Use of evoked potentials in deep brain stimulation neuromodulation
View Patent ↗Methods and systems for providing deep brain stimulation (DBS) for a patient are described. Electrical stimulation is provided to a patient's brain and evoked potentials (EPs) are recorded at two or more electrodes. The EPs evoked and/or recorded at different electrodes are used to estimate if the respective electrodes are located in the same or different anatomical brain regions. The EPs may also be used to predict or suggest appropriate stimulation rates for therapeutic stimulation.
1 . A method of estimating a position of an electrode lead within a patient's brain, wherein the electrode lead comprises a plurality of electrodes, the method comprising:
using one or more of the plurality of electrodes to provide active stimulation to the patient's brain;
using at least a first of the plurality of electrodes to record first evoked potentials (EPs) evoked by the active stimulation and a second of the plurality of electrodes to record second EPs evoked by the active stimulation;
comparing the first EPs and the second EPs to determine a delay between the EPs wherein the delay is indicative a difference in a number or kind of synapses between a first neural circuit giving rise to the first EP and a second neural circuit giving rise to the second EP; and
using the comparison to estimate a location of the electrode lead within the patient's brain.
2 . The method of claim 1 , wherein the first and second EPs comprise evoked resonant neural responses (ERNA).
3 . The method of claim 1 , wherein estimating a location of the electrode lead within the patient's brain comprises determining if the first and second electrodes are in different anatomical brain structures.
4 . The method of claim 1 , further comprising taking an action based on the estimated location of the electrode lead within the patient's brain.
5 . The method of claim 4 , wherein the action comprises moving the electrode lead or suggesting a move of the electrode lead.
6 . The method of claim 4 , wherein the action comprises suggesting or optimizing an electrode configuration, wherein the electrode configuration comprises one or more of the plurality of electrodes assigned to deliver therapeutic stimulation.
7 . The method of claim 4 , wherein the action comprises updating a prior estimate of the electrode lead's location within the patient's brain.
8 . The system of claim 7 , wherein the first and second EPs comprise evoked resonant neural responses (ERNA).
9 . A system for estimating a position of an electrode lead within a patient's brain, wherein the electrode lead comprises a plurality of electrodes, the system comprising:
control circuitry configured to:
use one or more of the plurality of electrodes to provide active stimulation to the patient's brain;
use at least a first of the plurality of electrodes to record first evoked potentials (EPs) evoked by the active stimulation and a second of the plurality of electrodes to record second EPs evoked by the active stimulation;
compare the first EPs and the second EPs to determine a delay between the EPs wherein the delay is indicative a difference in a number or kind of synapses between a first neural circuit giving rise to the first EP and a second neural circuit giving rise to the second EP; and
use the comparison to estimate a location of the electrode lead within the patient's brain.
10 . The system of claim 9 , wherein the first and second EPs comprise evoked compound action potentials (ERNA).
11 . The system of claim 9 , wherein estimating a location of the electrode lead within the patient's brain comprises determining if the first and second electrodes are in different anatomical brain structures.
12 . The system of claim 9 , further configured to take an action based on the location of the electrode lead within the patient's brain.
13 . The system of claim 12 , wherein the action comprises moving the electrode lead or suggesting a move of the electrode lead.
14 . The system of claim 12 , wherein the action comprises suggesting or optimizing an electrode configuration, wherein the electrode configuration comprises one or more of the plurality of electrodes assigned to deliver therapeutic stimulation.
15 . The system of claim 12 , wherein the action comprises updating a prior estimate of the electrode lead's location within the patient's brain.
16 . The system of claim 15 , wherein the updating comprises adjusting a location of a graphical representation of the electrode lead with respect to one or more graphical representations of imaging data using a graphical user interface (GUI).
17 . A method of estimating a position of an electrode lead within a patient's brain, wherein the electrode lead comprises a plurality of electrodes, the method comprising:
using one or more of the plurality of electrodes to provide active stimulation to the patient's brain;
using at least a first of the plurality of electrodes to record first evoked potentials (EPs) evoked by the active stimulation and a second of the plurality of electrodes to record second EPs evoked by the active stimulation;
comparing the first EPs and the second EPs to determine if the first and second electrodes are concurrently in different anatomical brain structures; and
using the comparison to estimate a location of the electrode lead within the patient's brain.
18 . The method of claim 17 , further comprising suggesting a move of the electrode lead based on the estimated location of the electrode lead within the patient's brain.
19 . The method of claim 17 , further comprising suggesting or optimizing an electrode configuration, wherein the electrode configuration comprises one or more of the plurality of electrodes assigned to deliver therapeutic stimulation based on the estimated location of the electrode lead within the patient's brain.
20 . The method of claim 17 , further comprising updating a prior estimate of the electrode lead's location within the patient's brain based on the estimated location of the electrode lead within the patient's brain.