Programming adjustment for brain network treatment
The present invention involves methods and systems for treatment of brain disorders using neuromodulation of brain networks. Implantation occurs by selecting sites which modulate the network in selected manners, or are modulated by a stimulus in a particular manner that is relevant to treatment of the network. The candidate locations within a brain region are evaluated in relation to how these are indirectly modulated by stimulation at a different brain region. Treatment of one or more brain networks associated with a brain disorder is realized with a consideration of network dynamics and coupling effects such as indirect stimulation of non-target regions. A brain modulation system (BMS) increases, decreases, or otherwise modulates network regional activity in a differential manner. Therapy and electrode locations are adjusted using sensed data and target implantation criteria related to the brain network model. Linking rules be derived during the implantation procedure and used in the subsequent adjusting of the therapy of regions of a brain network.
1. A method comprising:
defining, using a processor, a model of a brain network of connected brain structures of a patient, wherein the model of the brain network is calculated using sensed brain activity of the patient from neuroimaging data and includes at least one brain network model value indicating an interaction between at least a first brain structure and a second brain structure of the brain network;
sensing brain activity of the patient to obtain neuroimaging data and submitting said data to the processor to calculate the model of the brain network to obtain the at least one brain network model value indicating the interaction between at least the first brain structure and second brain structure of the brain network,
selecting at least one stimulation parameter of a stimulation protocol which is at least one stimulation parameter of a transcranial magnetic therapy based upon successful treatment of a disorder in a population of patients who have shown a similar abnormal network model value for the interaction;
adjusting at least one stimulation parameter value of the at least one stimulation parameter in a therapy session, based on an evaluation of the sensed brain activity and according to the at least one brain network model value indicating the interaction between at least the first brain structure and the second brain structure; and
providing transcranial magnetic therapy according to the adjusted at least one stimulation parameter value of the stimulation protocol of a stimulation subsystem, the therapy delivered to successfully modulate a selected brain structure.
2. The method of claim 1 , wherein the disorder is depression.
3. The method of claim 1 , wherein the model of the brain network is based on neuroimaging data of the patient including at least one type of data selected from the group of: functional magnetic resonance data of the patient, positron emission topography data of the patient, and electroencephalographic data of the patient.
4. The method of claim 1 , wherein interaction between the first and second brain structures is associated with a disease-specific state or trait.
5. The method of claim 1 , further including operating a clinician programmer to generate and display a graphical user interface that presents the model of the brain network and permits a user to select at least one stimulation parameter value of the stimulation protocol of the transcranial magnetic therapy to adjust a characteristic of the therapy delivered to modulate the selected brain structure by interacting with the graphical user interface.
6. The method of claim 1 , wherein adjusting at least one stimulation parameter value of the at least one stimulation parameter of the transcranial magnetic therapy further comprises adjusting the value to achieve normalization of the model of the brain network as assessed by at least one treatment criterion.
7. The method of claim 1 , wherein successful treatment includes normalization of at least one brain network model value when compared to a population-based normative brain network model.
8. The method of claim 1 , wherein the transcranial magnetic therapy delivered to modulate the selected brain structure is associated with treatment of at least one characteristic of a mood, anxiety, psychiatric, or neurological disorder.
9. The method of claim 1 , wherein adjusting at least one stimulation parameter value of the stimulation protocol includes adjusting at least one of: stimulation amplitude, stimulation frequency, and stimulator location.
10. A system comprising:
a sensor configured to sense activity associated with at least a first brain structure and a second brain structure of a brain network of a patient; and
a processor configured to:
define a model of a brain network of connected brain structures of the patient, wherein the model of the brain network is calculated using a sensing of brain activity of the patient from neuroimaging data and includes at least one brain network model value indicating an interaction between the first brain structure and the second brain structure of the brain network;
permit responsive selection of at least one stimulation parameter of a stimulation protocol which is at least one stimulation parameter of transcranial magnetic therapy based upon successful treatment of a disorder in a population of patients who have shown a similar abnormal network model value for the interaction between the at least first and second brain structures of the brain network;
permit responsive adjustment of at least one stimulation parameter value of the stimulation protocol, based on an evaluation of the sensed brain activity, and according to the at least one brain network model value indicating the interaction between at least the first brain structure and the second brain structure of the brain network; and,
control a stimulation subsystem to provide transcranial magnetic therapy according to the selected at least one stimulation parameter of a stimulation protocol of the stimulation subsystem, the therapy delivered to modulate a selected brain structure.
11. The system of claim 10 , wherein the disorder is depression.
12. The system of claim 10 , wherein the neuroimaging data include at least one type of data selected from the group of: functional magnetic resonance data of the patient, positron emission topography data of the patient, and electroencephalographic data of the patient.
13. The system of claim 10 , wherein the interaction between the first and second brain structures is associated with a disease-specific state or trait.
14. The system of claim 10 , further including a clinician programmer configured to generate and display a graphical user interface that presents the model of the brain network and permits a user to select at least one stimulation parameter value to adjust transcranial magnetic therapy delivered to modulate the selected brain structure by interacting with the graphical user interface.
15. The system of claim 10 , wherein the processor is further configured to adjust the at least one stimulation parameter value of the at least one stimulation parameter of the stimulation protocol of the transcranial magnetic therapy to achieve normalization of the model of the brain network as assessed by at least one treatment criterion.
16. The system of claim 10 , further comprising a memory, the memory configured for storing data of the model of the brain network, wherein the processor is further configured to compare data of the model of the brain network of the patient to stored population based normative brain network model data, said comparison assessing normalization of the abnormal network model value in the model of the brain network of the patient.
17. The system of claim 10 , wherein responsive adjustment of the at least one stimulation parameter value of the stimulation protocol includes an adjustment of at least one of: stimulation amplitude, stimulation frequency, and stimulator location.