Apparatus for treating neurological disorders by means of chronic adaptive brain stimulation as a function of local biopotentials
An apparatus and a related method for the deep brain stimulation have been invented wherein the parameters of the stimulation supplied at the human nervous system level are adjusted and optimized continuously by the analysis of the bioelectric signals coming from the tissue adjacent the stimulation electrode itself, adapting the therapy continuously and in line to the patient's clinical state. The apparatus is constituted at least by an electro-catheter ( 1 ) implantable in a patient's brain and equipped with four contacts ( 4, 5, 6, 7 ). Then, there is at least a stimulation module ( 9 ) which generates the stimulating signal ( 15 ) sent to the electro-catheter ( 1 ) and in particular to one of the contacts thereof ( 6 ). The electro-catheter ( 1 ) contemporarily sends a signal characterizing the brain activity coming from the tissue involved by the stimulating signal ( 15 ) to an acquisition module ( 8 ). The characterizing signal is used to determine the feedback of the stimulation parameters ( 15 ) and, consequently, to adapt the therapy continuously to the patient's clinical state.
1. Apparatus for chronic treating neurological disorders by means of brain stimulation comprising:
at least an electro-catheter ( 1 ) implantable into a patient's brain; and
a stimulation device ( 2 ) connected to the electro-catheter and comprising:
at least a stimulation module ( 9 ) for generating a substantially continuous stimulating signal ( 15 ) to be sent to the electro-catheter ( 1 ); and
at least an acquisition module ( 8 ) of a signal characterizing the brain activity coming from the patient's brain, said characterizing signal being the local field potential and being used in case for modifying the stimulating signal ( 15 ),
wherein the stimulation device ( 2 ) is able to detect the local field potential characterizing the brain activity also at the same time of sending the stimulating signal ( 15 ) to the patient, wherein the acquisition module ( 8 ) comprises at least a suppression filter ( 22 ) of a stimulus artefact ( 16 ), the suppression filter ( 22 ) attenuating the stimulus artefact ( 16 ) of a factor A F through a frequency analog conditioning and characterized in that the acquisition module ( 8 ) comprises at least two sub-blocks, one differential amplification sub-block ( 18 ) and one monopolar amplification sub-block ( 19 ), the differential amplification sub-block ( 18 ) allowing amplifying the potential difference of the input signals(V 1 A ;V 2 A ) to the same and allowing obtaining also a difference in the signals (V 01 ) reducing a signal of common mode, the suppression filter ( 22 ) being placed downwards the differential amplification sub-block ( 18 ), said suppression filter ( 22 ) receiving as input the difference of signals (V 01 ) the monopolar amplification sub-block ( 19 ) receiving as input the signal (V 02 ) outgoing from the suppression filter ( 22 ).
2. Apparatus according to claim 1 , wherein the stimulation device ( 2 ) utilizes the characterizing signal for determining the feedback of parameters of the stimulation signal ( 15 ) in order to adapt a therapy to a patient's symptomatic state.
3. Apparatus according to claim 1 , characterized in that said suppression filter ( 22 ) is a low-pass active filter or a notch filter.
4. Apparatus according to claim 1 , wherein the stimulation device ( 2 ) utilizes the characterizing signal for determining an optimum positioning of the electro-catheter ( 1 ) in the subthalamic nucleus during the surgical implantation phase.
5. Apparatus according to claim 1 , wherein the electro-catheter ( 1 ) is equipped with at least three contacts, at least two contacts ( 4 , 7 ) acting as sensors and sending the signals received from the patient's brain to the acquisition module ( 8 ), at least one contact ( 6 ) receiving the stimulating signal ( 15 ) from the stimulation module ( 9 ).
6. Apparatus according to claim 5 , wherein the stimulus artefact ( 16 ) is given by the potential difference recorded between the two contacts-sensors ( 4 , 7 ) and produced by the stimulating signal ( 15 ).
7. Apparatus according to claim 1 , wherein the acquisition module ( 8 ) further comprises a functional module ( 23 ) receiving as input a synchronization signal ( 26 ) coming from the stimulation module ( 9 ), the functional module ( 23 ) being placed upwards the differential amplification sub-block ( 18 ).
8. Apparatus according to claim 7 , wherein the functional module ( 23 ) brings the output voltages (V 1A ; V 2A ) to reference electric potential ( 17 ) during the sending of the stimulation signal ( 15 ) or wherein the functional module ( 23 ) de-couples the output voltages (V 1A ; V 2A ) from the input voltages (V 1 ;V 2 ) during the sending of the stimulation signal ( 15 ).
9. Apparatus according to claim 8 , wherein the acquisition module ( 8 ) further comprises a module ( 29 ) for eliminating the high frequencies produced by the operation of the functional module ( 23 ), said module ( 29 ) being a low-pass filter placed operatively downwards the functional module ( 23 ).
10. Apparatus according to claim 1 , wherein the acquisition module ( 8 ) further comprises a module ( 30 ) for the high-pass filtering apt to eliminate the voltages of common mode and differentials produced by the differences in the interface electro-chemical balances.
11. Apparatus according to claim 1 , wherein a frequency conditioning is implemented by means of a reduced analog amplification and a subsequent high-resolution digital conversion.