System and method for monitoring or treating nervous system disorders

• US 8,041,419 B2
• Filed: 12/19/2005
• Issued: 10/18/2011
• 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.
• Primary Examiner(s): NASSER, ROBERT L
• Application Number:
  US11/311,393
• Publication Number:
  US 20060135877A1
• Time in Patent Office: 2,129 Days
• Field of Search: 600/544
• US Class Current: 600/544
• 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. A medical device system comprising:

(a) a brain monitoring element for sensing activity of the brain and outputting a brain signal;

(b) a cardiac monitoring element for sensing activity of the heart and outputting a cardiac signal; and

(c) a processor in communication with the brain monitoring element and the cardiac monitoring element, the processor configured to;

(i) receive the brain signal and obtain information identifying one or more neurological events in the brain signal;

(ii) receive the cardiac signal and obtain information identifying one or more cardiac events in the cardiac signal; and

(iii) compare the brain signal to the cardiac signal,

wherein the processor being configured to compare the brain signal to the cardiac signal comprises the processor being configured to perform the following;

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

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

2. The medical device system of claim 1 wherein the medical device system includes a user interface for display of the brain signal and the cardiac signal, the user interface in communication with the processor, and wherein the processor being configured to obtain information identifying one or more neurological events in the brain signal comprises the processor being configured to receive a start point and an end point of each neurological event from a user via the user interface, and wherein the processor being configured to obtain information identifying one or more cardiac events in the cardiac signal comprises the processor being configured to receive a start point and an end point of each cardiac event from a user via the user interface.

3. The medical device system of claim 1 wherein the processor being configured to obtain information identifying one or more neurological events in the brain signal comprises the processor being configured to detect one or more neurological events from the brain signal, and wherein the processor being configured to obtain information identifying one or more cardiac events in the cardiac signal comprises the processor being configured to detect one or more cardiac events from the cardiac signal.

4. The medical device system of claim 1 wherein the processor being configured to compare the brain signal to the cardiac signal further comprises the processor being configured to perform the following:

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

(b) determining the number of neurological events that are not within the specified time period of a cardiac event; and

(c) determining the number of cardiac events that are not within the specified time period of a neurological event.

5. The medical device system of claim 1 wherein the processor further performs the following for the neurological events within the specified time period of a cardiac event:

(a) determining the temporal order of the neurological event and the cardiac event.

6. The medical device system of claim 5 wherein the processor further performs the step of determining the amount of time between the neurological event and the cardiac event.

7. The medical device system of claim 6 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 temporal location of the cardiac event.

8. The medical device system of claim 1 wherein the specified time period is programmable.

9. The medical device system of claim 1 wherein the processor is further configured to enable a cardiac event detection algorithm for detection of a neurological event, based on the results of comparing the brain signal to the cardiac signal.

10. The medical device system of claim 9 further comprising a neurological therapy delivery module, wherein the neurological therapy delivery module is configured to provide a therapeutic output to treat a neurological disorder when the cardiac event detection algorithm detects a cardiac event.

11. The medical device system of claim 1 wherein the processor is further configured to obtain information categorizing each cardiac event as one or more of first type cardiac event and second type cardiac event.

12. The medical device system of claim 1 wherein the processor is housed in a device configured to be external to a human body.

13. The medical device system of claim 1 wherein the processor is configured to be implanted in a human body.

14. A medical device system comprising:

(a) a brain monitoring element for sensing activity of the brain and outputting a brain signal;

(b) a cardiac monitoring element for sensing activity of the heart and outputting a cardiac signal; and

(c) a processor in communication with the brain monitoring element and the cardiac monitoring element, the processor configured to;

(i) receive the brain signal and obtain information identifying one or more neurological events in the brain signal;

(ii) receive the cardiac signal and obtain information identifying one or more cardiac events in the cardiac signal; and

(iii) compare the brain signal to the cardiac signal,

wherein comparing the brain signal to the cardiac signal performed by the processor comprises;

(a) categorizing the neurological event as cardiac matched when there is a cardiac event in close temporal relationship with the neurological event; and

(b) 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.

15. The medical device system of claim 14 wherein computing the rate of concordance by the processor comprises calculating the number of cardiac matched events divided by the number of neurological events.

16. A medical device system comprising:

(a) a brain monitoring element for sensing activity of the brain and outputting a brain signal;

(b) a cardiac monitoring element for sensing activity of the heart and outputting a cardiac signal; and

(c) a processor in communication with the brain monitoring element and the cardiac monitoring element, the processor configured to;

(i) receive the brain signal and obtain information identifying one or more neurological events in the brain signal;

(ii) receive the cardiac signal and obtain information identifying one or more cardiac events in the cardiac signal; and

(iii) compare the brain signal to the cardiac signal,

wherein the processor is further configured to perform the following;

(a) dividing the neurological event into at least two segments; and

(b) assigning the cardiac event to one or more of the segments according to when the cardiac event occurred relative to the segments.

17. The medical device system of claim 16 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.

18. A medical device system comprising:

(a) a brain monitoring element for sensing activity of the brain and outputting a brain signal;

(b) a cardiac monitoring element for sensing activity of the heart and outputting a cardiac signal; and

(c) a processor in communication with the brain monitoring element and the cardiac monitoring element, the processor configured to;

(i) receive the brain signal and obtain information identifying one or more neurological events in the brain signal;

(ii) receive the cardiac signal and obtain information identifying one or more cardiac events in the cardiac signal; and

(iii) compare the brain signal to the cardiac signal,

wherein the processor is further configured to obtain information categorizing each cardiac event as one or more of first type cardiac event and second type cardiac event, and

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

19. A medical device system comprising:

(a) a brain monitoring element for sensing activity of the brain and outputting a brain signal;

(b) a cardiac monitoring element for sensing activity of the heart and outputting a cardiac signal; and

(c) a processor in communication with the brain monitoring element and the cardiac monitoring element, the processor configured to;

(i) receive the brain signal and obtain information identifying one or more neurological events in the brain signal;

(ii) receive the cardiac signal and obtain information identifying one or more cardiac events in the cardiac signal; and

(iii) compare the brain signal to the cardiac signal,

wherein the processor is further configured to obtain information categorizing each cardiac event as one or more of first type cardiac event and second type cardiac event, and

wherein comparing the brain signal to the cardiac signal performed by the processor comprises;

(a) 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;

(b) 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;

(c) 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

(d) 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.

20. The medical device system of claim 19 wherein the processor is further configured to enable the use of the detection of a first type cardiac event for detection of a neurological event based on the first rate of concordance.

21. A medical device system comprising:

(a) brain monitoring means for sensing activity of the brain and outputting a brain signal;

(b) cardiac monitoring means for sensing activity of the heart and outputting a cardiac signal; and

(c) processing means for receiving the brain signal, receiving the cardiac signal, and comparing the brain signal to the cardiac signal,

wherein the processing means further comprises;

(a) neurological event detection means for evaluating the brain signal and identifying one or more neurological events; and

(b) cardiac event detection means for evaluating the cardiac signal and identifying one or more cardiac events, and

wherein the processing means further comprises;

concordance means for determining a rate of concordance between the neurological events and the cardiac events.

22. A non-transitory computer readable medium containing executable instructions causing a processor to perform the following:

(a) receiving a brain signal from a brain monitoring element;

(b) receiving a cardiac signal from a cardiac monitoring element; and

(c) comparing the brain signal to the cardiac signal,

wherein the step of comparing the brain signal to the cardiac signal comprises;

(a) detecting one or more neurological events in the brain signal;

(b) detecting one or more cardiac events in the cardiac signal;

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

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

23. The computer readable medium of claim 22 wherein the step of comparing the brain signal to the cardiac signal further comprises:

(a) determining the temporal order of the neurological event and the cardiac event that is within a specified time period of the neurological event.