User interface with 3D environment for configuring stimulation therapy

Abstract

The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by defining a three-dimensional (3D) stimulation field. After a stimulation lead is implanted in a patient, a clinician manipulates the 3D stimulation field in a 3D environment 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 the 3D 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 a three-dimensional (3D) anatomical region of a patient in a 3D environment;representing a 3D stimulation field within the 3D anatomical region;receiving stimulation field input from a user defining the 3D stimulation field in the 3D environment; andgenerating electrical stimulation parameters in a programming device based upon the 3D stimulation field and a location of at least one electrode within patient.

2. The method of claim 1, wherein the electrical stimulation parameters define an electrode combination from a complex electrode array geometry.

3. The method of claim 1, further comprising: representing an electrical stimulation lead as a lead icon in the 3D environment; andpositioning the lead icon relative to the 3D anatomical region of the patient in the 3D environment based on a physical location of the electrical stimulation lead in the patient.

4. The method of claim 3, wherein positioning the lead icon comprises receiving directional user input specifying placement of the lead icon relative to the 3D anatomical region of the patient.

5. The method of claim 3, wherein positioning the lead icon comprises: receiving information regarding the physical location of the electrical stimulation lead in the patient; andautomatically positioning the lead icon relative to the 3D anatomical region of the patient in the 3D environment based on the information.

6. The method of claim 3, further comprising: identifying an oblique plane of the 3D anatomical region that includes a central axis of the lead icon; andreceiving stimulation field input from the user defining a two-dimensional (2D) stimulation field on the oblique plane.

7. The method of claim 1, further comprising imaging an anatomical structure of the patient to generate the 3D anatomical region of the patient in the 3D environment.

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

9. The method of claim 8, wherein receiving input that defines at least one of a size, shape, or location of the stimulation field comprises receiving input that drags a boundary of the stimulation field.

10. The method of claim 1, wherein receiving stimulation field input comprises receiving input that drags the stimulation field to a location within the 3D anatomical region.

11. The method of claim 1, wherein receiving stimulation field input comprises receiving input highlighting a portion of the 3D anatomical region.

12. The method of claim 1, wherein receiving stimulation field input comprises receiving input that selects a predefined stimulation field and places the stimulation field at a location within the 3D anatomical region.

13. The method of claim 1, wherein generating electrical stimulation parameters comprises: selecting at least one predefined volumetric stimulation field template that substantially fills the 3D stimulation field; andselecting electrical parameters corresponding to the predefined volumetric stimulation field.

14. 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.

15. 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.

16. The method of claim 1, wherein representing a 3D anatomical region of the patient comprises representing at least one of a cerebrum, a cerebellum, and a brain stem.

17. The method of claim 1, wherein representing a 3D anatomical region of the patient comprises representing at least one of a substantia nigra, subthalamic nucleus, globus pallidus interna, ventral intermediate, and zona inserta.

18. A system comprising: a user interface that provides a three-dimensional (3D) environment; anda processor that represents a 3D stimulation field within a 3D anatomical region of a patient within the 3D environment, receives stimulation field input from a user via the user interface defining the 3D stimulation field within the 3D environment, and generates electrical stimulation parameters based upon the 3D stimulation field and a location of at least one electrode within patient.

19. The system of claim 18, wherein the electrical stimulation parameters define an electrode combination from a complex electrode array geometry.

20. The system of claim 18, wherein the processor represents an electrical stimulation lead as a lead icon within the 3D environment, and positions the lead icon relative to the 3D anatomical region of the patient based on a physical location of the electrical stimulation lead in the patient.

21. The system of claim 20, wherein the processor receives directional user input via the user interface specifying placement of the lead icon relative to the 3D anatomical region of the patient.

22. The system of claim 20, wherein the processor receives information regarding the physical location of the electrical stimulation lead in the patient, and automatically positions the lead icon relative to the 3D anatomical region of the patient in the 3D environment based on the information.

23. The system of claim 18, further comprising an imaging device that generates images of the anatomy of the patient, wherein the processor represents the 3D anatomical region of the patient within the 3D environment based on the images.

24. The system of claim 18, wherein the processor receives input that defines at least one of a size or shape of the stimulation field via the user interface.

25. The system of claim 24, wherein the processor receives input that drags a boundary of the stimulation field to define the size or shape of the stimulation field via the user interface.

26. The system of claim 18, wherein the processor receives input that drags the stimulation field to a location within the 3D anatomical region.

27. The system of claim 18, wherein the processor receives input highlighting a portion of the 3D anatomical region to define the 3D stimulation field.

28. The system of claim 18, wherein the processor receives input that selects a predefined stimulation field and places the stimulation field at a location within the 3D anatomical region.

29. The system of claim 18, wherein the processor selects at least one predefined volumetric stimulation field template that substantially fills the defined 3D stimulation field, and selects electrical parameters corresponding to the predefined volumetric stimulation field.

30. The system of claim 18, 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, compares the error value to a threshold value, and prompts a user via the user interface based on the comparison.

31. The system of claim 18, wherein the user interface comprises at least one of a joystick, a pointing device, a touch screen, a keyboard, or a spatial recognition device that receives the stimulation field input.

32. The system of claim 18, wherein the user interface includes a two-dimensional (2D) display that simulates 3D images to provide the 3D environment.

33. The system of claim 18, wherein the user interface includes at least one of a holographic display, a stereoscopic display, an autostereoscopic display, or a head-mounted 3D display to provide the 3D environment.

34. A computer-readable medium comprising instructions that cause a processor to: represent a three-dimensional (3D) anatomical region of a patient in a 3D environment;represent a 3D stimulation field within the 3D anatomical region;receive stimulation field input from a user defining the 3D stimulation field in the 3D environment; andgenerate electrical stimulation parameters in a programming device based upon the 3D stimulation field and a location of at least one electrode within patient.

35. The computer-readable medium of claim 34, further comprising instructions that cause a processor to: represent an electrical stimulation lead as a lead icon in the 3D environment; andposition the lead icon relative to the 3D anatomical region of the patient in the 3D environment based on a physical location of the electrical stimulation lead in the patient.

36. The computer-readable medium of claim 35, further comprising instructions that cause the processor to: identify an oblique plane of the 3D anatomical region that includes a central axis of the lead icon; andreceive stimulation field input from the user defining a two-dimensional (2D) stimulation field on the oblique plane.

37. The computer-readable medium of claim 34, 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.

38. The computer-readable medium of claim 37, 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.

39. The computer-readable medium of claim 34, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receiving input that drags the stimulation field to a location within the 3D anatomical region.

40. The computer-readable medium of claim 34, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive input highlighting a portion of the 3D anatomical region.

41. The computer-readable medium of claim 34, wherein the instructions that cause a processor to receive stimulation field input comprise instructions that cause a processor to receive input that selects a predefined stimulation field and places the stimulation field at a location within the 3D anatomical region.

42. The computer-readable medium of claim 34, wherein the instructions that cause a processor to generate electrical stimulation parameters comprise instructions that cause a processor to: select at least one predefined volumetric stimulation field template that substantially fills the 3D stimulation field; andselect electrical parameters corresponding to the predefined volumetric stimulation field.

43. The computer-readable medium of claim 34, further comprising instructions that cause a processor to: determine 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;compare the error value to a threshold value; andprompt a user based on the comparison.