JP6932835B2 - 電気刺激の臨床効果を推定するシステム及び方法 - Google Patents
電気刺激の臨床効果を推定するシステム及び方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36132—Control systems using patient feedback
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0526—Head electrodes
- A61N1/0529—Electrodes for brain stimulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36135—Control systems using physiological parameters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
- A61N1/36167—Timing, e.g. stimulation onset
- A61N1/36175—Pulse width or duty cycle
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/30—Determination of transform parameters for the alignment of images, i.e. image registration
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/70—Determining position or orientation of objects or cameras
Description
本出願は、2017年7月14日に出願された米国特許仮出願第62/532,869号の米国特許法119(e)条に基づく利益を主張するものであり、本仮出願は、引用により本明細書に組み込まれる。
(技術分野)
904:臨床反応を使用して、電気刺激リードと少なくとも1つの効果領域との間の空間関係を推定する
906:この空間関係に基づいて、少なくとも1つの臨床反応を刺激パラメータの更なるセットについて推定する
908:受信された臨床反応及び推定された臨床反応を含む臨床効果マップを生成して呈示する
Claims (15)
- 電気刺激に対する臨床効果マップを生成するシステムであって、
ディスプレイと、
前記ディスプレイに結合され、動作を実行するように構成されているプロセッサと、
を備え、前記動作が、
刺激パラメータの複数の第1のセットの各々について、前記刺激パラメータの第1のセットを受信し、前記刺激パラメータの第1のセットを使用した刺激から生じる少なくとも1つの臨床反応を受信するステップであって、前記刺激パラメータの第1のセットの各々は、前記刺激を生成するための電気刺激リードの少なくとも1つの電極の選択対象を含み、前記少なくとも1つの臨床反応の各々は、少なくとも1つの治療効果又は副作用を示す、ステップと、
前記臨床反応及び前記刺激パラメータの第1のセットを使用して、前記電気刺激リードと少なくとも1つの効果領域との間の空間関係を決定するステップであって、各効果領域は、刺激されたときに前記少なくとも1つの治療効果又は副作用のうちの少なくとも1つを生成する解剖学的領域である、ステップと、
前記空間関係に基づいて、前記刺激パラメータの第1のセットと異なる刺激パラメータの複数の第2のセットの各々について少なくとも1つの臨床反応を推定するステップと、
前記ディスプレイ上に、前記刺激パラメータの複数の第2のセットの各々について少なくとも、推定された前記少なくとも1つの臨床反応を示す臨床効果マップを生成して呈示するステップと、
を含む、システム。 - 前記空間関係を決定するステップは、前記刺激パラメータの第1のセットのうちの少なくとも1つについて、前記刺激パラメータの当該第1のセットのうちの前記少なくとも1つを使用して前記電気刺激リードによって刺激された組織の領域を推定するステップを含む、請求項1に記載のシステム。
- 前記刺激された組織の領域を推定するステップは、前記刺激パラメータの当該第1のセットのうちの前記少なくとも1つについて刺激場モデル(SFM)を決定するステップを含む、請求項2に記載のシステム。
- 前記空間関係を決定するステップは、前記刺激パラメータの第1のセットの1つを使用する刺激から生じる前記少なくとも1つの臨床反応に基づいて、前記刺激パラメータの第1のセットのうちの前記少なくとも1つによって刺激された組織の推定された領域と前記少なくとも1つの効果領域のうちの1つの領域との重なり合いの度合いを推定するステップを更に含む、請求項2又は3に記載のシステム。
- 前記少なくとも1つの臨床反応を推定するステップは、前記刺激パラメータの第2のセットのうちの少なくとも1つについて、前記刺激パラメータの当該第2のセットのうちの前記少なくとも1つを使用して前記電気刺激リードによって刺激された組織の領域を推定するステップを含む、請求項1〜4の何れか一項に記載のシステム。
- 前記組織の領域を推定するステップは、前記刺激パラメータの当該第2のセットのうちの前記少なくとも1つについて刺激場モデル(SFM)を決定するステップを含む、請求項5に記載のシステム。
- 前記少なくとも1つの臨床反応を推定するステップは、前記刺激パラメータの第2のセットの1つによって刺激された組織の推定された領域と前記少なくとも1つの効果領域のうちの1つの領域との重なり合いの度合いを決定するステップを更に含む、請求項5又は6に記載のシステム。
- 前記少なくとも1つの臨床反応を推定するステップは、前記重なり合いの度合いに基づいて前記臨床反応の度合いを推定するステップを更に含む、請求項7に記載のシステム。
- 前記空間関係を決定するステップは、前記電気刺激リードの位置を特定する画像と前記少なくとも1つの効果領域を含むアトラスとを受信するステップを含む、請求項1〜8の何れか一項に記載のシステム。
- 前記空間関係を決定するステップは、前記アトラスを前記画像と整合させるステップを更に含む、請求項9に記載のシステム。
- 前記空間関係を決定するステップは、前記アトラスを前記画像と整合させるステップの後、受信された前記臨床反応を使用して前記空間関係を修正するステップを更に含む、請求項10に記載のシステム。
- 請求項1〜11の何れか一項に記載のシステムを備えた刺激パラメータを選択するシステムであって、前記動作が、
前記臨床効果マップ上の項目の選択対象を受信するステップと、
選択された前記項目に対応する刺激パラメータの選択されたセットをパルス発生器に供給する信号を生起して、前記刺激パラメータの選択されたセットを使用して刺激を生成するステップと、
を更に含む、システム。 - 前記パルス発生器と、
前記パルス発生器に結合された前記電気刺激リードと、
を更に備える、請求項12に記載のシステム。 - 少なくとも1つのプロセッサによって実行されたときに、前記少なくとも1つのプロセッサに動作を実行させるコンピュータ実行可能命令が記憶された非一時的コンピュータ可読媒体であって、前記動作が、
刺激パラメータの複数の第1のセットの各々について、前記刺激パラメータの第1のセットを受信し、前記刺激パラメータの第1のセットを使用した刺激から生じる少なくとも1つの臨床反応を受信するステップであって、前記刺激パラメータの第1のセットの各々は、前記刺激を生成するための電気刺激リードの少なくとも1つの電極の選択対象を含み、前記少なくとも1つの臨床反応の各々は、少なくとも1つの治療効果又は副作用を示す、ステップと、
前記臨床反応及び前記刺激パラメータの第1のセットを使用して、前記電気刺激リードと少なくとも1つの効果領域との間の空間関係を決定するステップであって、各効果領域は、刺激されたときに前記少なくとも1つの治療効果又は副作用のうちの少なくとも1つを生成する解剖学的領域である、ステップと、
前記空間関係に基づいて、前記刺激パラメータの第1のセットと異なる刺激パラメータの複数の第2のセットの各々について少なくとも1つの臨床反応を推定するステップと、
ディスプレイ上に、前記刺激パラメータの複数の第2のセットの各々について少なくとも、推定された前記少なくとも1つの臨床反応を示す臨床効果マップを生成して呈示するステップと、
を含む、非一時的コンピュータ可読媒体。 - 前記動作は、
前記臨床効果マップ上の項目の選択対象を受信するステップと、
選択された前記項目に対応する刺激パラメータの選択されたセットをパルス発生器に供給する信号を生起して、前記刺激パラメータの選択されたセットを使用して刺激を生成するステップと、
を更に含む、請求項14に記載の非一時的コンピュータ可読媒体。
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US201762532869P | 2017-07-14 | 2017-07-14 | |
US62/532,869 | 2017-07-14 | ||
PCT/US2018/041446 WO2019014224A1 (en) | 2017-07-14 | 2018-07-10 | SYSTEMS AND METHODS FOR ESTIMATING CLINICAL EFFECTS OF ELECTRICAL STIMULATION |
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