Differential neurostimulation therapy driven by physiological therapy

• US 8,224,452 B2
• Filed: 05/17/2011
• Issued: 07/17/2012
• Est. Priority Date: 04/05/2000
• Status: Expired due to Term

• Current Assignee: Neuropace Inc.
• Original Assignee: Neuropace Inc.
• Inventors: Pless, Benjamin D, Tcheng, Thomas K
• Primary Examiner(s): GETZOW, SCOTT M
• Application Number:
  US13/109,970
• Publication Number:
  US 20110218591A1
• Time in Patent Office: 427 Days
• Field of Search: 607/45, 607/62
• US Class Current: 607/45
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36067 : Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36078 : Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00
• CPC Class Codes: A61N 1/36135 : using physiological parameters
• CPC Class Codes: A61N 1/36139 : with automatic adjustment

Abstract

An implantable neurostimulator system adapted to provide therapy for various neurological disorders is capable of varying therapy delivery strategies based on the context, physiological or otherwise, into which the therapy is to be delivered. Responsive and scheduled therapies can be varied depending on various sensor measurements, calculations, inferences, and device states (including elapsed times and times of day) to deliver an appropriate course of therapy under the circumstances.

Claims

1. An implantable neurostimulator for the treatment of a neurological disorder, comprising:

a detection subsystem including a plurality of detection channels that are configured to detect a neurological event of interest in a monitored electrographic signal of a patient, the plurality of detection channels including at least one triggering detection channel that is configured to derive signal timing for delivering a selected therapy when a parameter is detected, the parameter being associated with the triggering detection channel and corresponding to an electrographic measurement, a characteristic of the neurological event of interest being represented by the electrographic measurement;

a data storage area associated with the detection channels and configured to store the parameter that comprises the electrographic measurement; and

an adaptive stimulation subsystem configured to analyze the parameter, to select a therapy from a plurality of therapies based at least in part on the parameter, to determine a timing of the therapy based at least in part on the parameter, and to deliver the selected therapy to the patient in synchronization with the neurological event of interest based at least in part on the parameter.

2. The implantable neurostimulator of claim 1 wherein the detection subsystem is configured to detect the parameter using at least one of a half wave measurement, a line length measurement and an area measurement of a waveform.

3. The implantable neurostimulator of claim 1 wherein the adaptive stimulation subsystem is configured to analyze the parameter based on the parameter and historic patterns of measurements.

4. The implantable neurostimulator of claim 1 wherein the adaptive stimulation subsystem is configured to analyze the parameter based on the parameter and trends of the parameter.

5. The implantable neurostimulator of claim 1 wherein the adaptive stimulation subsystem is configured to analyze the parameter based on the parameter, trends of the parameter, and historic patterns of measurements.

6. The implantable neurostimulator of claim 1 wherein the parameter is stored in a portion of the data storage area associated with the triggering detection channel.

7. The implantable neurostimulator of claim 1 wherein the parameter is stored in a portion of the data storage area other than a portion associated with the triggering detection channel.

8. The implantable neurostimulator of claim 1, wherein the parameter is transformable into a numeric quantity that corresponds to an identification of which triggering detection channel of the plurality of detection channels corresponds to the neurological event of interest.