Medtronic, Inc.

Minnesota Mining and Manufacturing Company

Other

Cochlear Limited

Gn Resound Corporation

Paul H Stypulkowski

Jonathon E Giftakis

Timothy J Denison

Scott R Stanslaski

Mark Turner Rise

Christopher Van Den Honert

Robert S Raike

Thomas Adamski

David E Linde

Mae Eng

Steven M Goetz

Nathan Andrew Torgerson

Jonathan C Werder

Robert J Fretz

Lothar Krinke

William J George

Richard T Woods

Techniques, systems, and devices are disclosed for delivering stimulation therapy to a patient. In one example, a medical device senses, via one or more electrodes, one or more oscillations of a bioelectrical signal of a brain of a patient. In response to sensing the one or more oscillations, the medical device generates a plurality of bursts of stimulation therapy pulses, the plurality of bursts comprising an inter-burst frequency selected based on a frequency of the one or more oscillations of the bioelectrical signal. Further, the medical device delivers the plurality of bursts of stimulation therapy pulses to the patient to modulate a state of the patient associated with the one or more oscillations of the bioelectrical signal.

Non-continuous electrical stimulation therapy

In some examples of selecting a target therapy delivery site for treating a patient condition, a relatively high frequency electrical stimulation signal is delivered to at least two areas within a first region (e.g., an anterior nucleus of the thalamus) of a brain of a patient, and changes in brain activity (e.g., as indicated by bioelectrical brain signals) within a second region (e.g., a hippocampus) of the brain of the patient in response to the delivered stimulation are determined. The target therapy delivery site, an electrode combination, or both, may be selected based on the changes in brain activity.

Identification of compromised components in a medical system

Deep Brain Stimulation (DBS) electrodes are positioned within (or adjacent to) white matter fiber tracts in a brain of patient. The DBS electrodes may be positioned near one or more stimulation sites within the white matter fiber tracts. The stimulation sites may be selected based on the disorder of the patient. In some examples, the stimulation sites may be selected based on one or more symptoms of the patient. In some examples, additional electrodes may be positioned in another area to collect bioelectrical brain signals. The area in which the additional electrodes are placed is an area that is different from the stimulation site but is targeted by stimulation therapy provided at the stimulation site.

Brain stimulation therapy

Various embodiments concern delivering electrical stimulation to the brain at a plurality of different levels of a stimulation parameter and sensing a bioelectrical response of the brain to delivery of the electrical stimulation for each of the plurality of different levels of the stimulation parameter. A suppression window of the stimulation parameter can be identified as having a suppression threshold as a lower boundary and an after-discharge threshold as an upper boundary based on the sensed bioelectrical responses. A therapy level of the stimulation parameter can be set for therapy delivery based on the suppression window. The therapy level of the stimulation parameter may be set closer to the suppression threshold than the after-discharge threshold within the suppression window. Data for hippocampal stimulation demonstrating a suppression window is presented.

Brain stimulation response profiling

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

Target therapy delivery site selection

Techniques for varying stimulus parameters used in neural stimulation to improve therapy efficacy, minimize energy consumption, minimize undesired side effects, and minimize loss of therapeutic effectiveness due to physiologic tolerance to stimulation. Neural stimulation is provided having a stimulation amplitude, a stimulation frequency, a stimulation pulse duration, an electrode-firing pattern, and a set of electrode-firing-polarity conditions. At least one of the stimulation parameters is pseudo-randomly varied. A second stimulation parameter is changed based upon having pseudo-randomly varied the first stimulation parameter and based upon a predetermined relationship specifying how changes in the first parameter affect desirable values for the second parameter.

Variation of neural stimulation parameters

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

Bioelectrical brain signals may be monitored at one more regions of the brain of a patient by a medical device. The monitored bioelectrical signals may be used to select one or more therapy cycle parameters, e.g., on cycle duration and/or off cycle duration, for therapy delivered to treat a patient disorder. In one example, the off cycle duration of a therapy may be selected based on the washout period determined from sensed brain signals of the patient following delivery of therapy during an on cycle. In another example, the on cycle duration and/or off cycle duration of a therapy may be selected to maintain the value of one or more characteristics of a brain signal (e.g., cortical activity) of patient within a threshold range of a target value defined for the characteristic that is associated with effective treatment of the patient disorder.

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North Oaks, MN, United States of America

Paul H Stypulkowski