JP5199867B2 - 神経マーカを提供するシステム - Google Patents
神経マーカを提供するシステム Download PDFInfo
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Description
出願が参照によって本明細書に組み込まれている2005年4月25日に出願された米国特許出願番号11/113773に対する優先権の利益が、本明細書によって主張される。
以下の一般に譲渡された米国特許出願は、関係があり、参照によって完全に本明細書に組み込まれている:「Method and Apparatus For Simultaneously Presenting Cardiac Neural Signals」、出願番号11/114246、2005年4月25日出願;「System and Method for Closed−Loop Neural Stimulation」、出願番号10/922319、2004年11月18日出願;および「Cardiac Rhythm Management Device With Neural Sensor」、出願番号10/992320、2004年11月18日出願。
神経学に関係する生理学の簡潔な議論が、読者が本開示を理解するのを補助するために提供される。この簡潔な議論は、圧反射や化学受容体を含めて自律神経系を導入し、心臓生理学をも導入する。
本主題は、感知された神経活動の神経マーカを提供するシステムを提供する。システムは、埋込み型医療機器、外部機器、または埋込み型と外部機器の組合せを含む。いくつかの実施形態は、1つまたは複数の治療を制御するために、神経マーカを使用する。神経マーカがフィードバックを提供する治療の例には、神経刺激治療、心臓リズム管理(CRM)治療、薬剤治療、様々なそれらの組合せがある。
様々な実施形態は、神経トラフィック・フィードバックを有する神経刺激を含む。リードは、埋込み型神経刺激機器などの機器に接続されるように、またはCRM機器に統合されるように適合される。機器は、神経信号に関連付けられた低振幅と高雑音レベルに対して適切な増幅とろ過で神経信号を処理する。様々な実施形態は、ウェーブレット変換または他の雑音低減アルゴリズムを含むことができる信号処理モジュールを用意する。記録された神経トラフィックは、神経トラフィックのパターンや強度など、信号の特徴を識別するように適合された検出アルゴリズムで処理される。信号特徴は、持続時間、周波数、振幅など、所望の神経刺激パラメータを決定するために使用される。
様々な実施形態が、神経トラフィック・フィードバックを有するCRMシステムを含む。リードは、埋込み型CRM機器などの機器に接続されるように適合される。機器は、神経信号に関連付けられた低振幅と高雑音レベルに関して適切な振幅とろ過で神経信号を処理する。様々な実施形態は、ウェーブレット変形または他の雑音低減アルゴリズムを含むことができる信号処理モジュールを提供する。記録された神経トラフィックは、神経トラフィックのパターンと強度など、信号の特徴を識別するように適合された検出アルゴリズムで処理される。信号特徴は、持続時間、周波数、振幅など、所望の神経刺激パラメータを決定するために使用される。圧反射または他の治療を実施するために、リードをいくつかの適切な神経刺激位置と神経感知位置に配置することができる。
Claims (39)
- 埋込み型医療機器(IMD)を使用して、自律神経系(ANS)の活動を表す神経トラフィックを感知する手段と、
前記感知された神経トラフィックから特徴を抽出する手段と、
ANSの活動を表す前記感知された神経トラフィックの前記抽出された特徴のための自律神経系(ANS)の神経マーカを創出する手段とを備え、前記自律神経系(ANS)の神経マーカは、前記抽出された特徴に関する情報を含んでおり、前記抽出された特徴に関する情報は、前記感知された神経トラフィックの前記抽出された特徴に相関させた事象を含み、
さらに、外部機器に、前記自律神経系(ANS)の神経マーカの履歴を表示する手段を備え、前記ANSの神経マーカの表示は、前記感知された神経トラフィックの前記抽出された特徴に相関させた事象についての識別子を含む、
ことを特徴とするシステム。 - 前記特徴を抽出する手段は、前記感知された神経トラフィックをろ過する手段を含み、 前記ろ過する手段は、
ウェーブレット変形を前記感知された神経トラフィックに適用する手段、又は、
周波数ベース・フィルタを前記感知された神経トラフィックに適用する手段、又は、
前記感知された神経トラフィックを整流する手段、又は、
移動ウィンドウ平均を前記感知された神経トラフィックに適用する手段、又は、
対数平均を前記感知された神経トラフィックに適用する手段、又は、
インデックス事象に整列される反復信号を平均する手段を含む、
ことを特徴とする、請求項1に記載のシステム。 - 前記抽出する手段は、前記感知された神経トラフィックを事象に相関させる手段を含むことを特徴とする、請求項1に記載のシステム。
- 前記事象は、治療の適用を含むことを特徴とする、請求項3に記載のシステム。
- 前記事象は、感知された事象を含むことを特徴とする、請求項3に記載のシステム。
- 前記抽出する手段は、前記感知された神経トラフィックのパラメータを、少なくとも1つのプログラム可能値と比較する手段を含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、前記抽出された特徴のラベルを含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、前記抽出された特徴の時間スタンプを含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、前記神経活動が感知された位置のインジケータを含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、神経経路タイプのインジケータを含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、相関事象に関する情報を含むことを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報は、前記自律神経系(ANS)の活動を表す前記感知された神経トラフィックの少なくとも1つのパラメータに関する情報を含むことを特徴とする、請求項1に記載のシステム。
- さらに、治療を適用する手段と、前記神経マーカに基づいて治療を自動的に調整する手段とを備えることを特徴とする、請求項1に記載のシステム。
- さらに、治療を適用する手段と、前記神経マーカに基づいて、適用された治療に関する状態情報を自動的に提供する手段とを備えることを特徴とする、請求項1に記載のシステム。
- 前記自律神経系(ANS)の神経マーカに関する情報を表示する手段は、前記感知された神経トラフィックに関連付けられた相関事象に関する情報を表示する手段を含むことを特徴とする、請求項14に記載のシステム。
- さらに、前記感知された神経トラフィックから自律神経系(ANS)のニューログラムを形成する手段を含み、前記自律神経系(ANS)の神経マーカに関する情報を表示する手段は、前記自律神経系(ANS)の神経マーカの時間スタンプによって決定された時間期間について前記自律神経系(ANS)のニューログラムの各々のセグメントを表示する手段を含むことを特徴とする、請求項14に記載のシステム。
- さらに、前記神経マーカをメモリに記憶する手段を含み、前記神経マーカをメモリに記憶する手段は、前記感知された神経トラフィックから抽出された少なくとも1つの予め決めた特徴に関して生成されたトリガに応答して、神経マーカを前記メモリに自動的に記憶する手段を含むことを特徴とする、請求項1に記載のシステム。
- さらに、ユーザ開始トリガに応答して、前記神経マーカを前記メモリに記憶する手段を備えることを特徴とする、請求項17に記載のシステム。
- 前記感知された神経トラフィックを表示する信号を受信するポートと、
前記信号を受信して処理し、前記神経マーカを生成するように適合された特徴抽出器と、
を備えることを特徴とする、請求項1〜17のいずれか1項に記載のシステム。 - 前記埋込み型医療機器(IMD)は、神経トラフィックを感知して、前記信号を前記ポートに提供するために、前記ポートに接続されたセンサを含むことを特徴とする、請求項19に記載のシステム。
- 前記外部機器は、通信チャネルを経て前期埋込み型医療機器(IMD)と通信し、前記通信チャネルを経て前記ポートにおいて前記神経活動信号を受信するように構成されることを特徴とする、請求項19に記載のシステム。
- 前記特徴抽出器は、前記感知された神経刺激信号のフィルタを含むことを特徴とする、請求項19に記載のシステム。
- 前記特徴抽出器は、前記感知された神経刺激信号を事象に相関させる相関器を含むことを特徴とする、請求項19に記載のシステム。
- 前記特徴抽出器は、前記神経刺激信号の特徴を少なくとも1つのプログラム可能値と比較するために比較器を含むことを特徴とする、請求項19に記載のシステム。
- 前記特徴抽出器は、前記神経マーカをメモリに自動的に記憶するためにトリガ機構を含むことを特徴とする、請求項19に記載のシステム。
- さらに、前記神経マーカに基づいて警告を提供するように適合されたコントローラを備えることを特徴とする、請求項19に記載のシステム。
- ディスプレイを有する外部機器と、
神経マーカを記憶するように適合されたメモリと、
前記メモリおよび前記ディスプレイと通信し、前記神経マーカの表示を前記ディスプレイ上に提供するように適合されたコントローラと、
を備えることを特徴とする、請求項1〜26のいずれか1項に記載のシステム。 - 前記神経マーカの前記表示は、時間スタンプとラベルを含むことを特徴とする、請求項27に記載のシステム。
- 前記神経マーカの前記表示は、前記神経マーカに対応する前記感知された神経活動信号の一部の画像を含むことを特徴とする、請求項27に記載のシステム。
- 前記神経マーカの前記表示は、相関事象の表示を含むことを特徴とする、請求項27に記載のシステム。
- さらに、前記感知された神経トラフィックから自律神経系(ANS)のニューログラムを形成する手段と、前記自律神経系(ANS)のニューログラムの中の前記神経マーカを識別する表示を有する前記自律神経系(ANS)のニューログラムの一部を表示する手段とを備えることを特徴とする、請求項1に記載のシステム。
- さらに、前記履歴の前記自律神経系(ANS)の神経マーカの1つを選択して、前記選択された自律神経系(ANS)の前記神経マーカに対応する前記自律神経系(ANS)のニューログラムの1つの一部を表示する手段を備えることを特徴とする、請求項31に記載のシステム。
- さらに、前記自律神経系(ANS)の神経マーカに関する時間スタンプを使用して、表示すべき自律神経系(ANS)のニューログラムのセグメントを決定する手段を含むことを特徴とする、請求項32に記載のシステム。
- 前記履歴にある自律神経系(ANS)の神経マーカを表示する手段は、前記履歴にある前記自律神経系(ANS)の神経マーカの情報を表示する手段を含む、ことを特徴とする、請求項1に記載のシステム。
- 前記履歴にある自律神経系(ANS)の神経マーカを表示する手段は、前記自律神経系(ANS)の神経マーカを生成した前記感知された自律神経系(ANS)の活動の位置を表示する手段を含む、ことを特徴とする、請求項1に記載のシステム。
- 前記履歴にある自律神経系(ANS)の神経マーカを表示する手段は、前記自律神経系(ANS)の活動を感知する神経経路を識別するための神経経路識別器を表示する手段を含むことを特徴とする、請求項1に記載のシステム。
- 前記神経経路識別器は、遠心性経路識別器、又は、求心性経路識別器を含むことを特徴とする、請求項36に記載のシステム。
- 前記履歴にある自律神経系(ANS)の神経マーカを表示する手段は、前記感知された自律神経系(ANS)の活動に対応する信号の振幅を表示する手段を含むことを特徴とする、請求項1に記載のシステム。
- 前記履歴にある自律神経系(ANS)の神経マーカを表示する手段は、前記感知された自律神経系(ANS)の活動に対応する信号の周波数を表示する手段を含むことを特徴とする、請求項1に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/113,773 US7640057B2 (en) | 2005-04-25 | 2005-04-25 | Methods of providing neural markers for sensed autonomic nervous system activity |
US11/113,773 | 2005-04-25 | ||
PCT/US2006/014348 WO2006115868A1 (en) | 2005-04-25 | 2006-04-17 | System to provide neural markers |
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JP2008538994A (ja) | 2008-11-13 |
US7640057B2 (en) | 2009-12-29 |
US20060241697A1 (en) | 2006-10-26 |
EP1874401A1 (en) | 2008-01-09 |
WO2006115868A1 (en) | 2006-11-02 |
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