Stimulation templates for configuring stimulation therapy

Abstract

The disclosure describes a method and system that generates stimulation parameters by selecting one or more stimulation parameters according to a stimulation field defined by a user. The system includes a memory that stores a plurality of stimulation templates for multiple electrode configurations of an electrical lead. A processor selects one or more volumetric stimulation templates that best match, e.g., fill, the three-dimensional stimulation field defined by the clinician. Each stimulation template is associated with a set of stimulation parameters that can be used to deliver stimulation therapy to a patient.

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 stimulation input from a user defining at least one stimulation field within a visual representation of an anatomical region of a patient;selecting at least one volumetric stimulation template from a memory based on the at least one stimulation field; andselecting an electrical stimulation parameter set associated with the selected volumetric stimulation template in the memory.

2. The method of claim 1, further comprising delivering electrical stimulation therapy to the patient according to the selected electrical stimulation parameter set.

3. The method of claim 1, further comprising: generating at least one volumetric stimulation template for each electrode of an electrical stimulation lead based upon at least one of modeled data, experimental data, and analytical calculations; andstoring the generated volumetric stimulation template in the memory for selection based on the stimulation field.

4. The method of claim 1, wherein selecting at least one volumetric stimulation template comprises selecting the volumetric stimulation template based on a comparison of at least one of the volumes and shapes of the volumetric stimulation template and the user-defined stimulation field.

5. The method of claim 1, wherein selecting at least one volumetric stimulation template comprises selecting a volumetric stimulation template that fills at least a portion of the stimulation field without covering any portion of the anatomical region not included in the stimulation field.

6. The method of claim 1, wherein selecting at least one volumetric stimulation template comprises selecting a volumetric stimulation template that fills at least the entire stimulation field.

7. The method of claim 1, wherein selecting at least one volumetric stimulation template comprises selecting a volumetric stimulation template that maximizes the portion of the stimulation filled by the volumetric stimulation template while minimizing covering any portion of the anatomical region not include in the stimulation field.

8. The method of claim 1, further comprising displaying the anatomical region of the patient as plurality of different two-dimensional, cross-sectional views of the anatomical region, wherein receiving stimulation input comprises receiving stimulation field input that defines a cross-section of the stimulation field in each of the cross-sectional views, the method further comprising estimating the stimulation field in three dimensions based on the cross-sections of the stimulation field.

9. The method of claim 1, further comprising displaying the volumetric stimulation template over the visual representation of the anatomical region of the patient.

10. The method of claim 1, further comprising presenting a message to the user when the stimulation template set fails to match the stimulation area by an error that is greater than a predetermined error threshold.

11. A system comprising: a user interface that receives stimulation input from a user defining at least one stimulation field within a visual representation of an anatomical region of a patient;a memory that stores a plurality of volumetric stimulation templates; anda processor that selects at least one of the plurality of stimulation templates based on the at least one user-defined stimulation field, and selects an electrical stimulation parameter set associated with the selected volumetric stimulation template in the memory.

12. The system of claim 11, further comprising a medical device, wherein the processor controls the medical device to deliver electrical stimulation therapy to the patient according to the selected electrical stimulation parameter set.

13. The system of claim 11, wherein the processor selects the volumetric stimulation template based on a comparison of at least one of the volumes and shapes of the volumetric stimulation template and the user-defined stimulation field.

14. The system of claim 11, wherein the processor selects the volumetric stimulation template based on a determination that the template fills at least a portion of the stimulation field without covering any portion of the anatomical region not included in the stimulation field.

15. The system of claim 11, wherein the processor selects the one or more volumetric stimulation templates based on a determination that the templates fill at least the entire stimulation field.

16. The system of claim 11, wherein the processor selects at least one volumetric stimulation template that maximizes the portion of the stimulation filled by the volumetric stimulation template while minimizing covering any portion of the anatomical region not include in the stimulation field.

17. The system of claim 11, wherein the user interface displays the anatomical region of the patient as plurality of different two-dimensional, cross-sectional views of the anatomical region, and the processor receives stimulation input that defines a cross-section of the stimulation field in each of the cross-sectional views and estimates the stimulation field in three dimensions based on the cross-sections of the stimulation field.

18. The system of claim 11, wherein the user interface displays the volumetric stimulation template over the visual representation of the anatomical region of the patient.

19. The system of claim 11, wherein the processor presents a message to the user via the user interface when the stimulation template set fails to match the stimulation area by an error that is greater than a predetermined error threshold.

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

21. A computer-readable medium comprising instructions that cause a processor to: receive stimulation input from a user defining at least one stimulation field within a visual representation of an anatomical region of a patient;select at least one volumetric stimulation template from a memory based on the at least one stimulation field; andselect an electrical stimulation parameter set associated with the selected volumetric stimulation template in the memory.

22. The computer-readable medium of claim 21, further comprising instructions that cause a processor to control delivery of electrical stimulation therapy to the patient according to the selected electrical stimulation parameter set.

23. The computer-readable medium of claim 21, further comprising instructions that cause a processor to: generate at least one volumetric stimulation template for each electrode of an electrical stimulation lead based upon at least one of modeled data, experimental data, and analytical calculations; andstore the generated volumetric stimulation template in the memory for selection based on the stimulation field.

24. The computer-readable medium of claim 21, wherein the instructions that cause a processor to select at least one volumetric stimulation template comprise instructions that cause a processor to select the volumetric stimulation template based on a comparison of at least one of the volumes and shapes of the volumetric stimulation template and the user-defined stimulation field.

25. The computer-readable medium of claim 21, wherein the instructions that cause a processor to select at least one volumetric stimulation template comprise instructions that cause a processor to select a volumetric stimulation template that fills at least a portion of the stimulation field without covering any portion of the anatomical region not included in the stimulation field.

26. The computer-readable medium of claim 21, wherein the instructions that cause a processor to select at least one volumetric stimulation template comprise instructions that cause a processor to select a volumetric stimulation template that fills at least the entire stimulation field.

27. The computer-readable medium of claim 21, wherein the instructions that cause a processor to select at least one volumetric stimulation template comprise instructions that cause a processor to select a volumetric stimulation template that maximizes the portion of the stimulation filled by the volumetric stimulation template while minimizing covering any portion of the anatomical region not include in the stimulation field.

28. The computer-readable medium of claim 21, further comprising instructions that cause a processor to display the anatomical region of the patient as plurality of different two-dimensional, cross-sectional views of the anatomical region, wherein the instructions that cause a processor to receive stimulation input comprises receiving stimulation field input that defines a cross-section of the stimulation field in each of the cross-sectional views, the medium further comprising instructions that cause a processor to estimate the stimulation field in three dimensions based on the cross-sections of the stimulation field.

29. The computer-readable medium of claim 21, further comprising instructions that cause a processor to display the volumetric stimulation template over the visual representation of the anatomical region of the patient.

30. The computer-readable medium of claim 21, further comprising instructions that cause a processor to present a message to the user when the stimulation template set fails to match the stimulation area by an error that is greater than a predetermined error threshold.