Method and apparatus for event-triggered reinforcement of a favorable brain state

• US 8,473,063 B2
• Filed: 04/20/2011
• Issued: 06/25/2013
• Est. Priority Date: 09/22/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gupta, Rahul, Molnar, Gabriela C., Nelson, Dwight E.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US13/090,672
• Publication Number:
  US 20120071947A1
• Time in Patent Office: 797 Days
• Field of Search: 607/45, 607/46, 607/99, 600/544, 604/66
• US Class Current: 607/46
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/6868 Brain
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• 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 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset

Abstract

Methods and apparatuses are disclosed for potentiating a favorable brain state that is associated with relief in symptoms of a brain condition. Techniques include monitoring one or more brain signals and detecting an episode of a favorable brain state based on the one or more brain signals, the favorable brain state associated with a decrease in one or more symptoms of a brain condition of the patient. Then, in response to the detection of the favorable brain state episode, electrical stimulation that potentiates the favorable brain state is delivered to the brain of the patient, the electrical stimulation delivered within a window of time opened for detection of each favorable brain state episode.

Claims

1. A method of potentiating a brain state of a patient, comprising:

monitoring one or more brain signals in an area of the brain of the patient;

detecting an episode of a brain state based on the one or more brain signals, the brain state associated with a decrease in one or more symptoms of a brain condition of the patient; and

delivering to the monitored area of the brain electrical stimulation that potentiates the brain state in response to the detection of the brain state episode, the electrical stimulation delivered within a window of time that extends no greater than 250 milliseconds from occurrence of the brain state episode, wherein monitoring, detecting, and delivering are each performed at least in part by control circuitry of a medical device.

2. The method of claim 1, further comprising:

assessing the one or more symptoms of the brain condition of the patient;

analyzing brain information indicative of one or more brain states; and

identifying the brain state from the one or more brain states, the brain state identified based on a decrease in the one or more symptoms of the brain condition.

3. The method of claim 1, wherein detecting the brain state episode comprises recognizing one or more patterns in the one or more brain signals that correspond to one or more stored biomarkers of the brain state.

4. The method of claim 1, wherein the brain state episode is detected based on a power level of a frequency band of the one or more signals crossing a threshold.

5. The method of claim 1, wherein the brain state episode comprises the brain transitioning from one brain state to a different brain state.

6. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation to increase the potentiation effect of the electrical stimulation on the brain state.

7. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation based on increasing one or both of frequency and duration of occurrence of the brain state.

8. The method of claim 1, further comprising titrating one or more delivery parameters of the electrical stimulation based on increasing an amplitude of the one or more signals indicative of the brain state.

9. The method of claim 1, further comprising:

identifying one or more brain signal biomarkers of the patient as indicative of the brain state; and

storing the one or more brain signal biomarkers in memory, wherein detecting the brain state episode comprises recognizing presence of the one or more biomarkers in the one or more brain signals.

10. The method of claim 1, wherein the electrical stimulation comprises only one or two pulses delivered within the window of time which is opened for each detection of occurrence of the brain episode.

11. The method of claim 1, wherein delivery of the electrical stimulation is timed to coincide with a particular phase of the one or more brain signals that indicate the brain state episode.

12. The method of claim 1, wherein:

the brain state episode comprises detecting a plurality of brain state events; and

delivering the electrical stimulation comprises delivering one or more pulses to the brain within the window of time respectively for each of the plurality of brain state events detected.

13. The method of claim 1, wherein the window of time spans from the beginning of occurrence of the brain state episode and extends no greater than 100 milliseconds from the end of occurrence of the brain state episode.

14. The method of claim 1, wherein the one or more brain signals comprise one or more local field potential signals sensed from implanted electrodes.

15. A system comprising:

One or more sensors configured to receive from an area of the brain of a patient one or more signals indicative of brain activity of the patient;

A stimulation generator configured to generate and deliver electrical stimulation to the area of the brain of the patient, wherein the electrical stimulation potentiates a brain state of the patient; and

control circuitry configured to detect a brain state episode based on the one or more signals and control delivery of the electrical stimulation within a window of time that extends no greater than 250 milliseconds from occurrence of the brain state episode in response to the detection of the brain state episode, the brain state associated with a decrease in one or more symptoms of a brain condition of the patient.

16. The system of claim 15, wherein detection of the brain state episode by the control circuitry comprises recognition of one or more patterns in the one or more brain signals that correspond to one or more biomarkers stored in memory and indicative of the brain state.

17. The system of claim 15, wherein the control circuitry is configured to detect the brain state episode based on a power level of a frequency band of the one or more signals crossing a threshold.

18. The system of claim 15, wherein the brain state episode comprises the brain transitioning from one brain state to a different brain state.

19. The system of claim 15, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing the potentiation effect of the electrical stimulation on the brain state.

20. The system of claim 15, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing one or both of frequency and duration of occurrence of the brain state.

21. The system of claim 15, wherein the control circuitry is configured to titrate one or more delivery parameters of the electrical stimulation based on increasing the amplitude of the one or more signals indicative of the brain state.

22. The system of claim 15, wherein the control circuitry is configured to identify one or more brain signal biomarkers of the patient as indicative of the brain state and store the one or more brain signal biomarkers in memory, wherein the control circuitry is configured to detect the brain state episode by recognizing presence of the one or more biomarkers in the one or more brain signals.

23. The system of claim 15, wherein the electrical stimulation comprises only one or two pulses delivered within the window of time which is opened for each detection of the brain state.

24. The system of claim 15, wherein the control circuitry is configured to time delivery of the electrical stimulation to coincide with a particular phase of the one or more brain signals from which the brain state episode is detected.

25. The system of claim 15, wherein the window of time spans from the beginning of occurrence of the episode of the brain state and extends no greater than 100 milliseconds from the end of occurrence of the brain state episode.

26. The system of claim 15, wherein the one or more sensors comprise implantable brain electrodes and the one or more brain signals comprise one or more local field potential signals.

27. A system, comprising:

means for monitoring one or more brain signals within an area of the brain of a patient;

means for detecting an episode of a brain state based on the one or more brain signals, the brain state associated with a decrease in one or more symptoms of a brain condition of the patient; and

means for delivering to the monitored area of the brain of the patient electrical stimulation that potentiates the brain state, the electrical stimulation being delivered in response to the detection of the brain state episode, the electrical stimulation delivered within a window of time that extends no greater than 250 milliseconds from occurrence of the brain state episode.

28. A physically embodied computer-readable medium comprising instructions that cause a processor to:

monitor one or more brain signals from an area of a brain of a patient;

detect an episode of a brain state based on the one or more brain signals, the brain state associated with a decrease in one or more symptoms of a brain condition of the patient; and

deliver electrical stimulation to the monitored area of the brain of the patient that potentiates the brain state, the electrical stimulation being delivered in response to the detection of the brain state episode, the electrical stimulation delivered within a window of time that extends no greater than 250 milliseconds from occurrence of the brain state episode.