Point-and-click programming for deep brain stimulation using real-time monopolar review trendlines

• US 9,248,296 B2
• Filed: 08/28/2013
• Issued: 02/02/2016
• Est. Priority Date: 08/28/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Carcieri, Stephen, Chen, Dean, Moffitt, Michael A.
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US14/011,817
• Publication Number:
  US 20140067022A1
• Time in Patent Office: 888 Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A system and method for selecting leadwire stimulation parameters includes a processor iteratively performing, for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field: (a) shifting the current field longitudinally and/or rotationally to a respective plurality of locations about the leadwire; and (b) for each of the respective plurality of locations, obtaining clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and displaying a graph plotting the clinical effect information against values for the particular stimulation parameter and locations about the leadwire, and/or based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value.

Claims

1. A computer-implemented method for selecting electrical stimulation parameters for a leadwire implanted in patient tissue, the method comprising:

iteratively performing the following for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field;

positioning, by a computer processor, the current field at each of a respective plurality of locations about the leadwire; and

for each of the respective plurality of locations, obtaining, by the processor, clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and

based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value using a graph that plots the obtained clinical effect information against values for the particular stimulation parameter and against locations about the leadwire including the locations to which the current fields had been positioned in the positioning steps.

2. The method of claim 1, wherein the positioning is performed by shifting the current field at least one of longitudinally or rotationally.

3. The method of claim 2, wherein the shifting is performed in response to user input of a shift instruction by selection of a control, each selection of which is interpreted by the processor as an instruction to shift in a respective direction by a predetermined amount.

4. The method of claim 1, wherein the identifying includes estimating which one of a plurality of combinations of values of the particular stimulation parameter and location about the leadwire is associated with an optimal trade-off between therapeutic efficacy and adverse side-effects.

5. The method of claim 1, wherein the stimulation parameter is one of i) amplitude, ii) pulse width, and iii) frequency.

6. The method of claim 1, wherein the locations correspond to actual locations of electrodes of the leadwire and virtual locations of electrodes of the leadwire corresponding to a current field producible by a combination of a respective subset of the electrodes of the leadwire.

7. The method of claim 1, wherein the graph is three dimensional, and further plots the obtained clinical effect information against values for a second stimulation parameter.

8. The method of claim 1, wherein:

the locations differ longitudinally and rotationally about the leadwire; and

the graph is three dimensional, variations in longitudinal location about the leadwire being plotted along a first one of the dimensions of the graph and variations in rotational location about the leadwire being plotted along a second one of the dimensions of the graph.

9. The method of claim 1, further comprising:

determining, by the processor, values for the particular stimulation parameter for each of a plurality of electrodes of the leadwire; and

at least one of (a) displaying the determined values or (b) setting the leadwire in accordance with the determined values.

10. The method of claim 9, wherein the combination of values are applied in the step of setting the leadwire by interleaving current supply to different ones of the plurality of electrodes.

11. A computer-implemented method for selecting electrical stimulation parameters for a leadwire implanted in patient tissue, the method comprising:

iteratively performing the following for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field;

positioning, by a computer processor, the current field at each of a respective plurality of locations about the leadwire; and

for each of the respective plurality of locations, obtaining, by the processor, clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location, wherein the obtained clinical effect information includes therapeutic effect values and adverse side effect values; and

based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value, wherein the identifying includes, within a graph that plots the obtained therapeutic effect and adverse side effect values against values for the particular stimulation parameter and against locations about the leadwire including the locations to which the current fields had been positioned in the positioning steps, identifying a region whose plotted therapeutic effect values are lower than its adverse side effect values, with a greatest distance between plotted values of the therapeutic effect and adverse side effect.

12. The method of claim 11, wherein the graph is three dimensional, and further plots the obtained clinical effect information against values for a second stimulation parameter.

13. The method of claim 11, wherein:

the locations differ longitudinally and rotationally about the leadwire; and

the graph is three dimensional, variations in longitudinal location about the leadwire being plotted along a first one of the dimensions of the graph and variations in rotational location about the leadwire being plotted along a second one of the dimensions of the graph.

14. The method of claim 11, further comprising:

receiving user input of a point within the graph, the user input provided by point and click within the graph;

determining, by the processor, values for the particular stimulation parameter for each of a plurality of electrodes of the leadwire; and

at least one of (a) displaying the determined values or (b) setting the leadwire in accordance with the determined values.

15. The method of claim 14, wherein the combination of values are applied in the step of setting the leadwire by interleaving current supply to different ones of the plurality of electrodes.

16. The method of claim 11, wherein the positioning is performed by shifting the current field at least one of longitudinally or rotationally.

17. The method of claim 16, wherein the shifting is performed in response to user input of a shift instruction by selection of a control, each selection of which is interpreted by the processor as an instruction to shift in a respective direction by a predetermined amount.

18. The method of claim 11, wherein the identifying includes estimating which one of a plurality of combinations of values of the particular stimulation parameter and location about the leadwire is associated with an optimal trade-off between therapeutic efficacy and adverse side-effects.

19. The method of claim 11, wherein the stimulation parameter is one of i) amplitude, ii) pulse width, and iii) frequency.

20. The method of claim 11, wherein the locations correspond to actual locations of electrodes of the leadwire and virtual locations of electrodes of the leadwire corresponding to a current field producible by a combination of a respective subset of the electrodes of the leadwire.