Abstract: A system and method for finding a Pareto-optimal solution for automated detection, warning, and abatement of a medical condition based on a cost of event intervention in a patient is disclosed. The method includes acquiring at least one biological signal from the patient via at least one sensor of a medical device, detecting an abnormal biological event based on changes in the biological signal, and delivering at least one of a therapy and a warning. The method includes logging a set of parameters including at least one of a detection parameter, a therapy parameter, and a therapy modality. The method includes identifying an optimal set of parameters that yield a Pareto-optimal cost of event intervention by iteratively determining at least one metric over a time window, determining the cost of event intervention, and modifying at least one parameter, until the cost of event intervention meets an acceptability criteria.

Abstract: We report a method for optimizing the therapeutic efficacy of evoked responses elicited by one or more electrical impulses delivered to a neural structure, comprising: comparing a test evoked response to an evoked response elicited by therapeutically efficacious electrical stimulation; adjusting at least one parameter of the electrical impulses in response to a determination that said test evoked response is not similar to the therapeutic evoked response; determining that the test evoked response resembles the therapeutic evoked response after performing at least one of said adjustments; and saving to memory at least one adjusted parameter that increased the similarity between the test evoked response and the therapeutic evoked response. We also report a medical device system configured to implement the method. We also report a non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform the method.

Abstract: A method, comprising receiving at least one of a signal relating to a first cardiac activity and a signal relating to a first body movement from a patient; triggering at least one of a test of the patient's responsiveness, awareness, a second cardiac activity, a second body movement, a spectral analysis test of the second cardiac activity, and a spectral analysis test of the second body movement, based on at least one of the signal relating to the first cardiac activity and the signal relating to the first body movement; determining an occurrence of an epileptic event based at least in part on said one or more triggered tests; and performing a further action in response to said determination of said occurrence of said epileptic event. Further methods allow classification of epileptic events. Apparatus and systems capable of implementing the method.

Abstract: A thalamic medical device system and method enables automated detection of epileptic seizures and optionally providing contingent thalamic stimulation triggered by automated seizure detection. The method includes detecting electrical signals in a frequency band of 8-42 Hz from an anterior thalamic nucleus or a centro-median thalamic nucleus in a first hemisphere and/or a second hemisphere of a brain with one or more electrode assemblies surgically implanted at least partially within an anterior thalamic nuclei or a centro-median thalamic nuclei, and outside of a subthalamic nuclei of the patient. The method also includes transmitting the detected electrical signals to a medical device, analyzing them using a seizure detection algorithm, and delivering electrical stimulation to the anterior thalamic nuclei or centro-median thalamic nuclei in the first hemisphere and/or the second hemisphere via the electrode assemblies in response to a seizure detected by the medical device.

Abstract: A method for assessment, optimization and logging of the effects of a therapy for a medical condition, including (a) receiving into a signal processor input signals indicative of the subject's brain activity; (b) characterizing the spatio-temporal behavior of the brain activity using the signals; (c) delivering a therapy to a target tissue of the subject; (d) characterizing the spatio-temporal effect of the therapy on the brain activity; (e) in response to the characterizing, optimizing at least one parameter of the therapy if the brain activity has not been satisfactorily modified and/or has been adversely modified by the therapy; (f) characterizing the spatio-temporal effect of the at least one optimized parameter; and (g) logging to memory the at least one optimized parameter. A computer readable program storage unit encoded with instructions that, when executed by a computer, performs the method.

Abstract: We report a method of a method for detecting an epileptic seizure, comprising providing a first body signal reference value; determining a current body signal value from a time series of body signals; comparing the current body signal value and the first reference value; determining a work level of the patient; determining whether the current body signal value comprises an ictal component, based on the work level and the comparing; issuing a detection of an epileptic seizure in response to the determination that the current body signal value comprises the ictal component; and taking at least one further action (e.g. warning, delivering a therapy, etc.), based on the detection. We also report a medical device system configured to implement the method. We also report a non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform the method.

Abstract: Methods for detecting a seizure, by use of a wavelet transform maximum modulus (WTMM) algorithm applied to body data. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform such a method.

Abstract: A method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy is provided. The method includes receiving cardiac data and determining a cardiac index based upon the cardiac data. The method includes determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. Also presented is a second method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy comprising receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively.

Abstract: A method of distinguishing a non-epileptic seizure from an epileptic seizure in a patient, comprising: detecting a seizure in a patient based on at least one first body signal of the patient selected from an autonomic signal, a neurologic signal, a metabolic signal, an endocrine signal, and a tissue stress marker signal; analyzing at least one second body signal of the patient selected from an autonomic signal, a neurologic signal, a metabolic signal, an endocrine signal, and a tissue stress marker signal; determining, based on the analyzing, at least a first classification index comprising at least one of an epileptic seizure index and a non-epileptic seizure index; and classifying the seizure as one of a non-epileptic seizure or an epileptic seizure based on the at least a first classification index. A medical device system capable of implementing the method. A computer-readable device for storing data that, when executed, perform the method.

Abstract: A method, comprising detecting, in at least a first brain region of a patient, an electrical activity relating to an epileptic activity; determining a first regularity index of said electrical activity; and applying at least one first electrical stimulation to at least one neural target of said patient for treating said epileptic event, in response to said first regularity index being within a first range. A non-transitive, computer-readable storage device for storing instructions that, when executed by a processor, perform the method. A medical device system suitable for use in the method.

Abstract: Methods, systems, and apparatus for assessing a state of an epilepsy disease or a comorbidity thereof are provided. The methods comprise receiving at least one autonomic index, neurologic index, stress marker index, psychiatric index, endocrine index, adverse effect of therapy index, physical fitness index, or quality of life index of a patient; comparing the at least one index to at least one reference value; and assessing a state of an epilepsy disease or a body system of the patient based on the comparison. A computer readable program storage device encoded with instructions that, when executed by a computer, perform the method described above is also provided. A medical device system capable of implementing the method described above is also provided.

Abstract: Disclosed are methods and medical device systems for automated delivery of therapies for pain and determination of need for and safety of treatment. In one embodiment, such a medical device system may comprise a sensor configured to sense at least one body signal from a patient; and a medical device configured to receive a first sensed body signal from the sensor; determine a patient pain index based at least in part on said first sensed body signal; determine whether said patient pain index is above at least a first pain index threshold; determine a safety index based at least in part on a second sensed body signal; select a pain treatment regimen based on at least one of said safety index and or a determination that said pain index is above said first pain index threshold; and deliver said pain treatment regimen.

Abstract: We report a method of automatically titrating an electrical therapy administered to a patient by an implanted medical device to a target dosage, comprising programming the medical device with a programmed electrical therapy comprising a first target value for a first therapy parameter; programming at least one titration parameter for automatically adjusting the first therapy parameter from a first value to the first target value over a titration time period initiating the electrical therapy, wherein the first therapy parameter comprises said first value; and automatically titrating the electrical therapy by making a plurality of adjustments to the value of the first therapy parameter, whereby the first electrical therapy parameter is changed from the first value to the first target value according to a titration function. We also report a medical device system configured to implement the method.

Abstract: Methods, systems, and apparatus for detecting and/or validating a detection of a state change by matching the shape of one or more of an cardiac data series, a heart rate variability data series, or at least a portion of a heart beat complex, derived from cardiac data, to an appropriate template.

Abstract: Disclosed are methods and medical device systems for automated delivery of therapies for pain and determination of need for and safety of treatment. In one embodiment, such a medical device system may comprise a sensor configured to sense at least one body signal from a patient; and a medical device configured to receive a first sensed body signal from the sensor; determine a patient pain index based at least in part on said first sensed body signal; determine whether said patient pain index is above at least a first pain index threshold; determine a safety index based at least in part on a second sensed body signal; select a pain treatment regimen based on at least one of said safety index and or a determination that said pain index is above said first pain index threshold; and deliver said pain treatment regimen.

Abstract: Methods for detecting a seizure, by use of a wavelet transform maximum modulus (WTMM) algorithm applied to body data. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform such a method.

Abstract: A method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy is provided. The method includes receiving cardiac data and determining a cardiac index based upon the cardiac data. The method includes determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. Also presented is a second method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy comprising receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively.

Abstract: Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase.

Abstract: Methods, systems, and apparatus for determining probabilistic measures of seizure activity (PMSA) values based on a plurality of seizure detection algorithms and/or body signals used as inputs by the seizure detection algorithms. Use of the PMSA values to detect seizure activity based on a consensus of the algorithms and/or body signals, and/or warn, log, administer a therapy, or assess the efficacy of a therapy.

Abstract: Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase.