Clustering of recorded patient neurological activity to determine length of a neurological event

• US 8,738,136 B2
• Filed: 08/13/2007
• Issued: 05/27/2014
• Est. Priority Date: 10/15/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Frei, Mark G., Osorio, Ivan, Graves, Nina M., Schaffner, Scott F., Rise, Mark T., Giftakis, Jonathon E., Carlson, David L.
• Primary Examiner(s): DIETRICH, JOSEPH M
• Application Number:
  US11/837,994
• Publication Number:
  US 20080033508A1
• Time in Patent Office: 2,479 Days
• Field of Search: 607/45, 607/46, 607/117, 607/118
• US Class Current: 607/45
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• 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: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/721 using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/36025 for treating a mental or cerebral condition
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/361 Phantom sensations, e.g. tinnitus

Abstract

Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination. Therapy parameters may be updated for each m^th successive group of applications of the treatment therapy or for each n^th detection cluster.

Claims

1. A method for updating a therapy parameter that is associated with a treatment therapy by a medical device during a neurological event of a nervous system disorder, the method comprising:

(a) determining, with a processor, a first detection cluster corresponding to the neurological event based on determining an inter-detection interval between detections in a neurological signal;

(b) applying one or more groups of applications of a treatment therapy during the first detection cluster, wherein each group of applications of the treatment therapy comprises at least one application of the treatment therapy; and

(c) adjusting the therapy parameter for each m^th successive group of applications of the treatment therapy during the first detection cluster, wherein m is a first positive integer.

2. The method of claim 1, wherein step (c) comprises the step of:

(i) adjusting the therapy parameters from a predefined set of parameters.

3. The method of claim 1, wherein step (c) comprises the step of:

(i) incrementing the therapy parameter by a first incremental amount, wherein the first incremental amount is a positive amount or a non-positive amount.

8. The method of claim 1, wherein step (c) comprises the step of:

(i) modifying the therapy parameter in accordance with a random search technique.

9. The method of claim 1, wherein step (c) comprises the steps of:

(i) monitoring a neurological signal that is indicative of a degree of efficacy corresponding to a current application of the treatment therapy; and

(ii) modifying the therapy parameter for the m^th successive group of applications of the treatment therapy in accordance with the degree of efficacy.

10. The method of claim 1, further comprising the step:

(d) adjusting the therapy parameter for each n^th successive detection cluster, wherein n is a second positive integer.

11. The method of claim 10, wherein step (d) comprises the step of:

(i) modifying the therapy parameter in accordance with a random search technique.

12. The method of claim 10, wherein step (d) comprises the steps of:

(i) monitoring a neurological signal that is indicative of a degree of efficacy corresponding to a current application of the treatment therapy; and

(ii) modifying the therapy parameter for the n^th successive detection cluster in accordance with the degree of efficacy.

13. The method of claim 10, wherein step (d) comprises the step of:

(i) incrementing the therapy parameter by a second incremental amount, wherein the second incremental amount is a positive amount or a non-positive amount.

14. The method of claim 13, wherein step (d) further comprises the step of:

(ii) limiting the therapy parameter to be less than a second predetermined threshold.

15. The method of claim 13, wherein step (d) further comprises the step of:

(ii) limiting the therapy parameter so that a corresponding current density is less than a pre-specified current density.

16. The method of claim 15, comprising the further step of:

(e) in response to step (ii), shutting down the medical device.

17. The method of claim 15, comprising the further step of:

(e) reconfiguring an electrode configuration that is associated with the treatment therapy.

18. A non-transitory computer-readable medium having computer-executable instructions for performing the steps recited in claim 1.

20. The method of claim 1, wherein m is greater than one.

4. The method of 3, step (c) further comprises the step of:

(ii) limiting the therapy parameter to be less than a first predetermined threshold.

5. The method of 3, wherein step (c) further comprises the step of:

(ii) limiting the therapy parameter so that a corresponding current density is less than a pre-specified current density.

6. The method of claim 5, comprising the further step of:

(d) in response to step (ii), shutting down the medical device.

7. The method of claim 5, comprising the further step of:

(d) reconfiguring an electrode configuration that is associated with the treatment therapy.

19. A non-transitory computer-readable medium having computer-executable instructions for performing the steps recited in claim 7.

21. A medical device configured to update a therapy parameter that is associated with a treatment therapy during a neurological event of a nervous system disorder, the medical device comprising:

a configuration of monitoring elements;

a delivery module that delivers the treatment therapy to a patient with the nervous system disorder; and

a processor that is coupled to the configuration of monitoring elements, the processor configured to perform the steps of;

(a) determining a first detection cluster corresponding to the neurological event based on determining an inter-detection interval between detections in a neurological signal;

(b) applying one or more groups of applications of a treatment therapy during the first detection cluster, wherein each group of applications of the treatment therapy comprises at least one application of the treatment therapy; and

(c) adjusting the therapy parameter for each m^th successive group of applications of the treatment therapy during the first detection cluster, wherein m is a first positive integer.

22. The medical device of claim 21, wherein step (c) comprises the step of:

(i) incrementing the therapy parameter by a first incremental amount, wherein the first incremental amount is a positive amount or a non-positive amount.

23. The medical device of claim 22, wherein step (c) further comprises the step of:

(ii) limiting the therapy parameter to be less than a first predetermined threshold.

24. The medical device of claim 22, wherein step (c) further comprises the step of:

(ii) limiting the therapy parameter so that a corresponding current density is less than a pre-specified current density.

25. The medical device of claim 24, wherein the processor is configured to perform the further step of:

(d) in response to step (ii), shutting down the medical device.

26. The medical device of claim 24, wherein the processor is configured to perform the further step of:

(d) reconfiguring an electrode configuration that is associated with the treatment therapy.

27. The medical device of claim 21, wherein step (c) comprises the step of:

(i) modifying the therapy parameter in accordance with a random search technique.

28. The medical device of claim 21, wherein step (c) comprises the steps of:

(i) monitoring a neurological signal that is indicative of a degree of efficacy corresponding to a current application of the treatment therapy; and

(ii) modifying the therapy parameter for the m^th successive group of applications of the treatment therapy in accordance with the degree of efficacy.

29. The medical device of claim 21, wherein the processor is configured to perform the further step of:

(d) automatically adjusting the therapy parameter for each n^th successive detection cluster, wherein n is a second positive integer.

30. The medical device of claim 29, wherein step (d) comprises the step of:

(i) modifying the therapy parameter in accordance with a random search technique.

31. The medical device of claim 29, wherein step (d) comprises the steps of:

(i) monitoring a neurological signal that is indicative of a degree of efficacy corresponding to a current application of the treatment therapy; and

(ii) modifying the therapy parameter for the n^th successive detection cluster in accordance with the degree of efficacy.

32. The medical device of claim 29, wherein step (d) comprises the step of:

(i) incrementing the therapy parameter by a second incremental amount, wherein the second incremental amount is a positive amount or a non-positive amount.

33. The medical device of claim 32, wherein step (d) further comprises the step of:

(ii) limiting the therapy parameter to be less than a first predetermined threshold.

34. The medical device of claim 32, wherein step (d) further comprises the step of:

(ii) limiting the therapy parameter so that a corresponding current density is less than a pre-specified current density.

35. The medical device of claim 34, wherein the processor is configured to perform the further step of:

(e) in response to step (ii), shutting down the medical device.

36. The medical device of claim 21, wherein m is greater than one.