Control and/or quantification of target stimulation volume overlap and interface therefor

• US 9,364,665 B2
• Filed: 08/09/2012
• Issued: 06/14/2016
• Est. Priority Date: 08/09/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Bokil, Hemant Sharad, Pierre, Mark, Carlton, Keith, Moffitt, Michael A., Mustakos, Richard, Chen, Dean
• Primary Examiner(s): DIETRICH, JOSEPH M
• Application Number:
  US13/570,736
• Publication Number:
  US 20130116748A1
• Time in Patent Office: 1,405 Days
• Field of Search: 607/45, 607/46, 607/59
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/08 Arrangements or circuits for monitoring, protecting, controlling or indicating for external stimulators A61N1/3603; for implantable neurostimulators A61N1/36128; for heart stimulators A61N1/37; for defibrillators A61N1/3925
• CPC Class Codes: A61N 1/36 for stimulation
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

A method and system include a processor that outputs a characterization of a correspondence between a volume of estimated tissue activation and a target and/or side effect stimulation volume, and/or that provides controls by which to modify thresholds and/or amounts according to which the volume of estimated activation is to correspond to the target volume.

Claims

1. A computer-implemented method, comprising:

displaying, by a computer processor and in a graphical user interface, a first user-manipulable control, in response to a manipulation of which a first threshold is modifiable, the first threshold defining an extent to which a volume of activation (VOA) of tissue estimated to be activated by a stimulation is required to correspond to a target volume of tissue to be stimulated;

subsequent to a manipulation of the control, comparing, by the processor and to the first threshold as set by the manipulation, an extent of correspondence of an estimated VOA to a target volume, to determine whether the estimated VOA satisfies the requirement;

if the estimated VOA satisfies the requirement, determining, by the processor, a set of stimulation parameters that each satisfies at least the first threshold; and

outputting the set of stimulation parameters corresponding to the VOA to initiate stimulation of patient tissue using a leadwire implanted in the patient tissue.

2. The method of claim 1, wherein determining the set of stimulation parameters comprises

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting;

wherein, for the each of the plurality of sets, the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

a size of an area formed by a combination of the respective VOA and the other obtained volume.

3. The method of claim 1, wherein the other obtained volume is one of a specified anatomical volume and a VOA of tissue estimated to be activated by stimulation provided according to a different set of stimulation parameters.

4. The method of claim 1, wherein the first score is generated further based on a size of a predetermined area of which the area formed by the combination of the respective VOA and the other obtained stimulation volume forms a part.

5. The method of claim 1, wherein the other obtained volume is a target stimulation volume.

6. The method of claim 5, wherein, for the each of the plurality of sets, the calculating the respective score further includes calculating a second score for the respective VOA based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

7. The method of claim 6, wherein the second score is generated further based on a size of an area formed by a combination of the respective VOA and the side effect volume.

8. The method of claim 5, wherein the first score is further based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

9. The method of claim 1, wherein determining the set of stimulation parameters comprises

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting;

wherein, for the each of the plurality of sets, the calculating the respective score includes calculating, a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

a size of a predetermined area that includes both the respective VOA and the other obtained volume.

10. The method of claim 9, wherein the other obtained volume is a target stimulation volume.

11. The method of claim 10, wherein, for the each of the plurality of sets, the calculating the respective score further includes calculating a second score for the respective VOA based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

12. The method of claim 11, wherein the second score is generated further based on a size of a predetermined area that includes both the respective VOA and the side effect volume.

13. The method of claim 10, wherein the first score is further based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

14. The method of claim 1, wherein determining the set of stimulation parameters comprises

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting;

wherein, for the each of the plurality of sets, the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

an amount of the respective VOA that does not overlap the other obtained volume.

15. The method of claim 14, wherein the other obtained volume is a target stimulation volume.

16. The method of claim 15, wherein, for the each of the plurality of sets, the calculating the respective score further includes calculating a second score for the respective VOA based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

17. The method of claim 16, wherein the second score is generated further based on an amount of the respective VOA that does not overlap the side effect volume.

18. The method of claim 15, wherein the first score is further based on an amount by which the respective VOA overlaps an obtained side effect volume in which stimulation is to be avoided.

19. The method of claim 14, wherein the first score includes a first sub-score that represents the amount by which the respective VOA overlaps the other obtained volume and a second sub-score that represents the amount of the respective VOA that does not overlap the other obtained volume, the first and second sub-scores being output.

20. The method of claim 19, wherein the outputting includes plotting the first and second sub-scores as a single coordinate on a graph, a first axis of the graph corresponding to possible values of the first sub-score and a second axis of the graph corresponding to possible values of the second sub-score.

21. The method of claim 20, wherein the plotted coordinate representing the first and second sub-scores is one of a plurality of coordinates plotted in the graph others of the plotted coordinates representing respective pairs of sub-scores calculated for other sets of stimulation parameters.

22. The method of claim 21, further comprising:

displaying in the graph a curve formed by connecting the plotted coordinates.

23. The method of claim 22, wherein:

the selection includes automatically selecting, by the processor and based on a characteristic of the curve, one of the sets of stimulation parameters for which coordinates have been plotted in the graph; and

the selected set of stimulation parameters is output by the processor.

24. The method of claim 1, wherein determining the set of stimulation parameters comprises

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting;

wherein;

for the each of the plurality of sets the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps an obtained side effect volume; and

at least one of;

a size of an area formed by a combination of the respective VOA and the side effect volume;

a size of a predetermined area that includes both the respective VOA and the side effect volume; and

an amount of the respective VOA that does not overlap the side effect volume; and

the side effect volume includes at least one volume tagged as a region in which tissue stimulation is to be avoided.

25. The method of claim 24, wherein the first score contributes negatively to a composite score, the composite score being calculated for the respective VOA based on the first score and a second score that characterizes a correspondence of the respective VOA to a target volume tagged as a region in which tissue stimulation is targeted, the second score contributing positively to the composite score.

26. The method of claim 1, wherein the first threshold is one of a minimum and a maximum percentage of the target volume with which the VOA overlaps.

27. The method of claim 26, further comprising:

outputting a representation of the determined set of stimulation parameters.

28. The method of claim 27, wherein the output representation of the determined set of stimulation parameters includes a display of a VOA estimated for the determined set of stimulation parameters.

29. The method of claim 27, wherein the determining includes determining stimulation parameters estimated to result in one of a plurality of VOAs that, compared to all others of the VOAs, includes least spill beyond boundaries of the target volume, all of the plurality of VOAs meeting the first threshold.

30. The method of claim 1, wherein the first threshold is a maximum percentage of the VOA permitted to be non-overlapping with the target volume.

31. The method of claim 30, further comprising:

displaying in the graphical user interface a second user-manipulable control, in response to the manipulation of which a second threshold is modifiable, wherein the second threshold is a minimum percentage of the target volume with which the VOA must overlap.

32. The method of claim 31,

wherein the determining includes determining, by the processor, a set of stimulation parameters that satisfies the first threshold set by the manipulation of the first control and that satisfies the second threshold;

and

outputting a representation of the determined set of stimulation parameters.

33. The method of claim 32, wherein the determining includes determining a plurality of sets of stimulation parameters that each satisfies the first threshold and the second threshold, calculating a score for each of the plurality of sets, and selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting.

34. The method of claim 31, further comprising:

responsive to the user-manipulation of one of the first and second controls, automatically manipulating, by the processor, the other of the first and second controls.

35. The method of claim 1, wherein the first user-manipulable control is slidable between a first position of the graphical user interface corresponding to a first threshold value and a second position of the graphical user interface corresponding to a second threshold value.

36. The method of claim 1, further comprising:

outputting a representation of the determined set of stimulation parameters.

37. The method of claim 36, wherein the determining includes determining a plurality of sets of stimulation parameters that each satisfies the first threshold, calculating a score for each of the plurality of sets, and selecting one of the plurality of sets for which a best of the scores has been calculated as the set of stimulation parameters for outputting.

38. The method of claim 36, wherein:

the first threshold defines a boundary beyond which a first characteristic of correspondence between the VOA and the target volume cannot extend; and

the determining includes determining a plurality of sets of stimulation parameters that each satisfies the first threshold, and selecting from the plurality of sets of stimulation parameters, a set that is estimated to provide a VOA that, compared to VOAs with which all others of the plurality of sets are associated, that minimizes a value of a second characteristic of correspondence between the VOA and the target volume.

39. The method of claim 36, wherein:

the first threshold defines a boundary beyond which a first characteristic of correspondence between the VOA and the target volume cannot extend; and

the determining includes determining a plurality of sets of stimulation parameters that each satisfies the first threshold, and selecting from the plurality of sets of stimulation parameters as the set of stimulation parameters for outputting, a set that is estimated to provide a VOA that, compared to VOAs with which all others of the plurality of sets are associated, that maximizes a value of a second characteristic of correspondence between the VOA and the target volume.

40. The method of claim 36, wherein the output representation of the determined set of stimulation parameters includes a display of a VOA estimated for the determined set of stimulation parameters.

41. The method of claim 1, wherein determining the set of stimulation parameters comprises

obtaining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

for each set of the plurality of sets of stimulation parameters;

calculating, by the processor, a value representative of spill, by a VOA corresponding to the respective set of stimulation parameters, beyond another obtained volume; and

calculating, by the processor, a value representative of overlap of the respective VOA with the other obtained volume; and

displaying, by the processor, a graph in which each of the calculated values are plotted.

42. The method of claim 41, wherein the other obtained volume is a target volume of tissue activation.

43. The method of claim 14, wherein all of the spill representative values calculated for the plurality of sets are connected in the graph to form a first curve, and all of the overlap values calculated for the plurality of sets are connected in the graph to form a second curve.

44. The method of claim 43, further comprising:

for each set of the sets, calculating, by the processor, a difference between the respective spill representative value and overlap representative value calculated for the respective set; and

plotting the difference values as a displayed difference curve.

45. The method of claim 44, wherein the difference curve is a third displayed curve of the graph.

46. The method of claim 43, wherein each of the spill representative values is calculated as a percentage of the respective VOA that does not overlap the target volume, and each of the overlap representative values is calculated as a percentage of the target volume overlapped by the respective VOA.

47. The method of claim 43, wherein each of the spill representative values is calculated as a percentage of a predefined area in which the VOAs and the target volume are included that is overlapped by the respective VOA and not overlapped by the target volume, and each of the overlap representative values is calculated as a percentage of the target volume overlapped by the respective VOA.

48. The method of claim 43, wherein each of the spill representative values is calculated as number of voxels of the respective VOA that do not overlap the target volume, and each of the overlap representative values is calculated as a number of voxels of the respective VOA that do overlap the target volume.

49. A computer-implemented method, comprising:

displaying, by a computer processor and in a graphical user interface, a first user-manipulable control, in response to a manipulation of which a first threshold is modifiable, the first threshold defining an extent to which a volume of activation (VOA) of tissue estimated to be activated by a stimulation is to correspond to a target volume of tissue to be stimulated; and

responsive to user manipulation of the first control;

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated;

wherein;

for the each of the plurality of sets, the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

a size of an area formed by a combination of the respective VOA and the other obtained volume;

the generating of the first score includes calculating

50. A computer-implemented method, comprising:

displaying, by a computer processor and in a graphical user interface, a first user-manipulable control, in response to a manipulation of which a first threshold is modifiable, the first threshold defining an extent to which a volume of activation (VOA) of tissue estimated to be activated by a stimulation is to correspond to a target volume of tissue to be stimulated; and

responsive to user manipulation of the first control;

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated;

wherein;

for the each of the plurality of sets, the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

a size of a predetermined area that includes both the respective VOA and the other obtained volume;

the generating of the first score includes calculating

51. A computer-implemented method, comprising:

displaying, by a computer processor and in a graphical user interface, a first user-manipulable control, in response to a manipulation of which a first threshold is modifiable, the first threshold defining an extent to which a volume of activation (VOA) of tissue estimated to be activated by a stimulation is to correspond to a target volume of tissue to be stimulated; and

responsive to user manipulation of the first control;

determining, by the processor, a plurality of sets of stimulation parameters that each satisfies at least the first threshold;

calculating a respective score for each of the plurality of sets; and

selecting one of the plurality of sets for which a best of the scores has been calculated;

wherein;

for the each of the plurality of sets, the calculating the respective score includes calculating a first score based on;

an amount by which a respective VOA, estimated to be activated by stimulation provided according to the respective set of stimulation parameters, overlaps another obtained volume; and

an amount of the respective VOA that does not overlap the other obtained volume;

the first score includes a first sub-score that represents the amount by which the respective VOA overlaps the other obtained volume and a second sub-score that represents the amount of the respective VOA that does not overlap the other obtained volume, the first and second sub-scores being output;

the generating of the first sub-score includes calculating