The present application relates to the field of biomimetic neurostimulation devices.
An alternative treatment for neurological disorders is neurostimulation therapy. Such therapy applies electric or magnetic stimuli to neural tissues by means of external or implanted devices. A biomimetic neurostimulation device is described in Berger et al., “Brain Implantable Biomimetic Electronics as the next Era in Neural Prosthetics,” Proc. IEEE, Vol. 89, #7, July 2001 pp. 993-1012. This document describes an electronic model of the input-output transformation by the hippocampus.
It is desirable to make the known device more adaptable and flexible.
Objects and advantages will be apparent from reading the specification and claims that follow. It will be apparent from the following specification that a more adaptable and flexible device can be used as a prosthetic for compromised tissue and include at least one signal processing apparatus that includes a feed-forward path and a modulation path. The feed-forward path simulates neurological signal processing between regions afferent and efferent to a suspect region. The modulation path informs the feed-forward path responsive to signals received elsewhere. The modulation path can feed back signals even further efferent than an output of the feed-forward path.
Disorders potentially treatable with this therapy include motor disorders, cognitive disorders, or injury. It is particularly hoped that such a more adaptive and flexible device would be useful in neurological disorders such as Parkinson's Disease. Other examples of neurological disorders potentially treatable with such a device include Multiple Sclerosis; epilepsy; pain; and more cognitive disorders such as Alzheimer's Disease, depression, bipolar disorder, Obsessive Compulsive Disorder, and addiction; and possibly even obesity. Moreover, the treatment may be used in rehabilitation therapy following stroke or traumatic brain injury.
Aspects of the invention will now be described by means of non-limiting example with reference to the following figures:
The following additional patent documents are incorporated herein by reference: U.S. Pat. No. 5,913,882; WO2005053787A1; and US20050113744A1.
An optional external system 104 communicates with the device 102 via antenna 105. The external system 104 provides data to the device 102, for instance when a medical service provider detects progression of a disorder or from some sensor. The external system 104 may additionally or alternatively provide auxiliary processing or control for 102.
As an example of typical brain circuits,
The implanted neurostimulator includes a first sensor 309; a processor 310 including a training/recording process 310a and a steady state process 310b; a stimulus emitter 311, and a second sensor 312. First sensor 309 takes an afferent signal 313 from the compromised region.
The stimulus emitter 311 is for example an electrical pulse generator. Stimulus emitter 311 provides a simulated response to region 308. Second sensor 312 takes an efferent signal 314 from region 308.
An optional external unit or units 315 communicate (wirelessly or otherwise) with the processor. External unit or units 315 may have a variety of optional features such as an additional sensor that senses some input other than neural activity (e.g., muscle activity, motion, digestion, or some other physiological or non-physiological parameter), or a supplemental processor, in case some function, especially training, requires more processor.
Element 316 is an output of the neuromimetic prosthetic device, while elements 317 and 318 are inputs.
Sensors 309 and 312 may be of many types including: electrical, optical, chemical, biochemical, electrochemical, magnetic or some combination of these. Stimulus emitter 311 may emit stimuli of many types including electrical, magnetic, optical, chemical, biochemical, or some combination of these. While only one sensor is drawn at 309 and at 312, more than one may be used. Similarly, while only one stimulus emitter 311 is drawn, more than one may be used. Moreover, more than one processor 310 with more than two subprocesses might be used as well.
In another exemplary embodiment, processor 310 is designed to go through two stages of training, as shown in the flow chart of
In the first stage, region 307 is presumed to be functioning at least to some degree. During the first stage, process 310a merely monitors signals 313 and 314 at step 401 and trains itself at step 407 in the stimulus/response pattern of response of regions 307 and 308 to signals at 313. Then processor 310 detects at step 402 that region 307 has become so compromised that its functioning must be replaced. Such detection may be in response to observations of changes in efferent signal 314. Alternatively, such detection may be in response to a signal 330 from an external unit 315, for instance if a doctor diagnoses sufficient deterioration as to require activation of the prosthetic device.
In the second stage of training, the process 310b continues to monitor signals 313 and 314; however, at step 403, it now activates stimulator emitter unit 311, directing it to provide some stimulation 316 to region 308. Then, at step 405, processor compares the signals 313 and 314 to see if they follow the stimulus/response patterns recorded during the first training stage. If observed patterns are different from the trained patterns, at step 406, the processor must adapt stimulus emitter patterns 316, return to step 403, monitor some more at step 404, and then at step 405 compare signals 313 and 314 again.
The second stage of training may continue indefinitely, continuing to adapt the emitted stimulus to the ongoing deterioration of region 307.
Alternatively, the prosthetic device uses only the second stage of training, with reference to a database of stimulus/response patterns. Such device is well suited for application following e.g. stroke or traumatic brain injury where an abrupt degradation of brain function has occurred as opposed to a gradual degradation due to progressive disease.
The training aspects of the process of
Optionally, the patient may be asked to perform tasks during the first and/or second stage of training.
Processor 310 incorporates a function that allows output that is transmitted to the stimulus emitter 311 (e.g., pulse-generator) to be derived from the sensed signals. This output may result, for instance, in amplitude or frequency or phase modulation of the electrical stimulus generated by the stimulus emitter 311. The function implemented in 310 can be complicated, such as described in the Berger paper. Alternatively, the processor may have simpler functions such as a relay function or a frequency transform function.
Means for sensing and analyzing detected neuronal signals are well known in the art. For instance, by using spike-detection algorithms (see e.g. Zumsteg et al., IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2005, vol. 13, p 272-279) it is possible to determine the occurrence of neuronal spike signals detected by the sensing element(s). From this, a time sequence of action potentials can be obtained which can be further processed e.g. for frequency determination.
It is particularly expected that dyskinesia, especially that associated with Parkinson's disease will respond to a prosthetic of the sort illustrated in
a-d. illustrate an embodiment of the modulation of neurostimulator output based on sensed signals.
In general, the function performed by processors 310 and 810 will usually be learned by reference to experimental data and therefore not necessarily predictable in advance.
From reading the present disclosure, other modifications will be apparent to persons skilled in the art. Such modifications may involve other features which are already known in the design, manufacture and use of neurological prosthetic devices and which may be used instead of or in addition to features already described herein. Although claims have been formulated in this application to particular combinations of features, it should be understood that the scope of the disclosure of the present application also includes any novel feature or novel combination of features disclosed herein either explicitly or implicitly or any generalization thereof, whether or not it mitigates any or all of the same technical problems as does the present invention. The applicants hereby give notice that new claims may be formulated to such features during the prosecution of the present application or any further application derived therefrom.
The word “comprising”, “comprise”, or “comprises” as used herein should not be viewed as excluding additional elements. The singular article “a” or “an” as used herein should not be viewed as excluding a plurality of elements.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB2007/055215 | 12/18/2007 | WO | 00 | 1/13/2010 |
Number | Date | Country | |
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60871227 | Dec 2006 | US |