Therapy control based on a patient movement state

• US 8,554,325 B2
• Filed: 01/06/2012
• Issued: 10/08/2013
• 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:
  US13/345,397
• Publication Number:
  US 20120108998A1
• Time in Patent Office: 641 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:

sensing a brain signal within a dorsal-lateral prefrontal cortex of a brain of a patient;

determining the brain signal indicates prospective movement of the patient; and

controlling operation of a device, based on determining the brain signal indicates prospective movement of the patient, to deliver at least one neurostimulation therapy or fluid therapy to the patient.

2. The method of claim 1, wherein controlling operation of the device based on determining the brain signal indicates prospective movement comprises controlling operation of the device to cause movement of the patient.

3. The method of claim 1, wherein the device comprises a first device, the method further comprising controlling a second device to cause movement of the patient, wherein the second device includes one of a patient transport device or a patient limb movement device.

4. The method of claim 1, wherein the device comprises a first device, the method further comprising controlling operation of a second device based on determining the brain signal indicates prospective movement of the patient, wherein the second device includes a nonmedical appliance.

5. The method of claim 1, wherein controlling operation of the device based on determining the brain signal indicates prospective movement of the patient comprises controlling delivery of movement disorder therapy to the patient based on determining the brain signal indicates prospective movement, the movement disorder therapy comprising the at least one of neurostimulation therapy or fluid therapy.

6. The method of claim 5, wherein controlling delivery of movement disorder therapy comprises initiating delivery of the movement disorder therapy based on determining the brain signal indicates prospective movement.

7. The method of claim 5, wherein controlling delivery of movement disorder therapy comprises adjusting delivery of the movement disorder therapy based on determining the brain signal indicates prospective movement.

8. The method of claim 5, further comprising controlling the device to stop delivery of movement disorder therapy after a predetermined period of time.

9. The method of claim 5, wherein the brain signal comprises a first brain signal, the method further comprising:

sensing a second brain signal indicative of lack of prospective movement of the patient within the dorsal-lateral prefrontal cortex of the brain of the patient;

determining the second brain signal indicates a lack of prospective movement of the patient; and

controlling the device to stop delivery of movement disorder therapy based on determining the second brain signal indicates the lack of prospective movement of the patient.

10. The method of claim 1, wherein the device comprises a first device, the method further comprising controlling operation of a second device, based on determining the brain signal indicates prospective movement of the patient, to deliver functional electrical stimulation therapy to the patient.

11. The method of claim 1, further comprising controlling delivery of an external cue to the patient based on determining the brain signal indicates prospective movement.

12. The method of claim 1, further comprising controlling delivery of a sensory cue to the patient based on determining the brain signal indicates prospective movement.

13. The method of claim 1, wherein determining the brain signal indicates prospective movement of the patient comprises determining the brain signal indicates prospective movement based on one or more frequency characteristics of the sensed brain signal.

14. The method of claim 1, wherein determining the brain signal indicates prospective movement of the patient comprises determining the brain signal indicates prospective movement based on at least one of a comparison of an amplitude of the brain signal to a threshold value, or temporal correlation or frequency correlation of the brain signal with a template signal.

15. The method of claim 1, wherein determining the brain signal indicates prospective movement of the patient comprises at least one of comparing a slope of the brain signal over time to slope trend information or comparing a timing between inflection points of the brain signal over time to inflection point trend information.

16. The method of claim 1, wherein determining the brain signal indicates prospective movement of the patient comprises detecting a biomarker in the sensed brain signal, the biomarker being associated with prospective movement of the patient.

17. The method of claim 1, wherein controlling operation of the device comprises controlling operation of the device to deliver neurostimulation therapy to the patient, the neurostimulation therapy comprising deep brain stimulation therapy.

18. A system comprising:

a sensing module configured to sense a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient; and

a controller configured to determine the brain signal indicates prospective movement of the patient and control a device, based on the determination the brain signal indicates prospective movement of the patient, to deliver at least one of neurostimulation therapy or fluid therapy to the patient.

19. The system of claim 18, further comprising the device, wherein the controller is configured to control the device to cause movement of the patient based on the determination the brain signal indicates prospective movement of the patient.

20. The system of claim 18, further comprising at least one of a patient transport device or a patient limb movement device, wherein the controller is configured to control the at least one of the patient transport device or the patient limb movement device based on the determination the brain signal indicates prospective movement of the patient.

21. The system of claim 18, wherein the controller is configured to control the device to deliver movement disorder therapy to the patient based on the determination the brain signal indicates prospective movement of the patient.

22. The system of claim 21, further comprising an electrical stimulator, wherein the device comprises the electrical stimulator, and wherein the movement disorder therapy comprises electrical stimulation therapy delivered to the patient via the electrical stimulator.

23. The system of claim 21, wherein the device comprises a first device, the system further comprising:

the first device, the first device comprising one of a neurostimulator or a fluid delivery device; and

a second device, the second device being configured to deliver a sensory cue to the patient, wherein the movement disorder therapy comprises the sensory cue.

24. The system of claim 21, wherein the controller is configured to control the device to stop delivery of the movement disorder therapy after a predetermined period of time.

25. The system of claim 21, wherein the brain signal comprises a first brain signal, and the sensing module is configured to sense a second brain signal within the dorsal-lateral prefrontal cortex of the brain of the patient, and wherein the controller is configured to determine the second brain signal indicates a lack of prospective movement of the patient, and control the device to stop delivery of movement disorder therapy based on the determination that the second brain signal indicates the lack of prospective movement of the patient.

26. The system of claim 18, further comprising a fluid delivery device, wherein the device comprises the fluid delivery device, and wherein the movement disorder therapy comprises the fluid therapy delivered to the patient via the fluid delivery device.

27. The system of claim 18, wherein the controller is further configured to determine the brain signal indicates prospective movement based on one or more frequency characteristics of the brain signal.

28. The system of claim 18, wherein the controller is further configured to determine the brain signal indicates prospective movement based on at least one of a comparison of an amplitude of the brain signal to a threshold value, or temporal correlation or frequency correlation of the brain signal with a template signal.

29. The system of claim 18, wherein the controller is further configured to determine the brain signal indicates prospective movement based on comparing a slope of the brain signal over time or based on comparing a timing between inflection points of the brain signal over time to trend information.

30. The system of claim 18, wherein the controller is further configured to determine the brain signal indicates prospective movement by at least detecting a biomarker indicative of prospective movement of the patient in the brain signal.

31. The system of claim 18, further comprising the device, wherein the controller is configured to control the device to deliver neurostimulation therapy to the patient based on the determination the brain signal indicates prospective movement of the patient, the neurostimulation therapy comprising deep brain stimulation therapy.

32. A system comprising:

means for sensing a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient;

means for determining the brain signal indicates prospective movement of the patient; and

means for controlling operation of a device, based on determining the brain signal indicates prospective movement of the patient, to deliver at least one of neurostimulation therapy or fluid therapy to the patient.

33. The system of claim 32, further comprising the device, wherein the device comprises means for delivering movement disorder therapy to the patient.

34. The system of claim 32, wherein the means for controlling operation of the device is configured to control the device to deliver neurostimulation therapy to the patient based on determining the brain signal indicates prospective movement of the patient, the neurostimulation therapy comprising deep brain stimulation therapy.

35. A non-transitory computer-readable medium comprising instructions that, when executed by the processor, cause the processor to:

receive a brain signal sensed within a dorsal-lateral prefrontal cortex of a brain of the patient;

determine the brain signal indicates prospective movement of the patient; and

control operation of a device, based on determining the brain signal indicates prospective movement of the patient, to deliver at least one of neurostimulation therapy or fluid therapy to the patient.