The Cleveland Clinic Foundation

Cornell Research Foundation Inc.

Intelect Medical, Inc.

Andre G Machado

Ali R Rezai

Scott Lempka

Keith R Carlton

Cameron C McIntyre

Karl West

Jay L Alberts

David D Schindler

Mark S Lobosky

Scott Kokones

Nicholas D Schiff

John T Gale

Sandra Machado

Jorge A Gonzalez-Martinez

Imad Najm

Raghavan Gopalakrishnan

Kenneth Baker

Sierra Farris

Deep brain stimulation (DBS) can be used to treat many neurological conditions beyond traditional movement disorders. When patients do not suffer from traditional movement disorders, medical professionals cannot use traditional observation-based methods to configure the DBS system. A new method for selecting stimulation configurations can include recording internal data and external data as the patient performs (or attempts to perform) a motor task. The internal data is electrophysiology data recorded by a plurality of DBS electrodes, used to identify at least one of the plurality of electrodes closest to a neuronal population involved in control of the at least one motor task. The external data is electroencephalogram (EEG) data recorded by scalp electrodes, which is used to select at least one of the potential stimulation electrodes to deliver the DBS. When the electrode(s) delivering the DBS are selected, optimal parameters for the DBS are then chosen.

Configuring a deep brain stimulation (DBS) system to treat a neurological disorder

This disclosure relates to using stereo-thermo-lesioning (STL) to create lesions at one or more locations in the patient's nervous system at the patient's bedside without general anesthesia. A method that uses STL to treat a patient's neurological condition includes: using a plurality of stereotactically-implanted thermo-coupled multi-contact electrodes to record conduction data within a predetermined theoretical zone of activity within the patient's neurological tissue; detecting abnormal neurological activity of a neurological condition within the conduction data and localize a portion of the predetermined theoretical zone of activity that is responsible for a primary organization of the abnormal neurological activity; creating a lesion at the portion of the predetermined theoretical zone of activity that is responsible for a primary organization of the abnormal neurological activity using at least one contact of the plurality of thermo-coupled multi-contact electrodes.

Stereo-thermo-lesioning to treat a patient's neurological condition

This disclosure relates to a system and method to evaluate movement disorders. A movement data aggregator can combine data from a plurality of sensors into an aggregate movement data describing multi-dimensional movement of a handheld device. A calculator to compute an indication of a movement disorder based on the movement vector data and user input data, the user input data being generated in response to physical interaction between the handheld device and a human machine interface of a computing device/machine that is separate from the handheld device. In some examples, the handheld device can communicate with computing device via a wireless interface.

Evaluation of movement disorders

One aspect of the present disclosure relates to lead assemblies for stimulating tissue. The lead assemblies can include lead bodies that are slidably coupled to each other and include one or more contacts that are moveably disposed within the slits of the lead bodies. The positions of the one or more contacts can be adjusted to change the direction of stimulation. For example, the positions of the one or more contacts can be adjusted based on theoretically-optimal positions determined from a patient-specific computer model. Parameters of the stimulation applied by the one or more contacts can also be optimized based on the patient-specific computer model.

Lead assemblies with adjustable contacts

One aspect of the present disclosure relates to lead assemblies for stimulating tissue. The lead assemblies can include lead bodies that are slid ably coupled to each other and include one or more contacts that are movably disposed within the slits of the lead bodies. The positions of the one or more contacts can be adjusted to change the direction of stimulation. For example, the positions of the one or more contacts can be adjusted based on theoretically-optimal positions determined from a patient-specific computer model. Parameters of the stimulation applied by the one or more contacts can also be optimized based on the patient-specific computer model.

A system can include a model to represent a volumetric deformation of a brain corresponding to brain tissue that has been displaced by at least one of disease, surgery or anatomical changes. A fusion engine can perform a coarse and/or fine fusion to align a first image of the brain with respect to a second image of the brain after a region of the brain has been displaced and to employ the deformation model to adjust one or more points on a displacement vector extending through a displaced region of the brain to compensate for spatial deformations that occur between the first and second image of the brain.

Image fusion with automated compensation for brain deformation

A system for treating medical conditions by neuromodulation of one or more target sites in the nervous system. In certain embodiments, at least one of the target sites is the medial thalamic region, including the intralaminar nucleus and the adjacent white and grey matter. In certain embodiments, where there is more than one target site, the other target sites is elsewhere in the nervous system, including the globus pallidus interna, subthalamic nucleus, corpus callosum, cerebellum, cerebral cortex (including the premotor cortex, motor cortex, and sensory cortex), ventral striatum, lateral thalamus, substantia nigra, and pedunculopontine nuclei. The medical conditions include movement disorders or improvement of movement function, stroke, neuropsychiatric or neuropsychologic disorders, neurodevelopmental disorders, and pain. Methods for treating medical conditions by neuromodulation of the intralaminar nuclei either alone or in combination with another target site(s) is also provided.

Systems and methods for treating medical conditions by stimulation of medial thalamic region

One aspect of the present disclosure relates a method for determining effective stimulation parameters to apply to a patient in order to improve the patient's medical condition. The method can employ functional and/or structural imaging to determine the effective stimulation parameters. As such, the method includes programming a stimulation device with an initial stimulation parameter. An image can be received of at least a portion of the patient that is affected by a stimulation by the stimulation device. Based on the image, the efficacy of the stimulation with the at least one initial stimulation parameter can be assessed. The at least one initial stimulation parameter can be updated based on the assessed efficacy.

Systems and methods for determining effective stimulation parameters

A method is provided for neuromodulation to treat stroke. One step of the method includes recording an input waveform from a first site in the nervous system in a source subject. The first site is healthy or at least partially functioning. Next, an output waveform is applied to a second site in the nervous system of a target subject suffering from the stoke. The second site is diseased due to the stroke.

Systems and methods for neuromodulation using pre-recorded waveforms

A neurostimulation system can include a memory, a playback system, a stimulation electrode, and a controller. The memory can store data for first and second input waveforms. The playback system can provides first and second output waveforms, based on the first and second input waveforms in the memory, respectively, to form composite patterns of stimulation or waveforms. The first output waveform can be different than the second output waveform. The second output waveform can be periodically superimposed on the first output waveform. The controller can be in communication with the stimulation electrode. The controller can be configured to control application of the composite pattern of stimulation or waveform to a target site in a body of a subject suffering from a medical condition.

System and method for neuromodulation using composite patterns of stimulation or waveforms

Neuromodulation assemblies with lead bodies having curvatures that mimic the curvatures of the splenium, trunk, genu, or rostrum of the corpus callosum. Methods of stimulating the corpus callosum and methods of securing an electrical lead in the brain are also provided.

Corpus callosum neuromodulation method

Corpus callosum neuromodulation assembly

Methods for neuromodulation using waveform signals. In certain embodiments, an input waveform is obtained from a signal source site in a source subject and an output waveform is applied to a target site in a target subject. The source subject is a human or animal and the signal source site is in the nervous system, including the brain. The source subject and target subject are the same subjects or different subjects. The output waveform is identical to the input waveform or derived from the input waveform. In some embodiments, the output waveform is modified in response to physiologic feedback. Also provided are systems for neuromodulation using waveform signals.

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Beachwood, OH, United States of America

Andre G Machado