Medtronic, Inc.

Other

Medtronics, Inc.

Meadtronic, Inc

Mark Turner Rise

Gary William King

Jonathon E Giftakis

Michael J Schendel

Nina M Graves

Dennis D Elsberry

Warren L Starkebaum

Ivan Osorio

Mark G Frei

Richard S Schallhorn

David L Carlson

Scott F Schaffner

Michael D Baudino

Frans L Gielen

Daryle Petersen

Scott R Ward

David L Thompson

Timothy J Denison

Rahul Mehra

Paul H Stypulkowski

Lynn M Otten

Marc T Stein

Donald L Hall

Nathan Andrew Torgerson

Eric J Panken

Dwight E Nelson

Jonathan C Werder

Andres M Lozano

Jianping Wu

Maura G Donovan

Naresh C Bhavaraju

Randy M Jensen

David J Stanton

Kevin L Bright

Thomas E Peters

Robert J Klepinski

Alim Benabid

Chark Stanford

Dominique Caparros-Lefebvre

Richard Schallorn

Target tissue sites for therapy delivery to a patient may be selected based on the patient symptoms or a patient mood state. The therapy delivery may be used to manage a psychiatric disorder of the patient. Selected therapy sites may be weighted based on factors, such as the severity of the patient symptom or mood state or the type of patient symptom or mood state. In some cases, therapy delivery to the patient may be controlled based on the weighting factors. For example, the weighting factors may control the intensity of the therapy delivery or the frequency of the therapy delivery. In some examples, the weighting factors may dynamically change based on the patient's changing symptoms or mood disorders.

Therapy target selection for psychiatric disorder therapy

A characteristic of a washout period following the delivery of therapy to a patient according to a therapy program may be determined based on a physiological parameter of the patient. A washout period includes the period of time during which a carryover effect from the therapy delivery dissipates. Monitoring a washout period may be useful for timing the delivery of therapy according to different therapy programs during a therapy evaluation period. For example, at least one physiological signal of the patient may be monitored to automatically determine when a washout period has ended, e.g., when stimulation and carryover effects of therapy delivery according to a first therapy program have substantially dissipated, in order to determine when therapy delivery according to a second therapy program can be initiated.

Timing therapy evaluation trials

A characteristic of a washout period following the delivery of therapy to a patient according to a therapy program may be determined based on a physiological parameter of the patient. A washout period includes the period of time during which a carryover effect from the therapy dissipates. The washout period characteristic may include, for example, a duration of the washout period, an amplitude or a trend in a physiological signal during the washout period or a power level or a ratio of power levels in frequency bands of the physiological signal. In some embodiments, washout period characteristics associated with a plurality of therapy programs may be used to compare the programs. In other embodiments, a washout period characteristic may be used to determine a mood state of the patient and, in some cases, modify a therapy program. Monitoring a washout period may also be useful for timing therapy program trials.

Analyzing a washout period characteristic for psychiatric disorder therapy delivery

A therapy system for managing a psychiatric disorder of the patient may be controlled based on a patient mood state. Therapy may be delivered to a patient according to a therapy program, and a physiological parameter of the patient may be monitored during or after therapy delivery. The patient mood state may be determined based on the monitored physiological parameter, and the therapy delivery may be controlled based on the determined mood state. In some embodiments, the therapy delivery is stopped prior to determining the patient mood state and the therapy delivery is restarted upon detecting a negative mood state. In other embodiments, therapy delivery is delivered until a positive mood state is detected, at which point the therapy delivery may be stopped.

Psychiatric disorder therapy control

Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination. Therapy parameters may be updated for each msuccessive group of applications of the treatment therapy or for each ndetection cluster.

Clustering of recorded patient neurological activity to determine length of a neurological event

Apparatus and techniques to address problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Techniques for positioning therapy delivery elements within a spinal cord or brain

Apparatuses and methods support multi-modal operation of a medical device system for a nervous system disorder. The medical device system comprises an implanted component and an external component and supports a first feature and a second feature that are associated with the treatment therapy. The medical device system supports both features when the implanted component and the external component are coupled. If the external component is decoupled, the implanted component continues to support the first feature. Moreover, the embodiment may support a plurality of features during a treatment interval. Another aspect of the invention allows for modularly expanding a medical device system in order to add a feature that enhances existing functionality or that provides additional functionality. In an embodiment, a module that is associated with an external component of the medical device system supports the added feature.

Multi-modal operation of a medical device system

Apparatus and method support a neurological event screening for a medical device. The medical device assists a user in determining a configuration of the medical device for delivering an effective treatment for a nervous system disorder. The medical device detects a neurological event, such as a seizure, and reports a neurological event focus location and a neurological event spread to the user. The user may use the information to provide a configuration of a therapeutic delivery unit and associated therapy parameters. Therapeutic treatment is delivered to the patient, and the medical device is provided an indication of the patient's acceptance to the treatment. The user may modify the configuration and therapy parameters in order to achieve efficacy and acceptance. Depending upon the patient's acceptance, therapy is applied in either an open loop mode or a closed loop mode. The medical device determines whether the treatment is successful in accordance with a criterion.

Screening techniques for management of a nervous system disorder

In some examples, an arousal network of a brain of a patient can be activated to modify the arousal state of the patient, which may be useful in treating a cognitive disorder of the patient. In some examples, a bioelectrical brain signal indicative of electrical activity in a first portion of the brain is monitored to determine whether the patient is in a first arousal state, and, in response to determining the patient is in the first arousal state, electrical stimulation is delivered to a second portion of the brain to activate an arousal neural network in the first portion of the brain to induce a second arousal state to treat the cognitive disorder, where the second arousal state is different than the first arousal state.

Arousal state modulation with electrical stimulation

A medical device system that includes a brain stimulating element, cardiac monitoring element and a processor. The processor is configured to receive a brain stimulation signal from the brain stimulating element and a cardiac signal from the cardiac monitoring element. The processor is further configured to determine at least one reference point for a stimulation event time period by evaluation of the brain stimulation signal. The processor further identifies a first portion of the cardiac signal based on the at least one reference point of the stimulation event time period.

System and method for segmenting a cardiac signal based on brain stimulation

A medical device system and method for monitoring cardiac signal activity in patients with nervous system disorders. In some embodiments, a brain signal and a cardiac signal are received by a processor, brain events are identified in the brain signal, and the brain events are used to identify portions of the cardiac signal. In some embodiments, Event portions of the cardiac signal are identified corresponding to brain event time periods, and Inter-event portions are identified corresponding to time periods between brain events. An Inter-event heart-rate variability (HRV) calculation is performed using Inter-event portions of the cardiac signal, and an output of the medical device system is modified based upon the calculated Inter-event HRV according to certain embodiments of the invention. An Event HRV may also be calculated according to certain embodiments, and an output modified based on comparisons of the Event HRV to the Inter-event HRV, for example.

System and method for monitoring cardiac signal activity in patients with nervous system disorders

An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Apparatus and method for expanding a stimulation lead body in situ

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Monticello, MN, United States of America

Mark Turner Rise