Electrical and activation field models for configuring stimulation therapy

Abstract

The disclosure describes a method and system that generates an electrical field model of defined stimulation therapy and displays the electrical field model to a user via a user interface. The electrical field model is generated based upon a patient anatomy and stimulation parameters to illustrate which areas of a patient anatomical region will be covered by the electrical field during therapy. In addition, a neuron model may be applied to the electrical field model to generate an activation field model. The activation field model indicates which neurons will be activated by the electrical field in the anatomical region. These field models may be used by a clinician to determine effective therapy prior to stimulation delivery. In particular, the field models may be beneficial when programming non axi-symmetric, or three-dimensional (3D), leads which allow greater flexibility in creating stimulation fields.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a conceptual diagram illustrating an example stimulation system with a stimulation lead implanted in the brain of a patient.

FIGS. 2A and 2B are conceptual diagrams illustrating two different implantable stimulation leads.

FIGS. 3A-3D are cross-sections of example stimulation leads having one or more electrodes around the circumference of the lead.

FIG. 4 is a functional block diagram of an example implantable medical device that generates electrical stimulation pulses.

FIG. 5 is a functional block diagram of an example programmer.

FIG. 6 is an example screen shot of a lead icon placed on a coronal view of brain tissue.

FIG. 7 is an example screen shot of a lead icon placed on a sagittal view of brain tissue.

FIG. 8 is an example screen shot of a lead icon placed on an axial view of brain tissue.

FIG. 9 is an example screen shot of stimulation field selection on a coronal view of brain tissue.

FIG. 10 is an example screen shot of stimulation field adjustment on an axial view of brain tissue.

FIG. 11 is a flow diagram illustrating an example technique for implanting a stimulation lead in a brain of a patient.

FIG. 12 is a flow diagram illustrating an example technique for positioning a lead icon over anatomical regions of a patient.

FIG. 13 is a flow diagram illustrating an example technique for adjusting the stimulation field for stimulation therapy.

FIGS. 14A-14F are conceptual diagrams illustrating different stimulation fields produced by combinations of electrodes from a complex electrode array geometry.

FIGS. 15A-15D are conceptual diagrams illustrating possible stimulation templates for each electrode of a complex electrode array geometry.

FIG. 16 is a flow diagram illustrating an example technique for creating a template set according to the electrode configuration selected by the user.

FIGS. 17A and 17B are conceptual diagrams illustrating a template set that does not target any tissue outside of a defined stimulation area.

FIGS. 18A and 18B are conceptual diagrams illustrating a template set that targets all tissue within a defined stimulation area.

FIG. 19 is an example screen shot of an outline of a stimulation field placed on a coronal view of brain tissue.

FIG. 20 is an example screen shot of an outline of a stimulation field placed on a sagittal view of brain tissue.

FIG. 21 is an example screen shot of an outline of a stimulation field placed on an axial view of brain tissue.

FIG. 22 is a flow diagram illustrating an example technique for defining a stimulation field over an anatomical region without reference to an implanted lead.

FIG. 23 is an example screen shot of an outline of a stimulation field placed around a lead icon on a coronal view of brain tissue.

FIG. 24 is an example screen shot of an outline of a stimulation field placed around a lead icon on a sagittal view of brain tissue.

FIG. 25 is an example screen shot of an outline of a stimulation field placed around a lead icon on an axial view of brain tissue.

FIG. 26 is an example screen shot of an outline of a stimulation field placed away from a lead icon on a sagittal view of brain tissue.

FIG. 27 is an example screen shot of a warning message regarding the best template set available for a stimulation field on a sagittal view of brain tissue.

FIG. 28 is an example screen shot of an outline of a stimulation field and corresponding template set on a coronal view of brain tissue.

FIG. 29 is an example screen shot of an outline of a stimulation field and corresponding template set on a sagittal view of brain tissue.

FIG. 30 is an example screen shot of an outline of a stimulation field and corresponding template set on an axial view of brain tissue.

FIG. 31 is an example screen shot of a menu window for template sets over a sagittal view of brain tissue.

FIG. 32 is a flow diagram illustrating an example technique for creating a stimulation template set based upon received stimulation fields defined by the user.

FIG. 33 is an example screen shot of a coronal view of reference anatomy brain tissue to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 34 is an example screen shot of a sagittal view of reference anatomy brain tissue to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 35 is an example screen shot of an axial view of reference anatomy brain tissue to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 36 is an example screen shot of a coronal view of reference anatomy brain tissue with the lead icon to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 37 is an example screen shot of a sagittal view of reference anatomy brain tissue with the lead icon to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 38 is an example screen shot of an axial view of reference anatomy brain tissue to with the lead icon aid the user in selecting a structure of the anatomy to stimulate.

FIG. 39 is an example screen shot of a coronal view of reference anatomy brain tissue overlaid over a coronal view of the patient anatomy to aid the user in selecting a structure of the patient anatomy to stimulate.

FIG. 40 is an example screen shot of a sagittal view of reference anatomy brain tissue overlaid over a sagittal view of the patient anatomy to aid the user in selecting a structure of the patient anatomy to stimulate.

FIG. 41 is an example screen shot of an axial view of reference anatomy brain tissue overlaid over an axial view of the patient anatomy to aid the user in selecting a structure of the patient anatomy to stimulate.

FIG. 42 is a flow diagram illustrating an example technique for receiving stimulation input from a user using the reference anatomy.

FIG. 43 is an illustration that shows how the reference anatomy may be combined with the patient anatomy to result in a morphed atlas for programming the stimulation therapy.

FIG. 44 is an example screen shot of a coronal view of a morphed atlas to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 45 is an example screen shot of a sagittal view of a morphed atlas to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 46 is an example screen shot of an axial view of a morphed atlas to aid the user in selecting a structure of the anatomy to stimulate.

FIG. 47 is a flow diagram illustrating an example technique for creating the morphed atlas and receiving a structure selection from the user.

FIG. 48 is an example user interface that allows the user to select structures to stimulate from multiple pull down menus.

FIG. 49 is an example user interface that shows a pull down menu which contains anatomical structures that the user may select to program the stimulation therapy.

FIG. 50 is an example screen shot of a coronal view of a reference anatomy with a pull down menu which contains anatomical structures that the user may select to program the stimulation therapy.

FIG. 51 is an example screen shot of a coronal view of a morphed atlas that indicates which structure the user has pointed to with a pop-up message.

FIG. 52 is flow diagram illustrating an example technique for receiving a structure selection from a user and displaying the structure to the user.

FIG. 53 is an example screen shot of a coronal view of a patient anatomy with an electrical field model of the defined stimulation therapy.

FIG. 54 is an example screen shot of a sagittal view of a patient anatomy with an electrical field model of the defined stimulation therapy.

FIG. 55 is an example screen shot of an axial view of a patient anatomy with an electrical field model of the defined stimulation therapy.

FIG. 56 is an example screen shot of an axial view of a patient anatomy with an electrical field model of the enlarged defined stimulation therapy from FIG. 56.

FIG. 57 is a flow diagram illustrating an example technique for calculating and displaying the electrical field model of defined stimulation.

FIG. 58 is an example screen shot of a coronal view of a patient anatomy with an activation field model of the defined stimulation therapy.

FIG. 59 is an example screen shot of a sagittal view of a patient anatomy with an activation field model of the defined stimulation therapy.

FIG. 60 is an example screen shot of an axial view of a patient anatomy with an activation field model of the defined stimulation therapy.

FIG. 61 is an example screen shot of an axial view of a patient anatomy with an enlarged activation field model from increasing the voltage amplitude from FIG. 60.

FIG. 62 is a flow diagram illustrating an example technique for calculating and displaying the activation field model of defined stimulation.

FIG. 63 is a conceptual diagram illustrating a three-dimensional (3D) visualization environment including a 3D brain model for defining a 3D stimulation field.

FIG. 64 is a conceptual diagram illustrating a rotated 3D brain model with the currently defined 3D stimulation field.

FIG. 65 is a conceptual diagram illustrating a manipulated 3D stimulation field positioned within a 3D brain model.

FIG. 66 is a flow diagram illustrating an example technique for defining a 3D stimulation field within a 3D brain model of the patient.

FIG. 67 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and defined 3D stimulation field for creating a stimulation template set.

FIG. 68 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and the created template set corresponding to the defined 3D stimulation field.

FIG. 69 is a conceptual diagram illustrating a 3D) visualization environment including a 3D brain model, the created template set corresponding to the defined 3D stimulation field, and a lead icon.

FIG. 70 is a flow diagram illustrating an example technique for creating a template set and displaying the template set in a 3D brain model of the patient.

FIG. 71 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and 3D electrical field model.

FIG. 72 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and enlarged 3D electrical field model as defined by the user.

FIG. 73 is a flow diagram illustrating an example technique for calculating an electrical field model and displaying the field model to the user.

FIG. 74 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and 3D activation field model.

FIG. 75 is a conceptual diagram illustrating a 3D visualization environment including a 3D brain model and enlarged 3D activation field model as defined by the user.

FIG. 76 is a flow diagram illustrating an example technique for calculating an activation field model and displaying the field model to the user.

Claims

1. A method comprising: receiving a patient anatomy data set that describes at least one characteristic of patient tissue proximate to an electrical stimulation lead implanted within a patient;receiving user input that defines stimulation parameter values;generating a stimulation field model that represents where electrical stimulation will propagate from the electrical stimulation lead based upon the patient anatomy data set and stimulation parameter values; anddisplaying the stimulation field model on a representation of an anatomical region of the patient.

2. The method of claim 1, further comprising: receiving stimulation field input from a user that modifies at least one of the size, shape or location of the stimulation field model relative to the displayed anatomical location; anddetermining at least one new stimulation parameter value based on the modification of the stimulation field model.

3. The method of claim 1, wherein generating the stimulation field model comprises applying the patient anatomy data set to a stimulation field equation set.

4. The method of claim 1, wherein displaying the stimulation field model comprises displaying the stimulation field model via one of a two-dimensional display or a three-dimensional environment.

5. The method of claim 1, wherein receiving stimulation field input comprises receiving input that drags at least one of the stimulation field model or a boundary of the stimulation field model relative to the displayed anatomical region.

6. The method of claim 1, wherein displaying the stimulation field model on a representation of an anatomical region comprises displaying the stimulation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and receiving stimulation field input comprises receiving stimulation field input that modifies a cross-section of the stimulation field model in one or more of the cross-sectional views.

7. The method of claim 6, wherein the views comprise at least one of a coronal view, a saggital view, an axial view, and an oblique view.

8. The method of claim 1, further comprising: generating a neuron model that describes at least one characteristic of patient neural tissue proximate to the electrical stimulation lead implanted within the patient;generating an activation field model indicates which neural structures of the patient are activated by applying the stimulation field model to the anatomical region of the patient based on the neuron model and the stimulation field model; anddisplaying the activation field model over the anatomical region.

9. The method of claim 1, wherein the anatomical region comprises at least one of a spinal cord, a cerebrum, a cerebellum, a brain stem, skeletal muscle, and smooth muscle.

10. The method of claim 9, wherein the structure of the anatomical region is at least one of a substantia nigra, subthalamic nucleus, globus pallidus interna, ventral intermediate, and zona inserta.

11. A system comprising: a communications module that receives a patient anatomy data set that describes at least one characteristic of patient tissue proximate to an electrical stimulation lead implanted within a patient;a user interface that receives user input that defines stimulation parameter values; anda processor that generates a stimulation field model that represents where electrical stimulation will propagate from the electrical stimulation lead based upon the patient anatomy data set and stimulation parameter values, and displays the stimulation field model on a representation of an anatomical region of the patient via the user interface.

12. The system of claim 11, wherein the processor receives stimulation field input via the user interface that modifies at least one of the size, shape or location of the stimulation field model relative to the displayed anatomical region, and determines at least one new stimulation parameter value based on the modification of the stimulation field model.

13. The system of claim 11, wherein the processor applies the patient anatomy data set to a stimulation field equation set to generate the stimulation field model.

14. The system of claim 13, wherein the user interface comprises one of a two-dimensional display or a three-dimensional environment to display the stimulation field model on the representation of the anatomical region.

15. The system of claim 14, wherein the processor receives input via the user interface that drags at least one of the stimulation field model or a boundary of the stimulation field model relative to the displayed anatomical location as stimulation field input.

16. The system of claim 15, wherein the user interface displays the three-dimensional stimulation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and the processor receives stimulation field input via the user interface that modifies a cross-section of the stimulation field model in one or more of the cross-sectional views.

17. The method of claim 14, wherein the views comprise at least one of a coronal view, a saggital view, an axial view, and an oblique view.

18. The system of claim 11, wherein the processor generates a neuron model that describes at least one characteristic of patient neural tissue proximate to the electrical stimulation lead implanted within the patient, generates an activation field model indicates which neural structures of the patient are activated by applying the stimulation field model to the anatomical region of the patient based on the neuron model and the stimulation field model, and displays the activation field model over the anatomical region.

19. The system of claim 18, further comprising a memory that stores a neuron model equation set, wherein the processor utilizes the patient anatomy data set to generate the neuron model with the neuron model equation set.

20. The system of claim 11, further comprising a programmer for programming an implantable medical device that includes the communications module, the user interface, and the processor.

21. A computer-readable medium comprising instructions that cause a processor to: receive a patient anatomy data set that describes at least one characteristic of patient tissue proximate to an electrical stimulation lead implanted within a patient;receive user input that defines stimulation parameter values;generate a stimulation field model that represents where electrical stimulation will propagate from the electrical stimulation lead based upon the patient anatomy data set and stimulation parameter values; anddisplay the stimulation field model on a representation of an anatomical region of the patient.

22. The computer-readable medium of claim 21, further comprising instructions that cause a processor to: receive stimulation field input from a user that modifies at least one of the size, shape or location of the stimulation field model relative to the displayed anatomical location; anddetermine at least one new stimulation parameter value based on the modification of the stimulation field model.

23. The computer-readable medium of claim 21, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive input that drags at least one of the stimulation field model or a boundary of the stimulation field model relative to the displayed anatomical region.

24. The computer-readable medium of claim 21, wherein the instructions that cause a processor to display the stimulation field model on a representation of an anatomical region comprise instructions that cause a processor to display the three-dimensional stimulation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive stimulation field input that modifies a cross-section of the stimulation field model in one or more of the cross-sectional views.

25. The computer-readable medium of claim 21, further comprising instructions that cause a processor to: generate a neuron model that describes at least one characteristic of patient neural tissue proximate to the electrical stimulation lead implanted within the patient;generate an activation field model indicates which neural structures of the patient are activated by applying the stimulation field model to the anatomical region of the patient based on the neuron model and the stimulation field model; anddisplay the activation field model over the anatomical region.

26. A method comprising: receiving a patient anatomy data set that describes at least one characteristic of patient neural tissue proximate to an electrical stimulation lead implanted within a patient;receiving user input that defines stimulation parameter values;generating an activation field model that indicates which neural structures of the patient are activated based on the patient anatomy data set and stimulation parameter values; anddisplaying the activation field model over the anatomical region.

27. The method of claim 26, further comprising: receiving user input that modifies at least one of the size, shape or location of the activation field model relative to the displayed anatomical location; anddetermining at least one new stimulation parameter value based on the modification of the stimulation field model.

28. The method of claim 26, wherein receiving user input that modifies at least one of the size, shape or location of the activation field model comprises receiving input that drags at least one of the activation field model or a boundary of the activation field model relative to the displayed anatomical region.

29. The method of claim 26, wherein displaying the activation field model on a representation of an anatomical region comprises displaying the activation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and receiving user input that modifies the activation field comprises receiving user input that modifies a cross-section of the activation field model in one or more of the cross-sectional views.

30. The method of claim 29, wherein the views comprise at least one of a coronal view, a saggital view, an axial view, and an oblique view.

31. A system comprising: a communications module that receives a patient anatomy data set that describes at least one characteristic of patient neural tissue proximate to an electrical stimulation lead implanted within a patient;a user interface that receives user input that defines stimulation parameter values; anda processor that generates an activation field model that indicates which neural structures of the patient are activated based on the patient anatomy data set and stimulation parameter values, and displays the activation field model on a representation of an anatomical region of the patient via the user interface.

32. The system of claim 31, wherein the processor receives user input that modifies at least one of the size, shape or location of the activation field model relative to the displayed anatomical location, and determines at least one new stimulation parameter value based on the modification of the activation field model.

33. The system of claim 31, wherein the processor receives input that drags at least one of the activation field model or a boundary of the activation field model relative to the displayed anatomical region via the user interface.

34. The system of claim 31, wherein the user interface displays the activation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and the processor receives user input that modifies a cross-section of the activation field model in one or more of the cross-sectional views via the user interface.

35. The system of claim 34, wherein the views comprise at least one of a coronal view, a saggital view, an axial view, and an oblique view.

36. A computer-readable medium comprising instructions that cause a processor to: receive a patient anatomy data set that describes at least one characteristic of patient neural tissue proximate to an electrical stimulation lead implanted within a patient;receive user input that defines stimulation parameter values;generating an activation field model indicates which neural structures of the patient are activated based on the patient anatomy data set and stimulation parameter values; anddisplay the activation field model over the anatomical region.

37. The computer-readable medium of claim 36, further comprising instructions that cause a processor to: receive user input that modifies at least one of the size, shape or location of the activation field model relative to the displayed anatomical location; anddetermine at least one new stimulation parameter value based on the modification of the stimulation field model.

38. The computer-readable medium of claim 36, wherein the instructions that cause a processor to receive user input that modifies at least one of the size, shape or location of the activation field model comprise instructions that cause a processor to receive input that drags at least one of the activation field model or a boundary of the activation field model relative to the displayed anatomical region.

39. The computer-readable medium of claim 36, wherein the instructions that cause a processor to display the activation field model on a representation of an anatomical region comprise instructions that cause a processor to display the activation field model and anatomical region as plurality of different two-dimensional, cross-sectional views, and the instructions that cause a processor to receive user input that modifies the activation field comprise instructions that cause a processor to receive user input that modifies a cross-section of the activation field model in one or more of the cross-sectional views.