Brain stimulation models, systems, devices, and methods

• US 9,235,685 B2
• Filed: 10/09/2008
• Issued: 01/12/2016
• Est. Priority Date: 07/07/2004
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: McIntyre, Cameron C., Butson, Christopher R., Hall, John D., Henderson, Jaimie M.
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US12/287,471
• Publication Number:
  US 20090210208A1
• Time in Patent Office: 2,651 Days
• Field of Search: 600/407, 600/408, 600/416, 600/377, 600/378, 600/544, 607/2, 607/45, 607/115, 607/116, 607/148, 703/2, 382/128, 382/131
• US Class Current: 1/1
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

This document discusses, among other things, brain stimulation models, systems, devices, and methods, such as for deep brain stimulation (DBS) or other electrical stimulation. In an example, a target volume of activation (VOA) can be received, a test VOA can be simulated, and at least one of a target electrode location or parameter can be provide using a relationship between the target VOA and the test VOA.

Claims

1. A computer-implemented method comprising:

receiving, by a computer processor, a target volume of activation and a target volume to avoid activating;

for each of a plurality of test electrode locations or test electrode parameters of a stimulation leadwire;

ascertaining, by the processor, a respective distribution of electrical values of an electric field estimated to be produced in an anatomical region by the stimulation leadwire using the test electrode location or test electrode parameter;

based on the ascertained distribution of electrical values, determining, by the processor, an estimate of a volume of activation (VOA) of tissue in the anatomical region, in which volume an electrical characteristic of the tissue, which is dependent on the distribution of electrical values of the electric field, is predicted to reach a threshold level that causes the tissue to be activated, wherein, in the determining step, the processor estimates that tissue in at least a portion of the anatomical region in which some of the ascertained distribution of electrical values is located would not be activated by the electric field with the ascertained distribution of electrical values distribution; and

comparing, by the processor, the respective VOA to both the target volume of activation and the target volume to avoid activating;

selecting a target electrode location or a target electrode parameter using the comparisons between the respective VOAs and both the target volume of activation and the target volume to avoid activating; and

displaying, by the processor and on a display screen, the respective VOA to which the selected target electrode location or target electrode parameter corresponds; and

communicating the selected target electrode location or target electrode parameter to an implanted controller circuit to initiate production of electrical stimulation of patient tissue using an implanted leadwire coupled to the controller circuit at the selected target electrode location or using the selected target electrode parameter.

2. The method of claim 1, wherein the selecting includes selecting the target electrode location.

3. The method of claim 1, wherein the selecting includes selecting the target electrode parameter.

4. The method of claim 3, wherein the target electrode parameter includes at least one of a stimulation amplitude, a stimulation pulsewidth, a stimulation frequency, an electrode contact, an electrode polarity, or an electrode pulse polarity.

5. The method of claim 1, wherein the target volume of activation is received by user input.

6. The method of claim 1, wherein the target volume of activation is received in a form of a user selection of an anatomical structure.

7. The method of claim 1, wherein the target volume of activation includes neural tissue having a stimulatory effect when activated.

8. The method of claim 1, wherein the target volume of activation includes neural tissue having an inhibitory effect when activated.

9. The method of claim 1, wherein the target volume of activation represents an area targeted to be stimulated for a patient having a subthalamic nucleus which has a volume, and wherein the area corresponds to the volume of the subthalamic nucleus or a portion of the subthalamic nucleus in the patient.

10. The method of claim 9, wherein the patient is suffering from Parkinson'"'"'s disease and the target volume of activation represents a volume of tissue targeted for treatment of the Parkinson'"'"'s disease.

11. The method of claim 1, further comprising using the comparison between the respective VOAs and the target volume of activation, by the processor, to calculate a respective score for each of the respective VOAs, wherein the target electrode location or the target electrode parameter is selected based on the scores.

12. A system comprising:

a processor; and

a non-transitory computer-readable medium on which are stored instructions that are executable by the processor, the instructions which, when executed by the processor, cause the processor to;

receive a target volume of activation and a target volume to avoid activating;

for each of a plurality of test electrode locations or test electrode parameters of a stimulation leadwire;

ascertain a respective distribution of electrical values of an electric field estimated to be produced in an anatomical region by the stimulation leadwire using the test electrode location or test electrode parameter;

based on the ascertained distribution of electrical values, determine, by the processor an estimate of a volume of activation (VOA) of tissue in the anatomical region, in which volume an electrical characteristic of the tissue, which is dependent on the distribution of electrical values of the electric field, is predicted to reach a threshold level that causes the tissue to be activated, wherein, in the determination, the processor estimates that tissue in at least a portion of the anatomical region in which some of the ascertained distribution of electrical values is located would not be activated by the electric field with the ascertained distribution of electrical values; and

compare the respective VOA to both the target volume of activation and the target volume to avoid activating;

select a target electrode location or a target electrode parameter using the comparison between the respective VOAs and both the target volume of activation and the target volume to avoid activating;

display on a display screen the respective VOA to which the selected target electrode location or target electrode parameter corresponds; and

communicate the selected target electrode location or target electrode parameter to an implanted controller circuit to initiate production of electrical stimulation of patient tissue using an implanted leadwire coupled to the controller circuit at the selected target electrode location or using the selected target electrode parameter.

13. The system of claim 12, wherein the processor is configured to select the target electrode location using the comparison between the target volume of activation and the target volume to avoid activating and the respective VOAs.

14. The system of claim 12, wherein the processor is configured to select the target electrode parameter using the comparison between the target volume of activation and the target volume to avoid activating and the respective VOAs.

15. The system of claim 14, wherein the target electrode parameter includes at least one of a stimulation amplitude, a stimulation pulsewidth, a stimulation frequency, an electrode contact, an electrode polarity, or an electrode pulse polarity.

16. The system of claim 12, wherein the target volume of activation is received by user input.

17. The system of claim 12, wherein the target volume of activation is received as an anatomical structure selected by a user.

18. The system of claim 12, wherein the processor is configured to calculate a respective score for each of the respective VOAs using the comparison between the respective VOA and the target volume of activation, and is configured to select the target electrode location or the target electrode parameter based on the scores.

19. A computer-implemented method comprising:

receiving, by a computer processor, a target volume of activation (target VOA) and a target volume to avoid activating;

for each of a plurality of test electrode locations or test electrode parameters of a stimulation leadwire;

ascertaining, by the processor, a respective distribution of electrical values of an electric field estimated to be produced in an anatomical region by the stimulation leadwire using the test electrode location or test electrode parameter;

based on the ascertained distribution of electrical values, determining, by the processor, an estimate of a volume of activation (estimated VOA) of tissue in the anatomical region, in which volume an electrical characteristic of the tissue, which is dependent on the distribution of electrical values of the electric field, is predicted to reach a threshold level that causes the tissue to be activated;

comparing, by the processor, the respective estimated VOA to both the target VOA and the target volume to avoid activating;

using the comparison between the respective estimated VOAs and both the target VOA and the target volume to avoid activating, by the processor, to calculate a respective score for each of the respective estimated VOAs, wherein the score for the respective estimated VOA is calculated by an algorithm that includes mapping how much of the target VOA is within the respective estimated VOA;

based on the scores, selecting a target electrode location or a target electrode parameter;

displaying, by the processor and on a display screen, the respective estimated VOA to which the selected target electrode location or target electrode parameter corresponds; and

communicating the selected target electrode location or target electrode parameter to an implanted controller circuit to initiate production of electrical stimulation of patient tissue using an implanted leadwire coupled to the controller circuit at the selected target electrode location or using, the selected target electrode parameter.

20. A system comprising:

a processor; and

a non-transitory computer-readable medium on which are stored instructions that are executable by the processor, the instructions which, when executed by the processor, cause the processor to;

receive a target volume of activation (target VOA) and a target volume to avoid activating;

predict a respective VOA for each of a plurality of test electrode locations or test electrode parameters;

compare the respective predicted VOAs to both the target VOA and the target volume to avoid activating;

using the comparison between the respective predicted VOAs and both the target VOA and the target volume to avoid activating, compute a respective predicted VOA score for each of the respective predicted VOAs, wherein the respective score for the respective predicted VOA is computed by an algorithm that includes mapping how much of the target VOA is within the respective predicted VOA;

select a target electrode location or a target electrode parameter using the scores;

display on a display screen the respective predicted VOA to which the selected target electrode location or target electrode parameter corresponds; and

communicate the selected target electrode location or target electrode parameter to an implanted controller circuit to initiate production of electrical stimulation of patient tissue using an implanted leadwire coupled to the controller circuit at the selected target electrode location or using the selected target electrode parameter.