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

Patent metadata

Field	Value
Publication number	US-12194297-B2
Application number	US-202117154045-A
Country	US
Kind code	B2
Filing date	Jan 21, 2021
Priority date	Jan 23, 2020
Publication date	Jan 14, 2025
Grant date	Jan 14, 2025

Abstract

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.

First claim

The following is claimed:

1. A method for configuring a deep brain stimulation (DBS) system for a patient, the method comprising:
instructing the patient to perform or attempt to perform at least one motor task;
in response to the patient performing or attempting to perform the at least one motor task, receiving, by a system comprising a processor, electrophysiology data from a plurality of DBS electrodes implanted in at least one cerebellar pathway connecting to a brainstem, a diencephalon, or a cerebrum of the patient;
based on the electrophysiology data, identifying, by the system, at least one of the plurality of DBS electrodes implanted closest to a neuronal population involved in control of the at least one motor task as potential stimulation electrodes;
in response to the patient performing or attempting to perform the at least one motor task, receiving, by the system, electroencephalogram (EEG) data corresponding to at least one scalp EEG from a plurality of EEG scalp electrodes;
determining, by the system, at least one of the potential stimulation electrodes that is at an optimal electrode location for the patient to deliver the DBS by comparing the potential stimulation electrodes with the EEG data of the plurality of EEG scalp electrodes, wherein the comparing includes weighing the potential stimulation electrodes with the EEG data recorded while the patient performed or attempted to perform the at least one motor task;
selecting, by the system, the at least one of the potential stimulation electrodes that is at the optimal electrode location for the patient to deliver the DBS based on the weighing;
determining, by the system, optimal parameters for the DBS to be delivered by the at least one of the potential stimulation electrodes at the optimal electrode location for the patient, wherein the optimal parameters for the DBS are titrated to select a lowest amplitude that produces a robust response indicative of modulation with minimum side effects; and
outputting, by the system, the optimal parameters for the DBS and a location of the at least one of the potential stimulation electrodes that is at the optimal electrode location for the patient to deliver the DBS to guide configuration of the DBS system for the patient to treat a neurological disorder negatively affecting the patient during the at least one motor task.

2. The method of claim 1 , further comprising configuring the DBS system, by the system, so that the at least one of the potential stimulation electrodes delivers the DBS at the optimal parameters.

3. The method of claim 1 , wherein the at least one motor task comprises moving an arm, a hand, a finger, a foot, or a leg.

4. The method of claim 1 , wherein the electrophysiology data comprises one or more local field potentials (LFPs) measured by the plurality of DBS electrodes during the at least one motor task.

5. The method of claim 4 , wherein the electrophysiology data comprises a power in a theta, alpha, beta, and/or gamma oscillatory band of each LFP signal and/or a power change in the theta, alpha, beta, and/or gamma oscillatory band of each LFP signal.

6. The method of claim 1 , wherein the plurality of scalp EEG electrodes are located over the patient's primary motor cortex, secondary motor cortex, primary sensory cortex, and/or secondary sensory cortex.

7. The method of claim 1 , wherein the change in the EEG data is a change in event related desynchronization (ERD) and/or event related synchronization (ERS).

8. The method of claim 7 , wherein the change in the EEG is seen in theta, alpha, beta, and/or gramma band activity in the EEG data.

9. The method of claim 1 , wherein the selecting at least one of the potential stimulation electrodes to deliver the DBS is further based on a change in an instrumentation-based motor behavior.

10. The method of claim 1 , wherein the optimal parameters are parameters that provide a response indicative of modulation with a lowest magnitude of stimulation.

11. The method of claim 1 , wherein the optimal parameters comprise at least one of an optimal stimulation amplitude, one or more optimal pulse or burst parameters, an optimal stimulation frequency, and an optimal stimulation pulse width.

12. The method of claim 1 , before the instructing, excluding at least a portion of the plurality of DBS electrodes and/or stimulation parameters known to cause undesired side effects.

13. The method of claim 12 , wherein the excluding is based on an initial monopolar review specific to the patient.

14. The method of claim 12 , wherein the excluding is based on data specific to a population comprising at least one similar patient.

15. A system that configures a deep brain stimulation (DBS) system for a patient, the system comprising:
a memory storing instructions;
a processor to access the memory and execute the instructions to:
in response to the patient performing or attempting to perform at least one motor task, receive electrophysiology data from a plurality of DBS electrodes implanted in at least one cerebellar pathway connecting to a brainstem, a diencephalon, or a cerebrum of the patient and electroencephalogram (EEG) data corresponding to at least one scalp EEG from a plurality of EEG scalp electrodes;
based on the electrophysiology data, identify at least one of the plurality of DBS electrodes implanted closest to a neuronal population involved in control of the at least one motor task as potential stimulation electrodes;
determine at least one of the potential stimulation electrodes that is at an optimal electrode location for the patient to deliver the DBS by comparing the potential stimulation electrodes with the EEG data of the plurality of EEG scalp electrodes, wherein the comparing includes weighing the potential stimulation electrodes with the EEG data recorded while the patient performed or attempted to perform the at least one motor task;
select the at least one of the potential stimulation electrodes that is at the optimal electrode location for the patient to deliver the DBS based on the weighing;
determine optimal parameters for the DBS to be delivered by the at least one of the potential stimulation electrodes the optimal electrode location for the patient, wherein the optimal parameters for the DBS are titrated to select a lowest amplitude that produces a robust response with minimum side effects; and
output the optimal parameters for the DBS and a location of the at least one of the potential stimulation electrode that is at the optimal electrode location for the patient to deliver the DBS to guide configuration of the DBS system for the patient to treat a neurological disorder negatively affecting the patient during the at least one motor task.

16. The system of claim 15 , wherein the processor further executes the instructions to configure the DBS system so that the at least one of the potential stimulation electrodes delivers the DBS at the optimal parameters.

17. The system of claim 15 , wherein the electrophysiology data comprises one or more local field potentials (LFPs) measured by the plurality of DBS electrodes during the at least one motor task.

18. The system of claim 15 , further comprising the plurality of scalp EEG electrodes, and a task component configured to assist the patient in performing or attempting to perform the at least one motor task.

19. The system of claim 15 , wherein the optimal parameters are parameters that provide a response indicative of modulation with a lowest magnitude of stimulation.

20. The system

Assignees

• Cleveland Clinic Found

Inventors

• Machado Andre
• Gopalakrishnan Raghavan
• Baker Kenneth

Classifications

• A61N1/36135

  using physiological parameters · CPC title

• A61N1/0534 Primary

  Electrodes for deep brain stimulation · CPC title

• A61N1/36139

  with automatic adjustment · CPC title

• A61N1/36067 Primary

  Movement disorders, e.g. tremor or Parkinson disease (stimulating motor muscle A61N1/36003) · CPC title