Therapy control based on a patient movement state

• US 8,121,694 B2
• Filed: 09/25/2008
• Issued: 02/21/2012
• Est. Priority Date: 10/16/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Molnar, Gregory F., Gill, Steven S., Miesel, Keith A., Lent, Mark S., Denison, Timothy J., Panken, Eric J., Wahlstrand, Carl D., Werder, Jonathan C.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/237,799
• Publication Number:
  US 20090099627A1
• Time in Patent Office: 1,244 Days
• Field of Search: 607/45
• US Class Current: 607/45
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/374 Detecting the frequency distribution of signals, e.g. detecting delta, theta, alpha, beta or gamma waves
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/6814 Head
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A movement state of a patient is detected based on brain signals, such as an electroencephalogram (EEG) signal. In some examples, a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient indicative of prospective movement of the patient may be sensed in order to detect the movement state. The movement state may include the brain state that indicates the patient is intending on initiating movement, initiating movement, attempting to initiate movement or is actually moving. In some examples, upon detecting the movement state, a movement disorder therapy is delivered to the patient. In some examples, the therapy delivery is deactivated upon detecting the patient is no longer in a movement state or that the patient has successfully initiated movement. In addition, in some examples, the movement state detected based on the brain signals may be confirmed based on a signal from a motion sensor.

Claims

1. A method comprising:

monitoring a bioelectrical brain signal from a brain of a patient;

determining the brain signal indicates the patient is in a movement state, wherein the brain signal that indicates the patient is in the movement state results from a volitional patient movement or volitional intention to move;

at a first time, controlling delivery of therapy to the patient based on determining the brain signal indicates the patient is in the movement state;

at a second time following the first time, determining whether the patient is in the movement state; and

controlling the delivery of the therapy to the patient based on whether the patient is in the movement state at the second time following the first time.

2. The method of claim 1, wherein the bioelectrical brain signal comprises at least one of an electroencephalogram (EEG) signal, an electrocorticogram (ECoG) signal, a signal generated from measured field potentials within one or more regions of the brain or action potentials from single cells within the brain.

3. The method of claim 2, wherein determining whether the electroencephalogram (EEG) signal indicates the patient is in a movement state comprises determining whether a mu rhythm of the EEG signal indicate the patient in the movement state.

4. The method of claim 1, wherein monitoring the bioelectrical brain signal comprises monitoring a bioelectrical brain signal within a dorsal-lateral prefrontal cortex of the patient.

5. The method of claim 1, wherein determining whether the bioelectrical brain signal indicates the patient is in the movement state comprises evaluating one or more frequency characteristics of the bioelectrical brain signal.

6. The method of claim 5, wherein the frequency characteristics comprise signal power levels within at least one of an alpha frequency band comprising a range of about 5 hertz to about 15 hertz or a high gamma frequency band comprising a range of about 100 hertz to about 200 hertz.

7. The method of claim 1, wherein the movement state comprises at least one of an intention to initiate movement, initiation of movement, an attempt to initiate movement or actual movement.

8. The method of claim 1, wherein controlling delivery of therapy at the first time comprises initiating delivery of the therapy.

9. The method of claim 1, wherein controlling delivery of therapy at the first time comprises adjusting a therapy parameter value.

10. The method of claim 1, wherein controlling delivery of therapy at the first time comprises controlling the delivery of an external cue to the patient.

11. The method of claim 1, wherein controlling delivery of the therapy at the first time comprises controlling delivery of a sensory cue to the patient.

12. The method of claim 1, wherein controlling the delivery of the therapy to the patient based on whether the patient is in the movement state at the second time following the first time comprises modifying a therapy parameter value.

13. The method of claim 1, wherein controlling delivery of the therapy at the first time comprises controlling the delivery of the therapy to the patient according to a first therapy program, and wherein controlling the delivery of the therapy to the patient based on whether the patient is in the movement state at the second time following the first time comprises controlling the delivery of therapy to the patient according to the first therapy program.

14. The method of claim 1, further comprising stopping the delivery of therapy after a predetermined period of time.

15. The method of claim 1, further comprising:

determining whether the patient is no longer in the movement state; and

stopping delivery of therapy if the patient is no longer in the movement state.

16. The method of claim 15, wherein determining whether the patient is no longer in the movement state comprises determining whether the brain signal indicates the patient is in a rest state.

17. The method of claim 15, wherein determining whether the patient is no longer in the movement state comprises receiving input from a motion sensor.

18. The method of claim 1, wherein determining whether the patient is in the movement state at the second time comprises, at the second time, determining whether the brain signal indicates the patient is in a movement state.

19. The method of claim 1, wherein determining whether the patient is in the movement state at the second time comprises receiving input from a motion sensor and determining whether the patient is in the movement state based on the input from the motion sensor.

20. The method of claim 1, wherein determining whether the patient is in the movement state at the second time comprises determining whether the patient is in the movement state based on a signal other than the brain signal.

21. A system comprising:

a sensing module that monitors an bioelectrical brain signal of a patient; and

a processor that determines the bioelectrical brain signal indicates the patient is in a movement state and, at a first time, controls delivery of therapy to the patient based on determining the bioelectrical brain signal indicates the patient is in a movement state, wherein the processor, at a second time following the first time, determines whether the patient is in the movement state and controls the delivery of the therapy to the patient based on whether the patient is in the movement state at the second time following the first time, and wherein the brain signal that indicates the patient is in the movement state results from a volitional patient movement or volitional intention to move.

22. The system of claim 21, wherein the bioelectrical brain signal comprises at least one of an electroencephalogram (EEG) signal, an electrocorticogram (ECoG) signal, a signal generated from measured field potentials within one or more regions of the brain or action potentials from single cells within the brain.

23. The system of claim 21, wherein the sensing module monitors the bioelectrical brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient.

24. The system of claim 21, wherein the processor determines whether the bioelectrical brain signal indicates the patient is in a movement state based on one or more frequency characteristics of the bioelectrical brain signal.

25. The system of claim 21, wherein the processor controls the delivery of therapy to the patient at the first time if the bioelectrical brain signal indicates the patient is in the movement state by at least initiating the delivery of the therapy.

26. The system of claim 21, wherein the processor controls the delivery of therapy to the patient at the first time if the bioelectrical brain signal indicates the patient is in the movement state by at least adjusting a therapy parameter value of the therapy.

27. The system of claim 21, wherein the movement state comprises at least one of intending to initiate movement, initiating movement, attempting to initiate movement or undergoing movement.

28. The system of claim 21, further comprising a therapy delivery device, wherein the processor transmits a control signal to the therapy delivery device to control the delivery of the therapy to the patient by the therapy delivery device.

29. The system of claim 21, further comprising a device configured to delivery a sensory cue to the patient, wherein the therapy comprises the sensory cue.

30. The system of claim 21, wherein the processor controls the delivery of the therapy to the patient based on whether the patient is in the movement state at the second time following the first time by at least modifying a therapy parameter value.

31. The system of claim 21, wherein the processor determines whether the patient is no longer in the movement state and stops delivery of the therapy if the bioelectrical brain signal indicates the patient is no longer in the movement state.

32. The system of claim 21, further comprising a motion sensor, wherein the processor determines whether the patient is in the movement state at the second time based on input from the motion sensor.

33. The system of claim 21, wherein the processor determines whether the patient is in the movement state at the second time based on a signal other than the brain signal.

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

receive a bioelectrical brain signal;

determine the bioelectrical brain signal indicates the patient is in a movement state, wherein the brain signal that indicates the patient is in the movement state results from a volitional patient movement or volitional intention to move;

at a first time, control operation of a therapy device based on determining the bioelectrical brain signal indicates the patient is in a movement state;

at a second time following the first time, determine whether the patient is in the movement state; and

control the operation of the therapy device based on whether the patient is in the movement state at the second time following the first time.