User interface with an atlas for configuring stimulation therapy

Abstract

The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by selecting a structure of an anatomical region represented by an atlas. The atlas is a reference anatomical region of a reference anatomy that a clinician may use to identify structures of a patient anatomy that the clinician desires to stimulate during therapy. Selecting structures from the atlas may not provide the most efficacious stimulation therapy to the patient because of slight differences between the atlas and the patient anatomical region approximated by the atlas. However, structure selection may be efficient for the clinician, and allow the system to generate stimulation parameters that are adequate to treat the patient. The atlas may be most suitable for both axi-symmetric or three-dimensional leads having a complex electrode array geometry that 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 structure input from a user selecting at least one anatomical structure for receipt of electrical stimulation; andgenerating electrical stimulation parameters in a programming device based upon the structure input and a location of electrodes within a patient anatomy.

2. The method of claim 1, further comprising displaying an image of a reference anatomical region of a reference anatomy on a user interface, wherein receiving structure input comprises receiving structure input selecting at least one structure of the reference anatomical region.

3. The method of claim 2, further comprising overlaying a patient anatomical region of the patient anatomy on the reference anatomical region displayed on the user interface.

4. The method of claim 2, further comprising: generating a morphed anatomical region based upon the reference anatomical region and a patient anatomical region; anddisplaying the morphed anatomical region on the user interface.

5. The method of claim 2, wherein receiving structure input comprises touching the at least one structure within the image with a pointing object by the user.

6. The method of claim 2, further comprising displaying a label on the reference anatomical region that identifies the at least one structure of the reference anatomical region.

7. The method of claim 2, wherein displaying an image of a reference anatomical region of a reference anatomy on a user interface comprises displaying the reference anatomical region of the reference anatomy on the display as a plurality of different two-dimensional, cross-sectional views of the reference anatomical region

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

9. The method of claim 1, further comprising receiving structure input from a user selecting at least one anatomical structure that electrical stimulation is to avoid.

10. The method of claim 1, wherein receiving structure input comprises receiving a selection from at least one menu.

11. 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.

12. 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.

13. The method of claim 1, wherein receiving structure input from a user selecting at least one anatomical structure for receipt of electrical stimulation comprises receiving outcome selection input selecting a common result of the electrical stimulation.

14. The method of claim 1, wherein the reference anatomical region comprises at least one of a a cerebrum, a cerebellum, a brain stem,

15. The method of claim 14, wherein the structure of the reference anatomical region comprises at least one of a substantia nigra, subthalamic nucleus, globus pallidus interna, ventral intermediate, and zona inserta.

16. The method of claim 1, wherein the reference anatomical region comprises at least one of a skeletal muscle, a smooth muscle, and a spinal cord,

17. A system comprising: a user interface; anda processor that receives structure input from a user selecting at least one anatomical structure for receipt of electrical stimulation, and generates electrical stimulation parameters in a programming device based upon the structure input and a location of electrodes within a patient anatomy.

18. The system of claim 17, wherein the processor displays an image of a reference anatomical region of a reference anatomy on the user interface, and receives user selection of at least one structure of the reference anatomical region via the user interface as the structure input.

19. The system of claim 18, wherein the processor overlays a patient anatomical region of the patient anatomy on the reference anatomical region displayed via the user interface.

20. The system of claim 18, wherein the processor generates a morphed anatomical region based upon the reference anatomical region and a patient anatomical region, and displays the morphed anatomical region on the user interface.

21. The system of claim 18, wherein the processor receives structure input via the user touching the at least one structure within the image with a pointing object.

22. The system of claim 18, wherein the processor displays a label on the reference anatomical region that identifies the at least one structure of the reference anatomical region.

23. The system of claim 18, wherein the processor displays the reference anatomical region of the reference anatomy on the display as a plurality of different two-dimensional, cross-sectional views of the reference anatomical region

24. The system of claim 23, wherein the views comprise at least one of a coronal view, a sagittal view, an axial view, and an oblique view.

25. The system of claim 17, wherein the processor receives structure input from a user selecting at least one anatomical structure that electrical stimulation is to avoid.

26. The system of claim 17, wherein the processor receives a selection of the at least one anatomical structure from at least one menu as the structure input.

27. The system of claim 17, 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 based on the comparison.

28. The system of claim 17, wherein the processor determines 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, compares the error value to a threshold value, and prompts a user based on the comparison.

29. The system of claim 17, further comprising a programmer that includes the processor and the user interface.

30. A computer-readable medium comprising instructions that cause a processor to: receive structure input from a user selecting at least one anatomical structure for receipt of electrical stimulation; andgenerate electrical stimulation parameters in a programming device based upon the structure input and a location of electrodes within a patient anatomy.

31. The computer-readable medium of claim 30, further comprising instructions that cause a processor to display an image of a reference anatomical region of a reference anatomy on a user interface, wherein the instructions that cause a processor to receive structure input comprise instructions that cause a processor to receive structure input selecting at least one structure of the reference anatomical region.

32. The computer-readable medium of claim 31, further comprising instructions that cause a processor to overlay a patient anatomical region of the patient anatomy on the reference anatomical region displayed on the user interface.

33. The computer-readable medium of claim 31, further comprising instructions that cause a processor to: generate a morphed anatomical region based upon the reference anatomical region and a patient anatomical region; anddisplay the morphed anatomical region on the user interface.

34. The computer-readable medium of claim 31, wherein the instructions that cause a processor to display an image of a reference anatomical region of a reference anatomy on a user interface comprise instructions that cause a processor to display the reference anatomical region of the reference anatomy on the display as a plurality of different two-dimensional, cross-sectional views of the reference anatomical region

35. The computer-readable medium of claim 31, wherein the views comprise at least one of a coronal view, a sagittal view, an axial view, and an oblique view.

36. The computer-readable medium of claim 30, further comprising instructions that cause a processor to receive structure input from a user selecting at least one anatomical structure that electrical stimulation is to avoid.

37. The computer-readable medium of claim 30, wherein the instructions that cause a processor to receive structure input comprise instructions that cause a processor to receive a selection from at least one menu.

38. The computer-readable medium of claim 30, 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.