in Patent Office: Days
• US Class Current: 600/483
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/291 for electroencephalography [EEG]
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/37247 : User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37282 : characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/37288 : Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/39622 : Pacing therapy

Abstract

A medical device system that includes a brain monitoring element, cardiac monitoring element and a processor. The processor is configured to receive a brain signal from the brain monitoring element and a cardiac signal from the cardiac monitoring element. The processor is further configured to compare the brain signal to the cardiac signal. A method of comparing a brain signal to a cardiac signal is also provided.

Claims

1-38. -38. (canceled)

39. A method for comparing a brain signal and a cardiac signal, comprising:

receiving a brain signal for a period of time;

receiving a cardiac signal for a period of time;

obtaining information identifying one or more neurological events in the brain signal;

obtaining information identifying one or more cardiac events in the cardiac signal; and

comparing the brain signal and the cardiac signal to determine a relationship between the one or more neurological events and the one or more cardiac events.

40. The method of claim 39, wherein comparing the brain signal to the cardiac signal comprises:

for each of the one or more neurological events, determining whether the neurological event is within a specified time period of one of the one or more cardiac events; and

for each of the one or more cardiac events, determining whether the cardiac event is within a specified time period of one of the one or more neurological events.

41. The method of claim 40, further comprising:

determining the number of neurological events within the specified time period of a cardiac event;

determining the number of neurological events that are not within the specified time period of one of the one or more cardiac events; and

determining the number of cardiac events that are not within the specified time period of one of the one or more neurological events.

42. The method of claim 40, further comprising, for the neurological events within the specified time period of a cardiac event, determining the temporal order of the neurological event and the cardiac event.

43. The method of claim 42, further comprising determining the amount of time between the neurological event and the cardiac event.

44. The method of claim 43, wherein determining the amount of time between the neurological event and the cardiac event comprises comparing a first reference point indicative of the temporal location of the neurological event to a second reference point indicative of the temporal location of the cardiac event.

45. The method of claim 40, wherein the specified time period is programmable.

46. The method of claim 39, wherein obtaining information identifying the one or more neurological events in the brain signal comprises receiving a start point and an end point of each neurological event from a user via a user interface and wherein obtaining information identifying the one or more cardiac events in the cardiac signal comprises receiving a start point and an end point of each cardiac event from a user via a user interface.

47. The method of claim 39, wherein obtaining information identifying the one or more neurological events in the brain signal comprises detecting the one or more neurological events from the brain signal and wherein obtaining information identifying the one or more cardiac events in the cardiac signal comprises detecting the one or more cardiac events from the cardiac signal.

48. The method of claim 39, further comprising dividing each of the neurological events into at least two segments and assigning one of the cardiac events to one or more of the segments according to when the cardiac event occurred relative to the segments.

49. The method of claim 48, wherein the neurological event is a seizure and the at least two segments comprise three segments comprising a pre-ictal segment, an ictal segment and a post-ictal segment.

50. The method of claim 39, further comprising enabling a cardiac event detection algorithm for detection of a neurological event, based on results of comparing the brain signal to the cardiac signal.

51. The method of claim 50, further comprising providing a therapeutic output to treat a neurological disorder when the cardiac event detection algorithm detects a cardiac event.

52. A method for comparing a brain signal to a cardiac signal, comprising:

receiving a brain signal for a period of time;

receiving a cardiac signal for a period of time;

obtaining information identifying one or more neurological events in the brain signal;

obtaining information identifying one or more cardiac events in the cardiac signal; and

comparing the brain signal and the cardiac signal to determine a relationship between the one or more neurological events and the one or more cardiac events, the comparing comprising

categorizing each of the identified neurological events as cardiac matched when there is a cardiac event within a specified time period of the neurological event; and

computing a rate of concordance between the neurological events and the cardiac events based on the number of cardiac matched events and the number of neurological events.

53. The method of claim 52, wherein computing the rate of concordance comprises determining the number of cardiac matched events divided by the number of neurological events.

54. The method of claim 52, wherein obtaining information identifying the one or more neurological events in the brain signal comprises applying a neurological event detection algorithm to the brain signal and wherein obtaining information identifying the one or more cardiac events in the cardiac signal comprises applying a cardiac event detection algorithm to the cardiac signal.

55. The method of claim 52, further comprising for each neurological event categorized as cardiac matched, determining the temporal order of the neurological event and the cardiac event that is within a specified time period of the neurological event.

56. The method of claim 55, further comprising categorizing each of the cardiac events as cardiac unmatched when there is no neurological event within a specified time period of the cardiac event.

57. The method of claim 56, further comprising determining whether neurological event detection is improved by using the cardiac signal.

58. The method of claim 57, wherein determining whether the neurological event detection is improved comprises considering the rate of concordance, the temporal order of the cardiac matched events, and the number of cardiac unmatched events.

59. The method of claim 57, further comprising activating a cardiac event detection algorithm for use in neurological event detection based on a determination that the neurological event detection is improved by using the cardiac signal.

60. The method of claim 59, wherein the neurological event to be detected by the cardiac event detection algorithm is a seizure.

61. A method for comparing a brain signal to a cardiac signal, comprising:

receiving a brain signal for a period of time;

receiving a cardiac signal for a period of time;

obtaining information identifying one or more neurological events in the brain signal;

obtaining information identifying one or more cardiac events in the cardiac signal; and

comparing the brain signal and the cardiac signal to determine a relationship between the one or more neurological events and the one or more cardiac events, the comparing comprising obtaining information categorizing each cardiac event as one or more of first type cardiac event and second type cardiac event.

62. The method of claim 61, wherein the first type cardiac event and the second type cardiac event are selected from the group consisting of bradycardia, asystole, tachyrhythmia, ST segment elevation.

63. The method of claim 61, wherein the comparing the brain signal and the cardiac signal further comprises:

categorizing the neurological event as first type cardiac matched when there is a first type cardiac event within a specified time period of the neurological event;

categorizing the neurological event as second type cardiac matched when there is a second type cardiac event within a specified time period of the neurological event;

computing a first rate of concordance between the neurological events and the first type cardiac events based on the number of first type cardiac matched events and the number of neurological events; and

computing a second rate of concordance between the neurological events and the second type cardiac events based on the number of second type cardiac matched events and the number of neurological events.

64. The method of claim 63, further comprising enabling the use of detection of a first type cardiac event for detection of a neurological event based on the first rate of concordance.