Stereotactic multifocal recording and stimulation device and methods of use
11369797 · 2022-06-28
Assignee
Inventors
Cpc classification
A61N1/36067
HUMAN NECESSITIES
A61B5/24
HUMAN NECESSITIES
A61N1/3756
HUMAN NECESSITIES
International classification
Abstract
A neural stimulation and recording electrode assembly includes a selectively deformable guide tube. The guide tube includes a plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least one of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure. The electrode assembly further includes an electrode subassembly having a central axis and a plurality of electrode contacts that are configured for selective radial movement about and between a retracted position and a deployed position, wherein in the deployed position, and relative to the central axis, each electrode contact is spaced radially outwardly from the retracted position.
Claims
1. A neural stimulation and recording electrode assembly comprising: a selectively deformable guide tube having a length and including a plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least one of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure; and an electrode subassembly having a central axis and a plurality of electrode contacts that are configured for selective radial movement about and between a retracted position and a deployed position, wherein in the deployed position, and relative to the central axis, each electrode contact is spaced radially outwardly from the retracted position, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of sets of circumferentially spaced openings, wherein the plurality of sets are axially spaced along a length of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface to which the plurality of electrode contacts are coupled, wherein, in response to selective inflation and deflation of the balloon, the plurality of electrode contacts are configured for radial expansion and retraction through corresponding openings of the annular body.
2. The neural stimulation and recording electrode assembly of claim 1, wherein each of the at least one selectively deformable connecting structure of the guide tube is configured to be selectively independently deformed as the selectively deformable connecting structure is advanced within a tissue region.
3. The neural stimulation and recording electrode assembly of claim 1, wherein each of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure.
4. The neural stimulation and recording electrode assembly of claim 1, wherein each of the at least one selectively deformable connecting structure is selectively compressible and expandable relative to the central axis of the connecting structure, wherein the selectively deformable guide tube is deformable from a first compressed orientation to a second expanded orientation, and wherein in the second expanded orientation, at least one of the selectively deformable connecting structures is axially expanded in comparison to the first compressed orientation.
5. The neural stimulation and recording electrode assembly of claim 1, wherein each of the plurality of connecting structures comprise springs.
6. The neural stimulation and recording electrode assembly of claim 5, wherein each of the connecting structures further comprises rings attached at each end of the spring of the respective connecting structure.
7. The neural stimulation and recording electrode assembly of claim 1, wherein the length of at least one connecting structure of the plurality of connecting structures is different than the length of at least one other connecting structure of the plurality of connecting structures.
8. The neural stimulation and recording electrode assembly of claim 1, wherein the plurality of connecting structures comprises at least one joint and at least one linearly elongatable structure.
9. The neural stimulation and recording electrode assembly of claim 1, wherein the electrode subassembly comprises a plurality of branches extending radially outwardly from the central axis of the electrode subassembly, wherein the plurality of electrode contacts are provided on respective branches of the plurality of branches, wherein each branch is selectively radially moveable to effect movement of a corresponding electrode contact about and between the retracted position and the deployed position.
10. The neural stimulation and recording electrode assembly of claim 9, wherein each branch is selectively angularly deformable relative to the central axis of the shaft to effect movement of a corresponding electrode contact about and between the retracted position and the deployed position.
11. The neural stimulation and recording electrode array of claim 1, wherein the electrode subassembly further comprises: an annular body having an outer surface and an inner surface that defines an axial bore, wherein the plurality of electrode contacts are coupled to the outer surface of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the annular body comprises a flexible material that permits radial expansion and compression of the annular body in response to selective inflation and deflation of the balloon.
12. The neural stimulation and recording electrode assembly of claim 1, wherein the annular body has a generally cylindrical outer surface.
13. A neural stimulation and recording electrode assembly comprising: a selectively deformable guide tube having a length and including a plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least one of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure; and an electrode subassembly having a central axis and a plurality of electrode contacts that are configured for selective radial movement about and between a retracted position and a deployed position, wherein in the deployed position, and relative to the central axis, each electrode contact is spaced radially outwardly from the retracted position, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of openings that are axially spaced along a length of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface to which the plurality of electrode contacts are coupled, wherein, in response to selective inflation and deflation of the balloon, the plurality of electrode contacts are configured for radial expansion and retraction through corresponding openings of the annular body.
14. A neural stimulation and recording electrode assembly comprising: a selectively deformable guide tube having a length and including a plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least one of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure; and an electrode subassembly having a central axis and a plurality of electrode contacts that are configured for selective radial movement about and between a retracted position and a deployed position, wherein in the deployed position, and relative to the central axis, each electrode contact is spaced radially outwardly from the retracted position, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of openings; a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface; and a plurality of rods extending radially outwardly from and being coupled to the outer surface of the balloon, wherein a respective electrode contact is secured to a distal end of each rod, and wherein, in response to selective inflation and deflation of the balloon, the plurality of rods are configured for corresponding radial movement.
15. The neural stimulation and recording electrode assembly of claim 14, wherein the rods are rigid rods having respective fixed lengths.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several embodiments of the disclosed apparatus, system, and method and together with the description, serve to explain the principles of the disclosed apparatus, system, and method.
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DETAILED DESCRIPTION
(22) The disclosed system and method may be understood more readily by reference to the following detailed description of particular embodiments and the examples included therein and to the Figures and their previous and following description.
A. Definitions
(23) It is to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention which will be limited only by the appended claims.
(24) It must be noted that as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural references unless the context clearly dictates otherwise. Thus, for example, reference to “an elbow” includes a plurality of such elbows, and reference to “the elbow” is a reference to one or more joints and equivalents thereof known to those skilled in the art, and so forth.
(25) “Optional” or “optionally” means that the subsequently described event, circumstance, or material may or may not occur or be present, and that the description includes instances where the event, circumstance, or material occurs or is present and instances where it does not occur or is not present.
(26) Ranges may be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, also specifically contemplated and considered disclosed is the range from the one particular value and/or to the other particular value unless the context specifically indicates otherwise. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another, specifically contemplated embodiment that should be considered disclosed unless the context specifically indicates otherwise. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint unless the context specifically indicates otherwise. Finally, it should be understood that all of the individual values and sub-ranges of values contained within an explicitly disclosed range are also specifically contemplated and should be considered disclosed unless the context specifically indicates otherwise. The foregoing applies regardless of whether in particular cases some or all of these embodiments are explicitly disclosed.
(27) Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of skill in the art to which the disclosed apparatus, system, and method belong. Although any apparatus, systems, and methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present apparatus, system, and method, the particularly useful methods, devices, systems, and materials are as described. Publications cited herein and the material for which they are cited are hereby specifically incorporated by reference. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such disclosure by virtue of prior invention. No admission is made that any reference constitutes prior art. The discussion of references states what their authors assert, and applicants reserve the right to challenge the accuracy and pertinence of the cited documents. It will be clearly understood that, although a number of publications may be referred to herein, such reference does not constitute an admission that any of these documents forms part of the common general knowledge in the art.
(28) Throughout the description and claims of this specification, the word “comprise” and variations of the word, such as “comprising” and “comprises,” means “including but not limited to,” and is not intended to exclude, for example, other additives, components, integers or steps. In particular, in methods stated as comprising one or more steps or operations it is specifically contemplated that each step comprises what is listed (unless that step includes a limiting term such as “consisting of”), meaning that each step is not intended to exclude, for example, other additives, components, integers or steps that are not listed in the step.
B. Neural Stimulation and Recording Electrode Assembly
(29) Disclosed herein is a neural stimulation recording electrode assembly. Referring to
(30) Referring also to
(31) In this way, by beginning at a proximal end 124 of the electrode assembly 100 and alternating between expanding the linearly elongatable structures 108 and bending the elbows 106, the guide tube 102 of the electrode assembly 100 can be positioned along a desired path. In this way, an electrode subassembly, disclosed herein, that is positioned within the guide tube, can be positioned so as to allow for multifocal target simulation and recording at various locations along the guide tube's length (for example, as shown in
(32) While embodiments shown include alternating linearly elongatable structures 108 and angularly orienting elbows 106, it should be understood that in further embodiments, the linearly elongatable structures and angularly orienting joints need not alternate. Moreover, in some embodiments, the connecting structures can comprise a single structure. That is, each can include opposing rings 112, a connecting spring 114, and a plurality of cables 130 that actuate the structure. For example, some embodiments of such a connecting structure can include a four cables extending through the spring 112 and attached at points evenly spaced about the circumference of the distal ring 114. Protracting all four cables by an equal length can allow the spring to extend longitudinally, while protracting two adjacent cables can cause the spring to bend like an elbow, as discussed herein. It is further contemplated that the elbows can have shorter springs 112 than the springs 112 of the linearly elongatable structures. The shorter springs can enable short, tight bends, which can, in some circumstances, avoid tissue damage that might otherwise result from longer, sweeping bends. It is still further contemplated that connecting structures that are configured as linearly elongatable structures can, in some circumstances, be elongated along a curved pathway. For example, one or more of the cables of the connecting structures can be protracted by lengths that are greater than the protraction lengths of the remainder of its cables.
(33) Referring also to
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(45) Using the electrode assembly as discussed herein, the electrode subassembly can be positioned at a selected position within a selected tissue region. When the electrode subassembly is positioned, at least a first portion of a plurality of electrode contacts of the electrode subassembly can be moved from the retracted position to the deployed position. The at least a first portion of the plurality of electrode contacts can then be retracted from the deployed position. A second portion of the plurality of electrode contacts of the plurality of electrode contacts can be moved from the retracted position to the deployed position. For example, with reference to the cable-actuated embodiments shown in
(46) Referring to
(47) In several neurological conditions (e.g. large cortical dysplasia), the pathologic tissue is significantly larger than the spatial effective distribution of the electric field of the relatively smaller stimulation electrodes. Thus, neuromodulation of large cortical pathologic tissue will be suboptimal. Stimulation of small cross-sectional diameter of compact white matter axons allows the electric current to propagate to the large cortical pathologic tissue and modulates its function more efficiency in comparison to direct stimulation of cortical tissue. Stimulation of many central nervous systems structures, in various forms, has been proposed. However, conventionally, white matter tracts within corona radiate region have not been examined. In order to stimulate a specific part of white matter tract in a three-dimensional arrangement using conventional electrodes and conventional implantation methods currently used in clinical practice, it is necessary to implant multiple electrodes through multiple trajectories with different orientations, which might result in a significant tissue damage along the trajectories and because of suboptimal three dimensional arrangement of stimulation electrode contacts with respect to the target white matter tract, spatial electric field might not be optimal to modulate the target white matter tracts. In contrast with conventional electrodes currently used in clinical practice, using the disclosed guide tube and stimulation electrode assembly, electrodes can be flexibly implanted in a three dimensional curved trajectory to provides optimal stimulation. In addition, in order to refine the neurostimulation efficacy, using proposed retractable and deployable mechanism, spatial location of the electrode contacts can be rearranged anytime during the chronic implantation period.
(48) The electrode subassemblies 150, as illustrated in
(49) Referring to
(50) Referring to
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(52) In some embodiments, aspects of the axially extending electrode assemblies can be incorporated with the deployable electrode subassemblies as disclosed herein. For example, materials for structures 402, 432 can be selected from flexible materials. Accordingly, the electrode subassemblies can be both moved between deployed and retracted positions as well as repositioned along the length of the guide tube.
(53) In still further aspects, the guide tube can comprise stimulating/recording contacts. For example, referring to
(54) Exemplary Aspects
(55) In view of the described products, systems, and methods and variations thereof, herein below are described certain more particularly described aspects of the invention. These particularly recited aspects should not however be interpreted to have any limiting effect on any different claims containing different or more general teachings described herein, or that the “particular” aspects are somehow limited in some way other than the inherent meanings of the language literally used therein.
(56) Aspect 1: A neural stimulation and recording electrode assembly comprising: a selectively deformable guide tube having a length and including: a plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least one of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure; and an electrode subassembly having a central axis and a plurality of electrode contacts that are configured for selective radial movement about and between a retracted position and a deployed position, wherein in the deployed position, and relative to the central axis, each electrode contact is spaced radially outwardly from the retracted position.
(57) Aspect 2: The neural stimulation and recording electrode assembly of aspect 1, wherein each of the at least one selectively deformable connecting structures of the guide tube is configured to be selectively independently deformed as the selectively deformable connecting structure is advanced within a tissue region.
(58) Aspect 3: The neural stimulation and recording electrode assembly of aspect 1 or aspect 2, wherein each of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure.
(59) Aspect 4: The neural stimulation and recording electrode assembly of any one of the preceding aspects, wherein each of the at least one selectively deformable connecting structures is selectively compressible and expandable relative to the central axis of the connecting structure, wherein the selectively deformable guide tube is deformable from a first compressed orientation to a second expanded orientation, and wherein in the second expanded orientation, at least one of the selectively deformable connecting structures is axially expanded in comparison to the first compressed orientation.
(60) Aspect 5: The neural stimulation and recording electrode assembly of any one of the preceding aspects, wherein each of the plurality of connecting structures comprise springs.
(61) Aspect 6: The neural stimulation and recording electrode assembly of aspect 5, wherein each of the connecting structures further comprises rings attached at each end of the spring of the respective connecting structure.
(62) Aspect 7: The neural stimulation and recording electrode assembly of aspect 1, wherein the length of at least one connecting structure of the plurality of connecting structures is different than the length of at least one other connecting structure of the plurality of connecting structures.
(63) Aspect 8: The neural stimulation and recording electrode assembly of any one of the preceding aspects, wherein the plurality of connecting structures comprises at least one joint and at least one linearly elongatable structure, wherein each joint of the at least one joints and each linearly elongatable structure of the at least one linearly elongatable structure have respective lengths, and wherein the length of each linearly elongatable structure is greater than the length of each joint.
(64) Aspect 9: The neural stimulation and recording electrode assembly of any one of the preceding aspects, wherein the electrode subassembly comprises a plurality of branches extending radially outwardly from the central axis of the electrode subassembly, wherein the plurality of electrode contacts are provided on respective branches of the plurality of branches, wherein each branch is selectively radially moveable to effect movement of a corresponding electrode contact about and between the retracted position and the deployed position.
(65) Aspect 10: The neural stimulation and recording electrode assembly of aspect 9, wherein each branch is selectively angularly deformable relative to the central axis of the shaft to effect movement of a corresponding electrode contact about and between the retracted position and the deployed position.
(66) Aspect 11: The neural stimulation and recording electrode array of any one of aspects 1-8, wherein the electrode subassembly further comprises: an annular body having an outer surface and an inner surface that defines an axial bore, wherein the plurality of electrode contacts are coupled to the outer surface of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the annular body comprises a flexible material that permits radial expansion and compression of the annular body in response to selective inflation and deflation of the balloon.
(67) Aspect 12: The neural stimulation and recording electrode array of any one of aspects 1-8, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of sets of circumferentially spaced openings, wherein the plurality of sets are axially spaced along a length of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface to which the plurality of electrode contacts are coupled, wherein, in response to selective inflation and deflation of the balloon, the plurality of electrode contacts are configured for radial expansion and retraction through corresponding openings of the annular body.
(68) Aspect 13: The neural stimulation and recording electrode array of any one of aspects 1-8, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of openings that are axially spaced along a length of the annular body; and a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface to which the plurality of electrode contacts are coupled, wherein, in response to selective inflation and deflation of the balloon, the plurality of electrode contacts are configured for radial expansion and retraction through corresponding openings of the annular body.
(69) Aspect 14: The neural stimulation and recording electrode array of any one of aspects 1-8, wherein the electrode subassembly further comprises: an annular body defining an axial bore and a plurality of openings; a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface; and a plurality of rods extending radially outwardly from and being coupled to the outer surface of the balloon, wherein a respective electrode contact is secured to a distal end of each rod, wherein, in response to selective inflation and deflation of the balloon, the plurality of rods are configured for corresponding radial movement.
(70) Aspect 15: The neural stimulation and recording electrode array of aspect 14, wherein the plurality of rods are circumferentially spaced about the outer surface of the balloon.
(71) Aspect 16: The neural stimulation and recording electrode array of aspect 14, wherein the plurality of rods are axially spaced along an axial length of the balloon.
(72) Aspect 17: A method of using the neural stimulation and recording electrode array of any one of the preceding aspects, comprising: selectively and sequentially deforming at least one connecting structure of the guide tube to define an insertion pathway; and advancing the electrode subassembly through the guide tube until at least a portion of the plurality of electrode contacts are positioned at a selected position within selected a tissue region; effecting movement of at least a first portion of the plurality of electrode contacts from the retracted position to the deployed position.
(73) Aspect 18: The method of aspect 17, further comprising: retracting the at least a first portion of the plurality of electrode contacts from the deployed position to the retracted position; adjusting the position of the electrode subassembly within the tissue region; and effecting movement of a second portion of the plurality of electrode contacts from the retracted position to the deployed position.
(74) Aspect 19: The method of aspect 18, wherein at least one electrode contact of the second portion of the plurality of electrode contacts is not in included in the first portion of the plurality of electrode contacts.
(75) Aspect 20. The method of any one of aspects 17-19, further comprising: electrically stimulating tissue within the tissue region using the plurality of electrode contacts.
(76) Aspect 21: The method of any one of aspects 17-20, wherein the electrode subassembly comprises: an annular body defining an axial bore and a plurality of openings; a selectively inflatable balloon positioned within the axial bore of the annular body, wherein the selectively inflatable balloon has an outer surface; and a plurality of rods extending radially outwardly from and being coupled to the outer surface of the balloon, wherein a respective electrode contact is secured to a distal end of each rod, wherein, in response to selective inflation of the balloon, the plurality of rods undergo corresponding radial movement to enter into target tissue.
(77) Aspect 22: The method of aspect 21, wherein the target tissue comprises brain parenchyma, and wherein the plurality of rods and corresponding electrode contacts enter target tissue through a ventricle wall.
(78) Aspect 23: An assembly having a length and comprising: plurality of sequentially coupled connecting structures, wherein each connecting structure of the plurality of connecting structures has a respective central axis, and wherein at least two of the plurality of connecting structures is selectively deformable relative to the central axis of a sequential connecting structure of the plurality of connecting structures such that the central axis of the selectively deformable connecting structure is angularly oriented relative to the central axis of the sequential connecting structure.
(79) Aspect 24: The assembly of aspect 23, wherein the assembly comprises a plurality of electrodes positioned along the length of the length of the assembly.
(80) Aspect 25: The assembly of aspect 23, wherein at least a portion of at least one connecting structure is configured to provide electrical stimulation to a tissue.
(81) Aspect 26: An electrode subassembly as disclosed herein.
(82) Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the method and compositions described herein. Such equivalents are intended to be encompassed by the following claims.