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1. 发明申请

WO2018160271A1 DEVICES AND METHODS FOR SENSING PHYSIOLOGICAL SIGNALS DURING STIMULATION THERAPY 审中-公开
公开(公告)号：WO2018160271A1
公开(公告)日：2018-09-07
申请号：PCT/US2018/012758
申请日：2018-01-08
申请人： MEDTRONIC, INC.
发明人： STANSLASKI, Scott R. , DEVINE, Robert J. , DENISON, Timothy J. , ROCZNIAK, Vincent A. , SMITH, Todd V. , ADAMSKI, Thomas H.
IPC分类号： A61N1/36
摘要： Devices and methods provide for the sensing of physiological signals by providing a stimulation waveform that includes a stimulation pulse followed by an active recharge pulse to clear the charge in capacitors within the stimulation path. The active recharge pulse is followed by a period of passive recharge and then a period of no recharge. Non-neurological sources of artifacts within the sensed physiological signal may be handled by providing a brief period of passive recharge followed by a lengthy period of no recharge, which is made possible by the use of the active recharge pulse prior to the passive recharge. The period of no recharge removes any low impedance path to ground from the stimulation electrodes, which allows an amplifier of the sensing circuit to provide common mode rejection of non-neurological signals, such as cardiac signals, present at the sensing electrodes.

2. 发明申请

WO2013123112A1 BRAIN STIMULATION RESPONSE PROFILING 审中-公开
标题翻译：脑刺激反应概况
公开(公告)号：WO2013123112A1
公开(公告)日：2013-08-22
申请号：PCT/US2013/026024
申请日：2013-02-14
申请人： MEDTRONIC, INC.
发明人： GIFTAKIS, Jonathon E. , STYPULKOWSKI, Paul H. , DENISON, Timothy J. , STANSLASKI, Scott R.
IPC分类号： A61N1/36 , A61B5/00 , A61B5/04 , A61N1/05
CPC分类号： A61N1/36082 , A61B5/04001 , A61B5/04012 , A61B5/0476 , A61B5/048 , A61B5/4094 , A61B5/4848 , A61B5/7282 , A61N1/0534 , A61N1/36064 , A61N1/36067 , A61N1/36139 , A61N1/3615 , A61N1/36167
摘要： Various embodiments concern delivering electrical stimulation to the brain at a plurality of different levels of a stimulation parameter and sensing a bioelectrical response of the brain to delivery of the electrical stimulation for each of the plurality of different levels of the stimulation parameter. A suppression window of the stimulation parameter can be identified as having a suppression threshold as a lower boundary and an after-discharge threshold as an upper boundary based on the sensed bioelectrical responses. A therapy level of the stimulation parameter can be set for therapy delivery based on the suppression window. The therapy level of the stimulation parameter may be set closer to the suppression threshold than the after-discharge threshold within the suppression window. Data for hippocampal stimulation demonstrating a suppression window is presented.
摘要翻译：各种实施例涉及在多个不同水平的刺激参数下向大脑递送电刺激，并且感测脑的生物电响应以递送刺激参数的多个不同级别中的每一个的电刺激。刺激参数的抑制窗口可以基于感测的生物电响应被识别为具有作为下边界的抑制阈值和放电后阈值作为上边界。刺激参数的治疗水平可以设置为基于抑制窗口的治疗输送。刺激参数的治疗水平可以设定为比抑制窗口内的放电后阈值更接近抑制阈值。提出海马刺激的数据表明抑制窗口。

3. 发明申请

WO2013028680A2 METHOD AND APPARATUS FOR DETECTING A BIOMARKER IN THE PRESENCE OF ELECTRICAL STIMULATION 审中-公开
标题翻译：在存在电刺激下检测生物标志物的方法和设备
公开(公告)号：WO2013028680A2
公开(公告)日：2013-02-28
申请号：PCT/US2012/051705
申请日：2012-08-21
申请人： MEDTRONIC, INC. , CARLSON, David L. , AFSHAR, Pedram , DENISON, Timothy J. , GIFTAKIS, Jonathon E. , LINDE, David E. , STANSLASKI, Scott R.
发明人： CARLSON, David L. , AFSHAR, Pedram , DENISON, Timothy J. , GIFTAKIS, Jonathon E. , LINDE, David E. , STANSLASKI, Scott R.
IPC分类号： A61B5/04
CPC分类号： A61B5/04012 , A61B5/04001 , A61B5/04014 , A61B5/0476 , A61B5/0488 , A61B5/0496 , A61B5/4082 , A61B5/4094 , A61B5/7264 , A61B5/7282
摘要： Various embodiments concern identifying a biomarker in the presence of electrical stimulation. Various embodiments concern delivering electrical stimulation to a patient and sensing one or more signals while the electrical stimulation is being delivered, the one or more signals including data indicative of physiological activity. Various embodiments further include determining an intensity of the electrical stimulation and determining whether the data indicates the presence of a biomarker based on a variable threshold, the variable threshold being variable based on the intensity of the electrical stimulation. Various embodiments concern determining a relationship between stimulation intensity and a biomarker parameter to determine the variability of the variable threshold.
摘要翻译：各种实施方案涉及在存在电刺激的情况下鉴定生物标志物。各种实施例涉及在电刺激正被递送的同时向患者递送电刺激并且感测一个或多个信号，所述一个或多个信号包括指示生理活动的数据。各种实施例还包括确定电刺激的强度并且基于可变阈值确定数据是否指示生物标志物的存在，可变阈值基于电刺激的强度是可变的。各种实施例涉及确定刺激强度与生物标志物参数之间的关系以确定可变阈值的可变性。

4. 发明申请

WO2018064193A1 ADAPTIVE DEEP BRAIN STIMULATION USING HOMEOSTATIC WINDOW 审中-公开
标题翻译：使用遥控窗口进行自适应深层脑刺激
公开(公告)号：WO2018064193A1
公开(公告)日：2018-04-05
申请号：PCT/US2017/053770
申请日：2017-09-27
申请人： MEDTRONIC, INC.
发明人： STANSLASKI, Scott R. , ADAMSKI, Thomas , BOURGET, Duane L. , DENISON, Timothy J. , ISAACSON, Benjamin P. , PANKEN, Eric J. , RAIKE, Robert S. , PULLIAM, Christopher , ABRAHAM, Timothy R. , HERRON, Jeffrey
IPC分类号： A61N1/36 , A61B5/04 , A61B5/00 , A61N1/05
摘要： Techniques are disclosed for defining a homeostatic window for controlling delivery of electrical stimulation therapy to a patient. In one example, a method includes generating and delivering electrical stimulation therapy to tissue of a patient via electrodes. Further, the method includes adjusting a level of a parameter of the electrical stimulation therapy such that a signal of the patient is not less than a lower bound and not greater than an upper bound. The lower bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce one or more symptoms of a disease while the patient was receiving medication for reduction of the one or more symptoms. Further, the upper bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce the one or more symptoms when the patient was not receiving the medication.
摘要翻译：公开了用于限定用于控制向患者递送电刺激治疗的稳态窗口的技术。在一个示例中，一种方法包括通过电极产生电刺激治疗并将其递送至患者组织。此外，该方法包括调整电刺激治疗的参数的水平，使得患者的信号不小于下限且不大于上限。确定下限是当接受电刺激治疗时信号的幅度，该电刺激治疗足以在患者接受用于减少一种或多种症状的药物的同时减少疾病的一种或多种症状。此外，当患者没有接受药物时，上限被确定为信号的幅度，同时接受足以减少一种或多种症状的电刺激疗法。

5. 发明申请

WO2015065599A1 DEVICES FOR SENSING PHYSIOLOGICAL SIGNALS DURING STIMULATION THERAPY 审中-公开
标题翻译：在刺激治疗期间用于感测生理信号的装置
公开(公告)号：WO2015065599A1
公开(公告)日：2015-05-07
申请号：PCT/US2014/055553
申请日：2014-09-15
申请人： MEDTRONIC, INC.
发明人： STANSLASKI, Scott R. , CONG, Peng , SANTA, Wesley A. , DENISON, Timothy J.
IPC分类号： A61N1/36 , A61B5/00 , A61B5/04
CPC分类号： A61B5/04001 , A61B5/40 , A61B5/4836 , A61B5/7217 , A61B5/7225 , A61N1/36 , A61N1/3605 , A61N1/36125
摘要： Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the amplifiers are not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals between stimulation waveform pulses. A blanking switch may be used to blank the stimulation waveform artifacts where the blanking switch is operated in a manner synchronized with the stimulation waveform so that conduction in the sensing path is blocked during the stimulation pulse as well as during other troublesome artifacts such as a peak of a recharge pulse. A limiter may be used to limit the amplitude of the sensed signal, and hence the stimulation artifacts, that are passed to the amplifier without any synchronization of the limiter to the stimulation waveform.
摘要翻译：装置和方法通过防止刺激波形伪影通过到感测的生理信号的放大来提供在刺激治疗期间感测生理信号。因此，放大器不受刺激波形的不利影响，并且可以提供刺激波形脉冲之间的生理信号的成功感测。消隐开关可以用于消除刺激波形伪影，其中消隐开关以与刺激波形同步的方式操作，使得感测路径中的传导在刺激脉冲期间以及在其他麻烦的伪像期间被阻塞，例如峰值的充电脉冲。可以使用限制器来限制感测信号的幅度，并且因此限制器将刺激伪影传递到放大器而不限制器与刺激波形的任何同步。

6. 发明申请

WO2011152932A1 IMPLANTABLE MEDICAL PUMP WITH PRESSURE SENSOR 审中-公开
标题翻译：带压力传感器的可植入医用泵
公开(公告)号：WO2011152932A1
公开(公告)日：2011-12-08
申请号：PCT/US2011/034068
申请日：2011-04-27
申请人： MEDTRONIC, INC. , MIESEL, Keith A. , HAASE, James M. , PAIDOSH, Chris J. , JANZIG, Darren A. , DENISON, Timothy J.
发明人： MIESEL, Keith A. , HAASE, James M. , PAIDOSH, Chris J. , JANZIG, Darren A. , DENISON, Timothy J.
IPC分类号： A61M5/142 , A61M39/02
CPC分类号： A61M5/14276 , A61M39/0208 , A61M2205/3317 , A61M2205/3331 , G01L9/0072 , G01L15/00 , G01L19/0023 , G01L19/0069 , G01L19/086 , G01L19/143 , G01L19/148 , G01L19/149
摘要： The disclosure is directed to a pressure sensor (26) of an implantable medical device (16). The pressure sensor may utilize detect fluid pressure based on a changing capacitance between two capacitive elements. The pressure sensor may define at least a portion of a fluid enclosure of the IMD. In one example, the pressure sensor has a self - aligning housing shape that occludes an opening in the pump bulkhead (14) of the IMD. An operative surface of the pressure and the portion of the fluid enclosure may be formed of a corrosion resistant and/or biocompatible material. A first capacitive element of the pressure sensor may be a metal alloy diaphragm that deflects in response to external fluid pressure. A second capacitive element of the pressure sensor may be a metal coating on a rigid insulator sealed from the fluid by the diaphragm and a housing of the sensor.
摘要翻译：本公开涉及可植入医疗装置（16）的压力传感器（26）。压力传感器可以利用基于两个电容元件之间的变化的电容的检测流体压力。压力传感器可以限定IMD的流体外壳的至少一部分。在一个示例中，压力传感器具有封闭IMD的泵隔板（14）中的开口的自对准壳体形状。压力的操作表面和流体外壳的一部分可以由耐腐蚀和/或生物相容的材料形成。压力传感器的第一电容元件可以是响应于外部流体压力而偏转的金属合金膜片。压力传感器的第二电容元件可以是通过隔膜和传感器的壳体与流体密封的刚性绝缘体上的金属涂层。

7. 发明申请

WO2009131719A1 FLOW SENSOR CONTROLLED INFUSION DEVICE 审中-公开
标题翻译：流量传感器控制输液装置
公开(公告)号：WO2009131719A1
公开(公告)日：2009-10-29
申请号：PCT/US2009/030837
申请日：2009-01-13
申请人： MEDTRONIC, INC. , SEELEY, Dale F. , DENISON, Timothy J.
发明人： SEELEY, Dale F. , DENISON, Timothy J.
IPC分类号： A61M5/168
CPC分类号： A61M5/14276 , A61M5/16804
摘要： An implantable infusion device includes an outlet and a reservoir. A flow path in fluid communication with the reservoir and the outlet includes a pressure regulator and a flow restrictor. The pressure regulator includes a major chamber and a diaphragm that divides the major chamber into first and second minor chambers. The flow restrictor is in fluid communication with the first and second minor chambers of the pressure regulator and is disposed downstream of the first minor chamber and upstream of the second minor chamber. The device also includes a processor coupled to a flow sensor to detect information regarding flow rate of the fluid downstream of the flow restrictor and a pressure adjustment actuator assembly. The processor provides regulates the flow of the fluid by adjusting the pressure in the first minor chamber relative to pressure in the second minor chamber based on the information from the sensor.
摘要翻译：植入式输注装置包括出口和储存器。与储存器和出口流体连通的流路包括压力调节器和限流器。压力调节器包括主室和隔膜，其将主室分成第一和第二小室。限流器与压力调节器的第一和第二小室流体连通并且设置在第一小室的下游和第二小室的上游。该装置还包括耦合到流量传感器的处理器，以检测关于限流器下游的流体的流量的信息和压力调节致动器组件。处理器基于来自传感器的信息，通过相对于第二小室中的压力调节第一小室中的压力来调节流体的流动。

8. 发明申请

WO2009042313A1 CHOPPER-STABILIZED ANALOG-TO-DIGITAL CONVERTER 审中-公开
标题翻译： CHOPPER稳定的模拟数字转换器
公开(公告)号：WO2009042313A1
公开(公告)日：2009-04-02
申请号：PCT/US2008/073458
申请日：2008-08-18
申请人： MEDTRONIC, INC. , DENISON, Timothy J. , HEINKS, Michael W. , ANDERSON, Joel A.
发明人： DENISON, Timothy J. , HEINKS, Michael W. , ANDERSON, Joel A.
IPC分类号： H03M3/02
CPC分类号： A61B5/7203 , A61B5/04012 , A61B5/7217 , A61B5/7228 , A61B5/7242 , H03M3/34 , H03M3/39
摘要： This disclosure describes a chopper-stabilized sigma-delta analog-to-digital converter (ADC). The ADC is configured to provide accurate output at low frequency with relatively low power. The chopper stabilized ADC substantially reduces or eliminates noise and offset from an output signal produced by the mixer amplifier. Dynamic limitations, i.e., glitching that result from chopper stabilization at low power are substantially eliminated or reduced through a combination of chopping at low impedance nodes within the mixer amplifier and feedback. The signal path of the ADC operates as a continuous time system, providing minimal aliasing of noise or external signals entering the signal pathway at the chop frequency or its harmonics. In this manner, the chopper-stabilized ADC can be used in a low power system, such as an implantable medical device (IMD), to provide a stable, low-noise output signal.
摘要翻译：本公开描述了斩波稳定的Σ-Δ模数转换器（ADC）。 ADC配置为以较低功率提供低频精确输出。斩波稳定ADC大大减少或消除了由混频放大器产生的输出信号的噪声和偏移。通过在混频放大器和反馈中的低阻抗节点处的斩波的组合，基本上消除或减少动态限制，即，在低功率下由斩波器稳定产生的啁啾。 ADC的信号路径作为连续时间系统工作，在斩波频率或其谐波处提供噪声或进入信号通道的外部信号的最小混叠。以这种方式，斩波稳定的ADC可以用在诸如可植入医疗设备（IMD）的低功率系统中，以提供稳定的低噪声输出信号。

9. 发明申请

WO2016164179A1 TIMED DELIVERY OF ELECTRICAL STIMULATION THERAPY 审中-公开
标题翻译：定时递送电刺激治疗
公开(公告)号：WO2016164179A1
公开(公告)日：2016-10-13
申请号：PCT/US2016/024128
申请日：2016-03-25
申请人： MEDTRONIC, INC.
发明人： DENISON, Timothy J. , STANSLASKI, Scott R.
IPC分类号： A61N1/36 , A61B5/11 , A61B5/00 , A61B5/04 , A61B5/048 , A61N1/05
CPC分类号： A61N1/36167 , A61B5/04014 , A61B5/048 , A61B5/1101 , A61B5/4082 , A61B5/4836 , A61B5/7225 , A61B2562/0219 , A61N1/0534 , A61N1/36025 , A61N1/36053 , A61N1/36064 , A61N1/36067 , A61N1/36082 , A61N1/36096 , A61N1/36139 , A61N1/36171
摘要： The present application concerns a medical device comprising a circuit configured to: receive a patient signal indicative of a patient condition; determine a timing signal having a frequency based on the patient signal; and during a duration when the patient signal is not being received, output the timing signal having the same frequency as the frequency of the timing signal determined based on the patient signal, the device also comprises an electrical stimulation generator configured to deliver therapy based on the timing signal during at least a portion of the duration when the patient signal is not being received. In some examples, a phase locked loop (PLL) circuit outputs a timing signal having a frequency and phase that is the same as a patient signal that is an input to the PLL circuit. The PLL circuit includes or is coupled to a storage circuit that stores information needed to cause the PLL circuit to maintain the frequency of the timing signal to the same frequency even after the patient signal is not available as an input.
摘要翻译：本申请涉及包括电路的医疗设备，该电路被配置为：接收指示患者状况的患者信号; 确定具有基于患者信号的频率的定时信号; 并且在患者信号未被接收的持续时间期间，输出与基于患者信号确定的定时信号的频率相同的频率的定时信号，该装置还包括电刺激发生器，其被配置为基于在患者信号未被接收的持续时间的至少一部分期间的定时信号。在一些示例中，锁相环（PLL）电路输出具有与作为对PLL电路的输入的患者信号相同的频率和相位的定时信号。 PLL电路包括或耦合到存储电路，存储电路即使在患者信号不可用作为输入之后，也存储使PLL电路将定时信号的频率保持在相同频率所需的信息。

10. 发明申请

WO2015109239A1 MOVEMENT DISORDER SYMPTOM CONTROL 审中-公开
标题翻译：运动障碍症状控制
公开(公告)号：WO2015109239A1
公开(公告)日：2015-07-23
申请号：PCT/US2015/011829
申请日：2015-01-16
申请人： MEDTRONIC, INC.
发明人： AFSHAR, Pedram , DENISON, Timothy J. , LINDE, David E. , STANSLASKI, Scott R.
IPC分类号： A61N1/36 , A61B5/0476
CPC分类号： A61N1/36139 , A61B5/04012 , A61B5/0478 , A61B5/4082 , A61B5/4836 , A61B5/686 , A61N1/0534 , A61N1/3606 , A61N1/36067 , A61N1/36171 , G06F19/00 , G06F19/3481 , G16H20/40
摘要： The disclosure describes a method and system or controlling symptoms of patients suffering from Parkinson's Disease. In some examples, one or more biomarkers indicative of a patient's present symptoms are determined. The biomarkers may be used to control therapy delivered to the patient in a closed-loop manner. In addition, biomarkers may be used as an indication of therapy effectiveness.
摘要翻译：本公开描述了患有帕金森病的患者的方法和系统或控制症状。在一些实例中，确定指示患者目前症状的一种或多种生物标志物。生物标志物可用于控制以闭环方式递送给患者的治疗。此外，生物标志物可用作治疗有效性的指标。

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