User interface with 2D views for configuring stimulation therapy

Abstract

The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by defining a stimulation field. After a stimulation lead is implanted in a patient, a clinician manipulates a stimulation field on the display to encompass desired anatomical regions of the patient. In this manner, the clinician determines which anatomical regions to stimulate, and the system generates the necessary stimulation parameters. In some cases, a lead icon representing the implanted lead is displayed to show the clinician where the lead is relative to anatomical regions of the 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: representing an anatomical region on a display;representing a stimulation field on the anatomical region;receiving stimulation field input from a user defining the stimulation field; andgenerating electrical stimulation parameters based on the defined stimulation field and a location of at least one electrode within the patient, wherein the electrical stimulation parameters comprise an electrode combination of a complex electrode array geometry of an electrical stimulation lead.

2. The method of claim 1, further comprising: representing an electrical stimulation lead as a lead icon on the display; andpositioning the lead icon relative to the anatomical region based on the physical location of the electrical stimulation lead in the patient.

3. The method of claim 2, wherein positioning the lead icon comprises receiving directional user input specifying placement of the lead icon relative to the anatomical region on the display.

4. The method of claim 2, wherein positioning the lead icon comprises identifying electrodes of an imaged lead within the anatomical region.

5. The method of claim 3, wherein receiving directional user input comprises receiving input that specifies at least one of lateral or rotational movement of the lead icon on the display.

6. The method of claim 3, wherein representing an anatomical region of a patient on a display comprises representing a plurality of different two-dimensional, cross-sectional views of the anatomical region, and receiving directional user input comprises receiving directional input for each of the cross-sectional views.

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

8. The method of claim 1, further comprising imaging an anatomical structure of the patient to generate the anatomical region.

9. The method of claim 1, wherein receiving stimulation field input comprises receiving input that defines at least one of a size or shape of the stimulation field.

10. The method of claim 9, wherein receiving input that defines at least one of a size or shape of the stimulation field comprises receiving input that drags a boundary of the stimulation field.

11. The method of claim 9, wherein receiving input that defines a size of the stimulation field comprises receiving input via an analog adjustment mechanism represented on the display.

12. The method of claim 9, wherein receiving input that defines at least one of a size or shape of the stimulation field comprises receiving input highlighting a portion of the anatomical region.

13. The method of claim 1, wherein receiving stimulation field input comprises receiving input that drags the stimulation field to a desired location within the displayed anatomical region.

14. The method of claim 1, wherein representing the anatomical region of the patient comprises representing the anatomical region of the patient as plurality of different two-dimensional, cross-sectional views of the anatomical region, and receiving stimulation field input comprises receiving stimulation field input that defines a cross-section of the stimulation field in each of the cross-sectional views.

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

16. The method of claim 14, further comprising estimating a 3D shape of the stimulation field based on the cross-sections, wherein generating electrical stimulation parameters comprises: selecting at least one predefined volumetric stimulation field template that substantially fills the 3D shape; andselecting electrical parameters corresponding to the predefined volumetric stimulation field.

17. The method of claim 1, further comprising: determining an error value based on a volume of extraneous tissue that would be stimulated by delivery of stimulation according to the generated electrical stimulation parameters;comparing the error value to a threshold value; andprompting a user based on the comparison.

18. The method of claim 1, further comprising: determining an error value based on a volume of tissue within the stimulation field that would not be stimulated by delivery of stimulation according to the generated electrical stimulation parameters;comparing the error value to a threshold value; andprompting a user based on the comparison.

19. The method of claim 1, wherein the anatomical region comprises at least one of the cerebrum, cerebellum, or brain stem.

20. The method of claim 19, wherein anatomical region comprises at least one of a substantia nigra, subthalamic nucleus, globus pallidus interna, ventral intermediate, and zona inserta.

21. A system comprising: a user interface that displays a representation of an anatomical region of a patient, and receives a stimulation field input that defines a stimulation field on the representation of the anatomical region of the patient; anda processor that generates electrical stimulation parameters based on the stimulation field and a location of at least one electrode within the patient, wherein the electrical stimulation parameters comprise an electrode combination of a complex electrode array geometry of an electrical stimulation lead.

22. The system of claim 21, wherein the processor selects an electrode combination of a complex electrode array geometry of an electrical stimulation lead based on a location of the defined stimulation field.

23. The system of claim 21, wherein the user interface displays a representation an electrical stimulation lead as a lead icon, and the processor positions the lead icon relative to the anatomical region based on the physical location of the electrical stimulation lead in the patient.

24. The system of claim 23, wherein the processor receives directional user input specifying placement of the lead icon relative to the anatomical region via the user interface.

25. The system of claim 24, wherein the processor receives input that specifies at least one of lateral or rotational movement of the lead icon.

26. The system of claim 24, wherein the user interface displays a plurality of different two-dimensional, cross-sectional views of the anatomical region, and the processor receives directional input for each of the cross-sectional views.

27. The system of claim 26, wherein the views comprise at least one of a coronal view, a sagittal view, an axial view, and an oblique view.

28. The system of claim 21, further comprising an imaging device that generates images of the anatomy of the patient, wherein the user interface displays the anatomical region based on the images.

29. The system of claim 21, wherein processor receives input that defines at least one of a size or shape of the stimulation field as stimulation field input.

30. The system of claim 29, wherein the processor receives input that drags a boundary of the stimulation field to define at least one of a size or shape of the stimulation field.

31. The system of claim 29, wherein the user interface displays an analog adjustment mechanism, and the processor receives input that defines a size of the stimulation field via the analog adjustment mechanism.

32. The system of claim 29, wherein the processor receives input highlighting a portion of the anatomical region as input that defines of the stimulation field.

33. The system of claim 21, wherein the processor receives input that drags the stimulation field to a desired location within the displayed anatomical region.

34. The system of claim 21, wherein the user interface displays a plurality of different two-dimensional, cross-sectional views of the anatomical region, and the processor receives stimulation field input that defines a cross-section of the stimulation field in each of the cross-sectional views.

35. The system of claim 34, wherein the views comprise a coronal view, a sagittal view, and an axial view.

36. The system of claim 34, wherein the processor estimates a 3D shape of the stimulation field based on the cross-sections, selects at least one predefined volumetric stimulation field template that substantially fills the 3D shape, and selects electrical parameters corresponding to the predefined volumetric stimulation field.

37. The system of claim 21, wherein the processor determines an error value based on a volume of extraneous tissue that would be stimulated by delivery of stimulation according to the generated electrical stimulation parameters, comparing the error value to a threshold value, and prompts a user via the user interface based on the comparison.

38. The system of claim 21, further comprising a programming device for programming an implantable medical device that includes the user interface and the processor.

39. A computer-readable medium comprising instructions that cause a processor to: represent an anatomical region on a display;represent a stimulation field on the anatomical region;receive stimulation field input from a user defining the stimulation field; andgenerate electrical stimulation parameters based on the defined stimulation field and a location of at least one electrode within the patient, wherein the electrical stimulation parameters comprise an electrode combination of a complex electrode array geometry of an electrical stimulation lead.

40. The computer-readable medium of claim 39, further comprising instructions that cause a processor to: represent an electrical stimulation lead as a lead icon on the display; andposition the lead icon relative to the anatomical region based on the physical location of the electrical stimulation lead in the patient.

41. The computer-readable medium of claim 39, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive input that defines at least one of a size or shape of the stimulation field.

42. The computer-readable medium of claim 41, wherein the instructions that cause a processor to receive input that defines at least one of a size or shape of the stimulation field comprise instructions that cause a processor to receive input that drags a boundary of the stimulation field.

43. The computer-readable medium of claim 41, wherein the instructions that cause a processor to receive input that defines a size of the stimulation field comprise instructions that cause a processor to receive input via an analog adjustment mechanism represented on the display.

44. The computer-readable medium of claim 41, wherein the instructions that cause a processor to receive input that defines at least one of a size or shape of the stimulation field comprise instructions that cause a processor to receive input highlighting a portion of the anatomical region.

45. The computer-readable medium of claim 39, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive input that drags the stimulation field to a desired location within the displayed anatomical region.

46. The computer-readable medium of claim 39, wherein the instructions that cause a processor to represent the anatomical region of the patient comprise instructions that cause a processor to represent the anatomical region of the patient as plurality of different two-dimensional, cross-sectional views of the anatomical region, and the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive stimulation field input that defines a cross-section of the stimulation field in each of the cross-sectional views.

47. The computer-readable medium of claim 46, wherein the views comprise at least one of a coronal view, a sagittal view, an axial view, and an oblique view.