Method and apparatus for measurement of neural response
A method for determining a desired location at which to apply a neural therapy. An array of electrodes is positioned proximal to neural tissue. A stimulus is applied from the array which evokes a neural compound action potential response in the neural tissue proximal to the array. A plurality of electrodes of the array simultaneously obtain respective measurements of the neural compound action potential response. From the measurements of the neural compound action potential response a desired location for a neural therapy is determined.
1. A method for determining an indication of efficacy of a neural therapy, the method comprising:
applying, using a first plurality of electrodes from an array of electrodes implanted proximal to neural tissue, a first stimulus which evokes a neural compound action potential response in the neural tissue proximal to the array of electrodes;
obtaining, using a second plurality of electrodes from the array of electrodes, a plurality of simultaneous measurements of the neural compound action potential response evoked by the stimulus;
determining, from the plurality of simultaneous measurements of the neural compound action potential response, a neural sensitivity map of the neural tissue proximal to the array of electrodes; and
determining, from the neural activity map, the indication of efficacy of the neural therapy.
2. The method of claim 1 when applied intra-operatively in order to provide intra-operative information regarding the neural compound action potential response.
3. The method of claim 1 wherein the stimulus is applied under control of a remote control of the array of electrodes.
4. The method of claim 1 , wherein the determining comprises determining a presence of a strong A-beta fibre response from the simultaneous measurements of the neural compound action potential response.
5. The method of claim 1 , further comprising:
repeating the applying and obtaining for at least one further stimulus of a different intensity to the first applied stimulus, thereby yielding a plurality of measurements of neural compound action potential responses; and
fitting a growth curve to the plurality of measurements of the neural compound action potential responses.
6. The method of claim 5 further comprising estimating a threshold from the growth curve.
7. The method of claim 6 , wherein the determining the indication of efficacy comprises using a correlation between the estimated threshold with one or more patient outcomes of the neural therapy.
8. The method of claim 1 , wherein the obtaining comprises obtaining the plurality of simultaneous measurements from respective distinct measurement amplifiers each connected to respective distinct electrodes of the second plurality of electrodes.
9. The method of claim 1 , wherein the determining the indication of efficacy comprises using a correlation of neural sensitivity map measures with one or more patient outcomes of the neural therapy.
10. The method of claim 9 , wherein the neural sensitivity map measures comprise measures of a conduction velocity of the neural compound action potential response.
11. The method of claim 9 , wherein the neural sensitivity map measures comprise measures of an amplitude of the neural compound action potential response.
12. The method of claim 9 , wherein the neural sensitivity map measures comprise measures of a refractory period of the neural tissue proximal to the array of electrodes.
13. A system for determining an indication of efficacy of a neural therapy, the system comprising:
an array of electrodes configured to be implanted proximal to neural tissue; and
a control unit configured to:
cause application of a first stimulus from the array which evokes a neural compound action potential response in the neural tissue proximal to the array of electrodes;
obtain, using a second plurality of electrodes from the array of electrodes, a plurality of simultaneous measurements of the neural compound action potential response evoked by the stimulus;
determine, from the plurality of simultaneous measurements of the neural compound action potential response, a neural sensitivity map of the neural tissue proximal to the array of electrodes; and
determine from the neural sensitivity map the indication of efficacy of the neural therapy.
14. The system of claim 13 , wherein the control unit is further configured to determine the indication of efficacy by determining a presence of a strong A-beta fibre response from the simultaneous measurements of the neural compound action potential response.
15. The system of claim 14 , wherein the control unit is further configured to:
repeat the applying and obtaining for at least one further stimulus of a different intensity to the first applied stimulus, thereby yielding a plurality of measurements of neural compound action potential responses; and
fit a growth curve to the plurality of measurements of the neural compound action potential responses.
16. The system of claim 13 , wherein the control unit is further configured to simultaneously obtain the plurality of simultaneous measurements of the neural compound action potential response from respective distinct measurement amplifiers each connected to respective distinct electrodes of the second plurality of electrodes from the array of electrodes.
17. The system of claim 13 , wherein the determining the indication of efficacy comprises using a correlation of neural sensitivity map measures with one or more patient outcomes of the neural therapy, and wherein the neural sensitivity map measures comprise measures of an amplitude of the neural compound action potential response.