Medtronic, Inc.

Great Lakes Neurotechnologies Inc.

Cardiac Pacemakers, Inc.

Christopher L Pulliam

David A Dinsmoor

Kristin N Hageman

Hank Bink

Joseph P Giuffrida

Dustin A Heldman

Scott R Stanslaski

Thomas O Mera

Eric J Panken

Jadin C Jackson

Rene A Molina

Abbey Beuning Holt Becker

Timothy R Abraham

Robert S Raike

Michelle A Case

Jiashu Li

Yizi Xiao

Duane L Bourget

Thomas Adamski

Steven M Goetz

David L Perschbacher

Deepa Mahajan

Yanting Dong

Andrew H Houchins

Christopher M Arnett

Benjamin P Isaacson

Thomas L Chouinard

Evan Schnell

Lukas Valine

Alicia Weller Thompson

Ilan D Gordon

Karan Chitkara

Caleb C Zarns

Hijaz M Haris

Ankush Thakur

Brady N Fetting

Rucha Gokul G Samant

Paula Andrea Elma Dassbach Green

Timothy J Denison

David L Carlson

Jianping Wu

Thaddeus S Brink

Robert A Corey

David E Linde

Timothy Denison

Jeffrey Herron

Kevin M Johnson

Susan Heilman Kilbane

Nicholas D Buse

Susan E Heilman Kilbane

Elizabeth Brokaw

Kevin C Johnson

Devices, systems, and techniques for identifying electrodes closest to a target region of tissue are described. In one example, a device includes sensing circuitry configured to sense electrical signals from a plurality of electrode combinations. Processing circuitry identifies a first electrode combination of a first subset of electrode combinations. Each electrode combination of the first subset of electrode combination includes electrodes located at different axial positions along a length of the medical lead. The processing circuitry identifies a second electrode combination of a second subset of electrode combinations. Each electrode combination of the second subset of electrode combinations includes electrodes located at a same axial position and different circumferential positions around a perimeter of the medical lead. The processing circuitry then determines a third electrode combination and controls delivery of electrical stimulation via the third electrode combination.

Directional sensing for programming guidance

The present invention relates to methods for tuning treatment parameters in movement disorder therapy systems. The present invention further relates to a system for screening patients to determine viability as candidates for certain therapy modalities, such as deep brain stimulation (DBS). The present invention still further provides methods of quantifying movement disorders for the treatment of patients who exhibit symptoms of such movement disorders including, but not limited to, Parkinson's disease and Parkinsonism, Dystonia, Chorea, and Huntington's disease, Ataxia, Tremor and Essential Tremor, Tourette syndrome, stroke, and the like. The present invention yet further relates to methods of tuning a therapy device using objective quantified movement disorder symptom data acquired by a movement disorder diagnostic device to determine the therapy setting or parameters to be provided to the subject via his or her therapy device. The present invention also provides treatment and tuning remotely, allowing for home monitoring of subjects.

Movement disorder therapy system, devices and methods, and intelligent methods of tuning

Techniques are disclosed for implementing the use of electrically evoked compound action potentials (ECAPs) to adaptively adjust parameters of high frequency electrical stimulation. In one example, a medical device delivers electrical stimulation therapy comprising a train of electrical stimulation pulses to a patient, wherein the train of electrical stimulation pulses comprises a pulse frequency greater than or equal to 500 Hertz. After delivering the train of electrical stimulation pulses, the medical device ceases delivery of the high frequency electrical stimulation therapy for a predetermined period of time. During the predetermined period of time, the medical device senses an ECAP from the patient and determines, based on the sensed ECAP, a value of a parameter at least partially defining the train of electrical stimulation pulses. Responsive to the predetermined period of time elapsing, the medical device resumes delivery of the high frequency electrical stimulation according to the determined parameter.

ECAP sensing for high frequency neurostimulation

A medical device for providing electrical stimulation to a brain of a patient includes one or more processors. The one or more processors are configured to determine a first set of parameters of a first electrical signal that is delivered via a first electrode configured to apply electrical stimulation to a first region of the brain and to determine a second set of parameters of a second electrical signal based on the first set of parameters. The second electrical signal is delivered via a second electrode configured to apply electrical stimulation to a second region of the brain. The one or more processors are further configured to deliver, with the first electrode, the first electrical signal having the first set of parameters and to deliver, with the second electrode, the second electrical signal having the second set of parameters.

Electrical stimulation therapy

Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to monitor lead position and/or detect lead migration. An example system includes sensing circuitry configured to sense an ECAP signal, and processing circuitry. The processing circuitry controls the sensing circuitry to detect, after delivery of an electrical stimulation pulse, a current ECAP signal, and determines one or more characteristics of the current ECAP signal. The processing circuitry also compares the one or more characteristics of the current ECAP signal to corresponding one or more characteristics of a baseline ECAP signal, and determines, based on the comparison, a migration state of the electrodes delivering the electrical stimulation pulse. Additionally, the processing circuitry outputs, based on the migration state, an alert indicative of migration of the electrodes.

Implantable lead migration monitoring using ECAP

Systems, devices, and techniques are described for adjusting electrical stimulation based on detected ECAPs. In one example, a medical device includes processing circuitry configured to control stimulation circuitry to deliver a first electrical stimulation pulse and sensing circuitry to detect, after delivery of the first electrical stimulation pulse, an ECAP signal. The processing circuitry may be configured to determine a characteristic value of the ECAP signal, determine an ECAP differential value that indicates whether the characteristic value of the ECAP signal is one of greater than a selected ECAP characteristic value or less than the selected ECAP characteristic value, determine, based on the ECAP differential value, a gain value, determine, based on the gain value, a parameter value that at least partially defines a second electrical stimulation pulse, and control the stimulation circuitry to deliver the second electrical stimulation pulse according to the parameter value.

Hysteresis compensation for detection of ECAPs

Devices, systems, and techniques are described for selecting an evoked compound action potential (ECAP) growth curve based on a posture of a patient. The ECAP growth curve defines a relationship between a parameter defining delivery of stimulation pulses delivered to the patient and a parameter of an ECAP signal of a nerve of a patient elicited by a stimulation pulse. In one example, a medical device detects a posture of a patient and selects an ECAP growth curve corresponding to the detected posture. The medical device selects, based on the ECAP growth curve corresponding to the detected posture and a characteristic of a detected ECAP signal, a value for a parameter for defining delivery of the stimulation pulses to the patient and controls delivery of the stimulation pulses according to the selected value for the parameter.

Posture-based control of electrical stimulation therapy

Devices, systems, and techniques are described for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

Stimulation induced neural response for parameter selection

Devices, systems, and techniques are disclosed for managing electrical stimulation therapy and/or sensing of physiological signals such as brain signals. For example, a system may assist a clinician in identifying one or more electrode combinations for sensing a brain signal. In another example, a user interface may display brain signal information and values of a stimulation parameter at least partially defining electrical stimulation delivered to a patient when the brain signal information was sensed.

Brain stimulation and sensing

Systems, devices, and techniques are described for determining a posture state of a patient based on detected evoked compound action potentials (ECAPs). In one example, a medical device includes stimulation circuitry configured to deliver electrical stimulation and sensing circuitry configured to sense a plurality of evoked compound action potential (ECAP) signals. The medical device also includes processing circuitry configured to control the stimulation circuitry to deliver a plurality of electrical stimulation pulses having different amplitude values, control the sensing circuitry to detect, after delivery of each electrical stimulation pulse of the plurality of electrical stimulation pulses, a respective ECAP signal of the plurality of ECAP signals, and determine, based on the plurality of ECAP signals, a posture state of the patient.

Determining posture state from ECAPs

An example method includes determining, by an implantable medical device (IMD), an electrode of a plurality of electrodes of a lead to be used to deliver electrical stimulation to a patient at a particular time; selecting, by the IMD and based on the determined electrode, a set of electrodes of the plurality of electrodes; and sensing, by the IMD and via the selected set of electrodes, electrical signals of the patient at the particular time.

Dynamically optimized neural sensing

Systems, devices, and techniques for adjusting electrical stimulation based on a posture state of a patient are described. For example, a system may include sensing circuitry configured to sense an ECAP signal and processing circuitry configured to control delivery of the electrical stimulation to a patient according to a first value of a stimulation parameter and determine a characteristic value of the ECAP signal. The processing circuitry may also be configured to receive, from a sensor, a posture state signal representing a posture state of the patient, determine, based on the posture state signal, a gain value for the stimulation parameter, adjust, based on the characteristic value of the ECAP signal and the gain value, the first value of the stimulation parameter to a second value of the stimulation parameter, and control delivery of the electrical stimulation according to the second value of the stimulation parameter.

ECAP and posture state control of electrical stimulation

Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first response of a first sensed signal of the patient to the electrical stimulation therapy and a second response of a second sensed signal of the patient to the electrical stimulation therapy. Based on the first response and the second response for controlling the electrical stimulation therapy, the medical system selects one of the first sensed signal and the second sensed signal of the patient. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.

Adaptive deep brain stimulation using frequency sub-bands

Systems, devices, and techniques for adjusting electrical stimulation based on a posture state of a patient are described. For example, processing circuitry is configured to control delivery of a first informed stimulation pulse defined by at least a first value of an informed stimulation parameter, control delivery of a control stimulation pulse to a patient, the control stimulation pulse defined by at least a first value of a control stimulation parameter, determine a characteristic value of the ECAP signal elicited from the control stimulation pulse, receive, from a sensor, a posture state signal representing a posture state of the patient, and adjust, based on the characteristic value of the ECAP signal and the posture state signal, the first value of the informed stimulation parameter to a second value of the informed stimulation parameter.

Control pulses and posture for ECAPs

The present invention relates to methods for remotely and intelligently tuning movement disorder of therapy systems. The present invention still further provides methods of quantifying movement disorders for the treatment of patients who exhibit symptoms of such movement disorders including, but not limited to, Parkinson's disease and Parkinsonism, Dystonia, Chorea, and Huntington's disease, Ataxia, Tremor and Essential Tremor, Tourette syndrome, stroke, and the like. The present invention yet further relates to methods of remotely and intelligently or automatically tuning a therapy device using objective quantified movement disorder symptom data to determine the therapy setting or parameters to be transmitted and provided to the subject via his or her therapy device. The present invention also provides treatment and tuning intelligently, automatically and remotely, allowing for home monitoring of subjects.

Artificial intelligence systems for quantifying movement disorder symptoms and adjusting treatment based on symptom quantification

Growing community of inventors

Shaker Heights, OH, United States of America

Christopher L Pulliam