Method and device for displaying predicted volume of influence

• US 9,760,688 B2
• Filed: 10/02/2014
• Issued: 09/12/2017
• 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): Patel, Jayesh A
• Application Number:
  US14/504,621
• Publication Number:
  US 20150045852A1
• Time in Patent Office: 1,076 Days
• Field of Search: None
• 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, volumetric imaging data representing an anatomical volume of a brain of a patient can be obtained and transformed to brain atlas data. A patient-specific brain atlas can be created using the inverse of the transformation to map the brain atlas data onto the volumetric imaging data and a volume of influence can be calculated using the patient-specific brain atlas. In certain examples, the volume of influence can include a predicted volume of tissue affected by an electrical stimulation delivered by an electrode at a corresponding at least one candidate electrode target location.

Claims

1. A computer-implemented method of outputting information concerning an electrode inserted inside a patient'"'"'s neural tissue, the method comprising:

determining, by a computer processor, a distribution of electrical values, to be generated by the inserted electrode using a first set of settings, over a plurality of positions in the patient'"'"'s neural tissue in a region surrounding the inserted electrode;

determining at least one threshold electrical value for neural tissue activation;

determining, by the processor and by applying the at least one threshold electrical value to the electrical values to be generated by the inserted electrode using the first set of settings, an estimated volume of neural tissue activated by the inserted electrode using the first set of settings, wherein the estimated volume of neural tissue indicates that the distribution of the electrical values inside the estimated volume of neural tissue exceed the at least one threshold electrical value and indicates that the distribution of the electrical values beyond the estimated volume of neural tissue fail to exceed the at least one threshold electrical value; and

outputting, by the processor, a graphical representation of the determined estimated volume.

2. The method of claim 1, wherein the outputting includes displaying the graphical representation relative to an anatomical atlas.

3. The method of claim 1, further comprising determining conductivity at a plurality of tissue regions, wherein the determination of the distribution of the electrical values is based on the determined conductivity.

4. The method of claim 3, wherein the plurality of tissue regions span an anatomical area across which the determined conductivity is inhomogeneous.

5. The method of claim 3, wherein the determined conductivity is patient specific.

6. The method of claim 3, wherein the conductivity is determined based on diffusivity in the plurality of tissue regions.

7. The method of claim 1, wherein the determining of the distribution of the electrical values and the determining of the estimated volume of neural tissue activated is performed for each of a plurality of different sets of settings for the inserted electrode, different estimated volumes of neural tissue activated being determined for the different sets of settings, a location of the inserted electrode in the patient'"'"'s neural tissue being the same for the plurality of determinations of the estimated volume of neural tissue activated.

8. The method of claim 1, wherein the estimated volume is a combination of and is determined by the processor by combining, regions at which those of the electrical values that satisfy the at least one threshold electrical value are located.

9. The method of claim 1, wherein determining the distribution of the electrical values, to be generated by the inserted electrode using the first set of settings, over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode further comprises:

determining, by the processor, estimated conductivity of the patient'"'"'s neural tissue in the region surrounding the inserted electrode; and

determining, by the processor, an estimation of the distribution over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode based on the estimated conductivity.

10. The method of claim 1, wherein determining, by applying, the at least one threshold electrical value to the electrical values, the estimated volume of neural tissue activated by the inserted electrode using the first set of settings further comprises:

determining, by the processor and by applying the at least one threshold electrical value to the electrical values distributed in the patient'"'"'s neural tissue in the region surrounding the inserted electrode, an estimated volume of neural tissue activated by the inserted electrode using the first set of settings, wherein the region in which the distribution of the electrical values was determined exceeds the estimated volume of neural tissue activated.

11. The method of claim 1, wherein determining the distribution of the electrical values, to be generated by the inserted electrode using the first set of settings, over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode further comprises:

determining at least one of one or more estimated inhomogeneous electrical properties of the patient'"'"'s neural tissue in the region surrounding the inserted electrode or one or more estimated anisotropic electrical properties of the patient'"'"'s neural tissue in the region surrounding the inserted electrode; and

determining the distribution of the electrical values based on the at least one of the one or more estimated inhomogeneous electrical properties or the one or more estimated anisotropic electrical properties.

12. The method of claim 1, wherein determining the distribution of the electrical values, to be generated by the inserted electrode using the first set of settings, over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode further comprises:

determining at least one of one or more geometries of the inserted electrode or one or more structures of the inserted electrode; and

determining the distribution of the electrical values based on the at least one of the one or more geometries or the one or more structures.

13. The method of claim 1, wherein determining the distribution of the electrical values, to be generated by the inserted electrode using a first set of settings, over a plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode further comprises:

determining, with regard to the patient'"'"'s neural tissue in the region surrounding the inserted electrode, at least one of one or more neuron geometries, one or more neuron positions relative to the inserted electrode, or one or more neuron membrane dynamics; and

determining the distribution of the electrical values based on the at least one of the one or more neuron geometries, the one or more neuron positions relative to the inserted electrode, or the one or more neuron membrane dynamics.

14. The method of claim 1, wherein outputting the graphical representation of the determined estimated volume further comprises:

outputting, by the processor, the graphical representation of the determined estimated volume prior to insertion of the electrode into the patient'"'"'s neural tissue.

15. The method of claim 1, further comprising:

determining, by the processor, a distribution of other electrical values, to be generated by the inserted electrode using a second set of settings over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode;

determining, by the processor and by applying the at least one threshold electrical value to the other electrical values, another estimated volume of neural tissue activated by the inserted electrode using the second set of settings, wherein the other estimated volume of neural tissue indicates that the distribution of the other electrical values inside the other estimated volume of neural tissue exceed the at least one threshold electrical value and indicates that the distribution of the other electrical values beyond the other estimated volume of neural tissue fail to exceed the at least one threshold electrical value; and

outputting, by the processor, a graphical representation of the other determined estimated volume.

16. A computer-implemented method of outputting information concerning an electrode inserted inside a patient'"'"'s neural tissue, the method comprising:

determining, by a computer processor, a distribution of electrical values, to be generated by the inserted electrode, in the patient'"'"'s neural tissue in a region surrounding the inserted electrode;

determining at least one threshold electrical value for neural tissue activation;

determining, by the processor and by applying the at least one threshold electrical value to the electrical values, an estimated volume of neural tissue activated by the distribution of the electrical values; and

outputting, by the processor, a graphical representation of the determined estimated volume,

wherein determining the distribution of the electrical values, to be generated by the inserted electrode in the patient'"'"'s neural tissue in the region surrounding the inserted electrode further comprises;

determining one or more models of the patient'"'"'s neural tissue in the region surrounding the inserted electrode, wherein the one or more models have a plurality of data densities that vary as a function of distance from the inserted electrode; and

determining the distribution throughout the patient'"'"'s neural tissue in the region surrounding the inserted electrode of the electrical values to be generated by the inserted electrode based on the one or more models.

17. The method of claim 16, wherein determining, by applying the at least one threshold electrical value to the electrical values, the estimated volume of neural tissue activated by the distribution of the electrical values further comprises:

determining one or more boundaries in the patient'"'"'s neural tissue in the region surrounding the inserted electrode, wherein the one or more boundaries indicate that the distribution of the electrical values between the inserted electrode and the one or more boundaries exceed the at least one threshold electrical value and indicate that the distribution of the electrical values beyond the one or more boundaries fail to exceed the at least one threshold electrical value; and

determining the estimated volume of neural tissue activated by the electrical values distributed throughout the patient'"'"'s neural tissue in the region surrounding the inserted electrode based on the determined one or more boundaries.

18. A non-transitory computer-readable medium having computer executable instructions stored thereon that, when executed by a processor, cause the processor to perform a method for outputting information concerning an electrode inserted inside a patient'"'"'s neural tissue, the method comprising:

determining a distribution of electrical values, to be generated by the inserted electrode using a first set of settings, over a plurality of positions in the patient'"'"'s neural tissue in a region surrounding the inserted electrode;

determining at least one threshold electrical value for neural tissue activation;

determining, by applying the at least one threshold electrical value to the electrical values to be generated by the inserted electrode using the first set of settings, an estimated volume of neural tissue activated by the inserted electrode using the first set of settings, wherein the estimated volume of neural tissue indicates that the distribution of the electrical values inside the estimated volume of neural tissue exceed the at least one threshold electrical value and indicates that the distribution of the electrical values beyond the estimated volume of neural tissue fail to exceed the at least one threshold electrical value; and

outputting a graphical representation of the determined estimated volume.

19. The non-transitory computer-readable medium of claim 18, wherein outputting a graphical representation of the determined estimated volume further comprises:

outputting the graphical representation of the determined estimated volume subsequent to insertion of the electrode into the patient'"'"'s neural tissue and prior to the inserted electrode generating the electrical values, wherein the region in which the distribution of the electrical values was determined exceeds the estimated volume of neural tissue activated.

20. The non-transitory computer-readable medium of claim 18, wherein method further comprises:

determining a distribution of other electrical values, to be generated by the inserted electrode using a second set of settings, over the plurality of positions in the patient'"'"'s neural tissue in the region surrounding the inserted electrode;

determining, by applying the at least one threshold electrical value to the other electrical values, another estimated volume of neural tissue activated by the inserted electrode using the second set of settings, wherein the other estimated volume of neural tissue indicates that the distribution of the other electrical values inside the other estimated volume of neural tissue exceeds the at least one threshold electrical value and indicates that the distribution of the other electrical values beyond the other estimated volume of neural tissue fail to exceed the at least one threshold electrical value; and

output a graphical representation of the other determined estimated volume.