New! View global litigation for patent families

US20100125219A1 - Minimally invasive system for selecting patient-specific therapy parameters - Google Patents

Minimally invasive system for selecting patient-specific therapy parameters Download PDF

Info

Publication number
US20100125219A1
US20100125219A1 US12691650 US69165010A US20100125219A1 US 20100125219 A1 US20100125219 A1 US 20100125219A1 US 12691650 US12691650 US 12691650 US 69165010 A US69165010 A US 69165010A US 20100125219 A1 US20100125219 A1 US 20100125219A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
patient
device
implantable
devices
seizure
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US12691650
Inventor
John F. Harris
Kent W. Leyde
Jaideep Mavoori
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
NEUROVISTA CORP
Original Assignee
NEUROVISTA CORP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/37211Means for communicating with stimulators
    • A61N1/37217Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
    • A61N1/37223Circuits for electromagnetic coupling
    • A61N1/37229Shape or location of the implanted or external antenna
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0031Implanted circuitry
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/04Detecting, measuring or recording bioelectric signals of the body or parts thereof
    • A61B5/0476Electroencephalography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/40Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4076Diagnosing or monitoring particular conditions of the nervous system
    • A61B5/4094Diagnosing or monitoring seizure diseases, e.g. epilepsy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36064Epilepsy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02Operational features
    • A61B2560/0204Operational features of power management
    • A61B2560/0214Operational features of power management of power generation or supply

Abstract

The present invention provides systems and methods for ambulatory, long term monitoring of a physiological signal from a patient. At least a portion of the systems of the present invention may be implanted within the patient in a minimally invasive manner. In preferred embodiments, brain activity signals are sampled from the patient and are transmitted to a handheld patient communication device for further processing.

Description

    CROSS-REFERENCED TO RELATED APPLICATIONS
  • [0001]
    The present application is a continuation of U.S. patent application Ser. No. 11/766,760, filed Jun. 21, 2007 to Harris et al., entitled “Minimally Invasive System for Selecting Patient-Specific Therapy Parameters”, which claims the benefit of U.S. Provisional Patent Application Ser. No. 60/805,710, filed Jun. 23, 2006, to Harris et al., entitled “Implantable Ambulatory Brain Monitoring System,” the complete disclosure of which is incorporated herein by reference.
  • INCORPORATION BY REFERENCE
  • [0002]
    All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
  • BACKGROUND OF THE INVENTION
  • [0003]
    The present invention relates generally to systems and methods for sampling one or more physiological signals from a patient. More specifically, the present invention relates to long term, ambulatory monitoring of one or more neurological signals for selecting therapy parameters for a patient.
  • [0004]
    Epilepsy is a disorder of the brain characterized by chronic, recurring seizures. Seizures are a result of uncontrolled discharges of electrical activity in the brain. A seizure typically manifests itself as sudden, involuntary, disruptive, and often destructive sensory, motor, and cognitive phenomena. Seizures are frequently associated with physical harm to the body (e.g., tongue biting, limb breakage, and burns), a complete loss of consciousness, and incontinence. A typical seizure, for example, might begin as spontaneous shaking of an arm or leg and progress over seconds or minutes to rhythmic movement of the entire body, loss of consciousness, and voiding of urine or stool.
  • [0005]
    A single seizure most often does not cause significant morbidity or mortality, but severe or recurring seizures (epilepsy) results in major medical, social, and economic consequences. Epilepsy is most often diagnosed in children and young adults, making the long-term medical and societal burden severe for this population of patients. People with uncontrolled epilepsy are often significantly limited in their ability to work in many industries and usually cannot legally drive an automobile. An uncommon, but potentially lethal form of seizure is called status epilepticus, in which a seizure continues for more than 30 minutes. This continuous seizure activity may lead to permanent brain damage, and can be lethal if untreated.
  • [0006]
    While the exact cause of epilepsy is often uncertain, epilepsy can result from head trauma (such as from a car accident or a fall), infection (such as meningitis), or from neoplastic, vascular or developmental abnormalities of the brain. Most epilepsy, especially most forms that are resistant to treatment (i.e., refractory), are idiopathic or of unknown causes, and is generally presumed to be an inherited genetic disorder.
  • [0007]
    While there is no known cure for epilepsy, the primary treatment for these epileptic patients are a program of one or more anti-epileptic drugs or “AEDs.” Chronic usage of anticonvulsant and antiepileptic medications can control seizures in most people. An estimated 70% of patients will respond favorably to their first AED monotherapy and no further medications will be required. However, for the remaining 30% of the patients, their first AED will fail to fully control their seizures and they will be prescribed a second AED—often in addition to the first—even if the first AED does not stop or change a pattern or frequency of the patient's seizures. For those that fail the second AED, a third AED will be tried, and so on. Patients who fail to gain control of their seizures through the use of AEDs are commonly referred to as “medically refractory.”
  • [0008]
    For those patients with infrequent seizures, the problem is further compounded by the fact that they must remain on the drug for many months before they can discern whether there is any benefit. As a result, physicians are left to prescribe AEDs to these patients without clear and timely data on the efficacy of the medication. Because these drugs are powerful neural suppressants and are associated with undesirable side-effects and sedation, it is important to minimize the use and dosage of these drugs if the patient is not experiencing benefit.
  • [0009]
    A major challenge for physicians treating epileptic patients is gaining a clear view of the effect of a medication or incremental medications on the patient's condition. Presently, the standard metric for determining efficacy of the medication is for the patient or for the patient's caregiver to keep a diary of seizure activity. However, it is well recognized that such self-reporting is often of poor quality because patients often do not realize when they have had a seizure, or fail to accurately record seizures. In addition, patients often have “sub-clinical” seizures where the brain experiences a seizure, but the seizure does not manifest itself clinically, and the patient has no way of making note of such seizures. Due to such deficiencies in assessing the efficacy of the AEDs, patients and physicians are unable to reliably determine the effectiveness of the AEDs. Consequently, patient's are often given dosages and dosing schedules that are much more than needed, and the patient is subject to the unwanted side effects associated with the AEDs.
  • [0010]
    Consequently, what are needed are methods and systems that are capable of long-term, out-patient monitoring of epileptic patients. It would further be desirable if the long-term monitoring could be processed into appropriate metrics that can quantify the clinical benefit of the medication or other therapies and allow for intelligent titration of the medications. It would also be desirable to have system that could record seizure activity, to enable the meaningful study of patients with infrequent seizures.
  • SUMMARY OF THE INVENTION
  • [0011]
    The present invention provides methods and systems for monitoring one or more physiological signals from the patient. In preferred embodiments, the present invention provides minimally-invasive systems that provide for the long-term, ambulatory monitoring of patient's brain activity. The systems of the present invention will typically include one or more implantable devices that are capable of sampling and transmitting a signal that is indicative of the patient's brain activity to a data collection device that is external to the patient's body. The ambulatory systems of the present invention provide for substantially continuous sampling of brain wave electrical signals (e.g., electroencephalography or “EEG” and electrocorticogram “ECoG”, which are hereinafter referred to collectively as “EEG”).
  • [0012]
    A patient could wear their external data collection device at all times of the day (except while showering, etc.). At the physicians' office, the data from the external data collection device could be uploaded into a physician's computer, which could then automatically analyze the stored EEG data and calculate certain metrics that would provide insight into the patient's condition and the efficacy of their therapy. For example, such metrics may allow the epileptologist to assess seizure frequency, monitor for sub-clinical seizures, determine the efficacy of treatment, determine the effect of adjustments of the dosage of the AED, determine the effects of adjustments of the type of AED, adjust parameters of electrical stimulation, or the like.
  • [0013]
    The systems of the present invention typically include one or more low power implantable devices for sampling the patient's EEG signal. The implantable devices are in communication with a device that is external to the patient's body. The external device is typically configured to transmit power into the implantable device and to store the EEG signal that is sampled by the implantable device. The implantable device and the external device will be in communication with each other through a wireless communication link. While any number of different wireless communication links may be used, in preferred embodiments the systems of the present invention uses a high-frequency communication link. Such a communication link enables transmission of power into the implantable device and facilitates data transfer to and from the implantable device
  • [0014]
    In one aspect, the present invention provides a method for selecting a therapy for a patient suffering from a neurological or psychiatric condition. The method comprises implanting a monitoring device between at least one layer of the scalp and the skull and commencing a first therapy. A physiological signal from the patient is monitored with the implanted device for a first time period after commencement of the first therapy. A second therapy is commenced and a physiological signal from the patient is monitored with the implanted device for a second time period after commencement of the second therapy. The physiological signals from the first time period and second time period are processed and analyzed to select an appropriate therapy for the patient.
  • [0015]
    In one preferred embodiment, the neurological condition comprises epilepsy and the first and second therapy comprises different pharmacological agents. In other embodiments, the therapy may comprise electrical stimulation of the same or different portions of the nervous system (e.g., deep brain, cortical surface, cranial nerve, peripheral nerve, etc.)
  • [0016]
    In some embodiments processing of the physiological signals from the first time period and second time period comprises measuring seizure activity data from each of the time periods. Seizure activity data comprises a number a clinical seizures during the first time period, a number of sub-clinical seizures during the first time period, seizure duration, seizure patterns, seizure frequency, and time of day of seizure occurrence, or any combination thereof.
  • [0017]
    The monitoring devices implanted in the patient may take a variety of different forms, but in some configurations the devices are leadless. The leadless devices may have an internal power source, but they may also be devoid of a power source and externally powered via a signal (e.g., radiofrequency signal) generated in an external device. The signal from the external device may power the implanted devices and interrogate the electronic components to facilitate sampling of the physiological signals. Data indicative of the sampled physiological signals may be encoded in a data signal that is wirelessly transmitted to the external device. The physiological signals may thereafter be stored in a memory that is external to the patient's body.
  • [0018]
    In another aspect, the present invention provides a method for optimizing parameters of a selected therapy for patient having a neurological or psychiatric condition. The method comprises implanting a device in between a patient's skull and at least one layer of the scalp and commencing a therapy. A physiological signal is sampled from the patient with the implanted device after commencement of the therapy for a first time period. At least one parameter of the therapy is changed and the physiological signal is sampled from the patient with the implanted device for a second time period after the at least one parameter of the therapy is changed. The physiological signal from the first time period and second time period are processed. The processed physiological signals from the first and second time periods are thereafter analyzed to determine desirable parameters for the patient's therapy.
  • [0019]
    In one configuration, the neurological condition is epilepsy and processing comprises measuring seizure activity data from the first and second time periods. Seizure activity data typically comprises at least one of a number a clinical seizures during the first and second time period, a number of sub-clinical seizures during the first and second time period, seizure duration during the first and second time period, seizure patterns during the first and second time period, seizure frequency during the first and second time period, and time of seizure occurrence during the first and second time period.
  • [0020]
    The monitoring devices implanted in the patient may take a variety of different forms, but in some configurations the devices are leadless. The leadless devices may have an internal power source, but they may also be externally powered via a signal (e.g., radiofrequency signal) generated in an external device. The signal from the external device may power the implanted devices and interrogate the electronic components to facilitate sampling of the physiological signals. Data indicative of the sampled physiological signals may be encoded in a data signal that is wirelessly transmitted to the external device. The physiological signals may thereafter be stored in a memory in the external device.
  • [0021]
    To help facilitate selection of the appropriate parameters for the particular patient, the methods of the present invention may generate a report for the physician and/or patient. The report may indicate the seizure activity data for the first and second time period, a chart/graph and/or an analysis of the differences in the seizure activity data for the different time periods, and a recommendation for the parameters of the patient-specific therapy.
  • [0022]
    The therapy may be a pharmacological therapy (such as an AED, for patient's suffering from epilepsy). The parameters that may be varied include at least one of a dosage, dosage frequency, form of the AED, and formulation of the AED. In other embodiments, the therapy may be electrical stimulation (such as deep brain stimulation, cortical stimulation, cranial nerve stimulation, peripheral nerve stimulation, or the like). The parameters that may be varied for such therapy includes at least one of frequency, pulse amplitude, pulse width, pulses per burst, burst frequency, burst/no-burst, and duty cycle.
  • [0023]
    In a further aspect, the present invention provides a method for titrating parameters of a pharmacological agent for treating a patient having epilepsy. The method comprises implanting a leadless device in between a patient's skull and at least one layer of the scalp and commencing an anti-epileptic drug therapy. Sampling of an EEG signal from the patient is performed with the implanted device after commencement of the anti-epileptic drug therapy. A data signal that is encoded with the sampled EEG signal is transmitted from the implanted device to a portable external device for a first time period. At least one parameter of the anti-epileptic drug therapy is modified and An EEG signal from the patient is sampled with the implanted device after commencement of the anti-epileptic drug therapy with the at least one adjusted parameter. The data signal that is encoded with the sampled EEG signal is transmitted from the implanted device to a portable external device for a second time period. The sampled EEG signals from the first time period and second time period are processed to generate seizure activity data. The seizure activity data from the first and second time periods are analyzed to determine desirable parameters for the patient's therapy.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0024]
    The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
  • [0025]
    FIG. 1A illustrates a simplified system embodied by the present invention which comprises one or more implantable devices in communication with an external device.
  • [0026]
    FIG. 1B illustrates simplified methods of operating the system of the present invention.
  • [0027]
    FIG. 2A illustrates a bottom view of one embodiment of an active implantable device that is encompassed by the present invention.
  • [0028]
    FIG. 2B illustrates a cross-sectional view of the active implantable device of FIG. 2A along lines B-B.
  • [0029]
    FIG. 2C is a linear implantable device that comprises a plurality of electrode contacts in which at least one electrode contact comprises the active implantable device of FIG. 2A.
  • [0030]
    FIG. 2D is a cross sectional view of the implantable device of FIG. 2C along lines D-D.
  • [0031]
    FIG. 2E is a 4×4 electrode array that comprises a plurality of electrode contacts in which at least one electrode contact comprises the active implantable contact of FIG. 2A.
  • [0032]
    FIG. 3A is a cross-sectional view of another embodiment of an implantable device that is encompassed by the present invention.
  • [0033]
    FIG. 3B is a cross-sectional view of another embodiment of the implantable device in which a conductive can forms a housing around the electronic components and acts as an electrode.
  • [0034]
    FIG. 3C illustrates a simplified plan view of an embodiment that comprises four electrodes disposed on the implanted device.
  • [0035]
    FIG. 4 illustrates one embodiment of the electronic components that may be disposed within the implantable device.
  • [0036]
    FIG. 5 is a block diagram illustrating one embodiment of electronic components that may be in the external device.
  • [0037]
    FIG. 6 illustrates a simplified trocar or needle-like device that may be used to implant the implantable device beneath the patient's skin.
  • [0038]
    FIG. 7 illustrates a method of inserting an implantable device in the patient and wirelessly sampling EEG signals from a patient.
  • [0039]
    FIG. 8 illustrates a method of lateralizing a seizure focus.
  • [0040]
    FIG. 9 illustrates a method of measuring seizure activity data for clinical and/or sub-clinical seizures.
  • [0041]
    FIG. 10 illustrates a method of evaluating efficacy of a therapy.
  • [0042]
    FIG. 11 illustrates a method of titrating an efficacious therapy.
  • [0043]
    FIG. 12 illustrates a simplified method of performing a clinical trial.
  • [0044]
    FIG. 13 illustrates a more detailed method of performing a clinical trial.
  • [0045]
    FIG. 14 is a kit that is encompassed by the present invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0046]
    Certain specific details are set forth in the following description and figures to provide an understanding of various embodiments of the invention. Certain well-known details, associated electronics and devices are not set forth in the following disclosure to avoid unnecessarily obscuring the various embodiments of the invention. Further, those of ordinary skill in the relevant art will understand that they can practice other embodiments of the invention without one or more of the details described below. Finally, while various processes are described with reference to steps and sequences in the following disclosure, the description is for providing a clear implementation of particular embodiments of the invention, and the steps and sequences of steps should not be taken as required to practice this invention.
  • [0047]
    The term “condition” is used herein to generally refer to the patient's underlying disease or disorder—such as epilepsy, depression, Parkinson's disease, headache disorder, etc. The term “state” is used herein to generally refer to calculation results or indices that are reflective a categorical approximation of a point (or group of points) along a single or multi-variable state space continuum of the patient's condition. The estimation of the patient's state does not necessarily constitute a complete or comprehensive accounting of the patient's total situation. As used in the context of the present invention, state typically refers to the patient's state within their neurological condition. For example, for a patient suffering from an epilepsy condition, at any point in time the patient may be in a different states along the continuum, such as an ictal state (a state in which a neurological event, such as a seizure, is occurring), a pre-ictal state (which is a neurological state that immediately precedes the ictal state), a pro-ictal state (a state in which the patient has an increased risk of transitioning to the ictal state), an inter-ictal state (a state in between ictal states), a contra-ictal state (a protected state in which the patient has a low risk of transitioning to the ictal state within a calculated or predetermined time period), or the like. A pro-ictal state may transition to either an ictal or inter-ictal state. A pro-ictal state that transitions to an ictal state may also be referred to herein as a “pre-ictal state.”
  • [0048]
    The estimation and characterization of “state” may be based on one or more patient dependent parameters from the a portion of the patient's body, such as electrical signals from the brain, including but not limited to electroencephalogram signals and electrocorticogram signals “ECoG” or intracranial EEG (referred to herein collectively as EEG”), brain temperature, blood flow in the brain, concentration of AEDs in the brain or blood, changes thereof, etc.). While parameters that are extracted from brain-based signals are preferred, the present invention may also extract parameters from other portions of the body, such as the heart rate, respiratory rate, blood pressure, chemical concentrations, etc.
  • [0049]
    An “event” is used herein to refer to a specific event in the patient's condition. Examples of such events include transition from one state to another state, e.g., an electrographic onset of seizure, end of seizure, or the like. For conditions other than epilepsy, the event could be an onset of a migraine headache, onset of a depressive episode, a tremor, or the like.
  • [0050]
    The occurrence of a seizure may be referred to as a number of different things. For example, when a seizure occurs, the patient is considered to have exited a “pre-ictal state” or “pro-ictal state” and has transitioned into the “ictal state”. However, the electrographic onset of the seizure (one event) and/or the clinical onset of the seizure (another event) have also occurred during the transition of states.
  • [0051]
    A patient's “propensity” for a seizure is a measure of the likelihood of transitioning into the ictal state. The patient's propensity for seizure may be estimated by determining which “state” the patient is currently in. As noted above, the patient is deemed to have an increased propensity for transitioning into the ictal state (e.g., have a seizure) when the patient is determined to be in a pro-ictal state. Likewise, the patient may be deemed to have a low propensity for transitioning into the ictal state when it is determined that the patient is in a contra-ictal state.
  • [0052]
    The methods, devices and systems of the present invention are useful for long-term, ambulatory sampling and analysis of one or more physiological signals, such as a patient's brain activity. In one preferred embodiment, the system of the present invention may be used to monitor and store one or more substantially continuously sampled EEG signals from the patient, while providing a minimal inconvenience to the patient. Attempts at developing ambulatory monitoring systems in the past have relied on an array of electrodes being placed on the patient's head and scalp with adhesive. Unfortunately, such systems are poorly tolerated by patients and are impractical for the duration of time needed for the accurate evaluation of the patient's EEG and evaluation of the efficacy of the treatment the patients are undergoing. Unlike conventional ambulatory EEG systems, the ambulatory monitoring systems of the present invention typically include one or more devices that are implanted in a minimally invasive fashion in the patient and will be largely unnoticed by a patient as they go about their day-to-day activities. The implantable devices may be in wireless communication with an external device that may be carried by the patient or kept in close proximity to the patient. Consequently, the ambulatory monitoring systems of the present invention are conducive to longer, more effective monitoring of the patient (e.g., one week or longer, one month or longer, two months or longer, three months or longer, six months or longer, one year or longer, etc.).
  • [0053]
    The methods, devices and systems of the present invention may also find use in an emergency room or neurological intensive care units (ICU). For example, the systems may be used to monitor patients who have complex, potentially life-threatening neurological illnesses or brain injuries. Neuro ICUs may monitor patients who have suffered (or thought to have suffered) a stroke (e.g., cerebral infarction, transient ischemic attacks, intracerebral hemorrhage, aneurismal subarachnoid hemorrhage, arteriovenous malformations, dural sinus thrombosis, etc.), head trauma, spinal cord injury, tumors (e.g., spinal cord metastases, paraneoplastic syndromes), infections (e.g., encephalitis, meningitis, brain abscess), neuromuscular weakness (e.g., Guillain-barre syndrome, myasthenia gravis), eclampsia, neuropleptic malignant syndrome, CNS vasculitis, migraine headaches, or the like.
  • [0054]
    The neuro-ICUs require the ability to monitor the patient's neurological condition for a long period of time to identify issues and diagnose the patient before permanent neurological damage occurs. Because the systems of the present invention are able to provide real-time monitoring of a patient's EEG and many embodiments have the ability to detect or predict neurological events, such systems will be beneficial to patients and the staff of the ICU to allow the neurologist and support staff to detect and/or prevent complications that may arise from the patient's neurological condition, before the patient's condition deteriorates.
  • [0055]
    For example, a patient who is suffering from head trauma may be outfitted with a system of the present invention and because the implantable portions are MRI safe, the patient's may still undergo MRI sessions. Furthermore, the systems of the present invention may also be used to continuously monitor a patient's response to a drug therapy while the patient is in the neuro-ICU and when the patient leaves the neuro-ICU.
  • [0056]
    For epilepsy patients in particular, the monitoring systems of the present invention may be used in conjunction with, or as an alternative to, the in-patient video-EEG monitoring that occurs in the EMU. If used as an alternative to in-patient video-EEG monitoring, in some embodiments it may be desirable to provide one or more video recorders in the patient's home to provide time-synced video recording of the patient as they live with their ambulatory monitoring system. In some embodiments, it may be desirable to provide a patient-mounted video system so as to allow video-monitoring of the patient outside of their home. Such a video system may or may not be in communication with the ambulatory monitoring system of the present invention; but both the video and the monitored EEG signals should be time-synced and analyzed together by the physician to assess the patient's condition and/or efficacy of any therapy that the patient may be undergoing.
  • [0057]
    The systems and methods of the present invention may incorporate EEG analysis software to estimate and monitor the patient's brain state substantially in real-time. The EEG analysis software may include a safety algorithm, a seizure prediction algorithm and/or a seizure detection algorithm that uses one or more extracted features from the EEG signals (and/or other physiological signals) to estimate the patient's brain state (e.g., predict or detect the onset of a seizure). Additionally, some systems of the present invention may be used to facilitate delivery of a therapy to the patient to prevent the onset of a predicted seizure and/or abort or mitigate a seizure after it has started. Facilitation of the delivery of the therapy may be carried out by outputting a warning or instructions to the patient or automatically delivering a therapy to the patient (e.g., pharmacological, electrical stimulation, etc.). The therapy may be delivered to the patient using the implanted devices that are used to collect the ambulatory signals, or it may be delivered to the patient through a different implanted device. A description of some systems that may be used to delivery a therapy to the patient are described in commonly owned U.S. Pat. Nos. 6,366,813 and 6,819,956, U.S. Patent Application Publication Nos. 2005/0021103 (published Jan. 27, 2005), 2005/0119703 (published Jun. 2, 2005), 2005/0021104 (published Jan. 27, 2005), 2005/0240242 (published Oct. 27, 2005), 2005/0222626 (published Oct. 6, 2005), 2007/0150024 (published Jun. 28, 2007), 2007/0150025 (published Jun. 28, 2007) and 2007/0149952 (published Jun. 28, 2007) and U.S. patent application Ser. Nos. 11/282,317 (filed Nov. 17, 2005), the complete disclosures of which are incorporated herein by reference.
  • [0058]
    For patients suspected or known to have epilepsy, the systems of the present invention may be used to provide data and other metrics to the patients and physicians that heretofore have not been accurately measurable. For example, the data may be analyzed to (1) determine whether or not the patient has epilepsy, (2) determine the type of epilepsy, (3) determine the types of seizures, (4) localize or lateralize one or more seizure foci, (5) assess baseline seizure statistics and/or change from the baseline seizure statistics (e.g., seizure count, frequency, duration, seizure pattern, etc.) (6) monitor for sub-clinical seizures, assess a baseline frequency of occurrence, and/or change from the baseline occurrence, (7) measure the efficacy of AED treatments, (8) assess the effect of adjustments of the dosage of the AED, (9) determine the effects of adjustments of the type of AED, (10) determine the effect of, and the adjustment to parameters of, electrical stimulation (e.g., vagus nerve stimulation (VNS), deep brain stimulation (DBS), cortical stimulation, etc.), (11) determine “triggers” for the patient's seizures, (12) assess outcomes from surgical procedures, (13) provide immediate biofeedback to the patient, (14) screen patients for determining if they are an appropriate candidate for a seizure advisory system or other neurological monitoring or therapy system, or the like.
  • [0059]
    The systems of the present invention typically include one or more implantable devices that are in wireless communication with an external data collection device, typically with a high frequency communication link. The implantable devices of the present invention are typically implanted in a minimally invasive fashion beneath at least one layer of the scalp, above the patient's skull/calvarium, and over one or more target area of the patient's brain. As will be described in more detail below, the implantable devices are typically injected underneath the skin/scalp using an introducer, trocar or syringe-like device using local anesthesia. It is contemplated that such a procedure could be completed in 20 to 30 minutes by a physician or neurologist in an out-patient procedure.
  • [0060]
    The implantable devices are typically used to continuously sample the physiological signals for a desired time period so as to be able to monitor fluctuations of the physiological signal over substantially the entire time period. In alternative embodiments, however, the implantable devices may be used to periodically sample the patient's physiological signals or selectively/aperiodically monitor the patient's physiological signals.
  • [0061]
    The implantable devices may be permanently or temporarily implanted in the patient. If permanently implanted, the devices may be used for as long as the monitoring is desired, and once the monitoring is completed, because the implanted devices are biocompatible they may remain permanently implanted in the patient without any long term detrimental effects for the patient. However, if it is desired to remove the implanted devices, the devices may be explanted from the patient under local anesthesia. For ease of removal, it may be desirable to tether or otherwise attach a plurality of the implantable devices together (e.g., with a suture or leash) so that a minimal number of incisions are needed to explant the implantable devices.
  • [0062]
    Exact positioning of the implanted devices will usually depend on the desired type of monitoring. For patients who are being monitored for epilepsy diagnosis, the suspected type of epilepsy may affect the positioning of the implantable devices. For example, if the patient is thought to have temporal lobe epilepsy, a majority of the implantable devices will likely be located over the patient's temporal lobe. Additionally, if the focus of the seizure is known, it may be desirable to place a plurality of implantable devices directly over the focus. However, if the focus has not been localized, a plurality of implantable devices may be spaced over and around the target area of the patient's brain (and one or more implantable devices contralateral to the target area) in an attempt to locate or lateralize the seizure focus.
  • [0063]
    The number of implantable devices that are implanted in the patient will depend on the number of channels that the physician wants to concurrently monitor in the patient. Typically however, the physician will implant 32 or less, and preferably between about 2 and about 16 implantable devices, and most preferably between about 4 and about 8 implantable devices. Of course, in some instances, it may be desirable to implant more or less, and the present invention is not limited to the aforementioned number of implanted devices.
  • [0064]
    While the remaining discussion focuses on methods of using the systems and devices of the present invention for ambulatory monitoring of EEG signals of patients and patient populations for the diagnosis of epilepsy and/or evaluation of the efficacy and dosing of the patient's AEDs, it should be appreciated that the present invention is not limited to sampling EEG signals for epilepsy or for monitoring the efficacy of AEDs. For example, the implanted devices may be implanted under the skin of the patient's face, within the muscle of the patient's face, within the skull, above the jaw (e.g., sphenoidal implant that is placed under the skin just above the jaw to monitor the brain activity in the temporal lobes), or any other desired place on the patient's body. Furthermore, in addition to or as an alternative to monitoring EEG signals from the patient, it may be desired to monitor other physiological signals from a patient. For example, the system of the present invention may be used to monitor one or more of a blood pressure, blood oxygenation, temperature of the brain or other portion of the patient, blood flow measurements in the brain or other parts of the body, ECG/EKG, heart rate signals and/or change in heart rate signals, respiratory rate signals and/or change in respiratory rate signals, chemical concentrations of medications, pH in the blood or other portions of the body, other vital signs, other physiological or biochemical parameters of the patient's body, or the like.
  • [0065]
    Furthermore, the systems of the present invention may be useful for monitoring and assisting in the analysis of treatments for a variety of other neurological conditions, psychiatric conditions, episodic and non-episodic neurological phenomenon, or other non-neurological and non-psychiatric maladies. For example, the present invention may be useful for patients suffering from sleep apnea and other sleep disorders, migraine headaches, depression, Alzheimer's, Parkinson's Disease, eating disorders, dementia, attention deficit disorder, stroke, cardiac disease, diabetes, cancer, or the like. Likewise, the present invention may also be used to assess the symptoms, efficacy of pharmacological and electrical therapy on such disorders.
  • [0066]
    Referring now to the Figures, FIG. 1A illustrates a simplified system 10 embodied by the present invention. System 10 includes one or more implantable devices 12 that are configured to sample electrical activity from the patient's brain (e.g., EEG signals). The implantable devices may be active (with internal power source), passive (no internal power source), or semi-passive (internal power source to power components, but not to transmit data signal). The implantable devices 12 may be implanted anywhere in the patient, but typically one or more of the devices 12 may be implanted adjacent a previously identified epileptic focus or a portion of the brain where the focus is believed to be located. Alternatively, the devices 12 themselves may be used to help determine the location of the epileptic focus.
  • [0067]
    The physician may implant any desired number of devices in the patient. As noted above, in addition to monitoring brain signals, one or more additional implanted devices 12 may be implanted to measure other physiological signals from the patient.
  • [0068]
    While it may be possible to implant the implantable devices 12 under the skull and in or on the brain, it is preferred to implant the implantable devices 12 in a minimally invasive fashion under at least one layer of the patient's scalp and above the skull. Implantable devices 12 may be implanted between any of the layers of the scalp (sometimes referred to herein as “sub-galeal”). For example, the implantable devices may be positioned between the skin and the connective tissue, between the connective tissue and the epicranial aponeurosis/galea aponeurotica, between the epicranial aponeurosis/galea aponeurotica and the loose aerolar tissue, between the loose aerolar tissue and the pericranium, and/or between the pericranium and the calvarium. In some configurations, it may be useful to implant different implantable devices 12 between different layers of the scalp.
  • [0069]
    Implantable devices 12 will typically be configured to substantially continuously sample the brain activity of the groups of neurons in the immediate vicinity of the implanted device. In some embodiments, if placed below the skull and in contact with the cortical surface of the brain, the electrodes may be sized to be able to sample activity of a single neuron in the immediate vicinity of the electrode (e.g., a microelectrode). Typically, the implantable device 12 will be interrogated and powered by a signal from the external device to facilitate the substantially continuous sampling of the brain activity signals. Sampling of the brain activity is typically carried out at a rate above about 200 Hz, and preferably between about 200 Hz and about 1000 Hz, and most preferably at about 400 Hz, but it could be higher or lower, depending on the specific condition being monitored, the patient, and other factors. Each sample of the patient's brain activity will typically contain between about 8 bits per sample and about 32 bits per sample, and preferably between about 12 bits per sample and about 16 bits per sample. Thus, if each return communication transmission to the external device includes one EEG sample per transmission, and the sample rate is 400 Hz and there are 16 bits/sample, the data transfer rate from the implantable devices 12 to the external device 14 is at least about 6.4 Kbits/second. If there are 32 implantable devices, the total data transfer rate for the system 10 would be about 205 Kbits/second. In alternative embodiments, it may be desirable to have the implantable devices sample the brain activity of the patient in a non-continuous basis. In such embodiments, the implantable devices 12 may be configured to sample the brain activity signals periodically (e.g., once every 10 seconds) or aperiodically.
  • [0070]
    Implantable device 12 may comprise a separate memory module for storing the recorded brain activity signals, a unique identification code for the device, algorithms, other programming, or the like.
  • [0071]
    A patient instrumented with the implanted devices 12 will typically carry a data collection device 14 that is external to the patient's body. The external device 14 would receive and store the signal from the implanted device 12 with the encoded EEG data (or other physiological signals). The external device is typically of a size so as to be portable and carried by the patient in a pocket or bag that is maintained in close proximity to the patient. In alternative embodiments, the device may be configured to be used in a hospital setting and placed alongside a patient's bed. Communication between the data collection device 14 and the implantable device 12 typically takes place through wireless communication. The wireless communication link between implantable device 12 and external device 14 may provide a communication link for transmitting data and/or power. External device 14 may include a control module 16 that communicates with the implanted device through an antenna 18. In the illustrated embodiment, antenna 18 is in the form of a necklace that is in communication range with the implantable devices 12. It should be appreciated however, that the configuration of antenna 18 and control module 16 may be in a variety of other conventional or proprietary forms. For example, in another embodiment control module 16 may be attached around an arm or belt of the patient, integrated into a hat, integrated into a chair or pillow, and/or the antenna may be integrated into control module 16.
  • [0072]
    In order to facilitate the transmission of power and data, the antenna of the external device and the implantable devices must be in communication range of each other. The frequency used for the wireless communication link has a direct bearing on the communication range. Typically, the communication range is between at least one foot, preferably between about one foot and about twenty feet, and more preferably between about six feet and sixteen feet. As can be appreciated, however, the present invention is not limited to such communication ranges, and larger or smaller communication ranges may be used. For example, if an inductive communication link is used, the communication range will be smaller than the aforementioned range.
  • [0073]
    In some situations, it may be desirable, to have a wire running from the patient-worn data collection device 14 to an interface (not shown) that could directly link up to the implanted devices 12 that are positioned below the patient's skin For example, the interface may take the form of a magnetically attached transducer, as with cochlear implants. This could enable power to be continuously delivered to the implanted devices 12 and provide for higher rates of data transmission.
  • [0074]
    In some configurations, system 10 may include one or more intermediate transponder (not shown) that facilitates data transmission and power transmission between implantable device 12 and external device 14. The intermediate transponder may be implanted in the patient or it may be external to the patient. If implanted, the intermediate transponder will typically be implanted between the implantable device 12 and the expected position of the external device 14 (e.g., in the neck, chest, or head). If external, the transponder may be attached to the patient's skin, positioned on the patient's clothing or other body-worn assembly (e.g., eyeglasses, cellular phone, belt, hat, etc.) or in a device that is positioned adjacent the patient (e.g., a pillow, chair headrest, etc.). The intermediate transponder may be configured to only transmit power, only transmit data, or it may be configured to transmit both data and power. By having such intermediate transponders, the external device 14 may be placed outside of its normal communication range from the implanted devices 12 (e.g., on a patient's belt or in a patient's bag), and still be able to substantially continuously receive data from the implantable device 12 and/or transmit power to the implantable device 12.
  • [0075]
    Transmission of data and power between implantable device 12 and external device 14 is typically carried out through a radiofrequency link, but may also be carried out through magnetic induction, electromagnetic link, Bluetooth® link, Zigbee link, sonic link, optical link, other types of wireless links, or combinations thereof.
  • [0076]
    One preferred method 11 of wirelessly transmitting data and power is carried out with a radiofrequency link, similar to the link used with radiofrequency identification (RFID) tags. As illustrated in FIGS. 1A and 1B, in such embodiments, one or more radio frequency signals are emitted from the external device 14 through antenna 18 (step 13). If the external device 14 is in communication range of the implantable devices, at step 15 the radiofrequency (RF) energy signal illuminates the passive, implantable devices 12.
  • [0077]
    At step 17 the same RF signal interrogates the energized implantable device 12 to allow the implantable device to sample the desired physiological signal from the patient (such as an EEG signal). At step 19, the implantable device samples the instantaneous EEG signal (or other physiological signal) from the patient.
  • [0078]
    At step 21, the implantable device 12 then communicates a return RF signal to the external device 14 that is encoded with data that is indicative of the sampled EEG signal. Typically, the return RF signal is a based on the RF signal generated by the external device and includes detectable modifications which indicate the sampled EEG signal. For example, the return signal is typically a backscattering of the RF signal from the external device with the detectable modifications that indicate the sampled EEG signal. Advantageously, such backscattering does not require generation of a separate radiating signal and would not require an internal power source. The return RF signals may also include the identification code of the implanted device so as to identify which device the data is coming from. At step 23, the return RF signal emitted by the internal device 12 is received by the antenna 18, and the RF signal is decoded to extract the sampled EEG signal. The sampled EEG signal may thereafter be stored in a memory of the external device 14. For embodiments in which the method is used to collect data, such data will be stored until accessed by the patient. Typically, such data will be analyzed on a separate device (e.g., physician's computer workstation).
  • [0079]
    In alternative embodiments, however, in which the external device may comprise software to analyze the data in substantially real-time, the received RF signal with the sampled EEG may be analyzed by the EEG analysis algorithms to estimate the patient's brain state which is typically indicative of the patient's propensity for a neurological event (step 25). The neurological event may be a seizure, migraine headache, episode of depression, tremor, or the like. The estimation of the patient's brain state may cause generation of an output (step 27). The output may be in the form of a control signal to activate a therapeutic device (e.g., implanted in the patient, such as a vagus nerve stimulator, deep brain or cortical stimulator, implanted drug pump, etc.). In other embodiments, the output may be used to activate a user interface on the external device to produce an output communication to the patient. For example, the external device may be used to provide a substantially continuous output or periodic output communication to the patient that indicates their brain state and/or propensity for the neurological event. Such a communication could allow the patient to manually initiate therapy (e.g., wave wand over implanted vagus nerve stimulator, cortical, or deep brain stimulator, take a fast acting AED, etc.) or to make themselves safe.
  • [0080]
    In preferred embodiments, the return RF signal is transmitted (e.g., backscattered) immediately after sampling of the EEG signal to allow for substantially real-time transfer (and analysis) of the patient's EEG signals. In alternate embodiments, however, the return RF signal may be buffered in an internal memory and the communication transmission to the external device 14 may be delayed by any desired time period and may include the buffered EEG signal and/or a real-time sampled EEG signal. The return RF signal may use the same frequency as the illumination RF signal or it may be a different frequency as the illumination RF signal.
  • [0081]
    Unlike conventional digital implantable devices that send large packets of stored data with each return RF communication transmission, some embodiment of the methods and devices of the present invention substantially continuously sample physiological signals from the patient and communicate in real-time small amounts of data during each return RF signal communication. Because only small amounts of data (one or a small number of sampled EEG signals from each implantable device 12) are transmitted during each communication, a lower amount of power is consumed and the illumination of the implanted device from the incoming high-frequency RF signal will be sufficient to power the implantable device 12 for a time that is sufficient to allow for sampling of the patient's EEG signal. Consequently, in most embodiments no internal power source, such as a battery, is needed in the implantable device 12—which further reduces the package size of the implantable device 12.
  • [0082]
    The implantable devices 12 and the external devices 14 of the present invention typically use an electromagnetic field/high frequency communication link to both illuminate the implantable device and enable the high data transfer rates of the present invention. Conventional devices typically have an internally powered implantable device and use a slower communication link (e.g., that is designed for long link access delays) and transmit data out on a non-continuous basis. In contrast, some embodiments of the present invention uses a fast access communication link that transmits a smaller bursts of data (e.g., single or small number of EEG sample at a time) on a substantially continuous basis.
  • [0083]
    The frequencies used to illuminate and transfer data between the implantable devices 12 and external device are typically between 13.56 MHz and 10 GHz, preferably between 402 MHz and 2.4 GHz, more preferably between 900 MHz and 2.4 GHz. While it is possible to use frequencies above 2.4 GHz, Applicants have found that it is preferred to use a frequency below 2.4 GHz in order to limit attenuation effects caused by tissue. As can be appreciated, while the aforementioned frequencies are the preferred frequencies, the present invention is not limited to such frequencies and other frequencies that are higher and lower may also be used. For example, it may be desirable us use the MICS (Medical Implant Communication Service band) that is between 402-405 MHz to facilitate the communication link. In Europe, it may be desirable to use ETSI RFID allocation 869.4-869.65 MHz.
  • [0084]
    While not illustrated in FIG. 1B, the system 10 of the present invention may also make use of conventional or proprietary forward error correction (“FEC”) methods to control errors and ensure the integrity of the data transmitted from the implantable device 12 to the external device 14. Such forward error correction methods may include such conventional implementations such as cyclic redundancy check (“CRC”), checksums, or the like.
  • [0085]
    If desired, the data signals that are wirelessly transmitted from implantable device 12 may be encrypted prior to transmission to the control module 16. Alternatively, the data signals may be transmitted to the control module 16 as unencrypted data, and at some point prior to the storage of the data signals in the control module 16 or prior to transfer of the data signals to the physician's office, the EEG data may be encrypted so as to help ensure the privacy of the patient data.
  • [0086]
    FIGS. 3A and 3B illustrate two embodiments of the externally powered leadless, implantable device 12 that may be used with the system 10 of the present invention. The implantable devices 12 of the present invention are preferably passive or semi-passive and are “slaves” to the “master” external device 14. The implantable devices will typically remain dormant until they are interrogated and possibly energized by an appropriate RF signal from the external device 14. As will be described below, the implantable device 14 may have minimal electronic components and computing power, so as to enable a small package size for the implantable device.
  • [0087]
    Advantageously, the embodiment illustrated in FIGS. 3A and 3B are minimally invasive and may be implanted with an introducer, trocar or syringe-like device under local anesthesia by a physician or potentially even a physician's assistant. Typically, the implanted device of FIG. 3A may have a longitudinal dimension 20 of less than about 3 cm, and preferably between about 1 cm and about 10 cm, and a lateral dimension 22 of less than about 2 mm, and preferably between about 0.5 mm and about 10 mm. As can be appreciated, such dimensions are merely illustrative, and other embodiments of implanted device may have larger or smaller dimensions.
  • [0088]
    FIG. 3A illustrates an embodiment that comprises a first electrode 24 and a second electrode 26 that are disposed on opposing ends of housing 28. The first and second electrodes 24, 26 may be composed of platinum, platinum-iridium alloy, stainless steel, or any other conventional material. The electrodes may include a coating or surface treatment such as platinum-iridium or platinum-black in order to reduce electrical impedance. The first and second electrodes 24, 26 will typically have a smooth or rounded shape in order to reduce tissue erosion and may have a surface area of about 3 mm2, but other embodiments may be smaller or larger. Since electrodes 24, 26 are typically adapted to only sense physiological signals and are not used to deliver stimulation, the surface area of the electrodes may be smaller than conventional implantable devices. The smaller electrodes have the advantage of reducing the overall device size which can be beneficial for improving patient comfort and reducing the risk of tissue erosion.
  • [0089]
    Housing 28 is typically in the form of a radially symmetrical, substantially cylindrical body that hermetically seals electronic components 30 disposed within a cavity 32. Housing 28 may be composed of a biocompatible material, such as glass, ceramic, liquid crystal polymer, or other materials that are inert and biocompatible to the human body and able to hermetically seal electronic components. Housing 28 may have embedded within or disposed thereon one or more x-ray visible markers 33 that allow for x-ray localization of the implantable device. Alternatively, one or more x-ray visible markers may be disposed within the cavity 32. Cavity 32 may be filled with an inert gas or liquid, such as an inert helium nitrogen mixture which may also be used to facilitate package leakage testing. Alternatively, it may be desirable to fill the cavity 32 with a liquid encapsulant (not shown) that hardens around the electronic components. The liquid encapsulant may comprise silicone, urethane, or other similar materials.
  • [0090]
    While housing 28 is illustrated as a substantially cylindrical body with the electrodes 24, 26 on opposing ends, housing may take any desired shape and the electrodes may be positioned at any position/orientation on the housing 28. For example, housing 28 may taper in one direction, be substantially spherical, substantially oval, substantially flat, or the like. Additionally or alternatively, the body may have one or more substantially planar surfaces so as to enhance the conformity to the patient's skull and to prevent rotation of the implantable device 12. While not shown, housing 28 may optionally include a conductive electromagnetic interference shield (EMI) that is configured to shield the electronic components 30 in housing 28. The EMI shield may be disposed on an inner surface of the housing, outer surface of the housing, or impregnated within the housing.
  • [0091]
    If desired, housing 28 may optionally comprise an anchoring assembly (not shown) that improves the anchoring of the implantable device 12 to the skull or the layers within the scalp. Such anchoring may be carried out with adhesive, spikes, barbs, protuberances, suture holes, sutures, screws or the like.
  • [0092]
    In the illustrated embodiment, first electrode 24 is disposed on a first end of housing 28 and is in electrical communication with the electronic components 30 through a hermetic feedthrough 34. Feedthrough 34 may be the same material as the first electrode 24 or it may be composed of a material that has a similar coefficient of thermal expansion as the housing 28 and/or the first electrode 24. Feedthrough 34 may make direct contact with a pad (not shown) on a printed circuit board 36, or any other type of conventional connection may be used (e.g., solder ball, bond wire, wire lead, or the like) to make an electrical connection to the printed circuit board 36.
  • [0093]
    Second electrode 26 may be spaced from a second, opposing end of the housing 28 via an elongated coil member 38. In the illustrated embodiment, the second electrode 26 typically comprises a protuberance 39 that is disposed within and attached to a distal end of the coil member 38. Coil member 38 acts as an electrical connection between second electrode and the electronic components 30 disposed within housing 28.
  • [0094]
    Coil member 38 will typically be composed of stainless steel, a high strength alloy such as MP35N, or a combination of materials such as a MP35N outer layer with silver core.
  • [0095]
    The illustrated embodiment shows that coil member 38 has a largest lateral dimension (e.g., diameter) that is less than the largest lateral dimension (e.g., diameter) of housing 28, but in other embodiments, the coil may have the same lateral dimension or larger lateral dimension from housing 28.
  • [0096]
    Coil member 38 may also be used as an antenna to facilitate the wireless transmission of power and data between the implantable device 12 and the external device 14 (or other device). In preferred embodiments, coil member 38 may be used to receive and transmit radiofrequency signals. In alternative embodiments, however, coil member 38 may be inductively coupled to an external coil to receive energy from a modulating, alternating magnetic field. Unlike other conventional implantable devices, the RF antenna is disposed outside of the housing 28 and extends from one end of housing 28. It should be appreciated however, that the present invention is not limited to a substantially cylindrical antenna extending from an end of the housing 28 and various other configurations are possible. For example, it may be desirable to wind the antenna around or within the housing 28. Furthermore, it may be desirable to use a substantially flat antenna (similar to RFID tags) to facilitate the transmission of power and data. To facilitate implantation, such antennas may be rolled into a cylindrical shape and biased to take the flat shape upon release from the introducer.
  • [0097]
    While not shown, it may also be desirable to provide a second antenna between the first electrode 24 and the housing 28. The second antenna may be used for power and downlink using a first frequency, e.g., 13.56 MHz, while the first antenna may be used for uplink using a second frequency, e.g., 902-928 MHz. In such embodiments, however, the implantable devices would need to have an internal timebase (e.g., oscillator and a frequency synthesizer). For the embodiments that use only a single frequency for the downlink and uplink, an internal timebase or frequency synthesizer is not needed—and the timebase established by the master (e.g., external device 14) can be used.
  • [0098]
    Coil member 38 may be in electrical communication with the electronic components 30 with a hermetic feedthrough 42 that extends through a via 44 in housing 28. Feedthrough 42 is typically composed of a material that has a coefficient of thermal expansion that is substantially similar to the material of housing 40. Because the coil member 38 is outside of the housing 28 the length of the implantable device 12 will be increased, but the flexible coil will be better exposed to the RF signals and will be allowed to conform to the shape of the patient's skull.
  • [0099]
    Coil member 38 is typically disposed outside of the housing 28 and disposed within an elongate, substantially flexible housing 40. Compared to the more rigid housing 28, the flexible housing 40 is better able to conform to the shape of an outer surface of the patient's skull, more comfortable for the patient and reduces the chance of tissue erosion. Flexible housing 40 may comprise silicone, polyurethane, or the like In the illustrated embodiment, flexible housing 40 extends along the entire length of coil member 38, but in other embodiments, flexible housing 40 may extend less than or longer than the longitudinal length of coil member 38. Flexible housing 40 will typically have a substantially cylindrical shape, but if desired a proximal end 46 of the cylindrical housing may be enlarged or otherwise shaped to substantially conform to a shape of the housing 28. The shaped proximal end 46 may be adhered or otherwise attached to the end of the housing 40 to improve the hermetic seal of the housing and may reduce any potential sharp edge or transition between the housings 28, 40. While FIG. 3A only illustrates a single layered flexible housing, if desired, the flexible housing 40 may comprise a plurality of layers, and the different layers may comprise different types of materials, have embedded x-ray markers, or the like.
  • [0100]
    A longitudinal length of flexible housing 40 and the longitudinal length of the rigid housing 28 may vary depending on the specific embodiment, but a ratio of the longitudinal length of the flexible housing 40: the longitudinal length of the more rigid housing 28 is typically between about 0.5:1 and about 3:1, and preferably between about 1:1 and about 2:1. By having the longitudinal length of the flexible housing longer than the longitudinal length of the rigid housing, advantageously the implantable device will be more comfortable and better able to conform to the outer surface of the patient's skull. In alternative embodiments, it may also be desirable to have a longitudinal length of the rigid housing 28 be longer than the longitudinal length of the flexible housing 40, or in any other desired configuration.
  • [0101]
    Because the implantable devices 12 of the present invention consume a minimal amount of energy and use a high frequency RF coupling to power the device and communicate the EEG signals to the external device, unlike other conventional devices, some of the implantable devices 12 of the present invention will not need a ferrite core to store energy, and the electronic components 30 of the present invention will typically include aluminum or other MRI-safe material. Consequently, the patient's implanted with the implantable device 12 may safely undergo MRI imaging.
  • [0102]
    FIG. 3B illustrates another embodiment of implantable device 12 that is encompassed by the present invention. The embodiment of FIG. 3B shares many of the same components as the embodiment of FIG. 3A, and such components are noted with the same reference numbers as FIG. 3A. There are, however, a few notable exceptions. Specifically, instead of having a hermetically sealed housing, the embodiment of FIG. 3B provides a conductive body 48 that acts as both the housing for the electronic components 30 and as the second electrode. Conductive body 48 may be composed of a metallized polymer, one or more metal or metal alloys, or other conductive material. Because body 48 is conductive, it may act as an electromagnetic interference (EMI) shield to the electronic components disposed within the cavity 32. Electrical connections to the printed circuit board 36 may be carried out with one or more conductive spring conductors 50 or other conventional lead connectors.
  • [0103]
    Feedthrough 42 that is connected to the coil member 38 extends from the end of coil member 38 and makes an electrical connection with a lead on the printed circuit board 36. The feedthrough 42 works in conjunction with one or more dielectric seals or spacers 52 to hermetically seal the cavity 32. Similar to above, the cavity 32 may be filled with an inert gas or an encapsulant. The proximal end 46 of flexible body 40 may be coupled to the seals 52 and/or coupled to the conductive body 48.
  • [0104]
    As shown in the embodiment of FIG. 3B, the surface area of conductive body 48 (e.g., the first electrode) may be larger than the surface area of the second electrode 26. In other embodiments, however, the surface area of the second electrode 26 may have the substantially same surface area and/or shape as the conductive body 48.
  • [0105]
    In most embodiments, the implantable devices shown in FIGS. 3A and 3B function completely independent of the other implantable devices 12 and there is no physical connection or communication between the various devices. If desired, however, the implantable devices 12 may be physically coupled to each other with a connecting wire or tether and/or in communication with each other. If the plurality of implanted devices 12 are in communication with one another, it may be desired to use a communication frequency between the implanted devices 12 that is different from the frequency to communicate between the implanted devices and the external device 14. Of course, the communication frequency between the implanted devices 12 may also be the same frequency as the communication frequency with the external device 14.
  • [0106]
    While FIGS. 3A and 3B illustrate a first and second electrode 24, 26, the implantable devices 12 of the present invention are not limited to only two electrodes. Any number of electrodes may be coupled to the implantable device in any orientation. For example, the electrodes do not have to extend from ends of the housing, but may be positioned anywhere along a portion of the housings 28, 40. Furthermore, a plurality of electrodes and their leads may be disposed along the length of the flexible housing 40 and/or rigid housing 28 so as to provide more than two electrodes per implantable device. For example, FIG. 3C illustrates a simplified embodiment in which there are two additional electrode 24′, 26′ positioned on the rigid housing 28 and flexible housing 40, respectively. The spacing between the various contacts 24, 24′, 26, 26′ may vary or be the same distance between each other. The spacing between electrodes will likely depend on the overall length of the implantable device, but will typically be between about 2 mm and about 20 mm and preferably be between about 5 mm and about 10 mm. In addition to the embodiment shown in FIG. 3C, it may be desirable to have the additional electrodes only on the flexible housing 40 or only on the rigid housing 28. While only four electrodes are shown on the implanted device, it should be appreciated that any desirable number of electrodes (e.g., anywhere between two electrodes and about sixteen electrodes) may coupled to the implanted device.
  • [0107]
    While FIGS. 3A-3B illustrate some currently preferred embodiments of the implantable device 12, the present invention further encompasses other types of minimally invasive implantable devices 12 that can monitor the brain activity and other physiological signals from the patient. For example, a plurality of electrodes might reside on a single lead that could be tunneled under the scalp from a single point of entry. Examples of such embodiments are shown in FIGS. 2A-2E.
  • [0108]
    Such implantable devices 12 include an active electrode contact 400 that is in communication with one or more passive electrode contacts 401. The active electrode contact 400 may be used to facilitate monitoring of the physiological signals using the array of active and passive electrode contacts. The arrays of electrode contacts may be arranged in a linear orientation (FIG. 2C) or in a grid pattern (FIG. 2E), or any other desired pattern (e.g., circular, star pattern, customized asymmetric pattern, etc.) For example, if the implantable device comprises two electrode contacts (e.g., one active contact and one passive contact), such an embodiment would have a similar configuration as the embodiment of FIG. 3A. Similarly, if the implantable device were to have four substantially linearly positioned electrode contacts (e.g., one active contact and three passive contacts), such an embodiment would be substantially similar to the configuration shown in FIG. 3C.
  • [0109]
    FIG. 2A illustrates a bottom view of an active electrode contact 400 that may be part of the implantable device 12 of the present invention. The active electrode contact comprises a base 402 that is coupled to a contact portion 404. The base 402 and contact portion may be composed of any number of different types of materials, such as platinum, platinum-iridium alloy, stainless steel, or any other conventional material. In preferred embodiments, both the base 402 and contact portion 404 are formed to their desired shape. The base 402 may comprise a plurality of hermetic feedthroughs 413 that is implemented using conventional glass metal seal technology (e.g., pins 408, glass seal 414, and vias 406). The hermetic feedthroughs 413 may be used to connect to an antenna (not shown) for communication with the external device 14 or to make an electrical connection with an adjacent passive electrode contact 401 in the implanted device 12. In the illustrated embodiment, base 402 comprises four hermetic feedthroughs 413. But as can be appreciated the base 402 may comprise any desired number of feedthroughs 413 (e.g., anywhere between two and sixty four feedthroughs).
  • [0110]
    FIG. 2B illustrates a cross-sectional view of the active electrode contact 400 along lines B-B in FIG. 2A. As shown in FIG. 2B, the contact portion 404 is shaped to as to align the base 402 along a bottom surface defined by flanges 409. Base 402 may be coupled to the contact portion 404 with a laser weld, glass metal seal, or other conventional connector 410 along an outer perimeter of the base 402 to hermetically seal components of the active electrode contact within a cavity 412 defined by the base 402 and contact portion 404. If desired, the cavity 412 may be backfilled with nitrogen and/or helium to facilitate package leak testing.
  • [0111]
    A thin or thick filmed microcircuit or a printed circuit board (“PCB”) 416 may be mounted onto an inner surface of the base 402. PCB 416 may have active components 418 (e.g., integrated circuits, ASIC, memory, etc.) and passive components 420 (e.g., resistors, capacitors, etc.) mounted thereto. Leads or bond wires 422 from the active and passive components may be electrically attached to pads on the PCB (not shown) which make electrical connections to leads or bond wires 424 that are attached to the hermetic feedthroughs 413. While not shown in FIG. 2B, the active electrode contact 400 may comprise a rechargeable or non-rechargeable power supply (e.g., batteries), and/or x-ray visible markers (not shown).
  • [0112]
    As noted above, the active contacts may be used in conjunction with one or more passive contacts to form an active implantable device 12 to facilitate monitoring of the patient's physiological signals and to communicate with the external device 14. FIGS. 2C and 2D illustrate an embodiment of the implantable device 12 in which one active contact 400 is housed in a body 426 along with a plurality of passive contacts 401 to form a multiple contact implantable device 12. The contact portion of the active contact 400 is exposed through an opening in the body 426 to allow for sampling of the physiological signals (e.g., EEG) from the patient. The body 426 may be substantially flexible or rigid and may have similar dimensions and/or shapes as the embodiments shown in FIGS. 3A-3C. Body 426 may be composed of a biocompatible material such as silicone, polyurethane, or other materials that are inert and biocompatible to the human body. Body 426 may also be composed of a rigid material such as polycarbonate. The implantable device may be injected into the patient using the introducer assembly shown in FIG. 6 and methods shown in FIG. 7.
  • [0113]
    As shown in FIG. 2D wire leads 427 may extend from the passive contacts 401 and be electrically and physically coupled to one of the hermetic feedthroughs 413 of the active contact 400 to facilitate sampling of the physiological signals using all four electrode contacts. For embodiments which use a wireless link (e.g., RF) to wirelessly transmit data to the external device 14 and optionally to power the device, one of the feedthroughs may be coupled to an antenna 428 that is configured to wirelessly communicate with the external device. It should be appreciated, that while not described herein, the embodiments of FIGS. 2C-2E may have any of the components or variations as described above in relation to FIGS. 3A-3B.
  • [0114]
    FIG. 2E illustrates an alternative embodiment of the implantable device 12 in which the implantable device 12 is in the form of a 4×4 grid array of active and passive contacts. At least one of the electrode contacts may be an active contact 400 so as to facilitate monitoring of the patient's physiological signals with the array. In the illustrated embodiment, the contacts in the leftmost column (highlighted with cross-hatching) are active electrode contacts 400, and the contacts in remaining column are electrically connected to one of the active contacts 400. Of course, any number of active contacts 400 and passive contacts 401 may be in the grid array and the active contact(s) 400 may be positioned anywhere desired. For example, if the active electrode contact 400 has sixteen or more hermetic feedthroughs, only one of the contacts in the array needs to be active and the remaining fifteen contacts could be passive contacts.
  • [0115]
    FIG. 4 illustrates one simplified embodiment of the electronic components 30 (e.g., active components 418 and passive components 420 in FIG. 2B) that may be disposed in the implantable devices 12 as shown in FIGS. 2A-3C. It should be appreciated, however, that the electronic components 30 of the implantable device 12 may include any combination of conventional hardware, software and/or firmware to carry out the functionality described herein. For example, the electronic components 30 may include many of the components that are used in passive RF integrated circuits.
  • [0116]
    The first and second electrodes will be used to sample a physiological signal from the patient—typically an EEG signal 53, and transmit the sampled signal to the electronic components 30. While it may be possible to record and transmit the analog EEG signal to the external device, the analog EEG signal will typically undergo processing before transmission to the external device 14. The electronic components typically include a printed circuit board that has, among others, an amplifier 54, one or more filters 56 (e.g., bandpass, notch, lowpass, and/or highpass) and an analog-to-digital converter 58. In some embodiments, the processed EEG signals may be sent to a transmit/receive sub-system 60 for wireless transmission to the external device via an antenna (e.g., coil member 38). Additional electronic components that might be useful in implantable device 12 may be found in U.S. Pat. Nos. 5,193,539, 5,193,540, 5,312,439, 5,324,316, 5,405,367 and 6,051,017.
  • [0117]
    In some alternative embodiments of the present invention, the electronic components 30 may include a memory 64 (e.g., RAM, EEPROM, Flash, etc.) for permanently or temporarily storing or buffering the processed EEG signal. For example, memory 64 may be used as a buffer to temporarily store the processed EEG signal if there are problems with transmitting the data to the external device. For example, if the external device's power supply is low, the memory in the external device is removed, or if the external device is out of communication range with the implantable device, the EEG signals may be temporarily buffered in memory 64 and the buffered EEG signals and the current sampled EEG signals may be transmitted to the external device when the problem has been corrected. If there are problems with the transmission of the data from the implantable device, the external device may be configured to provide a warning or other output signal to the patient to inform them to correct the problem. Upon correction of the problems, the implantable device may automatically continue the transfer the temporarily buffered data and the real-time EEG data to the memory in the external device.
  • [0118]
    The electronic components 30 may optionally comprise dedicated circuitry and/or a microprocessor 62 (referred to herein collectively as “microprocessor”) for further processing of the EEG signals prior to transmission to the external device. The microprocessor 62 may execute EEG analysis software, such as a seizure prediction algorithm, a seizure detection algorithm, safety algorithm, or portions of such algorithms, or portions thereof. For example, in some configurations, the microprocessor may run one or more feature extractors that extract features from the EEG signal that are relevant to the purpose of monitoring. Thus, if the system is being used for diagnosing or monitoring epileptic patients, the extracted features (either alone or in combination with other features) may be indicative or predictive of a seizure. Once the feature(s) are extracted, the microprocessor 62 may send the extracted feature(s) to the transmit/receive sub-system 60 for the wireless transmission to the external device and/or store the extracted feature(s) in memory 64. Because the transmission of the extracted features is likely to include less data than the EEG signal itself, such a configuration will likely reduce the bandwidth requirements for the communication link between the implantable device and the external device. Since the extracted features do not add a large amount of data to the data signal, in some embodiments, it may also be desirable to concurrently transmit both the extracted feature and the EEG signal. A detailed discussion of various embodiments of the internal/external placement of such algorithms are described in commonly owned U.S. patent application Ser. No. 11/322,150, filed Dec. 28, 2005 to Bland et al., Publication No. 2007/0149952 published Jun. 28, 2007, the complete disclosure of which is incorporated herein by reference.
  • [0119]
    While most embodiments of the implantable device 12 are passive and does not need an internal power source or internal clock, in some embodiments, the electronic components 30 may include a rechargeable or non-rechargeable power supply 66 and an internal clock (not shown). The rechargeable or non-rechargeable power supply may be a battery, a capacitor, or the like. The rechargeable power supply 66 may also be in communication with the transmit/receive sub-system 60 so as to receive power from outside the body by inductive coupling, radiofrequency (RF) coupling, etc. Power supply 66 will generally be used to provide power to the other components of the implantable device. In such embodiments, the implanted device may generate and transmit its own signal with the sampled EEG signal for transmission back to the external device. Consequently, as used herein “transmit” includes both passive transmission of a signal back to the external device (e.g., backscattering of the RF signal) and internal generation of a separate signal for transmission back to the external device.
  • [0120]
    FIG. 5 is a simplified illustration of some of the components that may be included in external device 14. Antenna 18 and a transmit/receive subsystem 70 will receive a data signal that is encoded with the EEG data (or other physiological data) from the antenna 38 of the implantable device 12 (FIG. 4). As used herein, “EEG data” may include a raw EEG signal, a processed EEG signal, extracted features from the EEG signal, an answer from an implanted EEG analysis software (e.g., safety, prediction and/or detection algorithm), or any combination thereof.
  • [0121]
    The EEG data may thereafter be stored in memory 72, such as a hard drive, RAM, permanent or removable Flash Memory, or the like and/or processed by a microprocessor 74 or other dedicated circuitry. Microprocessor 74 may be configured to request that the implantable device perform an impedance check between the first and second electrodes and/or other calibrations prior to EEG recording and/or during predetermined times during the recording period to ensure the proper function of the system.
  • [0122]
    The EEG data may be transmitted from memory 72 to microprocessor 74 where the data may optionally undergo additional processing. For example, if the EEG data is encrypted, it may be decrypted. The microprocessor 74 may also comprise one or more filters that filter out high-frequency artifacts (e.g., muscle movement artifacts, eye-blink artifacts, chewing, etc.) so as to prevent contamination of the high frequency components of the sampled EEG signals. In some embodiments, the microprocessor may process the EEG data to measure the patient's brain state, detect seizures, predict the onset of a future seizure, generate metrics/measurements of seizure activity, or the like. A more complete description of seizure detection algorithms, seizure prediction algorithms, and related components that may be implemented in the external device 14 may be found in pending, commonly owned U.S. patent application Ser. Nos. 11/321,897 (2007/0150024, published Jun. 28, 2007) and 11/321,898, (2007/0150025, published Jun. 28, 2007) filed on Dec. 28, 2005, to Leyde et al. and DiLorenzo et al., and 60/897,551, filed on Jan. 25, 2007, to Leyde et al., the complete disclosures of which are incorporated herein by reference.
  • [0123]
    It should be appreciated, however, that in some embodiments some or all of the computing power of the system of the present invention may be performed in a computer system or workstation 76 that is separate from the system 10, and the external device 14 may simply be used as a data collection device. In such embodiments, the personal computer 76 may be located at the physician's office or at the patient's home and the EEG data stored in memory 72 may be uploaded to the personal computer 76 via a USB interface 78, removal of the memory (e.g., Flash Memory stick), or other conventional communication protocols, and minimal processing may be performed in the external device 14. In such embodiments, the personal computer 76 may contain the filters, decryption algorithm, EEG analysis software, such as a prediction algorithm and/or detection algorithm, report generation software, or the like. Some embodiments of the present invention may take advantage of a web-based data monitoring/data transfer system, such as those described in U.S. Pat. Nos. 6,471,645 and 6,824,512, the complete disclosures of which are incorporated herein by reference.
  • [0124]
    External device 14 may also comprise an RF signal generator 75 that is configured to generate the RF field for interrogating and optionally powering the implanted devices 12. RF generator 75 will be under control of the microprocessor 74 and generate the appropriate RF field to facilitate monitoring and transmission of the sampled EEG signals to the external device.
  • [0125]
    External device 14 will typically include a user interface 80 for displaying outputs to the patient and for receiving inputs from the patient. The user interface typically comprise outputs such as auditory devices (e.g., speakers) visual devices (e.g., LCD display, LEDs to indicate brain state or propensity to seizure), tactile devices (e.g., vibratory mechanisms), or the like, and inputs, such as a plurality of buttons, a touch screen, and/or a scroll wheel.
  • [0126]
    The user interface may be adapted to allow the patient to indicate and record certain events. For example, the patient may indicate that medication has been taken, the dosage, the type of medication, meal intake, sleep, drowsiness, occurrence of an aura, occurrence of a seizure, or the like. Such inputs may be used in conjunction with the recorded EEG data to improve the analysis of the patient's condition and determine the efficacy of the medications taken by the patient.
  • [0127]
    The LCD display of the user interface 80 may be used to output a variety of different communications to the patient including, status of the device (e.g., memory capacity remaining), battery state of one or more components of system, whether or not the external device 14 is within communication range of the implantable devices 12, brain state indicators (e.g., a warning (e.g., seizure warning), a prediction (e.g., seizure prediction), unknown brain state, safety indication, a recommendation (e.g., “take drugs”), or the like). Of course, it may be desirable to provide an audio output or vibratory output to the patient in addition to or as an alternative to the visual display on the LCD. In other embodiments, the brain state indicators may be separate from the LCD display to as to provide a clear separation between the device status outputs and the brain state indicators. In such embodiments, the external device may comprise different colored LEDs to indicate different brain states. For example, a green LED may indicate a safe brain state, a yellow light may indicate an unknown brain state, and a red light may indicate either a seizure detection or seizure prediction.
  • [0128]
    External device may also include a medical grade power source 82 or other conventional power supply that is in communication with at least one other component of external device 14. The power source 82 may be rechargeable. If the power source 80 is rechargeable, the power source may optionally have an interface for communication with a charger 84. While not shown in FIG. 5, external device 14 will typically comprise a clock circuit (e.g., oscillator and frequency synthesizer) to provide the time base for synchronizing external device 14 and the internal device(s) 12. In preferred embodiments, the internal device(s) 12 are slaves to the external device and the implantable devices 12 will not have to have an individual oscillator and a frequency synthesizer, and the implantable device(s) 12 will use the “master” clock as its time base. Consequently, it may be possible to further reduce the size of the implantable devices.
  • [0129]
    In use, one or more of the implantable devices are implanted in the patient. The implanted device is interrogated and powered so that the EEG signals are sampled from the patient's brain. The EEG signals are processed by the implanted device and the processed EEG signals are wirelessly transmitted from the implanted device(s) to an external device. The EEG signals are stored for future or substantially real-time analysis.
  • [0130]
    As noted above, in preferred embodiments, the implantable devices are implanted in a minimally invasive fashion under the patient's scalp and above an outer surface of the skull. FIG. 6 illustrates a simplified introducer assembly 90 that may be used to introduce the implantable devices into the patient. The introducer assembly 90 is typically in the form of a cannula and stylet or a syringe-like device that can access the target area and inject the implanted device under the skin of the patient. As noted above, the implantable devices 12 are preferably implanted beneath at least one layer of the patient's scalp and above the patient's skull. Because of the small size of the implantable devices 12, the devices may be injected into the patient under local anesthesia in an out-patient procedure by the physician or neurologist. Because the implantable devices are implanted entirely beneath the skin infection risk would be reduced and there would be minimal cosmetic implications. Due to the small size of the implantable devices 12, it may be desirable to have a plurality of implantable devices pre-loaded into a sterile introducer assembly 90 or into a sterile cartridge (not shown) so as to minimize the risk of contamination of the implantable devices 12 prior to implantation.
  • [0131]
    FIG. 7 schematically illustrates one example of a minimally invasive method 100 of implanting the implantable devices for ambulatory monitoring of a patient's EEG signals. At step 102, an incision is made in the patient's scalp. At step 104, an introducer assembly is inserted into the incision and a distal tip of the introducer assembly is positioned at or near the target site. Of course, the introducer assembly itself may be used to create the incision. For example, if the introducer assembly is in the form of a syringe, the syringe tip may be made to create the incision and steps 102 and 104 may be consolidated into a single step. At step 106, the introducer assembly is actuated to inject the implantable device 12 to the target site. If desired, the introducer may be repositioned to additional target sites underneath the patient's skin and above the skull. If needed, additional incisions may be created in the patient's skin to allow for injection of the implantable device 12 at the additional target sites. After a desired number of implantable devices are placed in the patient, at step 108 the introducer assembly is removed from the target site. At step 110, the implantable devices are activated and used to perform long term monitoring of the patient's EEG signals from each of the target sites. At step 112, the sampled EEG signals are then wirelessly transmitted to an external device. At step 114, the sampled EEG signals may then be stored in a memory in the external device or in another device (e.g., personal computer). If desired, the EEG signals may then be processed in the external device or in a personal computer of the physician.
  • [0132]
    While not shown in FIG. 7, it may also be desirable to anchor the implantable devices to the patient to reduce the likelihood that the implantable devices are dislodged from their desired position. Anchoring may be performed with tissue adhesive, barbs or other protrusions, sutures, or the like.
  • [0133]
    Advantageously, the implantable devices are able to monitor EEG signals from the patient without the use of burr holes in the skull or implantation within the brain—which significantly reduces the risk of infection for the patient and makes the implantation process easier. While there is some attenuation of the EEG signals and movement artifacts in the signals, because the implantable devices are below the skin, it is believed that there will be much lower impedance than scalp electrodes. Furthermore, having a compact implantable device 14 below the skin reduces common-mode interference signals which can cause a differential signal to appear due to any imbalance in electrode impedance and the skin provides some protection from interference caused by stray electric charges (static).
  • [0134]
    While FIG. 7 illustrates one preferred method of implanting the implantable devices in the patient and using the implantable devices to monitor the patient's EEG, the present invention is not limited to such a method, and a variety of other non-invasive and invasive implantation and monitoring methods may be used. For example, while minimally invasive monitoring is the preferred method, the systems and devices of the present invention are equally applicable to more invasive monitoring. Thus, if it is desired to monitor and record intracranial EEG signals (e.g., ECoG), then it may be possible to implant one or more of the implantable devices inside the patient's skull (e.g., in the brain, above or below the dura mater, or a combination thereof) through a burr hole created in the patient's skull.
  • [0135]
    Once implanted in the patient, the monitoring systems 10 of the present invention may be used for a variety of different uses. For example, in one usage the systems of the present invention may be used to diagnose whether or not the patient has epilepsy. Patients are often admitted to video-EEG monitoring sessions in an EMU to determine if the patient is having seizures, pseudo-seizures, or is suffering from vaso-vagal syncope, and the like. Unfortunately, if the patient has infrequent “seizures,” it is unlikely that the short term stay in the EMU will record a patient's seizure and the patient's diagnose will still be unclear. Consequently, in order to improve the patient's diagnosis, in addition to the in-hospital video-EEG monitoring or as an alternative to the in-hospital video-EEG monitoring, the patient may undergo an ambulatory, long term monitoring of the patient's EEG using the system of the present invention for a desired time period. The time period may be one day or more, a week or more, one month or more, two months or more, three months or more, six months or more, one year or more, or any other desired time period in between. The patient may be implanted with the system 10 using the method described above, and after a predetermined time period, the patient may return to the physician's office where the EEG data will be uploaded to the physician's personal computer for analysis. A conventional or proprietary seizure detection algorithm may be applied to the EEG data to determine whether or not a seizure occurred in the monitoring time period. If it is determined that one or more seizures occurred during the monitoring period, the seizure detection algorithm may be used to provide an output to the physician (and/or generate a report for the patient) indicating the occurrence of one or more seizures, and various seizure activity metrics, such as spike count over a period of time, seizure count over a period of time, average seizure duration over a period of time, the pattern of seizure occurrence over time, and other seizure and seizure related metrics. In addition, the software may be used to display the actual EEG signals from specific events or selected events for physician confirmation of seizure activity. Such data may be used as a “baseline” for the patient when used in assessing efficacy of AEDs or other therapies that the patient will undergo.
  • [0136]
    If the patient has been diagnosed with epilepsy (either using the system of the present invention or through conventional diagnosis methods), the present invention may also be used to determine the epilepsy classification and/or seizure type. To perform such methods, a desired number of implantable devices may be implanted in the patient for the long term monitoring of the patient's pattern of electrical activity in the different portions of the patient's brain. Such monitoring will be able to provide insight on whether or not the patient has partial/focal seizures or generalized seizures. In the event that the patient's epilepsy classification is already known, the classification may determine the desired placement for the implantable devices in the patient. For patients suspected or known to have temporal lobe epilepsy, the implantable devices will likely be focused over the temporal lobe and adjacent and/or over the regions of epileptiform activity. Likewise, for patient's suspected or known to have parietal lobe epilepsy, some or all of the implantable devices will be positioned over the parietal lobe and adjacent and/or over the regions of epileptiform activity. Furthermore, if the seizure focus or foci are known, at least some of the implantable devices may be positioned over the seizure focus or foci and some may be positioned contralateral to the known seizure focus or foci.
  • [0137]
    If a seizure focus in the patient has not been lateralized, the present invention may be used to lateralize the seizure focus. FIG. 8 illustrates one method 120 of lateralizing a seizure focus in a patient. At step 122, a set of implantable devices are implanted beneath at least one layer of the patient's scalp and above the patient's skull (or below the skull, if desired).
  • [0138]
    Preferably, the implantable devices will comprise more than two electrodes to improve the ability to localize the seizure focus. For embodiments that only include two electrodes, a very large number of implantable devices may be required to actually localize the seizure focus. In one embodiment, implantation may be carried out using the method steps 102-108 illustrated in FIG. 7. At step 124, the set of implantable devices are used to sample the patient's EEG signals. At step 126, each of the EEG signals from the implantable devices are analyzed over a period of time (e.g., with EEG analysis software, such as a seizure detection algorithm) to monitor the patient's seizure activity and once a seizure has occurred try to lateralize the seizure focus. At step 128, if the seizure focus is lateralized, a subset of the implantable devices that are lateralized to the seizure focus are identified. At steps 130 and 132, the EEG signals from the subset of implantable may continue to be sampled, and such EEG signals may thereafter be stored and processed to analyze the patient's brain activity. The implantable devices that are not lateralized to the focus may be removed from the patient, disabled, or the EEG signals from such implantable devices may be ignored or not captured/stored. However, if desired, such EEG signals may continue to be stored and processed. The location and/or lateralization o the seizure focus may thereafter be used by the physicians to determine whether or not the patient is a candidate for resective surgery or other procedures.
  • [0139]
    In another use, the present invention may be used to quantify seizure activity statistics for the patient. The most common method of quantifying a patient's seizure activity is through patient self reporting using a seizure diary. Unfortunately, it has been estimated that up to 63% of all seizures are missed by patients. Patient's missing the seizures are usually caused by the patients being amnesic to the seizures, unaware of the seizures, mentally incapacitated, the seizures occur during sleep, or the like. FIG. 9 illustrates a simplified method 140 of measuring and reporting a patient's seizure activity statistics. At step 142, one or more implantable devices are implanted in a patient, typically in a minimally invasive fashion as shown in FIG. 7. At step 144, the implantable devices are used to substantially continuously sample EEG signals from the patient. At step 146, the sampled EEG signals are wirelessly transmitted from the implantable device to an external device. At step 148, the sampled EEG signals are stored in a memory. At step 150, the stored EEG signals are analyzed with EEG analysis software, typically using a seizure prediction and/or detection algorithm, to derive statistics for the clinical seizures and/or the sub-clinical seizures for the patient based on the long-term, ambulatory EEG data. For example, the following statistics may be quantified using the present invention:
  • [0140]
    Seizure count over a time period—How many clinical and sub-clinical seizures does the patient have in a specific time period?
  • [0141]
    Seizure frequency—How frequent does the patient have seizures? What is the seizure frequency without medication and with medication? Without electrical stimulation and with electrical stimulation?
  • [0142]
    Seizure duration—How long do the seizures last? Without medication and with medication? Without electrical stimulation and with electrical stimulation?
  • [0143]
    Seizure timing—When did the patient have the seizure? Do the seizures occur more frequently at certain times of the day?
  • [0144]
    Seizure patterns—Is there a pattern to the patient's seizures? After certain activities are performed? What activities appear to trigger seizures for this particular patient?
  • [0145]
    Finally, at step 152, report generation software may be used to generate a report based on the statistics for the seizure activity. The report may include some or all of the statistics described above, an epilepsy/no epilepsy diagnosis, identification of a seizure focus, and may also include the EEG signal(s) associated with one or more of the seizures. The report may include text, graphs, charts, images, or a combination thereof so as to present the information to the physician and/or patient in an actionable format. Advantageously, the systems may be used to generate a baseline report for the patient, and the system may be continuously used to record data over a long period of time and provide a quantification of the patient's change in their condition and/or the efficacy of any therapy that the patient is undergoing (described in more detail below).
  • [0146]
    As noted above, the present invention enables the documentation and long term monitoring of sub-clinical seizures in a patient. Because the patient is unaware of the occurrence of sub-clinical seizures, heretofore the long term monitoring of sub-clinical seizures was not possible. Documentation of the sub-clinical seizures may further provide insight into the relationship between sub-clinical seizures and clinical seizures, may provide important additional information relevant to the effectiveness of patient therapy, and may further enhance the development of additional treatments for epilepsy.
  • [0147]
    FIG. 10 illustrates one exemplary method of how the seizure activity data may be used to evaluate the efficacy or clinical benefit of a current or potential therapy and allow for the intelligent selection of an appropriate therapy for an individual patient and/or stopping the usage of ineffective therapies. Currently, effectiveness of the AED therapy is based on self-reporting of the patient, in which the patient makes entries in a diary regarding the occurrence of their seizure(s). If the entries in the patient diary indicate a reduction in seizure frequency, the AED is deemed to be effective and the patient continues with some form of the current regimen of AEDs. If the patient entries in the patient diary do not indicate a change in seizure frequency, the AEDs are deemed to be ineffective, and typically another AED is prescribed—and most often in addition to the AED that was deemed to be ineffective. Because AEDs are typically powerful neural suppressants and are associated with undesirable side-effects, the current methodology of assessing the efficacy of the AEDs often keeps the patient on ineffective AEDs and exposes the patient to unnecessary side-effects.
  • [0148]
    By way of example, a medically refractory patient coming to an epilepsy center for the first time might first have the system of the present invention implanted and then asked to collect data for a prescribed time period, e.g., 30 days. The initial 30 days could be used to establish a baseline measurement for future reference. The physician could then prescribe an adjustment to the patient's medications and have the patient collect data for another time period, e.g., an additional 30 day period. Metrics from this analysis could then be compared to the previous analysis to see if the adjustment to the medications resulted in an improvement. If the improvement was not satisfactory, the patient can be taken off of the unsatisfactory medication, and a new medication could be tried. This process could continue until a satisfactory level of seizure control was achieved. The present invention provides a metric that allows physicians and patients to make informed decisions on the effectiveness and non-effectiveness of the medications.
  • [0149]
    FIG. 10 schematically illustrates one example of such a method. At step 162, one or more implantable devices are implanted in the patient, typically in a minimally-invasive fashion. At step 164, the one or more implantable devices are used to monitor the patient's EEG to obtain a baseline measurement for the patient. The baseline measurement is typically seizure activity statistics for a specific time period (e.g., number of seizures, seizure duration, seizure pattern, seizure frequency, etc.). It should be appreciated however, that the baseline measurement may include any number of types of metrics. For example, the baseline metric may include univariate, bivariate, or multivariate features that are extracted from the EEG, or the like. In one preferred embodiment, the baseline measurement is performed while the patient is not taking any AEDs or using any other therapy. In other embodiments, however, the patient may be taking one or more AEDs and the baseline measurement will be used to evaluate adjustments to dosage or efficacy of other add-on therapies.
  • [0150]
    At step 166, the therapy that is to be evaluated is commenced. The therapy will typically be an AED and the patient will typically have instructions from the neurologist, epileptologist, or drug-manufacturer regarding the treatment regimen for the AED. The treatment regimen may be constant (e.g., one pill a day) throughout the evaluation period, or the treatment regimen may call for varying of some parameter of the therapy (e.g., three pills a day for the first week, two pills a day for the second week, one pill a day for the third week, etc.) during the evaluation period. During the evaluation period, the implantable device(s) will be used to substantially continuously sample the patient's EEG and assess the effect that the AED has on the patient's EEG. The sampled EEG may thereafter be processed to obtain a follow-up measurement for the patient (Step 168). If the baseline measurement was seizure statistics for the baseline time period, then the follow-up measurement will be the corresponding seizure statistics for the evaluation period. At step 170, the baseline measurement is compared to the follow-up measurement to evaluate the therapy. If the comparison indicates that the therapy did not significantly change the patient's baseline, the therapy may be stopped, and other therapies may be tried.
  • [0151]
    Currently, the primary metric in evaluating the efficacy of an AED is whether or not the AED reduces the patient's seizure count. In addition to seizure count, the systems of the present invention would be able to track any reduction in seizure duration, modification in seizure patterns, reduction in seizure frequency, or the like. While seizure count is important, because the present invention is able to provide much greater detail than just seizure count, efficacy of an AED may be measured using a combination of additional metrics, if desired. For example, if the patient was having a large number of sub-clinical seizures (which the patient was not aware of) and the AED was effective in reducing or stopping the sub-clinical seizures, the systems of the present invention would be able to provide metrics for such a situation. With conventional patient diary “metrics”, the patient and physician would not be aware of such a reduction, and such an AED would be determined to be non-efficacious for the patient. However, because the present invention is able to provide metrics for the sub-clinical seizures, the efficacious medication could be continued, if desired.
  • [0152]
    At step 172, the epileptologist or neurologist may decide to change one or more parameters of the therapy. For example, they may change a dosage, frequency of dosage, form of the therapy or the like, and thereafter repeat the follow-up analysis for the therapy with the changed parameter. After the “second” follow up measurement is complete, the second follow up data may be obtained and thereafter compared to the “first” follow up measurements and/or the baseline measurements. While not shown in FIG. 10, the method may also comprise generating a report that details the patient's metrics, change in metrics, recommendations, etc.
  • [0153]
    In addition to evaluating an efficacy of a therapy for an individual patient, the metrics that are provided by the present invention also enable an intelligent titration of a patient's medications. As shown in FIG. 11, if the patient is on a treatment regimen of an efficacious therapy, the present invention may be used to reduce/titrate a dosage or frequency of intake of the AED or AEDs, or other pharmacological agents. At step 182, one or more implantable devices are minimally invasively implanted in the patient. Typically, the patient will already be on a treatment regimen of the efficacious therapy, but if not, the efficacious therapy is commenced with the prescribed parameters, e.g., “standard” dosage (Step 184). At step 186, the patient's EEG (and/or other physiological signal) is monitored for a desired time period to obtain a first patient data measurement for the patient (e.g., the baseline measurement). Similar to previous embodiments, the first patient data measurement may be any desired metrics, but will typically be clinical seizure frequency, clinical seizure duration, sub-clinical seizure frequency, sub-clinical seizure duration, medication side effects. At step 188, after the baseline measurement has been taken, the first efficacious therapy is stopped and a therapy with at least one changed parameter is started (referred to as “therapy with second parameters” in FIG. 11). Typically, the changed parameter will be a reduction in dosage, but it could be changing a frequency of the same dosage, a change in formulation or form of the same AED, or the like.
  • [0154]
    At step 190, the patient's EEG is monitored and processed to obtain a second patient data measurement for the patient (e.g., follow-up data measurement). If the neurologist or epileptologist is satisfied with the results, the titration may end. But in many embodiments, the titration process will require more than one modification of parameters of the therapy. In such embodiments, the second therapy is stopped (step 192), and a therapy with Nth parameters (e.g., third, fourth, fifth . . . ) is commenced (step 194). Monitoring and processing of the patient's EEG signals are repeated (step 196), and the process is repeated a desired number of times (as illustrated by arrow 197). Once the desired numbers of modifications to the therapy have been made, the various patient data measurements may be analyzed (e.g., compared to each other) to determine the most desirous parameters for the therapy (step 198). As can be imagined, any number of different analyses or statistical methods may be performed. In one embodiment, seizure activity statistics (e.g., clinical seizure frequency, sub-clinical seizure frequency, seizure rate per time period, seizure duration, seizure patterns, etc.) may be used to assess the efficacy and differences between the therapies.
  • [0155]
    With the instrumentation provided by the present invention, the process of selecting appropriate AEDs and the titration of dosages of such AEDs could occur much faster and with much greater insight than ever before. Further, the chance of a patient remaining on an incremental AED that was providing little incremental benefit would be minimized. Once a patient was under control, the patient could cease the use of the system, but the implantable device could remain in the patient. In the future, the patient might be asked to use the system again should their condition change or if the efficacy of the AED wane due to tolerance effects, etc.
  • [0156]
    While FIGS. 10 and 11 are primarily directed toward assessing the efficacy of a pharmacological agent (e.g., AED), such methods are equally applicable to assessing the efficacy and optimizing patient-specific parameters of non-pharmacological therapies. For example, the present invention may also be used to evaluate and optimize parameters for the electrical stimulation provided by the Vagus Nerve Stimulator (sold by Cyberonics Corporation), Responsive Neurostimulator (RNS) (manufactured by NeuroPace Corporation), Deep Brain Stimulators (manufactured by Medtronic), and other commercial and experimental neural and spinal cord stimulators.
  • [0157]
    Furthermore, the systems of the present invention will also be able to provide metrics for the effectiveness of changes to various electrical parameters (e.g., frequency, pulse amplitude, pulse width, pulses per burst, burst frequency, burst/no-burst, duty cycle, etc.) for the electrical stimulation treatments. Such metrics will provide a reliable indication regarding the effectiveness of such parameter changes, and could lead to optimization of stimulation for parameters for individual patients or the patient population as a whole.
  • [0158]
    In addition to facilitating the selection of appropriate AEDs and titration of dosages of the AEDs for an individual patient, the present invention may have beneficial use in the clinical trials for the development of experimental AEDs and other therapies for the epileptic patient population (and other neurological conditions). One of the greatest barriers to developing new AEDs (and other pharmacological agents) is the costs and difficulties associated with the clinical trials. Presently, the standard metric for such clinical trials is patient seizure count. Because this metric is self-reported and presently so unreliable, to power the study appropriately clinical trials for AEDs must involve very large patient populations, in which the patient's must have a high seizure count. At an estimated cost of $20,000 per patient for pharmacological trials, the cost of developing a new drug for epilepsy is exceedingly high and may deter drug companies from developing AEDs.
  • [0159]
    The minimally invasive systems of the present invention may be used to facilitate these clinical trials. Such systems could result in significantly more reliable data, which would result in much smaller sample patient populations, and could include a broader types of patients (e.g., patient's who don't have frequent seizures) for appropriately powering the study. Improved certainty in efficacy would also reduce risk to the company, as it moved from safety studies to efficacy studies. Significantly reducing risk and improving the economics of these studies by reducing the required number of study subjects could lead to an increase in the development of new therapies for this patient population, and other patient populations.
  • [0160]
    It should be appreciated however, that the present invention is not limited to clinical trials for epilepsy therapies, and the present invention has equal applicability to other clinical trials (e.g., cancer therapy, cardiac therapy, therapy for other neurological disorders, therapy for psychiatric disorders, or the like.)
  • [0161]
    FIGS. 12-13 illustrate some methods of performing clinical trials that are encompassed by the present invention. The present invention is applicable to any type of clinical trial, including but not limited to a randomized clinical trial, e.g., an open clinical trial, a single-blinded study, a double-blinded study, a triple-blinded study, or the like.
  • [0162]
    FIG. 12 illustrates a simplified method 200 of performing a clinical trial according to the present invention. At step 201 participants are enrolled in the clinical trial. At step 202, selected participants in the clinical trial are implanted with one or more leadless, implantable devices (such as those described above) in order to sample one or more physiological signal from the patient. Typically, the physiological signal is an EEG signal. In preferred embodiments, the EEG signal is sampled substantially continuously for the entire baseline period for each of the participants in the clinical trial. In alternative embodiments, it may be desirable to sample the EEG signals in a non-continuous basis.
  • [0163]
    At step 204, the sampled EEG signals are processed for a desired time period to obtain a first patient data measurement, e.g., a baseline data measurement, for each of the participants in the clinical trial. After the participants have commenced the experimental therapy (typically by following a prescribed treatment regimen by the investigator or drug company), the same implantable devices are used to sample the EEG signals from the participant for an evaluation period, and the EEG signals are processed to provide a second patient data measurement, e.g., follow-up measurement (Step 206, 208). At step 210, the baseline data measurement and the follow-up data measurement may be compared using conventional statistical methods in order to evaluate the experimental therapy on the patient population.
  • [0164]
    While not shown in FIG. 12, it may be desirable to have a “second” evaluation period (and a second follow-up measurement) in which at least one parameter of the experimental therapy is changed and the changed experimental therapy is administered to the patient. Similar to the method of FIG. 11, such a method may provide guidance to finding the appropriate dosing, formulation, and/or form of delivery of the experimental therapy.
  • [0165]
    The baseline period and the evaluation period are typically the same time length. The time length may be any desired time, but is typically at least one week, and preferably between at least one month and at least three months.
  • [0166]
    Evaluation of the experimental therapy may be to evaluate dosing requirements, evaluate toxicity of the experimental therapy, evaluate long-term adverse effects of the experimental therapy or to determine efficacy of the experimental therapy. In one preferred embodiment, the comparison may simply determine whether there was a statistically significant change in a seizure count between the baseline period and the evaluation period. But as noted above, the baseline data measurement and follow-up data measurement may include any metric that is extracted from the EEG signals.
  • [0167]
    FIG. 13 illustrates a more detailed method of performing a clinical trial according to the present invention. At step 222 participants are enrolled in the clinical trial. At step 224, the participants in the clinical trial are implanted with one or more leadless, implantable devices (such as those described above) in order to sample one or more physiological signal from the patient. Typically, the physiological signal is an EEG signal. In preferred embodiments, the EEG signal is sampled substantially continuously for the entire baseline period for each of the participants in the clinical trial.
  • [0168]
    At step 226, the sampled EEG signals are processed to obtain a first patient data measurement, e.g., a baseline data measurement, for each of the participants in the clinical trial. If the patients do not have any seizures during the baseline period, then the patient's will most likely be excluded from the remainder of the clinical trial. The remaining participants in the clinical trial are then broken into an intervention group and a control group. The experimental therapy is commenced in the intervention group of the patient population (step 228), and a placebo therapy is commenced in the control group of the patient population (step 230).
  • [0169]
    The implantable devices are used to substantially continuously sample the EEG signals of both the intervention group and the control group during an evaluation period. The EEG signals are processed to obtain follow-up seizure activity data (or some other metric) for both groups (step 232, 234). Thereafter, the baseline data and the follow up data for both the intervention group and the control group are analyzed, (e.g., compared with each other) to evaluate the efficacy of the experimental therapy for the patient population (step 236). While not shown in FIG. 13, the method may further include changing one or more parameters of the experimental therapy and comparing the “second” follow up data to the baseline data and/or other follow up data.
  • [0170]
    While the preferred embodiments described above are directed toward evaluating experimental AEDs in the clinical trial, the present invention is equally applicable to clinical trials for other experimental pharmacological agents, biologics, devices, and other non-pharmacological therapies. For example, the present invention may also be used to evaluate the Vagus Nerve Stimulator (sold by Cyberonics Corporation), Responsive Neurostimulator (RNS) (manufactured by NeuroPace Corporation), Deep Brain Stimulators manufactured by Medtronic, and other commercial and experimental neural and spinal cord stimulators. The minimally invasive systems of the present invention may be implanted in patients who are equipped with any of the above stimulators to provide metrics regarding the efficacy of the electrical stimulation treatments.
  • [0171]
    Furthermore, the systems of the present invention will also be able to provide metrics for the effectiveness of changes to various electrical parameters (e.g., frequency, pulse amplitude, pulse width, pulses per burst, burst frequency, burst/no-burst, etc.) for the electrical stimulation treatments. Such metrics will provide a reliable indication regarding the effectiveness of such parameter changes, and could lead to optimization of stimulation for parameters for individual patients or the patient population as a whole.
  • [0172]
    FIG. 14 illustrates a packaged system or kit 300 that is encompassed by the present invention. The packaged system 300 may include a package 302 that has one or more compartments for receiving an introducer assembly 304 and one or more implantable devices 12. The introducer 304 is typically in the form of a syringe-like device or a cannula and stylet. The implantable device 12 may include any of the embodiments described herein. One or more of the implantable devices 12 may be pre-loaded within the introducer 304. In other embodiments, the implantable devices 12 may be loaded in its separate sterile packaging (shown in dotted lines) for easy loading into the introducer 304. The packaged system 300 may include instructions for use (“IFU”) 306 that describe any of the methods described herein.
  • [0173]
    While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. For example, the present invention also encompasses other more invasive embodiments which may be used to monitor the patient's neurological system.
  • [0174]
    Alternative embodiments of the implantable device of the present invention may require a neurosurgeon to create a more invasive incision in the patient's scalp. For example, it may be desirable to use a low profile device that is not substantially cylindrical, but instead is substantially planar or concave so as to conform to the curvature of the patient's skull. Such embodiments would likely not be able to be implanted without general anesthesia and may require a surgeon to implant the device.
  • [0175]
    On the other hand, in some embodiments it may be desirable to be completely non-invasive. Such embodiments include “implantable” devices 12 that are not actually implanted, but instead are “wearable” and may be attached to the outer surface of the skin with adhesive or a bandage so as to maintain contact with the patient's skin For example, it may be possible to surface mount the device 12 behind the ears, in the scalp, on the forehead, along the jaw, or the like. Because the electrodes are wireless and are such a small size, unlike conventional electrodes, the visual appearance of the electrodes will be minimal.
  • [0176]
    Furthermore, in some embodiments, it may be desirable to modify the implantable device 12 to provide stimulation to the patient. In such embodiments, the implantable device 12 will include a pulse generator and associated hardware and software for delivering stimulation to the patient through the first and second electrodes 24, 26 (or other electrodes coupled to the device. In such embodiments, the external device 14 will include the hardware and software to generate the control signals for delivering the electrical stimulation to the patient.
  • [0177]
    While the above embodiments describe that power to the implanted devices may be derived wirelessly from an external device and/or from a battery in the implanted device, it should be appreciated that the internal devices may derive or otherwise “scavenge” power from other types of conventional or proprietary assemblies. Such scavenging methods may be used in conjunction with the external power source and/or the internal power source, or it may be used by itself to provide the necessary power for the implanted devices. For example, the implanted devices may include circuitry and other assemblies (e.g., a microgenerator) that derive and store power from patient-based energy sources such as kinetic movement/vibrations (e.g., gross body movements), movement of organs or other bodily fluids (e.g., heart, lungs, blood flow), and thermal sources in the body (e.g., temperature differences and variations across tissue). As can be imagined, such technology could reduce or eliminate the need for recharging of an implanted battery, replacement of a depleted battery, and/or the creation of an external RF field—and would improve the ease of use of the devices by the patients.
  • [0178]
    Some embodiments of the monitoring system may include an integral patient diary functionality. The patient diary may be a module in the external device and inputs by the patient may be used to provide secondary inputs to provide background information for the sampled EEG signals. For example, if a seizure is recorded, the seizure diary may provide insight regarding a trigger to the seizure, or the like. The diary may automatically record the time and date of the entry by the patient. Entries by the patient may be a voice recording, or through activation of user inputs on the external device. The diary may be used to indicate the occurrence of an aura, occurrence of a seizure, the consumption of a meal, missed meal, delayed meal, activities being performed, consumption of alcohol, the patient's sleep state (drowsy, going to sleep, waking up, etc.), mental state (e.g., depressed, excited, stressed), intake of their AEDs, medication changes, missed dosage of medication, menstrual cycle, illness, or the like. Thereafter, the patient inputs recorded in the diary may also be used by the physician in assessing the patient's epilepsy state and/or determine the efficacy of the current treatment. Furthermore, the physician may be able to compare the number of seizures logged by the patient to the number of seizures detected by the seizure detection algorithm.
  • [0179]
    It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims (1)

  1. 1. A method for selecting a therapy for a patient suffering from a neurological or psychiatric condition, the method comprising:
    implanting a monitoring device between at least one layer of the scalp and the skull;
    commencing a first therapy;
    monitoring a physiological signal from the patient with the implanted device for a first time period after commencement of the first therapy;
    commencing a second therapy;
    monitoring a physiological signal from the patient with the implanted device for a second time period after commencement of the second therapy;
    processing the physiological signals from the first time period and second time period; and
    analyzing the processed physiological signals to select an appropriate therapy for the patient.
US12691650 2006-06-23 2010-01-21 Minimally invasive system for selecting patient-specific therapy parameters Abandoned US20100125219A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US80571006 true 2006-06-23 2006-06-23
US11766760 US7676263B2 (en) 2006-06-23 2007-06-21 Minimally invasive system for selecting patient-specific therapy parameters
US12691650 US20100125219A1 (en) 2006-06-23 2010-01-21 Minimally invasive system for selecting patient-specific therapy parameters

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12691650 US20100125219A1 (en) 2006-06-23 2010-01-21 Minimally invasive system for selecting patient-specific therapy parameters
US13050839 US20110166430A1 (en) 2006-06-23 2011-03-17 System and methods for analyzing seizure activity

Publications (1)

Publication Number Publication Date
US20100125219A1 true true US20100125219A1 (en) 2010-05-20

Family

ID=38834405

Family Applications (8)

Application Number Title Priority Date Filing Date
US11766761 Abandoned US20080027348A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Systems for Monitoring a Patient's Propensity for a Neurological Event
US11766756 Abandoned US20080021341A1 (en) 2006-06-23 2007-06-21 Methods and Systems for Facilitating Clinical Trials
US11766751 Abandoned US20080027347A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Methods
US11766742 Abandoned US20080027515A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Systems
US11766760 Active US7676263B2 (en) 2006-06-23 2007-06-21 Minimally invasive system for selecting patient-specific therapy parameters
US12691650 Abandoned US20100125219A1 (en) 2006-06-23 2010-01-21 Minimally invasive system for selecting patient-specific therapy parameters
US13050839 Abandoned US20110166430A1 (en) 2006-06-23 2011-03-17 System and methods for analyzing seizure activity
US14644058 Active US9480845B2 (en) 2006-06-23 2015-03-10 Nerve stimulation device with a wearable loop antenna

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US11766761 Abandoned US20080027348A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Systems for Monitoring a Patient's Propensity for a Neurological Event
US11766756 Abandoned US20080021341A1 (en) 2006-06-23 2007-06-21 Methods and Systems for Facilitating Clinical Trials
US11766751 Abandoned US20080027347A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Methods
US11766742 Abandoned US20080027515A1 (en) 2006-06-23 2007-06-21 Minimally Invasive Monitoring Systems
US11766760 Active US7676263B2 (en) 2006-06-23 2007-06-21 Minimally invasive system for selecting patient-specific therapy parameters

Family Applications After (2)

Application Number Title Priority Date Filing Date
US13050839 Abandoned US20110166430A1 (en) 2006-06-23 2011-03-17 System and methods for analyzing seizure activity
US14644058 Active US9480845B2 (en) 2006-06-23 2015-03-10 Nerve stimulation device with a wearable loop antenna

Country Status (3)

Country Link
US (8) US20080027348A1 (en)
EP (1) EP2034885A4 (en)
WO (1) WO2007150003A3 (en)

Cited By (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080119900A1 (en) * 1998-08-05 2008-05-22 Dilorenzo Daniel John Providing Output Indicative of Subject's Disease State
US20090024449A1 (en) * 2007-05-16 2009-01-22 Neurofocus Inc. Habituation analyzer device utilizing central nervous system, autonomic nervous system and effector system measurements
US20090063255A1 (en) * 2007-08-28 2009-03-05 Neurofocus, Inc. Consumer experience assessment system
US20090327068A1 (en) * 2007-05-16 2009-12-31 Neurofocus Inc. Neuro-physiology and neuro-behavioral based stimulus targeting system
US20100130851A1 (en) * 2008-11-21 2010-05-27 Medtronic, Inc. Stylet for use with image guided systems
US20110047121A1 (en) * 2009-08-21 2011-02-24 Neurofocus, Inc. Analysis of the mirror neuron system for evaluation of stimulus
US8036736B2 (en) 2007-03-21 2011-10-11 Neuro Vista Corporation Implantable systems and methods for identifying a contra-ictal condition in a subject
US8209224B2 (en) 2009-10-29 2012-06-26 The Nielsen Company (Us), Llc Intracluster content management using neuro-response priming data
US8270814B2 (en) 2009-01-21 2012-09-18 The Nielsen Company (Us), Llc Methods and apparatus for providing video with embedded media
US8295934B2 (en) 2006-11-14 2012-10-23 Neurovista Corporation Systems and methods of reducing artifact in neurological stimulation systems
US8335716B2 (en) 2009-11-19 2012-12-18 The Nielsen Company (Us), Llc. Multimedia advertisement exchange
US8335715B2 (en) 2009-11-19 2012-12-18 The Nielsen Company (Us), Llc. Advertisement exchange using neuro-response data
US8386312B2 (en) 2007-05-01 2013-02-26 The Nielsen Company (Us), Llc Neuro-informatics repository system
US8386313B2 (en) 2007-08-28 2013-02-26 The Nielsen Company (Us), Llc Stimulus placement system using subject neuro-response measurements
US8392250B2 (en) 2010-08-09 2013-03-05 The Nielsen Company (Us), Llc Neuro-response evaluated stimulus in virtual reality environments
US8392255B2 (en) 2007-08-29 2013-03-05 The Nielsen Company (Us), Llc Content based selection and meta tagging of advertisement breaks
US8392251B2 (en) 2010-08-09 2013-03-05 The Nielsen Company (Us), Llc Location aware presentation of stimulus material
US8396744B2 (en) 2010-08-25 2013-03-12 The Nielsen Company (Us), Llc Effective virtual reality environments for presentation of marketing materials
US8464288B2 (en) 2009-01-21 2013-06-11 The Nielsen Company (Us), Llc Methods and apparatus for providing personalized media in video
US8473345B2 (en) 2007-03-29 2013-06-25 The Nielsen Company (Us), Llc Protocol generator and presenter device for analysis of marketing and entertainment effectiveness
US8494905B2 (en) 2007-06-06 2013-07-23 The Nielsen Company (Us), Llc Audience response analysis using simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)
US8494610B2 (en) 2007-09-20 2013-07-23 The Nielsen Company (Us), Llc Analysis of marketing and entertainment effectiveness using magnetoencephalography
US8533042B2 (en) 2007-07-30 2013-09-10 The Nielsen Company (Us), Llc Neuro-response stimulus and stimulus attribute resonance estimator
US8588933B2 (en) 2009-01-09 2013-11-19 Cyberonics, Inc. Medical lead termination sleeve for implantable medical devices
US8635105B2 (en) 2007-08-28 2014-01-21 The Nielsen Company (Us), Llc Consumer experience portrayal effectiveness assessment system
US8655428B2 (en) 2010-05-12 2014-02-18 The Nielsen Company (Us), Llc Neuro-response data synchronization
US8725243B2 (en) 2005-12-28 2014-05-13 Cyberonics, Inc. Methods and systems for recommending an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders
US8762065B2 (en) 1998-08-05 2014-06-24 Cyberonics, Inc. Closed-loop feedback-driven neuromodulation
US8781597B2 (en) 1998-08-05 2014-07-15 Cyberonics, Inc. Systems for monitoring a patient's neurological disease state
US8786624B2 (en) 2009-06-02 2014-07-22 Cyberonics, Inc. Processing for multi-channel signals
US8849390B2 (en) 2008-12-29 2014-09-30 Cyberonics, Inc. Processing for multi-channel signals
US8989835B2 (en) 2012-08-17 2015-03-24 The Nielsen Company (Us), Llc Systems and methods to gather and analyze electroencephalographic data
US9292858B2 (en) 2012-02-27 2016-03-22 The Nielsen Company (Us), Llc Data collection system for aggregating biologically based measures in asynchronous geographically distributed public environments
US9320450B2 (en) 2013-03-14 2016-04-26 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9357240B2 (en) 2009-01-21 2016-05-31 The Nielsen Company (Us), Llc Methods and apparatus for providing alternate media for video decoders
US9421373B2 (en) 1998-08-05 2016-08-23 Cyberonics, Inc. Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease
US9451303B2 (en) 2012-02-27 2016-09-20 The Nielsen Company (Us), Llc Method and system for gathering and computing an audience's neurologically-based reactions in a distributed framework involving remote storage and computing
US9454646B2 (en) 2010-04-19 2016-09-27 The Nielsen Company (Us), Llc Short imagery task (SIT) research method
US9480845B2 (en) 2006-06-23 2016-11-01 Cyberonics, Inc. Nerve stimulation device with a wearable loop antenna
US9560984B2 (en) 2009-10-29 2017-02-07 The Nielsen Company (Us), Llc Analysis of controlled and automatic attention for introduction of stimulus material
US9569986B2 (en) 2012-02-27 2017-02-14 The Nielsen Company (Us), Llc System and method for gathering and analyzing biometric user feedback for use in social media and advertising applications
US9622675B2 (en) 2007-01-25 2017-04-18 Cyberonics, Inc. Communication error alerting in an epilepsy monitoring system
US9622703B2 (en) 2014-04-03 2017-04-18 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9643019B2 (en) 2010-02-12 2017-05-09 Cyberonics, Inc. Neurological monitoring and alerts
US9886981B2 (en) 2007-05-01 2018-02-06 The Nielsen Company (Us), Llc Neuro-feedback based stimulus compression device
US9936250B2 (en) 2016-05-16 2018-04-03 The Nielsen Company (Us), Llc Methods and apparatus to adjust content presented to an individual

Families Citing this family (96)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9415222B2 (en) 1998-08-05 2016-08-16 Cyberonics, Inc. Monitoring an epilepsy disease state with a supervisory module
US7044911B2 (en) * 2001-06-29 2006-05-16 Philometron, Inc. Gateway platform for biological monitoring and delivery of therapeutic compounds
US8565867B2 (en) * 2005-01-28 2013-10-22 Cyberonics, Inc. Changeable electrode polarity stimulation by an implantable medical device
US9314633B2 (en) 2008-01-25 2016-04-19 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US9130602B2 (en) 2006-01-18 2015-09-08 Qualcomm Incorporated Method and apparatus for delivering energy to an electrical or electronic device via a wireless link
US8447234B2 (en) * 2006-01-18 2013-05-21 Qualcomm Incorporated Method and system for powering an electronic device via a wireless link
US7996079B2 (en) 2006-01-24 2011-08-09 Cyberonics, Inc. Input response override for an implantable medical device
EP2005569A4 (en) * 2006-03-17 2017-05-03 Endurance Rhythm Inc Energy generating systems for implanted medical devices
US8615309B2 (en) * 2006-03-29 2013-12-24 Catholic Healthcare West Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US7869885B2 (en) * 2006-04-28 2011-01-11 Cyberonics, Inc Threshold optimization for tissue stimulation therapy
US7962220B2 (en) 2006-04-28 2011-06-14 Cyberonics, Inc. Compensation reduction in tissue stimulation therapy
US7869867B2 (en) 2006-10-27 2011-01-11 Cyberonics, Inc. Implantable neurostimulator with refractory stimulation
US9898656B2 (en) 2007-01-25 2018-02-20 Cyberonics, Inc. Systems and methods for identifying a contra-ictal condition in a subject
EP2126791A2 (en) * 2007-02-21 2009-12-02 NeuroVista Corporation Methods and systems for characterizing and generating a patient-specific seizure advisory system
US7747551B2 (en) * 2007-02-21 2010-06-29 Neurovista Corporation Reduction of classification error rates and monitoring system using an artificial class
US9774086B2 (en) * 2007-03-02 2017-09-26 Qualcomm Incorporated Wireless power apparatus and methods
US8214453B2 (en) * 2007-03-14 2012-07-03 Steven Charles Estes Concept and associated device enabling multi-camera video and audio recording for synchronization with long term ambulatory electroencephalography (EEG) in the home, office, or hospital environment
US7974701B2 (en) * 2007-04-27 2011-07-05 Cyberonics, Inc. Dosing limitation for an implantable medical device
US9124120B2 (en) * 2007-06-11 2015-09-01 Qualcomm Incorporated Wireless power system and proximity effects
US9788744B2 (en) 2007-07-27 2017-10-17 Cyberonics, Inc. Systems for monitoring brain activity and patient advisory device
CN103187629B (en) * 2007-08-09 2016-08-24 高通股份有限公司 Increase factor of the resonator q
US8014167B2 (en) * 2007-09-07 2011-09-06 Seagate Technology Llc Liquid crystal material sealed housing
WO2009036405A1 (en) 2007-09-13 2009-03-19 Nigelpower, Llc Maximizing power yield from wireless power magnetic resonators
WO2009039113A1 (en) * 2007-09-17 2009-03-26 Nigel Power, Llc Transmitters and receivers for wireless energy transfer
CN101842963B (en) * 2007-10-11 2014-05-28 高通股份有限公司 Wireless power transfer using magneto mechanical systems
US8457757B2 (en) 2007-11-26 2013-06-04 Micro Transponder, Inc. Implantable transponder systems and methods
US9259591B2 (en) * 2007-12-28 2016-02-16 Cyberonics, Inc. Housing for an implantable medical device
US20090171168A1 (en) * 2007-12-28 2009-07-02 Leyde Kent W Systems and Method for Recording Clinical Manifestations of a Seizure
GB0800615D0 (en) * 2008-01-14 2008-02-20 Hypo Safe As Implantable electronic device
US8260426B2 (en) 2008-01-25 2012-09-04 Cyberonics, Inc. Method, apparatus and system for bipolar charge utilization during stimulation by an implantable medical device
US8986253B2 (en) 2008-01-25 2015-03-24 Tandem Diabetes Care, Inc. Two chamber pumps and related methods
US8629576B2 (en) 2008-03-28 2014-01-14 Qualcomm Incorporated Tuning and gain control in electro-magnetic power systems
WO2009129493A1 (en) * 2008-04-18 2009-10-22 Medtronic, Inc. Analyzing a washout period characteristic for psychiatric disorder therapy delivery
WO2009129480A3 (en) * 2008-04-18 2010-03-25 Medtronic, Inc. Psychiatric disorder therapy control
US20090264967A1 (en) * 2008-04-18 2009-10-22 Medtronic, Inc. Timing therapy evaluation trials
EP2280640A4 (en) * 2008-04-21 2013-10-09 Carl Frederick Edman Metabolic energy monitoring system
US8204603B2 (en) 2008-04-25 2012-06-19 Cyberonics, Inc. Blocking exogenous action potentials by an implantable medical device
US9089707B2 (en) 2008-07-02 2015-07-28 The Board Of Regents, The University Of Texas System Systems, methods and devices for paired plasticity
US20110218605A1 (en) * 2008-09-10 2011-09-08 Adrian Cryer Upgradeable implantable device
US8408421B2 (en) 2008-09-16 2013-04-02 Tandem Diabetes Care, Inc. Flow regulating stopcocks and related methods
US8650937B2 (en) 2008-09-19 2014-02-18 Tandem Diabetes Care, Inc. Solute concentration measurement device and related methods
US20110173027A1 (en) * 2008-10-10 2011-07-14 Koninklijke Philips Electronics N.V. Health-risk metric determination and/or presentation
US8457747B2 (en) 2008-10-20 2013-06-04 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
WO2010051382A1 (en) * 2008-10-31 2010-05-06 Medtronic, Inc. Mood circuit monitoring to control therapy delivery
WO2010060011A3 (en) * 2008-11-21 2010-09-16 Washington University In St. Louis Bipolar sieve electrode and method of assembly
EP2373375A4 (en) * 2008-12-02 2014-03-12 Purdue Research Foundation Radio transparent sensor implant package
EP2370147A4 (en) * 2008-12-04 2014-09-17 Neurovista Corp Universal electrode array for monitoring brain activity
US20100168603A1 (en) * 2008-12-23 2010-07-01 Himes David M Brain state analysis based on select seizure onset characteristics and clinical manifestations
US8412336B2 (en) 2008-12-29 2013-04-02 Autonomic Technologies, Inc. Integrated delivery and visualization tool for a neuromodulation system
US20130110195A1 (en) * 2009-01-15 2013-05-02 Autonomic Technologies, Inc. Neurostimulator system, apparatus, and method
US9320908B2 (en) * 2009-01-15 2016-04-26 Autonomic Technologies, Inc. Approval per use implanted neurostimulator
US20130116745A1 (en) * 2009-01-15 2013-05-09 Autonomic Technologies, Inc. Neurostimulator system, apparatus, and method
JP2012520746A (en) 2009-03-19 2012-09-10 ユニヴァーシティー オヴ フロリダ リサーチ ファウンデーション Implantable small electronic device into the body of a swallowable or subject by subject
US20100292545A1 (en) * 2009-05-14 2010-11-18 Advanced Brain Monitoring, Inc. Interactive psychophysiological profiler method and system
US8641671B2 (en) 2009-07-30 2014-02-04 Tandem Diabetes Care, Inc. Infusion pump system with disposable cartridge having pressure venting and pressure feedback
CN106075683A (en) 2009-08-28 2016-11-09 瑞思迈有限公司 Pap system
US8838217B2 (en) * 2009-11-10 2014-09-16 Makor Issues And Rights Ltd. System and apparatus for providing diagnosis and personalized abnormalities alerts and for providing adaptive responses in clinical trials
US20110117268A1 (en) * 2009-11-19 2011-05-19 Stratasys, Inc. Consumable materials having encoded markings for use with direct digital manufacturing systems
US20110121476A1 (en) * 2009-11-19 2011-05-26 Stratasys, Inc. Encoded consumable materials and sensor assemblies for use in additive manufacturing systems
CA2782811A1 (en) * 2009-12-02 2011-06-09 Widex A/S A method and apparatus for alerting a person carrying an eeg assembly
US8914115B2 (en) * 2009-12-03 2014-12-16 Medtronic, Inc. Selecting therapy cycle parameters based on monitored brain signal
CN102740767B (en) * 2010-02-01 2015-11-25 唯听助听器公司 It can be a portable monitoring system for wireless communication eeg
US8886323B2 (en) * 2010-02-05 2014-11-11 Medtronic, Inc. Electrical brain stimulation in gamma band
US20110218820A1 (en) * 2010-03-02 2011-09-08 Himes David M Displaying and Manipulating Brain Function Data Including Filtering of Annotations
US20110219325A1 (en) * 2010-03-02 2011-09-08 Himes David M Displaying and Manipulating Brain Function Data Including Enhanced Data Scrolling Functionality
US9075910B2 (en) * 2010-03-11 2015-07-07 Philometron, Inc. Physiological monitor system for determining medication delivery and outcome
US8386047B2 (en) * 2010-07-15 2013-02-26 Advanced Bionics Implantable hermetic feedthrough
US8552311B2 (en) 2010-07-15 2013-10-08 Advanced Bionics Electrical feedthrough assembly
US9037224B1 (en) * 2010-08-02 2015-05-19 Chi Yung Fu Apparatus for treating a patient
US9095266B1 (en) * 2010-08-02 2015-08-04 Chi Yung Fu Method for treating a patient
US8684921B2 (en) 2010-10-01 2014-04-01 Flint Hills Scientific Llc Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
KR101304338B1 (en) * 2010-10-21 2013-09-11 주식회사 엠아이텍 LCP-based electro-optrode neural interface and Method for fabricating the same
US8565886B2 (en) 2010-11-10 2013-10-22 Medtronic, Inc. Arousal state modulation with electrical stimulation
WO2012095171A1 (en) 2011-01-12 2012-07-19 Widex A/S Bi-hemispheric brain wave system and method of performing bi-hemispherical brain wave measurements
JP5580943B2 (en) 2011-01-20 2014-08-27 ヴェーデクス・アクティーセルスカプ Personal eeg monitoring device including an electrode validation
US8706181B2 (en) 2011-01-25 2014-04-22 Medtronic, Inc. Target therapy delivery site selection
EP2672888A1 (en) 2011-02-09 2013-12-18 The Charles Stark Draper Laboratory, Inc. Wireless, implantable electro-encephalography system
US8562524B2 (en) 2011-03-04 2013-10-22 Flint Hills Scientific, Llc Detecting, assessing and managing a risk of death in epilepsy
US8562523B2 (en) 2011-03-04 2013-10-22 Flint Hills Scientific, Llc Detecting, assessing and managing extreme epileptic events
US9504390B2 (en) 2011-03-04 2016-11-29 Globalfoundries Inc. Detecting, assessing and managing a risk of death in epilepsy
US20130046153A1 (en) 2011-08-16 2013-02-21 Elwha LLC, a limited liability company of the State of Delaware Systematic distillation of status data relating to regimen compliance
US20130072809A1 (en) * 2011-09-19 2013-03-21 Persyst Development Corporation Method And System For Analyzing An EEG Recording
RU2473304C1 (en) * 2011-12-28 2013-01-27 Учреждение Российской академии медицинских наук Научно-исследовательский институт нейрохирургии имени академика Н.Н. Бурденко РАМН Method of diagnosing malignancy of neuroepithelial tumours of iii ventricle by data of electroencephalographic examination
US9555186B2 (en) 2012-06-05 2017-01-31 Tandem Diabetes Care, Inc. Infusion pump system with disposable cartridge having pressure venting and pressure feedback
EP2685885B1 (en) * 2012-06-05 2015-08-26 Beurer GmbH Stress and burn-out analysis and diagnostic device
US20140148723A1 (en) * 2012-11-26 2014-05-29 Persyst Development Corporation Method And System For Displaying The Amount Of Artifact Present In An EEG Recording
US9687165B2 (en) * 2013-03-15 2017-06-27 Greatbatch Ltd. Apparatus and method for electrocardiographic monitoring
US9092552B2 (en) 2013-04-26 2015-07-28 Cyberonics, Inc. System monitor for monitoring functional modules of a system
CN105517484A (en) * 2013-05-28 2016-04-20 拉斯洛·奥斯瓦特 Systems and methods for diagnosis of depression and other medical conditions
US20140371544A1 (en) * 2013-06-14 2014-12-18 Medtronic, Inc. Motion-based behavior identification for controlling therapy
DK178081B9 (en) * 2013-06-21 2015-05-11 Ictalcare As Method of indicating the probability of psychogenic non-epileptic seizures
US9601267B2 (en) 2013-07-03 2017-03-21 Qualcomm Incorporated Wireless power transmitter with a plurality of magnetic oscillators
US20150018705A1 (en) * 2013-07-12 2015-01-15 Innara Health Neural analysis and treatment system
EP3110323A4 (en) * 2014-02-27 2017-08-09 Univ New York Minimally invasive subgaleal extra-cranial electroencephalography (eeg) monitoring device
EP3277159A1 (en) * 2015-03-31 2018-02-07 Koninklijke Philips N.V. System and method for automatic prediction and prevention of migraine and/or epilepsy
DE102015010189A1 (en) * 2015-08-04 2017-02-09 Infineon Technologies Ag Body parameter monitoring device

Citations (92)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3498287A (en) * 1966-04-28 1970-03-03 Neural Models Ltd Intelligence testing and signal analyzing means and method employing zero crossing detection
US3863625A (en) * 1973-11-02 1975-02-04 Us Health Epileptic seizure warning system
US4494950A (en) * 1982-01-19 1985-01-22 The Johns Hopkins University Plural module medication delivery system
US4505275A (en) * 1977-09-15 1985-03-19 Wu Chen Treatment method and instrumentation system
US4566464A (en) * 1981-07-27 1986-01-28 Piccone Vincent A Implantable epilepsy monitor apparatus
US4573481A (en) * 1984-06-25 1986-03-04 Huntington Institute Of Applied Research Implantable electrode array
US4991582A (en) * 1989-09-22 1991-02-12 Alfred E. Mann Foundation For Scientific Research Hermetically sealed ceramic and metal package for electronic devices implantable in living bodies
US5082861A (en) * 1989-09-26 1992-01-21 Carter-Wallace, Inc. Method for the prevention and control of epileptic seizure associated with complex partial seizures
US5097835A (en) * 1990-04-09 1992-03-24 Ad-Tech Medical Instrument Corporation Subdural electrode with improved lead connection
US5179950A (en) * 1989-11-13 1993-01-19 Cyberonics, Inc. Implanted apparatus having micro processor controlled current and voltage sources with reduced voltage levels when not providing stimulation
US5181520A (en) * 1987-12-22 1993-01-26 Royal Postgraduate Medical School Method and apparatus for analyzing an electro-encephalogram
US5186170A (en) * 1989-11-13 1993-02-16 Cyberonics, Inc. Simultaneous radio frequency and magnetic field microprocessor reset circuit
US5188104A (en) * 1991-02-01 1993-02-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5190029A (en) * 1991-02-14 1993-03-02 Virginia Commonwealth University Formulation for delivery of drugs by metered dose inhalers with reduced or no chlorofluorocarbon content
US5193540A (en) * 1991-12-18 1993-03-16 Alfred E. Mann Foundation For Scientific Research Structure and method of manufacture of an implantable microstimulator
US5193539A (en) * 1991-12-18 1993-03-16 Alfred E. Mann Foundation For Scientific Research Implantable microstimulator
US5292772A (en) * 1989-09-26 1994-03-08 Carter-Wallace, Inc. Method for the prevention and control of epileptic seizure associated with Lennox-Gastaut syndrome
US5293879A (en) * 1991-09-23 1994-03-15 Vitatron Medical, B.V. System an method for detecting tremors such as those which result from parkinson's disease
US5392788A (en) * 1993-02-03 1995-02-28 Hudspeth; William J. Method and device for interpreting concepts and conceptual thought from brainwave data and for assisting for diagnosis of brainwave disfunction
US5486999A (en) * 1994-04-20 1996-01-23 Mebane; Andrew H. Apparatus and method for categorizing health care utilization
US5611350A (en) * 1996-02-08 1997-03-18 John; Michael S. Method and apparatus for facilitating recovery of patients in deep coma
US5704352A (en) * 1995-11-22 1998-01-06 Tremblay; Gerald F. Implantable passive bio-sensor
US5707400A (en) * 1995-09-19 1998-01-13 Cyberonics, Inc. Treating refractory hypertension by nerve stimulation
US5711316A (en) * 1996-04-30 1998-01-27 Medtronic, Inc. Method of treating movement disorders by brain infusion
US5713923A (en) * 1996-05-13 1998-02-03 Medtronic, Inc. Techniques for treating epilepsy by brain stimulation and drug infusion
US5715821A (en) * 1994-12-09 1998-02-10 Biofield Corp. Neural network method and apparatus for disease, injury and bodily condition screening or sensing
US5716377A (en) * 1996-04-25 1998-02-10 Medtronic, Inc. Method of treating movement disorders by brain stimulation
US5720294A (en) * 1996-05-02 1998-02-24 Enhanced Cardiology, Inc. PD2I electrophysiological analyzer
US5857978A (en) * 1996-03-20 1999-01-12 Lockheed Martin Energy Systems, Inc. Epileptic seizure prediction by non-linear methods
US5862803A (en) * 1993-09-04 1999-01-26 Besson; Marcus Wireless medical diagnosis and monitoring equipment
US5876424A (en) * 1997-01-23 1999-03-02 Cardiac Pacemakers, Inc. Ultra-thin hermetic enclosure for implantable medical devices
US6016449A (en) * 1997-10-27 2000-01-18 Neuropace, Inc. System for treatment of neurological disorders
US6018682A (en) * 1998-04-30 2000-01-25 Medtronic, Inc. Implantable seizure warning system
US6042579A (en) * 1997-04-30 2000-03-28 Medtronic, Inc. Techniques for treating neurodegenerative disorders by infusion of nerve growth factors into the brain
US6042548A (en) * 1997-11-14 2000-03-28 Hypervigilant Technologies Virtual neurological monitor and method
US6171239B1 (en) * 1998-08-17 2001-01-09 Emory University Systems, methods, and devices for controlling external devices by signals derived directly from the nervous system
US6176242B1 (en) * 1999-04-30 2001-01-23 Medtronic Inc Method of treating manic depression by brain infusion
US6201980B1 (en) * 1998-10-05 2001-03-13 The Regents Of The University Of California Implantable medical sensor system
US6205359B1 (en) * 1998-10-26 2001-03-20 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6208893B1 (en) * 1998-01-27 2001-03-27 Genetronics, Inc. Electroporation apparatus with connective electrode template
US6339725B1 (en) * 1996-05-31 2002-01-15 The Board Of Trustees Of Southern Illinois University Methods of modulating aspects of brain neural plasticity by vagus nerve stimulation
US6341236B1 (en) * 1999-04-30 2002-01-22 Ivan Osorio Vagal nerve stimulation techniques for treatment of epileptic seizures
US6343226B1 (en) * 1999-06-25 2002-01-29 Neurokinetic Aps Multifunction electrode for neural tissue stimulation
US6353754B1 (en) * 2000-04-24 2002-03-05 Neuropace, Inc. System for the creation of patient specific templates for epileptiform activity detection
US6356784B1 (en) * 1999-04-30 2002-03-12 Medtronic, Inc. Method of treating movement disorders by electrical stimulation and/or drug infusion of the pendunulopontine nucleus
US6354299B1 (en) * 1997-10-27 2002-03-12 Neuropace, Inc. Implantable device for patient communication
US6356788B2 (en) * 1998-10-26 2002-03-12 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for depression, migraine, neuropsychiatric disorders, partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6358203B2 (en) * 1999-06-03 2002-03-19 Cardiac Intelligence Corp. System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care
US6358281B1 (en) * 1999-11-29 2002-03-19 Epic Biosonics Inc. Totally implantable cochlear prosthesis
US20020035338A1 (en) * 1999-12-01 2002-03-21 Dear Stephen P. Epileptic seizure detection and prediction by self-similar methods
US20030004428A1 (en) * 2001-06-28 2003-01-02 Pless Benjamin D. Seizure sensing and detection using an implantable device
US20030009207A1 (en) * 2001-07-09 2003-01-09 Paspa Paul M. Implantable medical lead
US20030013981A1 (en) * 2000-06-26 2003-01-16 Alan Gevins Neurocognitive function EEG measurement method and system
US6510340B1 (en) * 2000-01-10 2003-01-21 Jordan Neuroscience, Inc. Method and apparatus for electroencephalography
US20030018367A1 (en) * 2001-07-23 2003-01-23 Dilorenzo Daniel John Method and apparatus for neuromodulation and phsyiologic modulation for the treatment of metabolic and neuropsychiatric disease
US6511424B1 (en) * 1997-01-11 2003-01-28 Circadian Technologies, Inc. Method of and apparatus for evaluation and mitigation of microsleep events
US20030028072A1 (en) * 2000-08-31 2003-02-06 Neuropace, Inc. Low frequency magnetic neurostimulator for the treatment of neurological disorders
US6529774B1 (en) * 2000-11-09 2003-03-04 Neuropace, Inc. Extradural leads, neurostimulator assemblies, and processes of using them for somatosensory and brain stimulation
US20030050549A1 (en) * 2001-09-13 2003-03-13 Jerzy Sochor Implantable lead connector assembly for implantable devices and methods of using it
US20030050730A1 (en) * 2001-09-07 2003-03-13 John Greeven Method and apparatus for closed-loop pharmaceutical delivery
US6534693B2 (en) * 2000-11-06 2003-03-18 Afmedica, Inc. Surgically implanted devices having reduced scar tissue formation
US6678548B1 (en) * 2000-10-20 2004-01-13 The Trustees Of The University Of Pennsylvania Unified probabilistic framework for predicting and detecting seizure onsets in the brain and multitherapeutic device
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation
US6687538B1 (en) * 2000-06-19 2004-02-03 Medtronic, Inc. Trial neuro stimulator with lead diagnostics
US20040034368A1 (en) * 2000-11-28 2004-02-19 Pless Benjamin D. Ferrule for cranial implant
US20040039427A1 (en) * 2001-01-02 2004-02-26 Cyberonics, Inc. Treatment of obesity by sub-diaphragmatic nerve stimulation
US20040054297A1 (en) * 2002-09-13 2004-03-18 Neuropace, Inc. Spatiotemporal pattern recognition for neurological event detection and prediction in an implantable device
US20040059761A1 (en) * 2002-07-12 2004-03-25 Hively Lee M. Methods for improved forewarning of critical events across multiple data channels
US20050004621A1 (en) * 2002-05-09 2005-01-06 Boveja Birinder R. Method and system for modulating the vagus nerve (10th cranial nerve) with electrical pulses using implanted and external componants, to provide therapy for neurological and neuropsychiatric disorders
US20050010261A1 (en) * 2002-10-21 2005-01-13 The Cleveland Clinic Foundation Application of stimulus to white matter to induce a desired physiological response
US20050015129A1 (en) * 1999-12-09 2005-01-20 Mische Hans A. Methods and devices for the treatment of neurological and physiological disorders
US20050015128A1 (en) * 2003-05-29 2005-01-20 Rezai Ali R. Excess lead retaining and management devices and methods of using same
US20050021313A1 (en) * 2000-04-03 2005-01-27 Nikitin Alexei V. Method, computer program, and system for automated real-time signal analysis for detection, quantification, and prediction of signal changes
US20050021105A1 (en) * 2000-07-13 2005-01-27 Firlik Andrew D. Methods and apparatus for effectuating a change in a neural-function of a patient
US20050021108A1 (en) * 2002-06-28 2005-01-27 Klosterman Daniel J. Bi-directional telemetry system for use with microstimulator
US20050027328A1 (en) * 2000-09-26 2005-02-03 Transneuronix, Inc. Minimally invasive surgery placement of stimulation leads in mediastinal structures
US20050033369A1 (en) * 2003-08-08 2005-02-10 Badelt Steven W. Data Feedback loop for medical therapy adjustment
US20050043772A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Therapy triggered by prediction of disordered breathing
US20050043774A1 (en) * 2003-05-06 2005-02-24 Aspect Medical Systems, Inc System and method of assessment of the efficacy of treatment of neurological disorders using the electroencephalogram
US20050049649A1 (en) * 2002-10-21 2005-03-03 The Cleveland Clinic Foundation Electrical stimulation of the brain
US20060015153A1 (en) * 2004-07-15 2006-01-19 Gliner Bradford E Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy
US20060015034A1 (en) * 2002-10-18 2006-01-19 Jacques Martinerie Analysis method and real time medical or cognitive monitoring device based on the analysis of a subject's cerebral electromagnetic use of said method for characterizing and differenting physiological and pathological states
US6990372B2 (en) * 2002-04-11 2006-01-24 Alfred E. Mann Foundation For Scientific Research Programmable signal analysis device for detecting neurological signals in an implantable device
US20070027367A1 (en) * 2005-08-01 2007-02-01 Microsoft Corporation Mobile, personal, and non-intrusive health monitoring and analysis system
US20070027514A1 (en) * 2005-07-29 2007-02-01 Medtronic, Inc. Electrical stimulation lead with conformable array of electrodes
US7174212B1 (en) * 2003-12-10 2007-02-06 Pacesetter, Inc. Implantable medical device having a casing providing high-speed telemetry
US7177701B1 (en) * 2000-12-29 2007-02-13 Advanced Bionics Corporation System for permanent electrode placement utilizing microelectrode recording methods
US20070035910A1 (en) * 2005-08-15 2007-02-15 Greatbatch-Sierra, Inc. Feedthrough filter capacitor assembly with internally grounded hermetic insulator
US20080021341A1 (en) * 2006-06-23 2008-01-24 Neurovista Corporation A Delware Corporation Methods and Systems for Facilitating Clinical Trials
US7324851B1 (en) * 1998-08-05 2008-01-29 Neurovista Corporation Closed-loop feedback-driven neuromodulation
US20090018609A1 (en) * 1998-08-05 2009-01-15 Dilorenzo Daniel John Closed-Loop Feedback-Driven Neuromodulation
US20100023089A1 (en) * 1998-08-05 2010-01-28 Dilorenzo Daniel John Controlling a Subject's Susceptibility to a Seizure

Family Cites Families (385)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL156981A (en) * 1949-12-06
US3218638A (en) 1962-05-29 1965-11-16 William M Honig Wireless passive biological telemetry system
US3575162A (en) 1968-12-23 1971-04-20 Kenneth R Gaarder Physiological monitors and method of using the same in treatment of disease
US3522811A (en) 1969-02-13 1970-08-04 Medtronic Inc Implantable nerve stimulator and method of use
US3837922A (en) * 1969-09-12 1974-09-24 Inst Gas Technology Implantable fuel cell
US3967616A (en) 1972-10-24 1976-07-06 Ross Sidney A Multichannel system for and a multifactorial method of controlling the nervous system of a living organism
US3837331A (en) 1972-10-24 1974-09-24 S Ross System and method for controlling the nervous system of a living organism
US3850161A (en) 1973-04-09 1974-11-26 S Liss Method and apparatus for monitoring and counteracting excess brain electrical energy to prevent epileptic seizures and the like
US3882850A (en) 1973-05-09 1975-05-13 Howard Bailin Brain wave feedback instrument
US3918461A (en) 1974-01-31 1975-11-11 Irving S Cooper Method for electrically stimulating the human brain
US3993046A (en) 1974-11-06 1976-11-23 Heriberto Fernandez Seizure suppression device
JPS587291B2 (en) 1977-10-08 1983-02-09 Kotsu Igaku Kenkyu Zaidan
JPS6314629B2 (en) 1978-11-28 1988-03-31 Matsushita Electric Ind Co Ltd
US4201224A (en) 1978-12-29 1980-05-06 Roy John E Electroencephalographic method and system for the quantitative description of patient brain states
US4305402A (en) 1979-06-29 1981-12-15 Katims Jefferson J Method for transcutaneous electrical stimulation
US4279258A (en) 1980-03-26 1981-07-21 Roy John E Rapid automatic electroencephalographic evaluation
JPS6343092B2 (en) 1981-04-27 1988-08-29 Toyoda Chuo Kenkyusho Kk
USRE34015E (en) 1981-05-15 1992-08-04 The Children's Medical Center Corporation Brain electrical activity mapping
US4421122A (en) 1981-05-15 1983-12-20 The Children's Medical Center Corporation Brain electrical activity mapping
US4408616A (en) 1981-05-15 1983-10-11 The Children's Medical Center Corporation Brain electricaL activity mapping
US4407299A (en) 1981-05-15 1983-10-04 The Children's Medical Center Corporation Brain electrical activity mapping
US4793353A (en) 1981-06-30 1988-12-27 Borkan William N Non-invasive multiprogrammable tissue stimulator and method
US4612934A (en) 1981-06-30 1986-09-23 Borkan William N Non-invasive multiprogrammable tissue stimulator
US4556061A (en) 1982-08-18 1985-12-03 Cordis Corporation Cardiac pacer with battery consumption monitor circuit
EP0124663A1 (en) 1983-05-04 1984-11-14 General Foods Corporation Compressed tablets
US4545388A (en) 1983-06-09 1985-10-08 Roy John E Self-normed brain state monitoring
US5025807A (en) 1983-09-14 1991-06-25 Jacob Zabara Neurocybernetic prosthesis
US4702254A (en) 1983-09-14 1987-10-27 Jacob Zabara Neurocybernetic prosthesis
US4867164A (en) 1983-09-14 1989-09-19 Jacob Zabara Neurocybernetic prosthesis
EP0156854B1 (en) 1983-09-14 1990-09-05 ZABARA, Jacob Neurocybernetic prosthesis
US4844075A (en) 1984-01-09 1989-07-04 Pain Suppression Labs, Inc. Transcranial stimulation for the treatment of cerebral palsy
US4579125A (en) 1984-01-23 1986-04-01 Cns, Inc. Real-time EEG spectral analyzer
US4590946A (en) 1984-06-14 1986-05-27 Biomed Concepts, Inc. Surgically implantable electrode for nerve bundles
US4768176A (en) 1984-07-06 1988-08-30 Kehr Bruce A Apparatus for alerting a patient to take medication
US4768177A (en) 1984-07-06 1988-08-30 Kehr Bruce A Method of and apparatus for alerting a patient to take medication
US4679144A (en) 1984-08-21 1987-07-07 Q-Med, Inc. Cardiac signal real time monitor and method of analysis
US4686999A (en) * 1985-04-10 1987-08-18 Tri Fund Research Corporation Multi-channel ventilation monitor and method
US4817628A (en) 1985-10-18 1989-04-04 David L. Zealear System and method for evaluating neurological function controlling muscular movements
US5167229A (en) 1986-03-24 1992-12-01 Case Western Reserve University Functional neuromuscular stimulation system
US4735208B1 (en) * 1987-01-09 1995-07-04 Ad Tech Medical Instr Corp Subdural strip electrode for determining epileptogenic foci
US4785827A (en) 1987-01-28 1988-11-22 Minnesota Mining And Manufacturing Company Subcutaneous housing assembly
US5070873A (en) 1987-02-13 1991-12-10 Sigmedics, Inc. Method of and apparatus for electrically stimulating quadriceps muscles of an upper motor unit paraplegic
US5047930A (en) * 1987-06-26 1991-09-10 Nicolet Instrument Corporation Method and system for analysis of long term physiological polygraphic recordings
US4838272A (en) 1987-08-19 1989-06-13 The Regents Of The University Of California Method and apparatus for adaptive closed loop electrical stimulation of muscles
US4926865A (en) 1987-10-01 1990-05-22 Oman Paul S Microcomputer-based nerve and muscle stimulator
US5010891A (en) 1987-10-09 1991-04-30 Biometrak Corporation Cerebral biopotential analysis system and method
US5871472A (en) 1987-11-17 1999-02-16 Brown University Research Foundation Planting devices for the focal release of neuroinhibitory compounds
US4852573A (en) 1987-12-04 1989-08-01 Kennedy Philip R Implantable neural electrode
US5343064A (en) 1988-03-18 1994-08-30 Spangler Leland J Fully integrated single-crystal silicon-on-insulator process, sensors and circuits
US4920979A (en) 1988-10-12 1990-05-01 Huntington Medical Research Institute Bidirectional helical electrode for nerve stimulation
US4873981A (en) 1988-10-14 1989-10-17 Somatics, Inc. Electroconvulsive therapy apparatus and method for automatic monitoring of patient seizures
US4878498A (en) 1988-10-14 1989-11-07 Somatics, Inc. Electroconvulsive therapy apparatus and method for automatic monitoring of patient seizures
US4903702A (en) * 1988-10-17 1990-02-27 Ad-Tech Medical Instrument Corporation Brain-contact for sensing epileptogenic foci with improved accuracy
US5016635A (en) 1988-11-29 1991-05-21 Sigmedics, Inc. Of Delaware Control of FNS via pattern variations of response EMG
US5766573A (en) 1988-12-06 1998-06-16 Riker Laboratories, Inc. Medicinal aerosol formulations
US4955380A (en) 1988-12-15 1990-09-11 Massachusetts Institute Of Technology Flexible measurement probes
FR2645641B1 (en) 1989-04-10 1991-05-31 Bruno Comby Method and device for measuring vibrations, in particular of the microscopic shaking living organisms
EP0399063B1 (en) 1989-05-22 1994-01-05 Pacesetter AB Implantable medical device to stimulate contraction in tissues with an adjustable stimulation intensity, and process for using same
US4978680A (en) 1989-09-26 1990-12-18 Carter-Wallace, Inc. Method for the prevention and control of epileptic seizure
US4979511A (en) 1989-11-03 1990-12-25 Cyberonics, Inc. Strain relief tether for implantable electrode
US5215088A (en) 1989-11-07 1993-06-01 The University Of Utah Three-dimensional electrode device
US5361760A (en) 1989-11-07 1994-11-08 University Of Utah Research Foundation Impact inserter mechanism for implantation of a biomedical device
US5154172A (en) 1989-11-13 1992-10-13 Cyberonics, Inc. Constant current sources with programmable voltage source
US5235980A (en) 1989-11-13 1993-08-17 Cyberonics, Inc. Implanted apparatus disabling switching regulator operation to allow radio frequency signal reception
US5031618A (en) 1990-03-07 1991-07-16 Medtronic, Inc. Position-responsive neuro stimulator
US5314458A (en) 1990-06-01 1994-05-24 University Of Michigan Single channel microstimulator
EP0489879A1 (en) 1990-06-28 1992-06-17 VERHOEVEN, Jean-Marie Method and device for treating epilepsy
DE69209324T2 (en) 1991-01-09 1996-11-21 Medtronic Inc Servo control for muscles
US5263480A (en) 1991-02-01 1993-11-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5269303A (en) 1991-02-22 1993-12-14 Cyberonics, Inc. Treatment of dementia by nerve stimulation
US5222503A (en) 1991-04-24 1993-06-29 Beth Israel Hospital Association Ambulatory electroencephalography system
US5215086A (en) 1991-05-03 1993-06-01 Cyberonics, Inc. Therapeutic treatment of migraine symptoms by stimulation
US5299569A (en) 1991-05-03 1994-04-05 Cyberonics, Inc. Treatment of neuropsychiatric disorders by nerve stimulation
US5251634A (en) 1991-05-03 1993-10-12 Cyberonics, Inc. Helical nerve electrode
US5335657A (en) 1991-05-03 1994-08-09 Cyberonics, Inc. Therapeutic treatment of sleep disorder by nerve stimulation
US5269302A (en) 1991-05-10 1993-12-14 Somatics, Inc. Electroconvulsive therapy apparatus and method for monitoring patient seizures
US5205285A (en) 1991-06-14 1993-04-27 Cyberonics, Inc. Voice suppression of vagal stimulation
US5222494A (en) 1991-07-31 1993-06-29 Cyberonics, Inc. Implantable tissue stimulator output stabilization system
US5231988A (en) 1991-08-09 1993-08-03 Cyberonics, Inc. Treatment of endocrine disorders by nerve stimulation
US5269315A (en) 1991-08-16 1993-12-14 The Regents Of The University Of California Determining the nature of brain lesions by electroencephalography
US5215089A (en) 1991-10-21 1993-06-01 Cyberonics, Inc. Electrode assembly for nerve stimulation
US5458117A (en) 1991-10-25 1995-10-17 Aspect Medical Systems, Inc. Cerebral biopotential analysis system and method
US5304206A (en) 1991-11-18 1994-04-19 Cyberonics, Inc. Activation techniques for implantable medical device
US5237991A (en) 1991-11-19 1993-08-24 Cyberonics, Inc. Implantable medical device with dummy load for pre-implant testing in sterile package and facilitating electrical lead connection
US5312439A (en) 1991-12-12 1994-05-17 Loeb Gerald E Implantable device having an electrolytic storage electrode
US5330515A (en) 1992-06-17 1994-07-19 Cyberonics, Inc. Treatment of pain by vagal afferent stimulation
US5376359A (en) 1992-07-07 1994-12-27 Glaxo, Inc. Method of stabilizing aerosol formulations
US5672154A (en) * 1992-08-27 1997-09-30 Minidoc I Uppsala Ab Method and apparatus for controlled individualized medication
US5476494A (en) 1992-09-11 1995-12-19 Massachusetts Institute Of Technology Low pressure neural contact structure
CA2105781C (en) 1992-09-14 2000-07-11 Alton B. Otis, Jr. Contactless communication system
US5311876A (en) 1992-11-18 1994-05-17 The Johns Hopkins University Automatic detection of seizures using electroencephalographic signals
US6117066A (en) 1992-12-04 2000-09-12 Somatics, Inc. Prevention of seizure arising from medical magnetoictal non-convulsive stimulation therapy
US5769778A (en) 1994-04-22 1998-06-23 Somatics, Inc. Medical magnetic non-convulsive stimulation therapy
US5342408A (en) 1993-01-07 1994-08-30 Incontrol, Inc. Telemetry system for an implantable cardiac device
US5782874A (en) 1993-05-28 1998-07-21 Loos; Hendricus G. Method and apparatus for manipulating nervous systems
US6081744A (en) 1993-05-28 2000-06-27 Loos; Hendricus G. Electric fringe field generator for manipulating nervous systems
US6167304A (en) 1993-05-28 2000-12-26 Loos; Hendricus G. Pulse variability in electric field manipulation of nervous systems
US5411540A (en) 1993-06-03 1995-05-02 Massachusetts Institute Of Technology Method and apparatus for preferential neuron stimulation
US5649068A (en) 1993-07-27 1997-07-15 Lucent Technologies Inc. Pattern recognition system using support vectors
US5549656A (en) 1993-08-16 1996-08-27 Med Serve Group, Inc. Combination neuromuscular stimulator and electromyograph system
US5365939A (en) 1993-10-15 1994-11-22 Neurotrain, L.C. Method for evaluating and treating an individual with electroencephalographic disentrainment feedback
US5349962A (en) 1993-11-30 1994-09-27 University Of Washington Method and apparatus for detecting epileptic seizures
US5578036A (en) * 1993-12-06 1996-11-26 Stone; Kevin T. Method and apparatus for fixation of bone during surgical procedures
US5513649A (en) 1994-03-22 1996-05-07 Sam Technology, Inc. Adaptive interference canceler for EEG movement and eye artifacts
US5782891A (en) * 1994-06-16 1998-07-21 Medtronic, Inc. Implantable ceramic enclosure for pacing, neurological, and other medical applications in the human body
US6249703B1 (en) 1994-07-08 2001-06-19 Medtronic, Inc. Handheld patient programmer for implantable human tissue stimulator
US5571148A (en) 1994-08-10 1996-11-05 Loeb; Gerald E. Implantable multichannel stimulator
US6009061A (en) * 1994-08-25 1999-12-28 Discovision Associates Cartridge-loading apparatus with improved base plate and cartridge receiver latch
US5531778A (en) 1994-09-20 1996-07-02 Cyberonics, Inc. Circumneural electrode assembly
US5540734A (en) 1994-09-28 1996-07-30 Zabara; Jacob Cranial nerve stimulation treatments using neurocybernetic prosthesis
US5555191A (en) 1994-10-12 1996-09-10 Trustees Of Columbia University In The City Of New York Automated statistical tracker
US20020169485A1 (en) 1995-10-16 2002-11-14 Neuropace, Inc. Differential neurostimulation therapy driven by physiological context
US5571150A (en) 1994-12-19 1996-11-05 Cyberonics, Inc. Treatment of patients in coma by nerve stimulation
US5638826A (en) 1995-06-01 1997-06-17 Health Research, Inc. Communication method and system using brain waves for multidimensional control
US5540730A (en) 1995-06-06 1996-07-30 Cyberonics, Inc. Treatment of motility disorders by nerve stimulation
EP0778768B1 (en) 1995-06-09 2004-05-26 Euroceltique S.A. Formulations and methods for providing prolonged local anesthesia
GB9511964D0 (en) 1995-06-13 1995-08-09 Rdm Consultants Limited Monitoring an EEG
US5626627A (en) * 1995-07-27 1997-05-06 Duke University Electroconvulsive therapy method using ICTAL EEG data as an indicator of ECT seizure adequacy
US5700282A (en) 1995-10-13 1997-12-23 Zabara; Jacob Heart rhythm stabilization using a neurocybernetic prosthesis
US5683432A (en) * 1996-01-11 1997-11-04 Medtronic, Inc. Adaptive, performance-optimizing communication system for communicating with an implanted medical device
US7630757B2 (en) 1997-01-06 2009-12-08 Flint Hills Scientific Llc System for the prediction, rapid detection, warning, prevention, or control of changes in activity states in the brain of a subject
US5995868A (en) 1996-01-23 1999-11-30 University Of Kansas System for the prediction, rapid detection, warning, prevention, or control of changes in activity states in the brain of a subject
US6066163A (en) 1996-02-02 2000-05-23 John; Michael Sasha Adaptive brain stimulation method and system
US6463328B1 (en) 1996-02-02 2002-10-08 Michael Sasha John Adaptive brain stimulation method and system
US6051017A (en) 1996-02-20 2000-04-18 Advanced Bionics Corporation Implantable microstimulator and systems employing the same
US5626145A (en) 1996-03-20 1997-05-06 Lockheed Martin Energy Systems, Inc. Method and apparatus for extraction of low-frequency artifacts from brain waves for alertness detection
US5743860A (en) 1996-03-20 1998-04-28 Lockheed Martin Energy Systems, Inc. Apparatus and method for epileptic seizure detection using non-linear techniques
US5690681A (en) 1996-03-29 1997-11-25 Purdue Research Foundation Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation
US5813993A (en) 1996-04-05 1998-09-29 Consolidated Research Of Richmond, Inc. Alertness and drowsiness detection and tracking system
US5683422A (en) 1996-04-25 1997-11-04 Medtronic, Inc. Method and apparatus for treating neurodegenerative disorders by electrical brain stimulation
US6094598A (en) 1996-04-25 2000-07-25 Medtronics, Inc. Method of treating movement disorders by brain stimulation and drug infusion
US5824021A (en) 1996-04-25 1998-10-20 Medtronic Inc. Method and apparatus for providing feedback to spinal cord stimulation for angina
US5735814A (en) 1996-04-30 1998-04-07 Medtronic, Inc. Techniques of treating neurodegenerative disorders by brain infusion
US5690691A (en) * 1996-05-08 1997-11-25 The Center For Innovative Technology Gastro-intestinal pacemaker having phased multi-point stimulation
US5782798A (en) 1996-06-26 1998-07-21 Medtronic, Inc. Techniques for treating eating disorders by brain stimulation and drug infusion
DE19645371C1 (en) * 1996-10-23 1997-12-18 Biotronik Mess & Therapieg Implant, e.g. heart pacemaker, for mounting in human tissue
US5800474A (en) 1996-11-01 1998-09-01 Medtronic, Inc. Method of controlling epilepsy by brain stimulation
US5752979A (en) 1996-11-01 1998-05-19 Medtronic, Inc. Method of controlling epilepsy by brain stimulation
US5957861A (en) 1997-01-31 1999-09-28 Medtronic, Inc. Impedance monitor for discerning edema through evaluation of respiratory rate
US5950632A (en) 1997-03-03 1999-09-14 Motorola, Inc. Medical communication apparatus, system, and method
US7111009B1 (en) 1997-03-14 2006-09-19 Microsoft Corporation Interactive playlist generation using annotations
US20050124863A1 (en) * 2001-06-28 2005-06-09 Cook Daniel R. Drug profiling apparatus and method
US6128537A (en) 1997-05-01 2000-10-03 Medtronic, Inc Techniques for treating anxiety by brain stimulation and drug infusion
US5975085A (en) 1997-05-01 1999-11-02 Medtronic, Inc. Method of treating schizophrenia by brain stimulation and drug infusion
US5815413A (en) 1997-05-08 1998-09-29 Lockheed Martin Energy Research Corporation Integrated method for chaotic time series analysis
US6052619A (en) * 1997-08-07 2000-04-18 New York University Brain function scan system
US6479523B1 (en) 1997-08-26 2002-11-12 Emory University Pharmacologic drug combination in vagal-induced asystole
US6931274B2 (en) 1997-09-23 2005-08-16 Tru-Test Corporation Limited Processing EEG signals to predict brain damage
US5941906A (en) 1997-10-15 1999-08-24 Medtronic, Inc. Implantable, modular tissue stimulator
US5938688A (en) 1997-10-22 1999-08-17 Cornell Research Foundation, Inc. Deep brain stimulation method
US6459936B2 (en) 1997-10-27 2002-10-01 Neuropace, Inc. Methods for responsively treating neurological disorders
US6647296B2 (en) 1997-10-27 2003-11-11 Neuropace, Inc. Implantable apparatus for treating neurological disorders
US6427086B1 (en) 1997-10-27 2002-07-30 Neuropace, Inc. Means and method for the intracranial placement of a neurostimulator
US6597954B1 (en) 1997-10-27 2003-07-22 Neuropace, Inc. System and method for controlling epileptic seizures with spatially separated detection and stimulation electrodes
US5931791A (en) * 1997-11-05 1999-08-03 Instromedix, Inc. Medical patient vital signs-monitoring apparatus
FR2772484B1 (en) 1997-12-12 2000-02-11 Biospace Instr Image Processing Method for autoradiography
DE69921449D1 (en) 1998-01-12 2004-12-02 Ronald P Lesser A process for the treatment of brain suffering by controlled heat supply
US5978710A (en) 1998-01-23 1999-11-02 Sulzer Intermedics Inc. Implantable cardiac stimulator with safe noise mode
US6227203B1 (en) 1998-02-12 2001-05-08 Medtronic, Inc. Techniques for controlling abnormal involuntary movements by brain stimulation and drug infusion
US5971594A (en) 1998-03-24 1999-10-26 Innovative Medical Devices, Inc. Medication dispensing system
US6266556B1 (en) 1998-04-27 2001-07-24 Beth Israel Deaconess Medical Center, Inc. Method and apparatus for recording an electroencephalogram during transcranial magnetic stimulation
US6374140B1 (en) 1998-04-30 2002-04-16 Medtronic, Inc. Method and apparatus for treating seizure disorders by stimulating the olfactory senses
US6411854B1 (en) 1998-04-30 2002-06-25 Advanced Bionics Corporation Implanted ceramic case with enhanced ceramic case strength
US6006134A (en) 1998-04-30 1999-12-21 Medtronic, Inc. Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers
US6006124A (en) 1998-05-01 1999-12-21 Neuropace, Inc. Means and method for the placement of brain electrodes
US5938689A (en) 1998-05-01 1999-08-17 Neuropace, Inc. Electrode configuration for a brain neuropacemaker
US5928272A (en) 1998-05-02 1999-07-27 Cyberonics, Inc. Automatic activation of a neurostimulator device using a detection algorithm based on cardiac activity
US7242984B2 (en) 1998-08-05 2007-07-10 Neurovista Corporation Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease
US7403820B2 (en) 1998-08-05 2008-07-22 Neurovista Corporation Closed-loop feedback-driven neuromodulation
US7747325B2 (en) 1998-08-05 2010-06-29 Neurovista Corporation Systems and methods for monitoring a patient's neurological disease state
US9375573B2 (en) 1998-08-05 2016-06-28 Cyberonics, Inc. Systems and methods for monitoring a patient's neurological disease state
US8762065B2 (en) 1998-08-05 2014-06-24 Cyberonics, Inc. Closed-loop feedback-driven neuromodulation
US7231254B2 (en) 1998-08-05 2007-06-12 Bioneuronics Corporation Closed-loop feedback-driven neuromodulation
US7277758B2 (en) * 1998-08-05 2007-10-02 Neurovista Corporation Methods and systems for predicting future symptomatology in a patient suffering from a neurological or psychiatric disorder
US7209787B2 (en) 1998-08-05 2007-04-24 Bioneuronics Corporation Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease
US6366813B1 (en) 1998-08-05 2002-04-02 Dilorenzo Daniel J. Apparatus and method for closed-loop intracranical stimulation for optimal control of neurological disease
EP1107693A4 (en) 1998-08-24 2003-03-19 Univ Emory Method and apparatus for predicting the onset of seizures based on features derived from signals indicative of brain activity
DE19844296A1 (en) 1998-09-18 2000-03-23 Biotronik Mess & Therapieg Arrangement for patient monitoring
US6366814B1 (en) 1998-10-26 2002-04-02 Birinder R. Boveja External stimulator for adjunct (add-on) treatment for neurological, neuropsychiatric, and urological disorders
US6668191B1 (en) 1998-10-26 2003-12-23 Birinder R. Boveja Apparatus and method for electrical stimulation adjunct (add-on) therapy of atrial fibrillation, inappropriate sinus tachycardia, and refractory hypertension with an external stimulator
US6496724B1 (en) 1998-12-31 2002-12-17 Advanced Brain Monitoring, Inc. Method for the quantification of human alertness
US6280198B1 (en) * 1999-01-29 2001-08-28 Scientific Learning Corporation Remote computer implemented methods for cognitive testing
US6650779B2 (en) 1999-03-26 2003-11-18 Georgia Tech Research Corp. Method and apparatus for analyzing an image to detect and identify patterns
US6109269A (en) 1999-04-30 2000-08-29 Medtronic, Inc. Method of treating addiction by brain infusion
US6923784B2 (en) 1999-04-30 2005-08-02 Medtronic, Inc. Therapeutic treatment of disorders based on timing information
US6161045A (en) 1999-06-01 2000-12-12 Neuropace, Inc. Method for determining stimulation parameters for the treatment of epileptic seizures
DE19930263A1 (en) * 1999-06-25 2000-12-28 Biotronik Mess & Therapieg Method and apparatus for data transmission between an electromedical implant and an external device
US6587719B1 (en) 1999-07-01 2003-07-01 Cyberonics, Inc. Treatment of obesity by bilateral vagus nerve stimulation
CA2314517A1 (en) 1999-07-26 2001-01-26 Gust H. Bardy System and method for determining a reference baseline of individual patient status for use in an automated collection and analysis patient care system
US6221011B1 (en) 1999-07-26 2001-04-24 Cardiac Intelligence Corporation System and method for determining a reference baseline of individual patient status for use in an automated collection and analysis patient care system
US6230049B1 (en) * 1999-08-13 2001-05-08 Neuro Pace, Inc. Integrated system for EEG monitoring and electrical stimulation with a multiplicity of electrodes
US6304775B1 (en) * 1999-09-22 2001-10-16 Leonidas D. Iasemidis Seizure warning and prediction
US6560486B1 (en) 1999-10-12 2003-05-06 Ivan Osorio Bi-directional cerebral interface system
US6473644B1 (en) 1999-10-13 2002-10-29 Cyberonics, Inc. Method to enhance cardiac capillary growth in heart failure patients
US6882881B1 (en) 1999-10-19 2005-04-19 The Johns Hopkins University Techniques using heat flow management, stimulation, and signal analysis to treat medical disorders
US6386882B1 (en) 1999-11-10 2002-05-14 Medtronic, Inc. Remote delivery of software-based training for implantable medical device systems
US6309406B1 (en) 1999-11-24 2001-10-30 Hamit-Darwin-Fresh, Inc. Apparatus and method for inducing epileptic seizures in test animals for anticonvulsant drug screening
CA2393535A1 (en) 1999-12-07 2001-06-14 Krasnow Institute Adaptive electric field modulation of neural systems
US6873872B2 (en) 1999-12-07 2005-03-29 George Mason University Adaptive electric field modulation of neural systems
US6513046B1 (en) * 1999-12-15 2003-01-28 Tangis Corporation Storing and recalling information to augment human memories
WO2001048676A1 (en) 1999-12-24 2001-07-05 Medtronic, Inc. Central network to facilitate remote collaboration with medical instruments
US6471645B1 (en) 1999-12-30 2002-10-29 Medtronic, Inc. Communications system for an implantable device and a drug dispenser
US8002700B2 (en) 1999-12-30 2011-08-23 Medtronic, Inc. Communications system for an implantable medical device and a delivery device
US6328699B1 (en) 2000-01-11 2001-12-11 Cedars-Sinai Medical Center Permanently implantable system and method for detecting, diagnosing and treating congestive heart failure
US7483743B2 (en) * 2000-01-11 2009-01-27 Cedars-Sinai Medical Center System for detecting, diagnosing, and treating cardiovascular disease
US6622036B1 (en) 2000-02-09 2003-09-16 Cns Response Method for classifying and treating physiologic brain imbalances using quantitative EEG
US20010027384A1 (en) 2000-03-01 2001-10-04 Schulze Arthur E. Wireless internet bio-telemetry monitoring system and method
US6473639B1 (en) 2000-03-02 2002-10-29 Neuropace, Inc. Neurological event detection procedure using processed display channel based algorithms and devices incorporating these procedures
US6973342B1 (en) 2000-03-02 2005-12-06 Advanced Neuromodulation Systems, Inc. Flexible bio-probe assembly
US6484132B1 (en) 2000-03-07 2002-11-19 Lockheed Martin Energy Research Corporation Condition assessment of nonlinear processes
DE60107062D1 (en) * 2000-03-31 2004-12-16 Advanced Bionics Corp Totally implantable cochlear prosthesis micro contacts with a variety of
WO2001075660A1 (en) 2000-04-03 2001-10-11 Flint Hills Scientific, L.L.C. Method, computer program, and system for automated real-time signal analysis for detection, quantification, and prediction of signal changes
US6944501B1 (en) 2000-04-05 2005-09-13 Neurospace, Inc. Neurostimulator involving stimulation strategies and process for using it
US6466822B1 (en) 2000-04-05 2002-10-15 Neuropace, Inc. Multimodal neurostimulator and process of using it
US6480743B1 (en) 2000-04-05 2002-11-12 Neuropace, Inc. System and method for adaptive brain stimulation
US7660621B2 (en) * 2000-04-07 2010-02-09 Medtronic, Inc. Medical device introducer
US6441747B1 (en) * 2000-04-18 2002-08-27 Motorola, Inc. Wireless system protocol for telemetry monitoring
US6442421B1 (en) 2000-04-27 2002-08-27 Centre National De La Recherche Scientifique Method for the medical monitoring in real time of a patient from the analysis of electroencephalograms to characterize and differentiate between physiological or pathological conditions, and a method for anticipating epileptic seizures
US6453198B1 (en) 2000-04-28 2002-09-17 Medtronic, Inc. Power management for an implantable medical device
US7120489B2 (en) * 2000-05-08 2006-10-10 Brainsgate, Ltd. Method and apparatus for stimulating the sphenopalatine ganglion to modify properties of the BBB and cerebral blood flow
US20040176359A1 (en) 2001-02-20 2004-09-09 University Of Kentucky Research Foundation Intranasal Benzodiazepine compositions
US6306403B1 (en) 2000-06-14 2001-10-23 Allergan Sales, Inc. Method for treating parkinson's disease with a botulinum toxin
US6505077B1 (en) * 2000-06-19 2003-01-07 Medtronic, Inc. Implantable medical device with external recharging coil electrical connection
WO2001097906A3 (en) 2000-06-20 2002-03-28 Advanced Bionics Corp Apparatus for treatment of mood and/or anxiety disorders by electrical brain stimulation and/or drug infusion
US7010351B2 (en) * 2000-07-13 2006-03-07 Northstar Neuroscience, Inc. Methods and apparatus for effectuating a lasting change in a neural-function of a patient
US7299096B2 (en) * 2001-03-08 2007-11-20 Northstar Neuroscience, Inc. System and method for treating Parkinson's Disease and other movement disorders
US6811562B1 (en) 2000-07-31 2004-11-02 Epicor, Inc. Procedures for photodynamic cardiac ablation therapy and devices for those procedures
US6402678B1 (en) 2000-07-31 2002-06-11 Neuralieve, Inc. Means and method for the treatment of migraine headaches
JP2004507293A (en) 2000-08-15 2004-03-11 ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア Method and apparatus for reducing contamination of the electrical signal
WO2002014635A1 (en) * 2000-08-17 2002-02-21 Biometix Pty Ltd. A security container for medicines and system for filling prescriptions
US6443891B1 (en) 2000-09-20 2002-09-03 Medtronic, Inc. Telemetry modulation protocol system for medical devices
US6488617B1 (en) 2000-10-13 2002-12-03 Universal Hedonics Method and device for producing a desired brain state
WO2002038031A3 (en) 2000-10-30 2003-10-23 Neuropace Inc System and method for determining stimulation parameters for the treatment of epileptic seizures
US7089059B1 (en) 2000-11-03 2006-08-08 Pless Benjamin D Predicting susceptibility to neurological dysfunction based on measured neural electrophysiology
US6591137B1 (en) 2000-11-09 2003-07-08 Neuropace, Inc. Implantable neuromuscular stimulator for the treatment of gastrointestinal disorders
US6618623B1 (en) 2000-11-28 2003-09-09 Neuropace, Inc. Ferrule for cranial implant
US6594524B2 (en) 2000-12-12 2003-07-15 The Trustees Of The University Of Pennsylvania Adaptive method and apparatus for forecasting and controlling neurological disturbances under a multi-level control
DE60115707T2 (en) * 2000-12-21 2006-08-10 Insulet Corp., Beverly A medical device for remote control
US6788975B1 (en) * 2001-01-30 2004-09-07 Advanced Bionics Corporation Fully implantable miniature neurostimulator for stimulation as a therapy for epilepsy
US6571125B2 (en) 2001-02-12 2003-05-27 Medtronic, Inc. Drug delivery device
US6597953B2 (en) 2001-02-20 2003-07-22 Neuropace, Inc. Furcated sensing and stimulation lead
US6901292B2 (en) 2001-03-19 2005-05-31 Medtronic, Inc. Control of externally induced current in an implantable pulse generator
US6889086B2 (en) * 2001-04-06 2005-05-03 Cardiac Pacemakers, Inc. Passive telemetry system for implantable medical device
US8321032B2 (en) 2006-11-09 2012-11-27 Greatbatch Ltd. RFID-enabled AIMD programmer system for identifying MRI compatibility of implanted leads
US7369897B2 (en) 2001-04-19 2008-05-06 Neuro And Cardiac Technologies, Llc Method and system of remotely controlling electrical pulses provided to nerve tissue(s) by an implanted stimulator system for neuromodulation therapies
US6572528B2 (en) 2001-04-20 2003-06-03 Mclean Hospital Corporation Magnetic field stimulation techniques
US6671555B2 (en) 2001-04-27 2003-12-30 Medtronic, Inc. Closed loop neuromodulation for suppression of epileptic activity
US6901296B1 (en) * 2001-05-25 2005-05-31 Advanced Bionics Corporation Methods and systems for direct electrical current stimulation as a therapy for cancer and other neoplastic diseases
US6901294B1 (en) * 2001-05-25 2005-05-31 Advanced Bionics Corporation Methods and systems for direct electrical current stimulation as a therapy for prostatic hypertrophy
US6694159B2 (en) * 2001-07-16 2004-02-17 Art, Advanced Research Technologies Inc. Choice of wavelengths for multiwavelength optical imaging
WO2003009207A1 (en) 2001-07-20 2003-01-30 Medical Research Group Ambulatory medical apparatus and method using a robust communication protocol
US6622038B2 (en) 2001-07-28 2003-09-16 Cyberonics, Inc. Treatment of movement disorders by near-diaphragmatic nerve stimulation
US6622047B2 (en) 2001-07-28 2003-09-16 Cyberonics, Inc. Treatment of neuropsychiatric disorders by near-diaphragmatic nerve stimulation
US8190695B2 (en) * 2001-08-02 2012-05-29 Sony Corporation Remote control system and remote control method, device for performing remote control operation and control method therefor, device operable by remote control operation and control method therefor, and storage medium
US6600956B2 (en) 2001-08-21 2003-07-29 Cyberonics, Inc. Circumneural electrode assembly
US6622041B2 (en) 2001-08-21 2003-09-16 Cyberonics, Inc. Treatment of congestive heart failure and autonomic cardiovascular drive disorders
US6547746B1 (en) 2001-08-27 2003-04-15 Andrew A. Marino Method and apparatus for determining response thresholds
US6760626B1 (en) 2001-08-29 2004-07-06 Birinder R. Boveja Apparatus and method for treatment of neurological and neuropsychiatric disorders using programmerless implantable pulse generator system
US7136695B2 (en) 2001-10-12 2006-11-14 Pless Benjamin D Patient-specific template development for neurological event detection
US20030083716A1 (en) 2001-10-23 2003-05-01 Nicolelis Miguel A.L. Intelligent brain pacemaker for real-time monitoring and controlling of epileptic seizures
US6591132B2 (en) 2001-11-30 2003-07-08 Stellate Systems Inc. Artifact detection in encephalogram data using an event model
US6721603B2 (en) 2002-01-25 2004-04-13 Cyberonics, Inc. Nerve stimulation as a treatment for pain
WO2003063684A3 (en) * 2002-01-25 2003-12-31 Michael W Geatz Evaluation of a patient and prediction of chronic symptoms
US20030144711A1 (en) 2002-01-29 2003-07-31 Neuropace, Inc. Systems and methods for interacting with an implantable medical device
US7110820B2 (en) 2002-02-05 2006-09-19 Tcheng Thomas K Responsive electrical stimulation for movement disorders
US7024249B2 (en) 2002-02-21 2006-04-04 Alfred E. Mann Foundation For Scientific Research Pulsed magnetic control system for interlocking functions of battery powered living tissue stimulators
WO2003073175A3 (en) 2002-02-26 2009-03-26 Brendan Z Allison Method and system for an intelligent supervisory control system
US7269455B2 (en) * 2003-02-26 2007-09-11 Pineda Jaime A Method and system for predicting and preventing seizures
US7460903B2 (en) 2002-07-25 2008-12-02 Pineda Jaime A Method and system for a real time adaptive system for effecting changes in cognitive-emotive profiles
DE10215115A1 (en) 2002-04-05 2003-10-16 Oliver Holzner Process and apparatus for the prevention of epileptic seizures
US6735467B2 (en) 2002-04-15 2004-05-11 Persyst Development Corporation Method and system for detecting seizures using electroencephalograms
US7146222B2 (en) 2002-04-15 2006-12-05 Neurospace, Inc. Reinforced sensing and stimulation leads and use in detection systems
US20030195588A1 (en) 2002-04-16 2003-10-16 Neuropace, Inc. External ear canal interface for the treatment of neurological disorders
CN105326478A (en) * 2002-04-22 2016-02-17 马尔西奥·马克·阿布雷乌 Apparatus and method for measuring biologic parameters
US6937891B2 (en) 2002-04-26 2005-08-30 Medtronic, Inc. Independent therapy programs in an implantable medical device
US6950706B2 (en) 2002-04-26 2005-09-27 Medtronic, Inc. Wave shaping for an implantable medical device
US6921538B2 (en) 2002-05-10 2005-07-26 Allergan, Inc. Therapeutic treatments for neuropsychiatric disorders
US7373198B2 (en) * 2002-07-12 2008-05-13 Bionova Technologies Inc. Method and apparatus for the estimation of anesthetic depth using wavelet analysis of the electroencephalogram
US7139677B2 (en) 2002-07-12 2006-11-21 Ut-Battelle, Llc Methods for consistent forewarning of critical events across multiple data channels
US6934580B1 (en) 2002-07-20 2005-08-23 Flint Hills Scientific, L.L.C. Stimulation methodologies and apparatus for control of brain states
US7007191B2 (en) * 2002-08-23 2006-02-28 Lsi Logic Corporation Method and apparatus for identifying one or more devices having faults in a communication loop
US7373199B2 (en) 2002-08-27 2008-05-13 University Of Florida Research Foundation, Inc. Optimization of multi-dimensional time series processing for seizure warning and prediction
US20060200038A1 (en) 2002-09-13 2006-09-07 Robert Savit Noninvasive nonlinear systems and methods for predicting seizure
US7209790B2 (en) 2002-09-30 2007-04-24 Medtronic, Inc. Multi-mode programmer for medical device communication
US7263467B2 (en) 2002-09-30 2007-08-28 University Of Florida Research Foundation Inc. Multi-dimensional multi-parameter time series processing for seizure warning and prediction
US7460904B2 (en) 2002-10-09 2008-12-02 Wake Forest University Health Sciences Wireless systems and methods for the detection of neural events using onboard processing
WO2004034231A3 (en) 2002-10-11 2005-04-07 Flint Hills Scient Llc Intrinsic timescale decomposition, filtering, and automated analysis of signals of arbitrary origin or timescale
DE60335134D1 (en) 2002-10-11 2011-01-05 Flint Hills Scient Llc Multimodal system for the detection and control of changes in the state of the brain
WO2004034885A3 (en) 2002-10-15 2004-07-01 Medtronic Inc Signal quality monitoring and control for a medical device system
EP1565102A4 (en) 2002-10-15 2008-05-28 Medtronic Inc Synchronization and calibration of clocks for a medical device and calibrated clock
EP1578487B1 (en) 2002-10-15 2012-01-25 Medtronic, Inc. Channel-selective blanking for a medical device system
EP1558330A4 (en) 2002-10-15 2008-10-01 Medtronic Inc Cycle mode providing redundant back-up to ensure termination of treatment therapy in a medical device system
US7174206B2 (en) 2002-10-15 2007-02-06 Medtronic, Inc. Signal quality monitoring and control for a medical device system
WO2004034880A3 (en) 2002-10-15 2004-07-22 Medtronic Inc Timed delay for redelivery of treatment therapy for a medical device system
US20040138518A1 (en) 2002-10-15 2004-07-15 Medtronic, Inc. Medical device system with relaying module for treatment of nervous system disorders
EP1562674A4 (en) 2002-10-15 2008-10-08 Medtronic Inc Control of treatment therapy during start-up and during operation of a medical device system
US8594798B2 (en) 2002-10-15 2013-11-26 Medtronic, Inc. Multi-modal operation of a medical device system
WO2004036377A3 (en) 2002-10-15 2004-07-29 Naresh C Bhavaraju Configuring and testing treatment therapy parameters for a medical device system
US8187181B2 (en) 2002-10-15 2012-05-29 Medtronic, Inc. Scoring of sensed neurological signals for use with a medical device system
US8579786B2 (en) 2002-10-15 2013-11-12 Medtronic, Inc. Screening techniques for management of a nervous system disorder
EP1556127A2 (en) 2002-10-21 2005-07-27 The Cleveland Clinic Foundation Electrical stimulation of the brain
US7212851B2 (en) 2002-10-24 2007-05-01 Brown University Research Foundation Microstructured arrays for cortex interaction and related methods of manufacture and use
WO2004043536A1 (en) 2002-11-12 2004-05-27 Neuropace, Inc. System for adaptive brain stimulation
US20040243146A1 (en) 2002-11-18 2004-12-02 Chesbrough Richard M Method and apparatus for supporting a medical device
WO2004052450A1 (en) * 2002-12-12 2004-06-24 Metin Tulgar Externally activated neuro-implant which directly transmits therapeutic signals
US7294101B2 (en) 2002-12-21 2007-11-13 Neuropace, Inc. Means and methods for treating headaches
US7149581B2 (en) * 2003-01-31 2006-12-12 Medtronic, Inc. Patient monitoring device with multi-antenna receiver
US20050070970A1 (en) 2003-09-29 2005-03-31 Knudson Mark B. Movement disorder stimulation with neural block
US20040199212A1 (en) 2003-04-01 2004-10-07 Fischell David R. External patient alerting system for implantable devices
US7191012B2 (en) 2003-05-11 2007-03-13 Boveja Birinder R Method and system for providing pulsed electrical stimulation to a craniel nerve of a patient to provide therapy for neurological and neuropsychiatric disorders
US20050055035A1 (en) * 2003-05-23 2005-03-10 Cosman Eric Richard Image-based stereotactic frame for non-human animals
US7117108B2 (en) * 2003-05-28 2006-10-03 Paul Ernest Rapp System and method for categorical analysis of time dependent dynamic processes
US20050004622A1 (en) 2003-07-03 2005-01-06 Advanced Neuromodulation Systems System and method for implantable pulse generator with multiple treatment protocols
US20050059867A1 (en) * 2003-09-13 2005-03-17 Cheng Chung Yuan Method for monitoring temperature of patient
US7252090B2 (en) 2003-09-15 2007-08-07 Medtronic, Inc. Selection of neurostimulator parameter configurations using neural network
US7617002B2 (en) 2003-09-15 2009-11-10 Medtronic, Inc. Selection of neurostimulator parameter configurations using decision trees
US7502650B2 (en) 2003-09-22 2009-03-10 Cvrx, Inc. Baroreceptor activation for epilepsy control
US7129836B2 (en) 2003-09-23 2006-10-31 Ge Medical Systems Information Technologies, Inc. Wireless subject monitoring system
US7187967B2 (en) * 2003-09-30 2007-03-06 Neural Signals, Inc. Apparatus and method for detecting neural signals and using neural signals to drive external functions
US8190248B2 (en) * 2003-10-16 2012-05-29 Louisiana Tech University Foundation, Inc. Medical devices for the detection, prevention and/or treatment of neurological disorders, and methods related thereto
US20050113744A1 (en) 2003-11-21 2005-05-26 Cyberkinetics, Inc. Agent delivery systems and related methods under control of biological electrical signals
US20050113885A1 (en) 2003-11-26 2005-05-26 Haubrich Gregory J. Patient notification of medical device telemetry session
US7813799B2 (en) 2003-12-08 2010-10-12 Cardiac Pacemakers, Inc. Adaptive safety pacing
EP1720597A2 (en) * 2004-02-13 2006-11-15 Medtronic, Inc. Methods and apparatus for securing a therapy delivery device within a burr hole
JP2007522249A (en) 2004-02-13 2007-08-09 ニューロモレキュラー・インコーポレイテッドNeuromolecular, Inc. For the treatment of psychiatric conditions, the combination of the nmda receptor antagonist, a mao inhibitor or gadph inhibitor an antidepressant
US20050187789A1 (en) 2004-02-25 2005-08-25 Cardiac Pacemakers, Inc. Advanced patient and medication therapy management system and method
US20050203584A1 (en) * 2004-03-10 2005-09-15 Medtronic, Inc. Telemetry antenna for an implantable medical device
US20050203366A1 (en) 2004-03-12 2005-09-15 Donoghue John P. Neurological event monitoring and therapy systems and related methods
US7881798B2 (en) * 2004-03-16 2011-02-01 Medtronic Inc. Controlling therapy based on sleep quality
US7805196B2 (en) * 2004-03-16 2010-09-28 Medtronic, Inc. Collecting activity information to evaluate therapy
US8055348B2 (en) 2004-03-16 2011-11-08 Medtronic, Inc. Detecting sleep to evaluate therapy
US7387608B2 (en) 2004-04-06 2008-06-17 David A Dunlop Apparatus and method for the treatment of sleep related disorders
JP4705952B2 (en) 2004-04-07 2011-06-22 カーディアック ペースメイカーズ, インコーポレイテッド System and method rf transceiver duty cycle in implantable medical devices
US7283856B2 (en) 2004-04-09 2007-10-16 Neuro Pace, Inc. Implantable lead system with seed electrodes
US7272435B2 (en) 2004-04-15 2007-09-18 Ge Medical Information Technologies, Inc. System and method for sudden cardiac death prediction
US20050231374A1 (en) 2004-04-15 2005-10-20 Diem Bjorn H Data management system
US7532936B2 (en) 2004-04-20 2009-05-12 Advanced Neuromodulation Systems, Inc. Programmable switching device for implantable device
EP1740267A4 (en) 2004-04-28 2008-06-25 Transoma Medical Inc Implantable medical devices and related methods
US7463917B2 (en) * 2004-04-28 2008-12-09 Medtronic, Inc. Electrodes for sustained delivery of energy
US20050245984A1 (en) 2004-04-30 2005-11-03 Medtronic, Inc. Implantable medical device with lubricious material
US20060111644A1 (en) * 2004-05-27 2006-05-25 Children's Medical Center Corporation Patient-specific seizure onset detection system
US7450991B2 (en) 2004-05-28 2008-11-11 Advanced Neuromodulation Systems, Inc. Systems and methods used to reserve a constant battery capacity
WO2006022993A3 (en) 2004-06-10 2006-12-21 Ndi Medical Llc Implantable generator for muscle and nerve stimulation
US8197395B2 (en) 2004-07-14 2012-06-12 Arizona Board Of Regents For And On Behalf Of Arizona State University Pacemaker for treating physiological system dysfunction
US20060025828A1 (en) 2004-07-28 2006-02-02 Armstrong Randolph K Impedance measurement for an implantable device
US7890180B2 (en) * 2004-08-09 2011-02-15 Cardiac Pacemakers, Inc. Secure remote access for an implantable medical device
US20060049957A1 (en) * 2004-08-13 2006-03-09 Surgenor Timothy R Biological interface systems with controlled device selector and related methods
US7463927B1 (en) 2004-09-02 2008-12-09 Intelligent Neurostimulation Microsystems, Llc Self-adaptive system for the automatic detection of discomfort and the automatic generation of SCS therapies for chronic pain control
WO2006035392A1 (en) * 2004-09-27 2006-04-06 Koninklijke Philips Electronics N. V. Biosensors for the analysis of samples
EP1827207A2 (en) 2004-10-04 2007-09-05 Cyberkinetics Neurotechnology Systems, Inc. Biological interface system
US20060095091A1 (en) * 2004-11-02 2006-05-04 Medtronic, Inc. Apparatus for data retention in an implantable medical device
US20060122469A1 (en) * 2004-11-16 2006-06-08 Martel Normand M Remote medical monitoring system
US20060129056A1 (en) * 2004-12-10 2006-06-15 Washington University Electrocorticography telemitter
US8112153B2 (en) * 2004-12-17 2012-02-07 Medtronic, Inc. System and method for monitoring or treating nervous system disorders
US20060293578A1 (en) 2005-02-03 2006-12-28 Rennaker Robert L Ii Brian machine interface device
US7916013B2 (en) * 2005-03-21 2011-03-29 Greatbatch Ltd. RFID detection and identification system for implantable medical devices
US7493167B2 (en) * 2005-03-22 2009-02-17 Greatbatch-Sierra, Inc. Magnetically shielded AIMD housing with window for magnetically actuated switch
US20060253096A1 (en) 2005-04-15 2006-11-09 Blakley Daniel R Intelligent medical cabinet
CN101287411B (en) 2005-04-28 2013-03-06 普罗秋斯生物医学公司 Pharma-informatics system
US8644941B2 (en) * 2005-06-09 2014-02-04 Medtronic, Inc. Peripheral nerve field stimulation and spinal cord stimulation
US20070055320A1 (en) * 2005-09-07 2007-03-08 Northstar Neuroscience, Inc. Methods for treating temporal lobe epilepsy, associated neurological disorders, and other patient functions
US9042974B2 (en) * 2005-09-12 2015-05-26 New York University Apparatus and method for monitoring and treatment of brain disorders
US7729773B2 (en) * 2005-10-19 2010-06-01 Advanced Neuromodualation Systems, Inc. Neural stimulation and optical monitoring systems and methods
EP1965696A2 (en) 2005-12-20 2008-09-10 Philips Electronics N.V. Device for detecting and warning of a medical condition
US20070149952A1 (en) * 2005-12-28 2007-06-28 Mike Bland Systems and methods for characterizing a patient's propensity for a neurological event and for communicating with a pharmacological agent dispenser
US8868172B2 (en) 2005-12-28 2014-10-21 Cyberonics, Inc. Methods and systems for recommending an appropriate action to a patient for managing epilepsy and other neurological disorders
US8725243B2 (en) 2005-12-28 2014-05-13 Cyberonics, Inc. Methods and systems for recommending an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders
US8078618B2 (en) * 2006-01-30 2011-12-13 Eastman Kodak Company Automatic multimode system for organizing and retrieving content data files
US7787945B2 (en) * 2006-03-08 2010-08-31 Neuropace, Inc. Implantable seizure monitor
US8002701B2 (en) * 2006-03-10 2011-08-23 Angel Medical Systems, Inc. Medical alarm and communication system and methods
US8209018B2 (en) * 2006-03-10 2012-06-26 Medtronic, Inc. Probabilistic neurological disorder treatment
US20070217121A1 (en) * 2006-03-14 2007-09-20 Greatbatch Ltd. Integrated Filter Feedthrough Assemblies Made From Low Temperature Co-Fired (LTCC) Tape
JP5649303B2 (en) * 2006-03-30 2015-01-07 エスアールアイ インターナショナルSRI International A method and apparatus for annotating media streams
US7844070B2 (en) 2006-05-30 2010-11-30 Sonitus Medical, Inc. Methods and apparatus for processing audio signals
US7885706B2 (en) * 2006-09-20 2011-02-08 New York University System and device for seizure detection
US20080091090A1 (en) * 2006-10-12 2008-04-17 Kenneth Shane Guillory Self-contained surface physiological monitor with adhesive attachment
US8380311B2 (en) * 2006-10-31 2013-02-19 Medtronic, Inc. Housing for implantable medical device
US9913593B2 (en) * 2006-12-27 2018-03-13 Cyberonics, Inc. Low power device with variable scheduling
US20080161712A1 (en) * 2006-12-27 2008-07-03 Kent Leyde Low Power Device With Contingent Scheduling
US20080221876A1 (en) * 2007-03-08 2008-09-11 Universitat Fur Musik Und Darstellende Kunst Method for processing audio data into a condensed version
US8036736B2 (en) 2007-03-21 2011-10-11 Neuro Vista Corporation Implantable systems and methods for identifying a contra-ictal condition in a subject
US7917218B2 (en) 2007-03-21 2011-03-29 Medtronic, Inc. Filtering capacitor feedthrough assembly
US8075499B2 (en) * 2007-05-18 2011-12-13 Vaidhi Nathan Abnormal motion detector and monitor
US20090171168A1 (en) 2007-12-28 2009-07-02 Leyde Kent W Systems and Method for Recording Clinical Manifestations of a Seizure
US9259591B2 (en) 2007-12-28 2016-02-16 Cyberonics, Inc. Housing for an implantable medical device

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3498287A (en) * 1966-04-28 1970-03-03 Neural Models Ltd Intelligence testing and signal analyzing means and method employing zero crossing detection
US3863625A (en) * 1973-11-02 1975-02-04 Us Health Epileptic seizure warning system
US4505275A (en) * 1977-09-15 1985-03-19 Wu Chen Treatment method and instrumentation system
US4566464A (en) * 1981-07-27 1986-01-28 Piccone Vincent A Implantable epilepsy monitor apparatus
US4494950A (en) * 1982-01-19 1985-01-22 The Johns Hopkins University Plural module medication delivery system
US4573481A (en) * 1984-06-25 1986-03-04 Huntington Institute Of Applied Research Implantable electrode array
US5181520A (en) * 1987-12-22 1993-01-26 Royal Postgraduate Medical School Method and apparatus for analyzing an electro-encephalogram
US4991582A (en) * 1989-09-22 1991-02-12 Alfred E. Mann Foundation For Scientific Research Hermetically sealed ceramic and metal package for electronic devices implantable in living bodies
US5082861A (en) * 1989-09-26 1992-01-21 Carter-Wallace, Inc. Method for the prevention and control of epileptic seizure associated with complex partial seizures
US5292772A (en) * 1989-09-26 1994-03-08 Carter-Wallace, Inc. Method for the prevention and control of epileptic seizure associated with Lennox-Gastaut syndrome
US5179950A (en) * 1989-11-13 1993-01-19 Cyberonics, Inc. Implanted apparatus having micro processor controlled current and voltage sources with reduced voltage levels when not providing stimulation
US5186170A (en) * 1989-11-13 1993-02-16 Cyberonics, Inc. Simultaneous radio frequency and magnetic field microprocessor reset circuit
US5097835A (en) * 1990-04-09 1992-03-24 Ad-Tech Medical Instrument Corporation Subdural electrode with improved lead connection
US5188104A (en) * 1991-02-01 1993-02-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5190029A (en) * 1991-02-14 1993-03-02 Virginia Commonwealth University Formulation for delivery of drugs by metered dose inhalers with reduced or no chlorofluorocarbon content
US5293879A (en) * 1991-09-23 1994-03-15 Vitatron Medical, B.V. System an method for detecting tremors such as those which result from parkinson's disease
US5193539A (en) * 1991-12-18 1993-03-16 Alfred E. Mann Foundation For Scientific Research Implantable microstimulator
US5193540A (en) * 1991-12-18 1993-03-16 Alfred E. Mann Foundation For Scientific Research Structure and method of manufacture of an implantable microstimulator
US5392788A (en) * 1993-02-03 1995-02-28 Hudspeth; William J. Method and device for interpreting concepts and conceptual thought from brainwave data and for assisting for diagnosis of brainwave disfunction
US5862803A (en) * 1993-09-04 1999-01-26 Besson; Marcus Wireless medical diagnosis and monitoring equipment
US5486999A (en) * 1994-04-20 1996-01-23 Mebane; Andrew H. Apparatus and method for categorizing health care utilization
US5715821A (en) * 1994-12-09 1998-02-10 Biofield Corp. Neural network method and apparatus for disease, injury and bodily condition screening or sensing
US5707400A (en) * 1995-09-19 1998-01-13 Cyberonics, Inc. Treating refractory hypertension by nerve stimulation
US5704352A (en) * 1995-11-22 1998-01-06 Tremblay; Gerald F. Implantable passive bio-sensor
US5611350A (en) * 1996-02-08 1997-03-18 John; Michael S. Method and apparatus for facilitating recovery of patients in deep coma
US5857978A (en) * 1996-03-20 1999-01-12 Lockheed Martin Energy Systems, Inc. Epileptic seizure prediction by non-linear methods
US5716377A (en) * 1996-04-25 1998-02-10 Medtronic, Inc. Method of treating movement disorders by brain stimulation
US5711316A (en) * 1996-04-30 1998-01-27 Medtronic, Inc. Method of treating movement disorders by brain infusion
US5720294A (en) * 1996-05-02 1998-02-24 Enhanced Cardiology, Inc. PD2I electrophysiological analyzer
US5713923A (en) * 1996-05-13 1998-02-03 Medtronic, Inc. Techniques for treating epilepsy by brain stimulation and drug infusion
US6339725B1 (en) * 1996-05-31 2002-01-15 The Board Of Trustees Of Southern Illinois University Methods of modulating aspects of brain neural plasticity by vagus nerve stimulation
US6511424B1 (en) * 1997-01-11 2003-01-28 Circadian Technologies, Inc. Method of and apparatus for evaluation and mitigation of microsleep events
US5876424A (en) * 1997-01-23 1999-03-02 Cardiac Pacemakers, Inc. Ultra-thin hermetic enclosure for implantable medical devices
US6042579A (en) * 1997-04-30 2000-03-28 Medtronic, Inc. Techniques for treating neurodegenerative disorders by infusion of nerve growth factors into the brain
US6016449A (en) * 1997-10-27 2000-01-18 Neuropace, Inc. System for treatment of neurological disorders
US20020002390A1 (en) * 1997-10-27 2002-01-03 Fischell Robert E. Implantable neurostimulator having a data communication link
US6354299B1 (en) * 1997-10-27 2002-03-12 Neuropace, Inc. Implantable device for patient communication
US6360122B1 (en) * 1997-10-27 2002-03-19 Neuropace, Inc. Data recording methods for an implantable device
US6042548A (en) * 1997-11-14 2000-03-28 Hypervigilant Technologies Virtual neurological monitor and method
US6208893B1 (en) * 1998-01-27 2001-03-27 Genetronics, Inc. Electroporation apparatus with connective electrode template
US6018682A (en) * 1998-04-30 2000-01-25 Medtronic, Inc. Implantable seizure warning system
US6337997B1 (en) * 1998-04-30 2002-01-08 Medtronic, Inc. Implantable seizure warning system
US20090018609A1 (en) * 1998-08-05 2009-01-15 Dilorenzo Daniel John Closed-Loop Feedback-Driven Neuromodulation
US20100023089A1 (en) * 1998-08-05 2010-01-28 Dilorenzo Daniel John Controlling a Subject's Susceptibility to a Seizure
US7324851B1 (en) * 1998-08-05 2008-01-29 Neurovista Corporation Closed-loop feedback-driven neuromodulation
US6171239B1 (en) * 1998-08-17 2001-01-09 Emory University Systems, methods, and devices for controlling external devices by signals derived directly from the nervous system
US6201980B1 (en) * 1998-10-05 2001-03-13 The Regents Of The University Of California Implantable medical sensor system
US6356788B2 (en) * 1998-10-26 2002-03-12 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for depression, migraine, neuropsychiatric disorders, partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6205359B1 (en) * 1998-10-26 2001-03-20 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6356784B1 (en) * 1999-04-30 2002-03-12 Medtronic, Inc. Method of treating movement disorders by electrical stimulation and/or drug infusion of the pendunulopontine nucleus
US6176242B1 (en) * 1999-04-30 2001-01-23 Medtronic Inc Method of treating manic depression by brain infusion
US6341236B1 (en) * 1999-04-30 2002-01-22 Ivan Osorio Vagal nerve stimulation techniques for treatment of epileptic seizures
US6358203B2 (en) * 1999-06-03 2002-03-19 Cardiac Intelligence Corp. System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care
US6343226B1 (en) * 1999-06-25 2002-01-29 Neurokinetic Aps Multifunction electrode for neural tissue stimulation
US6358281B1 (en) * 1999-11-29 2002-03-19 Epic Biosonics Inc. Totally implantable cochlear prosthesis
US20020035338A1 (en) * 1999-12-01 2002-03-21 Dear Stephen P. Epileptic seizure detection and prediction by self-similar methods
US20050015129A1 (en) * 1999-12-09 2005-01-20 Mische Hans A. Methods and devices for the treatment of neurological and physiological disorders
US6510340B1 (en) * 2000-01-10 2003-01-21 Jordan Neuroscience, Inc. Method and apparatus for electroencephalography
US20050021313A1 (en) * 2000-04-03 2005-01-27 Nikitin Alexei V. Method, computer program, and system for automated real-time signal analysis for detection, quantification, and prediction of signal changes
US6353754B1 (en) * 2000-04-24 2002-03-05 Neuropace, Inc. System for the creation of patient specific templates for epileptiform activity detection
US6687538B1 (en) * 2000-06-19 2004-02-03 Medtronic, Inc. Trial neuro stimulator with lead diagnostics
US20030013981A1 (en) * 2000-06-26 2003-01-16 Alan Gevins Neurocognitive function EEG measurement method and system
US20050021105A1 (en) * 2000-07-13 2005-01-27 Firlik Andrew D. Methods and apparatus for effectuating a change in a neural-function of a patient
US20030028072A1 (en) * 2000-08-31 2003-02-06 Neuropace, Inc. Low frequency magnetic neurostimulator for the treatment of neurological disorders
US20050027328A1 (en) * 2000-09-26 2005-02-03 Transneuronix, Inc. Minimally invasive surgery placement of stimulation leads in mediastinal structures
US6678548B1 (en) * 2000-10-20 2004-01-13 The Trustees Of The University Of Pennsylvania Unified probabilistic framework for predicting and detecting seizure onsets in the brain and multitherapeutic device
US6534693B2 (en) * 2000-11-06 2003-03-18 Afmedica, Inc. Surgically implanted devices having reduced scar tissue formation
US6529774B1 (en) * 2000-11-09 2003-03-04 Neuropace, Inc. Extradural leads, neurostimulator assemblies, and processes of using them for somatosensory and brain stimulation
US20040034368A1 (en) * 2000-11-28 2004-02-19 Pless Benjamin D. Ferrule for cranial implant
US7177701B1 (en) * 2000-12-29 2007-02-13 Advanced Bionics Corporation System for permanent electrode placement utilizing microelectrode recording methods
US20040039427A1 (en) * 2001-01-02 2004-02-26 Cyberonics, Inc. Treatment of obesity by sub-diaphragmatic nerve stimulation
US20030004428A1 (en) * 2001-06-28 2003-01-02 Pless Benjamin D. Seizure sensing and detection using an implantable device
US20030009207A1 (en) * 2001-07-09 2003-01-09 Paspa Paul M. Implantable medical lead
US20030018367A1 (en) * 2001-07-23 2003-01-23 Dilorenzo Daniel John Method and apparatus for neuromodulation and phsyiologic modulation for the treatment of metabolic and neuropsychiatric disease
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation
US20030050730A1 (en) * 2001-09-07 2003-03-13 John Greeven Method and apparatus for closed-loop pharmaceutical delivery
US20030050549A1 (en) * 2001-09-13 2003-03-13 Jerzy Sochor Implantable lead connector assembly for implantable devices and methods of using it
US6990372B2 (en) * 2002-04-11 2006-01-24 Alfred E. Mann Foundation For Scientific Research Programmable signal analysis device for detecting neurological signals in an implantable device
US20050004621A1 (en) * 2002-05-09 2005-01-06 Boveja Birinder R. Method and system for modulating the vagus nerve (10th cranial nerve) with electrical pulses using implanted and external componants, to provide therapy for neurological and neuropsychiatric disorders
US20050021108A1 (en) * 2002-06-28 2005-01-27 Klosterman Daniel J. Bi-directional telemetry system for use with microstimulator
US20040059761A1 (en) * 2002-07-12 2004-03-25 Hively Lee M. Methods for improved forewarning of critical events across multiple data channels
US20040054297A1 (en) * 2002-09-13 2004-03-18 Neuropace, Inc. Spatiotemporal pattern recognition for neurological event detection and prediction in an implantable device
US20060015034A1 (en) * 2002-10-18 2006-01-19 Jacques Martinerie Analysis method and real time medical or cognitive monitoring device based on the analysis of a subject's cerebral electromagnetic use of said method for characterizing and differenting physiological and pathological states
US20050049649A1 (en) * 2002-10-21 2005-03-03 The Cleveland Clinic Foundation Electrical stimulation of the brain
US20050010261A1 (en) * 2002-10-21 2005-01-13 The Cleveland Clinic Foundation Application of stimulus to white matter to induce a desired physiological response
US20050043774A1 (en) * 2003-05-06 2005-02-24 Aspect Medical Systems, Inc System and method of assessment of the efficacy of treatment of neurological disorders using the electroencephalogram
US20050015128A1 (en) * 2003-05-29 2005-01-20 Rezai Ali R. Excess lead retaining and management devices and methods of using same
US20050033369A1 (en) * 2003-08-08 2005-02-10 Badelt Steven W. Data Feedback loop for medical therapy adjustment
US20050043772A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Therapy triggered by prediction of disordered breathing
US7174212B1 (en) * 2003-12-10 2007-02-06 Pacesetter, Inc. Implantable medical device having a casing providing high-speed telemetry
US20060015153A1 (en) * 2004-07-15 2006-01-19 Gliner Bradford E Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy
US20070027514A1 (en) * 2005-07-29 2007-02-01 Medtronic, Inc. Electrical stimulation lead with conformable array of electrodes
US20070027367A1 (en) * 2005-08-01 2007-02-01 Microsoft Corporation Mobile, personal, and non-intrusive health monitoring and analysis system
US20070035910A1 (en) * 2005-08-15 2007-02-15 Greatbatch-Sierra, Inc. Feedthrough filter capacitor assembly with internally grounded hermetic insulator
US20080027348A1 (en) * 2006-06-23 2008-01-31 Neuro Vista Corporation Minimally Invasive Monitoring Systems for Monitoring a Patient's Propensity for a Neurological Event
US20080027515A1 (en) * 2006-06-23 2008-01-31 Neuro Vista Corporation A Delaware Corporation Minimally Invasive Monitoring Systems
US20080027347A1 (en) * 2006-06-23 2008-01-31 Neuro Vista Corporation, A Delaware Corporation Minimally Invasive Monitoring Methods
US20080033502A1 (en) * 2006-06-23 2008-02-07 Neurovista Corporation A Delaware Corporation Minimally Invasive System for Selecting Patient-Specific Therapy Parameters
US20080021341A1 (en) * 2006-06-23 2008-01-24 Neurovista Corporation A Delware Corporation Methods and Systems for Facilitating Clinical Trials

Cited By (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080119900A1 (en) * 1998-08-05 2008-05-22 Dilorenzo Daniel John Providing Output Indicative of Subject's Disease State
US8762065B2 (en) 1998-08-05 2014-06-24 Cyberonics, Inc. Closed-loop feedback-driven neuromodulation
US8781597B2 (en) 1998-08-05 2014-07-15 Cyberonics, Inc. Systems for monitoring a patient's neurological disease state
US9320900B2 (en) 1998-08-05 2016-04-26 Cyberonics, Inc. Methods and systems for determining subject-specific parameters for a neuromodulation therapy
US7930035B2 (en) 1998-08-05 2011-04-19 Neurovista Corporation Providing output indicative of subject's disease state
US9421373B2 (en) 1998-08-05 2016-08-23 Cyberonics, Inc. Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease
US9044188B2 (en) 2005-12-28 2015-06-02 Cyberonics, Inc. Methods and systems for managing epilepsy and other neurological disorders
US9592004B2 (en) 2005-12-28 2017-03-14 Cyberonics, Inc. Methods and systems for managing epilepsy and other neurological disorders
US8725243B2 (en) 2005-12-28 2014-05-13 Cyberonics, Inc. Methods and systems for recommending an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders
US9480845B2 (en) 2006-06-23 2016-11-01 Cyberonics, Inc. Nerve stimulation device with a wearable loop antenna
US8295934B2 (en) 2006-11-14 2012-10-23 Neurovista Corporation Systems and methods of reducing artifact in neurological stimulation systems
US8855775B2 (en) 2006-11-14 2014-10-07 Cyberonics, Inc. Systems and methods of reducing artifact in neurological stimulation systems
US9622675B2 (en) 2007-01-25 2017-04-18 Cyberonics, Inc. Communication error alerting in an epilepsy monitoring system
US8036736B2 (en) 2007-03-21 2011-10-11 Neuro Vista Corporation Implantable systems and methods for identifying a contra-ictal condition in a subject
US8543199B2 (en) 2007-03-21 2013-09-24 Cyberonics, Inc. Implantable systems and methods for identifying a contra-ictal condition in a subject
US9445730B2 (en) 2007-03-21 2016-09-20 Cyberonics, Inc. Implantable systems and methods for identifying a contra-ictal condition in a subject
US8473345B2 (en) 2007-03-29 2013-06-25 The Nielsen Company (Us), Llc Protocol generator and presenter device for analysis of marketing and entertainment effectiveness
US8484081B2 (en) 2007-03-29 2013-07-09 The Nielsen Company (Us), Llc Analysis of marketing and entertainment effectiveness using central nervous system, autonomic nervous system, and effector data
US8386312B2 (en) 2007-05-01 2013-02-26 The Nielsen Company (Us), Llc Neuro-informatics repository system
US9886981B2 (en) 2007-05-01 2018-02-06 The Nielsen Company (Us), Llc Neuro-feedback based stimulus compression device
US20090024449A1 (en) * 2007-05-16 2009-01-22 Neurofocus Inc. Habituation analyzer device utilizing central nervous system, autonomic nervous system and effector system measurements
US20090327068A1 (en) * 2007-05-16 2009-12-31 Neurofocus Inc. Neuro-physiology and neuro-behavioral based stimulus targeting system
US8392253B2 (en) 2007-05-16 2013-03-05 The Nielsen Company (Us), Llc Neuro-physiology and neuro-behavioral based stimulus targeting system
US8494905B2 (en) 2007-06-06 2013-07-23 The Nielsen Company (Us), Llc Audience response analysis using simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)
US8533042B2 (en) 2007-07-30 2013-09-10 The Nielsen Company (Us), Llc Neuro-response stimulus and stimulus attribute resonance estimator
US8392254B2 (en) 2007-08-28 2013-03-05 The Nielsen Company (Us), Llc Consumer experience assessment system
US20090063255A1 (en) * 2007-08-28 2009-03-05 Neurofocus, Inc. Consumer experience assessment system
US8386313B2 (en) 2007-08-28 2013-02-26 The Nielsen Company (Us), Llc Stimulus placement system using subject neuro-response measurements
US8635105B2 (en) 2007-08-28 2014-01-21 The Nielsen Company (Us), Llc Consumer experience portrayal effectiveness assessment system
US8392255B2 (en) 2007-08-29 2013-03-05 The Nielsen Company (Us), Llc Content based selection and meta tagging of advertisement breaks
US8494610B2 (en) 2007-09-20 2013-07-23 The Nielsen Company (Us), Llc Analysis of marketing and entertainment effectiveness using magnetoencephalography
US20100130851A1 (en) * 2008-11-21 2010-05-27 Medtronic, Inc. Stylet for use with image guided systems
US8204574B2 (en) * 2008-11-21 2012-06-19 Medtronic, Inc. Stylet for use with image guided systems
US8849390B2 (en) 2008-12-29 2014-09-30 Cyberonics, Inc. Processing for multi-channel signals
US9289595B2 (en) 2009-01-09 2016-03-22 Cyberonics, Inc. Medical lead termination sleeve for implantable medical devices
US8588933B2 (en) 2009-01-09 2013-11-19 Cyberonics, Inc. Medical lead termination sleeve for implantable medical devices
US8270814B2 (en) 2009-01-21 2012-09-18 The Nielsen Company (Us), Llc Methods and apparatus for providing video with embedded media
US8464288B2 (en) 2009-01-21 2013-06-11 The Nielsen Company (Us), Llc Methods and apparatus for providing personalized media in video
US8977110B2 (en) 2009-01-21 2015-03-10 The Nielsen Company (Us), Llc Methods and apparatus for providing video with embedded media
US8955010B2 (en) 2009-01-21 2015-02-10 The Nielsen Company (Us), Llc Methods and apparatus for providing personalized media in video
US9826284B2 (en) 2009-01-21 2017-11-21 The Nielsen Company (Us), Llc Methods and apparatus for providing alternate media for video decoders
US9357240B2 (en) 2009-01-21 2016-05-31 The Nielsen Company (Us), Llc Methods and apparatus for providing alternate media for video decoders
US8786624B2 (en) 2009-06-02 2014-07-22 Cyberonics, Inc. Processing for multi-channel signals
US20110047121A1 (en) * 2009-08-21 2011-02-24 Neurofocus, Inc. Analysis of the mirror neuron system for evaluation of stimulus
US8655437B2 (en) 2009-08-21 2014-02-18 The Nielsen Company (Us), Llc Analysis of the mirror neuron system for evaluation of stimulus
US8209224B2 (en) 2009-10-29 2012-06-26 The Nielsen Company (Us), Llc Intracluster content management using neuro-response priming data
US9560984B2 (en) 2009-10-29 2017-02-07 The Nielsen Company (Us), Llc Analysis of controlled and automatic attention for introduction of stimulus material
US8762202B2 (en) 2009-10-29 2014-06-24 The Nielson Company (Us), Llc Intracluster content management using neuro-response priming data
US8335716B2 (en) 2009-11-19 2012-12-18 The Nielsen Company (Us), Llc. Multimedia advertisement exchange
US8335715B2 (en) 2009-11-19 2012-12-18 The Nielsen Company (Us), Llc. Advertisement exchange using neuro-response data
US9643019B2 (en) 2010-02-12 2017-05-09 Cyberonics, Inc. Neurological monitoring and alerts
US9454646B2 (en) 2010-04-19 2016-09-27 The Nielsen Company (Us), Llc Short imagery task (SIT) research method
US9336535B2 (en) 2010-05-12 2016-05-10 The Nielsen Company (Us), Llc Neuro-response data synchronization
US8655428B2 (en) 2010-05-12 2014-02-18 The Nielsen Company (Us), Llc Neuro-response data synchronization
US8392250B2 (en) 2010-08-09 2013-03-05 The Nielsen Company (Us), Llc Neuro-response evaluated stimulus in virtual reality environments
US8392251B2 (en) 2010-08-09 2013-03-05 The Nielsen Company (Us), Llc Location aware presentation of stimulus material
US8548852B2 (en) 2010-08-25 2013-10-01 The Nielsen Company (Us), Llc Effective virtual reality environments for presentation of marketing materials
US8396744B2 (en) 2010-08-25 2013-03-12 The Nielsen Company (Us), Llc Effective virtual reality environments for presentation of marketing materials
US9292858B2 (en) 2012-02-27 2016-03-22 The Nielsen Company (Us), Llc Data collection system for aggregating biologically based measures in asynchronous geographically distributed public environments
US9569986B2 (en) 2012-02-27 2017-02-14 The Nielsen Company (Us), Llc System and method for gathering and analyzing biometric user feedback for use in social media and advertising applications
US9451303B2 (en) 2012-02-27 2016-09-20 The Nielsen Company (Us), Llc Method and system for gathering and computing an audience's neurologically-based reactions in a distributed framework involving remote storage and computing
US9215978B2 (en) 2012-08-17 2015-12-22 The Nielsen Company (Us), Llc Systems and methods to gather and analyze electroencephalographic data
US9907482B2 (en) 2012-08-17 2018-03-06 The Nielsen Company (Us), Llc Systems and methods to gather and analyze electroencephalographic data
US8989835B2 (en) 2012-08-17 2015-03-24 The Nielsen Company (Us), Llc Systems and methods to gather and analyze electroencephalographic data
US9060671B2 (en) 2012-08-17 2015-06-23 The Nielsen Company (Us), Llc Systems and methods to gather and analyze electroencephalographic data
US9320450B2 (en) 2013-03-14 2016-04-26 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9668694B2 (en) 2013-03-14 2017-06-06 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9622702B2 (en) 2014-04-03 2017-04-18 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9622703B2 (en) 2014-04-03 2017-04-18 The Nielsen Company (Us), Llc Methods and apparatus to gather and analyze electroencephalographic data
US9936250B2 (en) 2016-05-16 2018-04-03 The Nielsen Company (Us), Llc Methods and apparatus to adjust content presented to an individual

Also Published As

Publication number Publication date Type
US7676263B2 (en) 2010-03-09 grant
WO2007150003A2 (en) 2007-12-27 application
US20110166430A1 (en) 2011-07-07 application
EP2034885A4 (en) 2010-12-01 application
EP2034885A2 (en) 2009-03-18 application
US20080027347A1 (en) 2008-01-31 application
US20080027348A1 (en) 2008-01-31 application
US20150182753A1 (en) 2015-07-02 application
US20080027515A1 (en) 2008-01-31 application
US9480845B2 (en) 2016-11-01 grant
US20080033502A1 (en) 2008-02-07 application
US20080021341A1 (en) 2008-01-24 application
WO2007150003A3 (en) 2008-11-06 application

Similar Documents

Publication Publication Date Title
US7003352B1 (en) Treatment of epilepsy by brain stimulation
US7491181B2 (en) Collecting activity and sleep quality information via a medical device
US7089059B1 (en) Predicting susceptibility to neurological dysfunction based on measured neural electrophysiology
US7155279B2 (en) Treatment of movement disorders with drug therapy
US5231988A (en) Treatment of endocrine disorders by nerve stimulation
US20050209513A1 (en) Collecting sleep quality information via a medical device
US20060265022A1 (en) Modulation and analysis of cerebral perfusion in epilepsy and other neurological disorders
US7242983B2 (en) Channel-selective blanking for a medical device system
US20080045775A1 (en) Method and Apparatus for Affecting Neurologic Function and/or Treating Neurologic Dysfunction Through Timed Neural Stimulation
US20110172744A1 (en) Presentation of information associated with medical device therapy
US7447545B2 (en) Collecting posture information to evaluate therapy
US20090030476A1 (en) Methods and Apparatus for Electrical Stimulation of Tissues Using Signals that Minimize the Effects of Tissue Impedance
US7079977B2 (en) Synchronization and calibration of clocks for a medical device and calibrated clock
US7280867B2 (en) Clustering of recorded patient neurological activity to determine length of a neurological event
US20070149952A1 (en) Systems and methods for characterizing a patient's propensity for a neurological event and for communicating with a pharmacological agent dispenser
US7353065B2 (en) Responsive therapy for psychiatric disorders
US7395113B2 (en) Collecting activity information to evaluate therapy
US8180446B2 (en) Method and system for cyclical neural modulation based on activity state
US20070027484A1 (en) Autonomic nerve stimulation to treat a pancreatic disorder
US20080064934A1 (en) Clustering of recorded patient neurological activity to determine length of a neurological event
US20070179557A1 (en) Controlling neuromodulation using stimulus modalities
US20070255155A1 (en) Method and system for loop recording with overlapping events
US7149572B2 (en) Phase shifting of neurological signals in a medical device system
US7620455B2 (en) Cranial nerve stimulation to treat eating disorders
US7167751B1 (en) Method of using a fully implantable miniature neurostimulator for vagus nerve stimulation

Legal Events

Date Code Title Description
AS Assignment

Owner name: NEUROVISTA CORPORATION,WASHINGTON

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:HARRIS, JOHN F.;LEYDE, KENT W.;MAVOORI, JAIDEEP;SIGNING DATES FROM 20071009 TO 20071010;REEL/FRAME:024591/0323