Movement disorder recovery system and method

• US 9,314,190 B1
• Filed: 07/14/2014
• Issued: 04/19/2016
• Est. Priority Date: 05/11/2006
• Status: Active Grant

• Current Assignee: Great Lakes Neurotechnologies Inc.
• Original Assignee: Great Lakes Neurotechnologies Inc.
• Inventors: Giuffrida, Joseph P, Heldman, Dustin A, Mera, Thomas O
• Primary Examiner(s): Porter, Jr., Allen
• Application Number:
  US14/330,255
• Time in Patent Office: 645 Days
• Field of Search: 607/45, 607/48, 607/49
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1124 Determining motor skills
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/6825 Hand
• CPC Class Codes: A61B 5/6826 Finger
• 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 1/0452 Specially adapted for transcutaneous muscle stimulation [TMS]
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36034 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Most particularly, the present invention relates to a customized and adaptive movement recovery system and a method of improving the functional motor recovery of a subject with a movement disorder. The present invention provides for a system and method, which in some embodiments can accurately quantify treatment device parameters and protocols including electrical stimulation amplitude (volts/amps), frequency (Hz), and pulse width (microseconds), and medication titrations, doses, and times by utilizing accelerometric, gyroscopic or other movement related information, such as electromyography (EMG) data, or the like, and a central database, or system of databases, of patient and treatment histories. In other embodiments, the system and method provide for an adaptive central database system and automated control of movement disorder treatment devices.

Claims

1. A system for providing treatment recommendations for movement disorders comprising:

a movement measuring apparatus for measuring external body motion of a subject with a movement disorder and for calculating a movement score representative of a score that a skilled clinician might give to a subject during a movement analysis exam using a standardized scale, the movement measuring apparatus comprising at least one sensor and a transmitter;

an algorithm trained for correlating at least in part movement scores calculated from the subject with at least in part movement scores stored in at least one central database;

at least one central database where historical movement data comprising at least in part movement data, including at least in part movement scores, from a plurality of other subjects is stored;

a processor for correlating at least in part the calculated movement scores to the at least one central database and determining a recommended treatment using the algorithm; and

a device for outputting or otherwise communicating the recommended treatment to a clinician or other user for review and administering;

wherein the at least one central database contains at least former patient disorder and treatment information; and

the algorithm is trained through a supervised learning process that uses as algorithm inputs at least any three of patient demographics, treatment history, disorder details, recorded movement data, current treatment protocols, and movement scores, and uses as matched outputs recommended treatment stimulation parameters; and

the algorithm performs a stepwise regression to determine a combination of algorithm inputs and matched outputs with a correlation to clinician treatments for subjects, wherein, when calculated by the processor or algorithm, the resultant correlation to clinician treatments for subjects with successful outcomes has a correlation coefficient of greater than 0.25.

2. The system of claim 1, wherein the at least one sensor is selected from the group consisting of accelerometers, gyroscopes, magnometers, resistive bend sensors, and load cells.

3. The system of claim 2, wherein the algorithm is trained with a training set that only includes subject data where treatment was successful.

4. The system of claim 3, wherein the training set only includes subject data where movement scores based on measured external body motion decreased by more than 10%.

5. The system of claim 1, wherein the algorithm for correlating movement data is an artificial neural network in the form of a multilayer perceptron.

6. A method for providing treatment recommendations for movement disorders comprising steps of:

providing a movement measuring apparatus comprising at least one sensor and a transmitter, the movement measuring apparatus adapted to measure external body motion of a subject;

measuring external body motion of a subject wearing the movement measuring apparatus;

calculating at least one movement score representative of a score that a skilled clinician might give to a subject during a movement analysis exam using a standardized scale based at least in part on the measured external body motion of the subject;

transmitting the calculated at least one movement score from the movement measuring apparatus to a processor;

training an algorithm to correlate the at least one movement score with a database of movement data;

correlating with the processor the at least one movement score to at least one central database comprising movement data, including movement scores, from a plurality of other subjects using the algorithm, the database further comprising recommended treatment protocols; and

determining a recommended treatment based at least in part on the correlation between the at least one movement score and the at least one central database;

wherein the training of the algorithm is performed using a backpropagation technique on a feedforward model comprising at least three input layers, at least one hidden layer, and at least one output layer, and wherein the at least three input layers consist at least of;

clinical definitions, comprising one or more of current patient demographics, disorder history, treatment history, or clinician notes;

subject data, comprising one or more of recorded movement data and diary information; and

a dynamic input that accounts for changes in any other input variables with respect to time.

7. The method of claim 6, wherein the plurality of other subjects in the at least one central database suffer from similar movement disorders.

8. A method for providing treatment recommendations for movement disorders comprising steps of:

providing a movement measuring apparatus comprising at least one sensor and a transmitter, the movement measuring apparatus adapted to measure external body motion of a subject;

measuring external body motion of a subject wearing the movement measuring apparatus;

calculating at least one movement score representative of a score that a skilled clinician might give to a subject during a movement analysis exam using a standardized scale based at least in part on the measured external body motion of the subject;

transmitting the calculated at least one movement score from the movement measuring apparatus to a processor;

training an algorithm to correlate the at least one movement score with a database of movement data;

correlating with the processor the at least one movement score to at least one central database comprising movement data, including movement scores, from a plurality of other subjects using the algorithm, the database further comprising recommended treatment protocols; and

determining a recommended treatment based at least in part on the correlation between the at least one movement score and the at least one central database,

wherein the algorithm is a neural network algorithm, and the step of training the algorithm comprises using a set of input variables and neural network layer weights to test the neural network'"'"'s ability to generalize data using a “

one left out”

technique where training data consists of all but one subject, a “

left out”

subject, and the training data is used to solve for the neural network weights, and the “

left out”

subject is then input to the neural network to generate predicted treatments.

9. The method of claim 8, wherein the training step is repeated for each subject in the training data, and success criteria of at least 80% agreement between the generated predicted treatments and the recommended treatment protocols is determined separately for at least two elements of an electric stimulation treatment protocol, the elements selected from the group consisting of contacts voltage, frequency, and pulse width.

10. A method for providing treatment recommendations for movement disorders comprising steps of:

providing a movement measuring apparatus comprising at least one sensor and a transmitter, the movement measuring apparatus adapted to measure external body motion of a subject;

measuring external body motion of a subject wearing the movement measuring apparatus;

calculating at least one movement score representative of a score that a skilled clinician might give to a subject during a movement analysis exam using a standardized scale based at least in part on the measured external body motion of the subject;

transmitting the calculated at least one movement score from the movement measuring apparatus to a processor;

training an algorithm to correlate the at least one movement score with a database of movement data;

correlating with the processor the at least one movement score to at least one central database comprising movement data, including movement scores, from a plurality of other subjects using the algorithm, the database further comprising recommended treatment protocols; and

determining a recommended treatment based at least in part on the correlation between the at least one movement score and the at least one central database,

wherein the at least one central database contains at least former patient disorder and treatment information; and

the algorithm is trained through a supervised learning process that uses as algorithm inputs at least any three of patient demographics, treatment history, disorder details, recorded movement data, current treatment protocols, and movement scores, and uses as matched outputs recommended treatment stimulation parameters; and

the combination of algorithm inputs and matched outputs is determined using a stepwise regression wherein the resultant correlation to clinician treatments for subjects with successful outcomes has a correlation coefficient of greater than 0.25.