Multimodal neurological monitoring system

Abstract

Presented herein are systems and techniques for using an external component / device to collect eye movement data that is complementary to neurological measures / measurements (e.g., EEG measurements, inner ear measurements, or other electrophysiological measurements) obtained by an implantable component / device. Recipient eye movement can be tracked directly (e.g., with smart glasses) and / or indirectly (e.g., using eye movement-related eardrum oscillations (EMREO) measurements). The systems and techniques presented herein can use an implantable component (e.g., a cochlear implant, an EEG implant, etc.) to obtain electrophysiological measurements from a recipient. According to aspects presented herein, the electrophysiological measurements and the eye movement measurements are analyzed together in order to, for example, diagnosis a medical condition, predict or characterize a medical event, etc.

Description

MUUTIMODAU NEUROUOGICAU MONITORING SYSTEMBACKGROUNDField of the Invention[oooi] The present invention relates generally to neurological monitoring.Related Art

[0002] Medical devices have provided a wide range of therapeutic benefits to recipients over recent decades. Medical devices can include internal or implantable components / devices, external or wearable components / devices, or combinations thereof (e.g., a device having an external component communicating with an implantable component). Medical devices, such as traditional hearing aids, partially or fully-implantable hearing prostheses (e.g., bone conduction devices, mechanical stimulators, cochlear implants, etc.), pacemakers, defibrillators, functional electrical stimulation devices, and other medical devices, have been successful in performing lifesaving and / or lifestyle enhancement functions and / or recipient monitoring for a number of years.

[0003] The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as “implantable medical devices,” now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease / injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and / or data received from external devices that are part of, or operate in conjunction with, implantable components.SUMMARY

[0004] In one aspect, a method is provided. The method comprises: obtaining a set of electrophysiological measurements captured by an implantable device, wherein the electrophysiological measurements originate from a recipient of the implantable device; obtaining measurements representative of movement of the eyes of the recipient by an external device, wherein the measurements representative of movement of the eyes of the recipient are synchronized with the set of electrophysiological measurements obtained from the implantable device; and at least one of diagnosing a medical condition or predicting or characterizing amedical event based on an analysis that combines the electrophysiological measurements originating from the recipient and the measurements representative of the movement of the eyes of the recipient.

[0005] In another aspect, a system is provided. The system comprises: an implantable component configured to obtain electrophysiological measurements from a recipient of the implantable component; an external component configured to obtain measurements representative of movement of the eyes of the recipient; and at least one processor configured to associate the electrophysiological measurements obtained from the recipient by the implantable component with the measurements representative of movement of the eyes of the recipient obtained by the external component.

[0006] In another aspect, a system is provided. The system comprises: an implantable device including a wireless transmitter and an inner ear electrode array, wherein the implantable device is configured to obtain electrophysiological measurements from a recipient of the implantable device via the inner ear electrode array, and transmit the electrophysiological measurements via the wireless transmitter; and an external device including a wireless receiver and a memory module, wherein the external device is configured to receive the electrophysiological measurements from the implantable device via the wireless receiver, obtain measurements representative of movement of the eyes of the recipient that are synchronized with the electrophysiological measurements, and store the measurements representative of movement of the eyes of the recipient that are synchronized with the electrophysiological measurements in the memory module.

[0007] In another aspect, one or more non-transitory computer readable storage media are provided. The one or more non-transitory computer readable storage media comprise instructions that, when executed by a processor, cause the processor to: obtain a set of electrophysiological measurements from a recipient of an implantable device; obtain measurements representative of movement of the eyes of the recipient by an external device; and analyze the measurements representative of movement of the eyes of the recipient in association with the set of electrophysiological measurements obtained from the implantable device.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:

[0009] FIG. 1A is a schematic diagram illustrating a cochlear implant system with which aspects of the techniques presented herein can be implemented;[ooio] FIG. IB is a side view of a recipient wearing a sound processing unit of the cochlear implant system of FIG. 1A;[ooii] FIG. 1C is a schematic view of components of the cochlear implant system of FIG. 1 A;

[0012] FIG. ID is a block diagram of the cochlear implant system of FIG. 1A;

[0013] FIG. IE is a schematic diagram illustrating a computing device with which aspects of the techniques presented herein can be implemented;

[0014] FIG. IF provides an exemplary embodiment of an EEG system that is implanted in the recipient;

[0015] FIG. 1G provides another exemplary embodiment of an implantable EEG system;

[0016] FIG. 1H provides yet another exemplary embodiment of an implantable EEG system;

[0017] FIG. 2 depicts a simplified block diagram of a system, including an implantable component / device and an external component / device, according to a first example embodiment;

[0018] FIG. 3 depicts a simplified block diagram of a system, including an implantable component / device and an external component / device, according to a second example embodiment;

[0019] FIG. 4 depicts a simplified block diagram of a system, including an implantable component / device and an external component / device, according to a third example embodiment;

[0020] FIG. 5 is a flowchart of a method for multimodial neurological monitoring, according to an example embodiment;

[0021] FIG. 6 is a schematic diagram illustrating a vestibular stimulator system with which aspects of the techniques presented herein can be implemented; and

[0022] FIG. 7 is a schematic diagram illustrating a retinal prosthesis system with which aspects of the techniques presented herein can be implemented.DETAILED DESCRIPTIONOverview

[0023] Presented herein are systems and techniques for using an external component / device to collect eye movement data that is complementary to neurological measure s / measurements (e.g., EEG measurements, inner ear measurements, or other electrophysiological measurements) obtained by an implantable component / device. Recipient eye movement can be tracked directly (e.g., with smart glasses) and / or indirectly (e.g., using eye movement- related eardrum oscillations (EMREO) measurements). The systems and techniques presented herein can use an implantable component (e.g., a cochlear implant, an EEG implant, etc.) to obtain electrophysiological measurements from a recipient. According to aspects presented herein, the electrophysiological measurements and the eye movement measurements are analyzed together in order to, for example, diagnosis a medical condition, predict or characterize a medical event, etc. In certain embodiments, measurement data can be logged and stored, and notifications can be provided to inform the recipient or a medical professional about the medical condition or medical event, for example. The systems and techniques can be useful, for example, in the collection and analysis of sleep data, seizure-related data, etc.

[0024] There are a number of different types of devices in / with which embodiments of the present invention can be implemented. Merely for ease of description, the techniques presented herein are primarily described with reference to a specific device in the form of a cochlear implant system. However, it is to be appreciated that the techniques presented herein can also be partially or fully implemented by any of a number of different types of devices, including hearing devices, implantable medical devices, consumer electronic devices (e.g., mobile phones), wearable devices (e.g., smart watches), etc. As used herein, the term “hearing device” is to be broadly construed as any device that delivers sound signals to a user in any form, including in the form of acoustical stimulation, mechanical stimulation, electrical stimulation, etc. As such, a hearing device can be a device for use by a hearing -impaired person (e.g., hearing aids, middle ear auditory prostheses, bone conduction devices, direct acoustic stimulators, electro-acoustic hearing prostheses, auditory brainstem stimulators, bimodal hearing prostheses, bilateral hearing prostheses, dedicated tinnitus therapy devices, tinnitus therapy device systems, combinations or variations thereof, etc.) or a device for use by a person with normal hearing (e.g., consumer devices that provide audio streaming, consumerheadphones, earphones, and other listening devices). In other examples, the techniques presented herein can be implemented by, or used in conjunction with, various implantable medical devices, such as vestibular devices (e.g., vestibular implants), visual devices (i.e., bionic eyes), sensors, pacemakers, drug delivery systems, defibrillators, functional electrical stimulation devices, catheters, seizure devices (e.g., devices for monitoring and / or treating epileptic events), sleep apnea devices, electroporation devices, etc.Example System and Components

[0025] FIGs. 1A-1D illustrates an example cochlear implant system 102 with which aspects of the techniques presented herein can be implemented. The cochlear implant system 102 comprises an external component 104 that is configured to be directly or indirectly attached to the body of the user, and an intemal / implantable component 112 that is configured to be implanted in or worn on the head of the user. In the examples of FIGs. 1A-1D, the implantable component 112 is sometimes referred to as a “cochlear implant.” FIG. 1A illustrates the cochlear implant 112 implanted in the head 154 of a user, while FIG. IB is a schematic drawing of the external component 104 worn on the head 154 of the user. FIG. 1C is another schematic view of the cochlear implant system 102, while FIG. ID illustrates further details of the cochlear implant system 102. For ease of description, FIGs. 1A-1D will generally be described together.

[0026] In the examples of FIGs. 1A-1D, the external component 104 comprises a sound processing unit 106, an external coil 108, and generally, a magnet fixed relative to the external coil 108. The cochlear implant 112 includes an implantable coil 114, an implant body 134, and an elongate stimulating assembly 116 configured to be implanted in the user’s cochlea. In one example, the sound processing unit 106 is an off-the-ear (OTE) sound processing unit, sometimes referred to herein as an OTE component, which is configured to send data and power to the implantable component 112. In general, an OTE sound processing unit is a component having a generally cylindrically shaped housing 111 and which is configured to be magnetically coupled to the user’s head 154 (e.g., includes an integrated external magnet 150 configured to be magnetically coupled to an intemal / implantable magnet 152 in the implantable component 112). The OTE sound processing unit 106 also includes an integrated external (headpiece) coil 108 (the external coil 108) that is configured to be inductively coupled to the implantable coil 114.

[0027] It is to be appreciated that the OTE sound processing unit 106 is merely illustrative of the external devices that could operate with implantable component 112. For example, in alternative examples, the external component 104 can comprise a behind-the-ear (BTE) sound processing unit configured to be attached to, and worn adjacent to, the recipient’s ear. In general, a BTE sound processing unit comprises a housing that is shaped to be worn on the outer ear of the user and is connected to the separate external coil assembly via a cable, where the external coil assembly is configured to be magnetically and inductively coupled to the implantable coil 114. It is also to be appreciated that alternative external components could be located in the user’s ear canal, worn on the body, etc.

[0028] Although the cochlear implant system 102 includes the sound processing unit 106 and the cochlear implant 112, as described below, the cochlear implant 112 can operate independently from the sound processing unit 106, for at least a period, to stimulate the user. For example, the cochlear implant 112 can operate in a first general mode, sometimes referred to as an “external hearing mode,” in which the sound processing unit 106 captures sound signals which are then used as the basis for delivering stimulation signals to the user. The cochlear implant 112 can also operate in a second general mode, sometimes referred as an “invisible hearing” mode, in which the sound processing unit 106 is unable to provide sound signals to the cochlear implant 112 (e.g., the sound processing unit 106 is not present, the sound processing unit 106 is powered-off, the sound processing unit 106 is malfunctioning, etc.). As such, in the invisible hearing mode, the cochlear implant 112 captures sound signals itself via implantable sound sensors and then uses those sound signals as the basis for delivering stimulation signals to the user. Further details regarding operation of the cochlear implant 112 in the external hearing mode are provided below, followed by details regarding operation of the cochlear implant 112 in the invisible hearing mode. It is to be appreciated that reference to the external hearing mode and the invisible hearing mode is merely illustrative and that the cochlear implant 112 could also operate in alternative modes.

[0029] In FIGs. 1A and 1C, the cochlear implant system 102 is shown with an external device 110, configured to implement aspects of the techniques presented. The external device 110, which is shown in greater detail in FIG. IE, is a computing device, such as a personal computer (e.g,, laptop, desktop, tablet), a mobile phone (e.g., smartphone), remote control unit, etc. The external device 110 and the cochlear implant system 102 (e.g., sound processing unit 106 or the cochlear implant 112) wirelessly communicate via a bi-directional communication link 126. The bi-directional communication link 126 can comprise, for example, a short-rangecommunication, such as Bluetooth link, Bluetooth Low Energy (BLE) link, a proprietary link, etc.

[0030] Returning to the example ofFIGs. 1A-1D, the sound processing unit 106 of the external component 104 also comprises one or more input devices configured to capture and / or receive input signals (e.g., sound or data signals) at the sound processing unit 106. The one or more input devices include, for example, one or more sound input devices 118 (e.g., one or more external microphones, audio input ports, telecoils, etc.), one or more auxiliary input devices 128 (e.g., audio ports, such as a Direct Audio Input (DAI), data ports, such as a Universal Serial Bus (USB) port, cable port, etc.), and a short-range wireless transmitter / receiver (wireless transceiver) 120 (e.g., for communication with the external device 110), each located in, on or near the sound processing unit 106. However, it is to be appreciated that one or more input devices can include additional types of input devices and / or less input devices (e.g., the short- range wireless transceiver 120 and / or one or more auxiliary input devices 128 could be omitted).

[0031] The sound processing unit 106 also comprises the external coil 108, a charging coil130, a closely-coupled radio frequency transmitter / receiver (RF transceiver) 122, at least one rechargeable battery 132, and an external sound processing module 124. The external sound processing module 124 can be configured to perform a number of operations which are represented in FIG. ID by a processor 131, a memory 133, and a sensor 135 that is configured to capture eye movement measurements, as described further below. Each of the processor131, the memory 133, and sensor 135 can be formed by one or more processors (e.g., one or more Digital Signal Processors (DSPs), one or more uC cores, etc.), firmware, software, etc. arranged to perform operations described herein. That is, the processor 131, the memory 133, and the sensor 135 can each be implemented as firmware elements, partially or fully implemented with digital logic gates in one or more application-specific integrated circuits (ASICs), partially or fully in software, etc. Although FIG. ID illustrates the processor 131, the memory 133, and the sensor 135 as being implemented / performed at the external sound processing module 124, it is to be appreciated that these elements (e.g., functional operations) could also or alternatively be implemented / performed as part of the implantable sound processing module 158, as part of the external computing device 110, etc.

[0032] Returning to the example of FIGs. 1A-1D, the implantable component 112 comprises an implant body (main module) 134, a lead region 136, and the intra-cochlear stimulating assembly 116, all configured to be implanted under the skin (tissue) 115 of the user. Theimplant body 134 generally comprises a hermetically-sealed housing 138 that includes, in certain examples, at least one power source 125 (e.g., one or more batteries, one or more capacitors, etc.), in which RF interface circuitry 140 and a stimulator unit 142 are disposed. The implant body 134 also includes the intemal / implantable coil 114 that is generally external to the housing 138, but which is connected to the RF interface circuitry 140 via a hermetic feedthrough (not shown in FIG. ID).

[0033] As noted, stimulating assembly 116 is configured to be at least partially implanted in the user’s cochlea. Stimulating assembly 116 includes a plurality of longitudinally spaced intra-cochlear electrical stimulating contacts (electrodes) 144 that collectively form a contact array (electrode array) 146 for delivery of electrical stimulation (current) to the recipient’s cochlea. Stimulating assembly 116 extends through an opening in the recipient’s cochlea (e.g., cochleostomy, the round window, etc.) and has a proximal end connected to stimulator unit 142 via lead region 136 and a hermetic feedthrough (not shown in FIG. ID). Lead region 136 includes a plurality of conductors (wires) that electrically couple the electrodes 144 to the stimulator unit 142. The implantable component 112 also includes an electrode outside of the cochlea, sometimes referred to as the extra-cochlear electrode (ECE) 139.

[0034] As noted, the cochlear implant system 102 includes the external coil 108 and the implantable coil 114. The external magnet 150 is fixed relative to the external coil 108 and the intemal / implantable magnet 152 is fixed relative to the implantable coil 114. The external magnet 150 and the intemal / implantable magnet 152 fixed relative to the external coil 108 and the intemal / implantable coil 114, respectively, facilitate the operational alignment of the external coil 108 with the implantable coil 114. This operational alignment of the coils enables the external component 104 to transmit data and power to the implantable component 112 via a closely-coupled wireless link 148 formed between the external coil 108 with the implantable coil 114. In certain examples, the closely-coupled wireless link 148 is a radio frequency (RF) link. However, various other types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, can be used to transfer the power and / or data from an external component to an implantable component and, as such, FIG. ID illustrates only one example arrangement.

[0035] As noted above, sound processing unit 106 includes the external sound processing module 124. The external sound processing module 124 is configured to process the received input audio signals (received at one or more of the input devices, such as sound input devices 118 and / or auxiliary input devices 128), and convert the received input audio signals into outputcontrol signals for use in stimulating a first ear of a recipient or user (i.e., the external sound processing module 124 is configured to perform sound processing on input signals received at the sound processing unit 106). Stated differently, the one or more processors (e.g., processing element(s) implementing firmware, software, etc.) in the external sound processing module 124 are configured to execute sound processing logic in memory to convert the received input audio signals into output control signals (stimulation signals) that represent electrical stimulation for delivery to the recipient.

[0036] As noted, FIG. ID illustrates an embodiment in which the external sound processing module 124 in the sound processing unit 106 generates the output control signals. In an alternative embodiment, the sound processing unit 106 can send less processed information (e.g., audio data) to the implantable component 112 and the sound processing operations (e.g., conversion of input sounds to output control signals 156) can be performed by a processor within the implantable component 112.

[0037] In FIG. ID, according to an example embodiment, output control signals (stimulation signals) are provided to the RF transceiver 122, which transcutaneously transfers the output control signals (e.g., in an encoded manner) to the implantable component 112 via external coil 108 and implantable coil 114. That is, the output control signals (stimulation signals) are received at the RF interface circuitry 140 via implantable coil 114 and provided to the stimulator unit 142. The stimulator unit 142 is configured to utilize the output control signals to generate electrical stimulation signals (e.g., current signals) for delivery to the user’s cochlea via one or more of the stimulating contacts (electrodes) 144. In this way, cochlear implant system 102 electrically stimulates the user’s auditory nerve cells, bypassing absent or defective hair cells that normally transduce acoustic vibrations into neural activity, in a manner that causes the recipient to perceive one or more components of the input audio signals (the received sound signals).

[0038] As detailed above, in the external hearing mode the cochlear implant 112 receives processed sound signals from the sound processing unit 106. However, in the invisible hearing mode, the cochlear implant 112 is configured to capture and process sound signals for use in electrically stimulating the user’s auditory nerve cells. In particular, as shown in FIG. ID, an example embodiment of the cochlear implant 112 can include a plurality of implantable sound sensors 165(1), 165(2) that collectively form a sensor array 160, and an implantable sound processing module 158. The implantable sound processing module 158 can comprise, for example, one or more processors and a memory device (memory) that includes soundprocessing logic, and a sensor 155 that is configured to capture electrophysiological measurements, as described further below. The memory device can comprise any one or more of: Non-Volatile Memory (NVM), Ferroelectric Random Access Memory (FRAM), read only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The one or more processors are, for example, microprocessors or microcontrollers that execute instructions for the sound processing logic stored in memory device.

[0039] In the invisible hearing mode, the implantable sound sensors 165(1), 165(2) of the sensor array 160 are configured to detect / capture input sound signals 166 (e.g., acoustic sound signals, vibrations, etc.), which are provided to the implantable sound processing module 158. The implantable sound processing module 158 is configured to convert received input sound signals 166 (received at one or more of the implantable sound sensors 165(1), 165(2)) into output control signals 156 for use in stimulating the first ear of a recipient or user (i.e., the implantable sound processing module 158 is configured to perform sound processing operations). Stated differently, the one or more processors (e.g., processing element(s) implementing firmware, software, etc.) in implantable sound processing module 158 are configured to execute sound processing logic in memory to convert the received input sound signals 166 into output control signals 156 that are provided to the stimulator unit 142. The stimulator unit 142 is configured to utilize the output control signals 156 to generate electrical stimulation signals (e.g., current signals) for delivery to the user’s cochlea, thereby bypassing the absent or defective hair cells that normally transduce acoustic vibrations into neural activity.

[0040] It is to be appreciated that the above description of the so-called external hearing mode and the so-called invisible hearing mode are merely illustrative and that the cochlear implant system 102 could operate differently in different embodiments. For example, in one alternative implementation of the external hearing mode, the cochlear implant 112 could use signals captured by the sound input devices 118 and the implantable sound sensors 165(1), 165(2) of sensor array 160 in generating stimulation signals for delivery to the user.

[0041] FIG. IE is a block diagram illustrating one example arrangement for an external computing device 110 configured to perform one or more operations in accordance with certain embodiments presented herein. As shown in FIG. IE, in its most basic configuration, the external computing device 110 includes at least one processing unit 183 and a memory 184.The processing unit 183 includes one or more hardware or software processors (e.g., Central Processing Units) that can obtain and execute instructions. The processing unit 183 can communicate with and control the performance of other components of the external computing device 110. The memory 184 is one or more software or hardware-based computer-readable storage media operable to store information accessible by the processing unit 183. The memory 184 can store, among other things, instructions executable by the processing unit 183 to implement applications or cause performance of operations described herein, as well as other data. The memory 184 can be volatile memory (e.g., RAM), non-volatile memory (e.g., ROM), or combinations thereof. The memory 184 can include transitory memory or non-transitory memory. The memory 184 can also include one or more removable or non-removable storage devices. In examples, the memory 184 can include random access memory (RAM), read only memory (ROM), EEPROM (Electronically-Erasable Programmable Read-Only Memory), flash memory, optical disc storage, magnetic storage, solid state storage, or any other memory media usable to store information for later access. By way of example, and not limitation, the memory 184 can include wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media or combinations thereof. In certain embodiments, the memory 184 comprises logic 195 that, when executed, enables the processing unit 183 to perform aspects of the techniques presented.

[0042] In the illustrated example of FIG. IE, the external computing device 110 further includes a network adapter 186, one or more input devices 187, and one or more output devices 188. The external computing device 110 can include other components, such as a system bus, component interfaces, a graphics system, a power source (e.g., a battery), among other components. The network adapter 186 is a component of the external computing device 110 that provides network access (e.g., access to at least one network 189). The network adapter 186 can provide wired or wireless network access and can support one or more of a variety of communication technologies and protocols, such as ETHERNET, cellular, BLUETOOTH, near-field communication, and RF (Radiofrequency), among others. The network adapter 186 can include one or more antennas and associated components configured for wireless communication according to one or more wireless communication technologies and protocols. The one or more input devices 187 are devices over which the external computing device 110 receives input from a user. The one or more input devices 187 can include physically- actuatable user-interface elements (e.g., buttons, switches, or dials), a keypad, keyboard, mouse, touchscreen, and voice input devices, among other input devices that can accept userinput. The one or more output devices 188 are devices by which the computing device 110 is able to provide output to a user. The output devices 188 can include a display 190 (e.g., a liquid crystal display (LCD)) and one or more speakers 191, among other output devices for presentation of visual or audible information to the recipient, a clinician, an audiologist, or other user.

[0043] It is to be appreciated that the arrangement for the external computing device 110 shown in FIG. IE is merely illustrative and that aspects of the techniques presented herein can be implemented at a number of different types of systems / devices including any combination of hardware, software, and / or firmware configured to perform the functions described herein. For example, the external computing device 110 can be a personal computer (e.g., a desktop or laptop computer), a hand-held device (e.g., a tablet computer), a mobile device (e.g., a smartphone), a surgical system, and / or any other electronic device having the capabilities to perform the associated operations described elsewhere herein.

[0044] FIG. IF provides an exemplary embodiment of an EEG system that is implanted in the recipient. A series of subcutaneous read / sense electrodes 1220 are arrayed under the skin of the recipient’s head. The subcutaneous read / sense electrodes 1220 are in signal communication with a coil 1210 via electrical leads. In this embodiment, the implanted device has no recording / storage capabilities, and requires an external device to receive a signal from the implanted inductance coil 1210 so as to retrieve in real time the signal therefrom. Not shown is an implantable component that converts the electrophysiological signal sensed by the sensor / read electrodes into a signal that is transmitted by the inductance coil 1210. In an exemplary embodiment, the sensor arrangement seen in FIG. IF is an implanted EEG sensor arrangement.

[0045] FIG. 1G depicts another arrangement of an implantable EEG system that again includes the subcutaneous sensor / read electrodes 1220 and the leads. In this embodiment, there is a housing 1330 which includes circuitry that is configured to receive the electrophysiological signals from the leads from the electrodes 1220 and record the data therefrom or otherwise store the data. The circuitry permits the data to be periodically read by an external device when the external device comes into signal communication with the implanted inductance coil 1210. Alternatively, and / or in addition to this, the circuitry is configured to periodically energize the inductance coil 1210 so as to provide the data to the coil 1210 so that it creates an inductance signal which in turn communicates with an external component that reads the signal and thus reads the data associated with the electrodes. Thus, in at least some exemplary embodiments,the implantable apparatus is configured to stream the data. Still further, in some embodiments, the data is not streamed, but instead provided in bursts. Any arrangement that can enable the data associated with the read electrodes to be provided from inside the recipient to outside the recipient can be utilized in at least some exemplary embodiments. In this regard, traditional implanted EEG sensor arrangements can be obtained and modified so as to implement the teachings detailed herein and / or variations thereof.

[0046] FIG. 1H depicts another arrangement of an implantable EEG system. The depicted EEG system 1400 has a single elongate lead 1410 that extends laterally across the recipient’s scalp 1454 (e.g., from a location proximate one ear to a location proximate the contralateral ear). Discrete electrodes 1420 are distributed at intervals along the length of the lead 1410, and the electrodes 1420 are connected to the implant housing by a bundle of conductors. A processing unit 1430 is provided for processing electrical signals (e.g., raw EEG data) that can be sent to and / or received from the electrodes 1420. An electrical amplifier 1440 (e.g., a preamp) is positioned along the elongate lead 1410 between the electrodes 1420 and the processing unit 1430. In at least some embodiments, the lead 1410 comprises a bundle of platinum wires encapsulated in a silicone carrier with a series of full ring electrodes 1420 disposed at regular intervals along the length of the lead 1410.

[0047] It is noted that some embodiments of the sensor EEG system of figures IF, 1G or 1H include an implanted battery or otherwise implanted power storage arrangement, while in other embodiments the arrangement specifically does not.Example Embodiments

[0048] Conventional neurological monitoring (e.g., epilepsy diagnosis and / or seizure characterization) is typically performed in a clinical setting. For example, electroencephalography (EEG) measurements can readily be combined with data from other tests (e.g., blood tests, imaging tests such as MRI, CT and PET scans, and / or magnetoencephalography (MEG) tests) and / or clinical observations in this setting.

[0049] Eye movement measurements can potentially augment neurological (EEG) data to improve diagnosis of a medical condition and / or characterization of a medical event. For example, eye data can be used to detect rapid eye movement (REM) sleep (e.g., using eye movement-related eardrum oscillations (EMREO)), differentiate different types of seizures (e.g., eyes open versus eyes closed, etc.), and / or to give an early indication (e.g., predict onset of a seizure). There are several non-limiting illustrative examples of eye data associated withseizures, in particular. Psychogenic non-epileptic seizures can be distinguished from epileptic seizures by determining whether the patient’s eyes are closed or open. During tonic -clonic activity, rhythmic eye blinking is typically followed by postictal confusion and eye closure. Epileptic nystagmus can be caused by focal onset seizures and contains a fast phase and a slow phase. Tonic eye deviation can occur due to excessive activation of the contralateral frontal eye field. Eyelid flutter can be seen in occipital / temporal / frontal lobe seizures.Smart Eyewear (Direct Tracking) + Implant

[0050] FIG. 2 depicts a simplified block diagram of a system 200 according to a first example embodiment. As shown in FIG. 2, the system 200 includes an implantable component 212 (also referred to as an implantable device 212) and an external component 204 (also referred to as an external device 204).

[0051] The implantable component / device 212 can be an implantable neurological monitoring and stimulation system, such as an electroencephalography (EEG) implant (e.g., an epilepsy implant), cochlear implant, etc. can include a sensor 255 that is configured to obtain electrophysiological measurements (e.g., EEG measurements and / or magnetoencephalography (MEG) measurements) from a recipient of the implantable component / device 212. The implantable component / device 212 can also include an RF transceiver 240, and optionally, a processor 258.

[0052] The external component / device 204 can be a wearable device 206 with a camera 218 (or other imaging sensor) that is configured to obtain measurements representative of movement of the eyes of the recipient. According to the first example embodiment of FIG. 2, the wearable device 206 can be a pair of smart glasses 206 (or other smart eyewear) configured to be worn on the face of the recipient, and can include a sensor 235 (e.g., the camera 218 or other imaging sensor, or a dedicated sensor) that is configured to directly track movement of the eyes of the recipient (tracking movement of the eyelids and detecting other facial movements are also possible). The sensor 235 can comprise, for example, skin contacting electrodes that are configured to sense activation of facial muscles associated with movement of the eyes and / or eyelids of the recipient. In some example embodiments, the camera 218 can be omitted if the sensor 235 is included and capable of capturing eye movement measurements. In some other example embodiments, the sensor 235 can be omitted if the camera 218 is included and capable of capturing eye movement measurements. The external component / device 204 (e.g., eye movement tracking glasses or smart eyewear 206) can bewirelessly paired with the implantable component / device 212 using an RF connection 248, for example, although example embodiments are not limited thereto.

[0053] In the example shown in FIG. 2, the external component / device 204 of the system 200 can include a processor 231 configured to associate the electrophysiological (EEG) measurements obtained from the recipient by the implantable component / device 212 with the measurements representative of movement of the eyes of the recipient obtained by the external component / device 204, and a memory 233 configured to store the electrophysiological (EEG) measurements in association with the measurements representative of movement of the eyes of the recipient.

[0054] In some variations, the external component / device 204 can further include a wireless transceiver 220 to facilitate communication with other devices. For example, an external computing device 210 (e.g., a laptop / PC, a mobile device, a smartphone, etc.) that includes a wireless transceiver 286 can be configured to receive the electrophysiological (EEG) measurements obtained from the recipient and the measurements representative of movement of the eyes of the recipient from the external component / device 204. The external computing device 210 illustrated in FIG. 2 comprises a processor 283 configured to associate the electrophysiological (EEG) measurements obtained from the recipient by the implantable component / device 212 with the measurements representative of movement of the eyes of the recipient obtained by the external component / device 204, and a memory 284 configured to store the electrophysiological (EEG) measurements in association with the measurements representative of movement of the eyes of the recipient. The external computing device 210 (e.g., a mobile device) can be wirelessly paired with the external component / device 204 (e.g., the smart eyewear 206) via a wireless connection 226, and can be configured to perform various operations, including but not limited to, data logging, data analysis, user notification, and / or complementary data collection (e.g., fall detection, gait monitoring, etc.) using an inertial measurement unit (IMU), gyroscope, accelerometer, or other sensing means (not shown in FIG. 2) of the external computing device 210. The external computing device 210 can also include input devices 287 (e.g., keyboard, touchscreen, etc.) for receiving user input and output devices 288 (e.g., display screen, speakers, etc.) for providing user output. In some embodiments, the external component 204 can be configured to integrate some or all of the functions attributed to the external computing device 210. For example, the external component 204 can log data to onboard memory 233 and / or derive complementary data from sensor 235.

[0055] In some example embodiments, the processor 231 of the external component / device 204 (or the processor 283 of the external computing device 210) can be configured to synchronize the measurements representative of movement of the eyes of the recipient with the set of electrophysiological (EEG) measurements obtained from the implantable medical device. For example, timestamp data can be used to coarsely synchronize the respective data sets. In at least some embodiments, machine learning / artificial intelligence (e.g., a deep neural network, convolutional neural network, support vector machine, etc.) can be used to enhance coarsely synchronized data sets and / or confirm synchronization accuracy. For example, a machine learning / artificial intelligence algorithm can be developed (e.g., trained) to synchronize the respective data sets by detecting and aligning recurrent correlated measurements. In at least some embodiments, coarsely synchronized data sets can be refined by aligning blinking artifacts in EEG measurements with eye movement measurements that are representative of blinking.

[0056] In some example embodiments, the processor 231 of the external component / device 204 (or the processor 283 of the external computing device 210) can be configured to diagnose a medical condition based on an analysis that combines the electrophysiological (EEG) measurements obtained from the recipient and the measurements representative of the movement of the eyes of the recipient. In at least some embodiments, eye movement data can be combined with EEG measurements to confirm and / or classify seizure activity. For example, distinctive eye movement can be present during some forms of seizure, such that augmenting EEG measurements with eye movement data can increase the dimensionality of seizure pattern recognition algorithms, leading to improved diagnostic confidence. In some embodiments, eye movement data can be used to refine seizure characterizations inferred from EEG activity (e.g., eliminate false positive seizure characterizations).

[0057] In some example embodiments, the processor 231 of the external component / device 204 (or the processor 283 of the external computing device 210) can be configured to predict a medical event (in advance or at onset) and / or characterize a medical event (during or after occurrence) based on an analysis that combines the electrophysiological (EEG) measurements obtained from the recipient and the measurements representative of the movement of the eyes of the recipient.

[0058] Some general requirements for the system 200 can include reliable wireless connectivity and accurate synchronization (for time stamping data) with respect to the electrophysiological (EEG) measurements and the eye tracking measurements. Incorporatingsmart eyewear 206 as the external component / device 204 provides the ability to track eyelid movement and / or other facial movement, in addition to eye movement (e.g., nystagmus, tonic eye deviation, eyelid flutter, etc.). Furthermore, the availability of other existing sensors (e.g., accelerometers, gyroscopes, microphones, etc.) in contemporary smart glasses can be used to supplement the analysis of the electrophysiological (EEG) measurements and the eye tracking measurements to assist in diagnosing a medical condition or predicting or characterizing a medical event.

[0059] One drawback of using smart eyewear 206 as the external component / device 204 is the lack of an ability to detect eye movement when the recipient’s eyes are closed (e.g., while the recipient is sleeping, or during some particular types of seizures). This drawback can be remedied with supplementary sensors (e.g., sensors that are configured to sense activation of facial muscles associated with movement of the eyes and / or eyelids), or by using either of a second example embodiment described below with reference to FIG. 3, or a third example embodiment described below with reference to FIG. 4 (either as a substitute for, or in combination with, the smart eyewear 206), which each utilize indirect detection of eye movement based on eye movement-related eardrum oscillations (EMREO) as a proxy to direct tracking.EMREO + EEG Implant

[0060] FIG. 3 depicts a simplified block diagram of a system 300 according to a second example embodiment. As shown in FIG. 3, the system 300 includes an implantable component 312 (also referred to as an implantable device 312) and an external component 304 (also referred to as an external device 304).

[0061] The implantable component / device 312 can be an implantable neurological monitoring and stimulation system, such as an electroencephalography (EEG) implant (e.g., an epilepsy implant), for example, and can include a sensor 355 that is configured to obtain electrophysiological measurements (e.g., EEG measurements) from a recipient of the implantable component / device 312. The implantable component / device can also include an RF transceiver 340, and optionally, a processor 358.

[0062] The external component / device 304 can be an ear worn device 306 (e.g., a wireless ear bud, a hearing aid, a sound processing unit) with a microphone 318 (e.g., an in-the-ear microphone) capable of measuring EMREO, and can be configured to obtain measurements representative of movement of the eyes of the recipient. According to the second exampleembodiment of FIG. 3, the external component / device 304 can be an ear worn device 306 that further includes a sensor 335 (e.g., the microphone 318, or another dedicated sensor) that is configured to indirectly detect movement of the eyes of the recipient based on eye movement- related eardrum oscillations (EMREO). EMREO relates to oscillations synchronized with and covarying with the direction and amplitudes of saccades. Interactions between sensory pathways, such as the visual and auditory systems, are known to occur in the brain, but where they first occur in uncertain. Here, a multimodal interaction evident at the eardrum is used to track eye movements. The sensor 335 can comprise, for example, an optical sensorthat is held in the recipient’s ear canal and configured to sense movement of the ear drum and / or ossicles. In some example embodiments, the microphone 318 can be omitted if the sensor 335 is included and capable of capturing EMREO measurements. In some other example embodiments, the sensor 335 can be omitted if the microphone 318 is included and capable of capturing EMREO measurements. The external component / device 304 (e.g., the ear worn device 306) can be wirelessly paired with the implantable component / device 312 using RF connection 348, for example, although example embodiments are not limited thereto.

[0063] In the example shown in FIG. 3, the external component / device 304 of the system 300 can include a processor 331 configured to associate the electrophysiological (EEG) measurements obtained from the recipient by the implantable component / device 312 with the measurements representative of movement of the eyes of the recipient (EMREO) obtained by the external component / device 304, and a memory 333 configured to store the electrophysiological (EEG) measurements in association with the measurements representative of movement of the eyes of the recipient (EMREO).

[0064] In some variations, the external component / device 304 can further include a wireless transceiver 320 to facilitate communication with other devices. For example, an external computing device 310 (e.g., a laptop / PC, a mobile device, a smartphone, etc.) that includes a wireless transceiver 386 can be configured to receive the electrophysiological (EEG) measurements obtained from the recipient and the measurements representative of movement of the eyes of the recipient (EMREO) from the external component / device 304. The external computing device 310 illustrated in FIG. 3 comprises a processor 383 configured to associate the electrophysiological (EEG) measurements obtained from the recipient by the implantable component / device 312 with the measurements representative of movement of the eyes of the recipient (EMREO) obtained by the external component / device 304, and a memory 384 configured to store the electrophysiological (EEG) measurements in association with themeasurements representative of movement of the eyes of the recipient (EMREO). The external computing device 310 (e.g., a mobile device) can be wirelessly paired with the external component / device 304 (e.g., the ear worn device 306) via a wireless connection 426, and can be configured to perform various operations, including but not limited to, data logging, data analysis, user notification, and / or complementary data collection (e.g., fall detection, gait monitoring, etc.) using an inertial measurement unit (IMU), gyroscope, accelerometer, or other sensing means (not shown in FIG. 2) of the external computing device 310. The external computing device 310 can also include input devices 387 (e.g., keyboard, touchscreen, etc.) for receiving user input and output devices 388 (e.g., display screen, speakers, etc.) for providing user output. In some embodiments, the external component 304 (e.g., the ear worn device 306) can be configured to integrate some or all of the functions attributed to the external computing device 310. For example, the external component 304 can log data to onboard memory 333 and / or derive complementary data from sensor 335.

[0065] In some example embodiments, the processor 331 of the external component / device 304 (or the processor 383 of the external computing device 310) can be configured to synchronize the measurements representative of movement of the eyes of the recipient (EMREO) with the set of electrophysiological measurements (EEG) obtained from the implantable component / device 312. For example, timestamp data can be used to coarsely synchronize the respective data sets. In at least some embodiments, machine learning / artificial intelligence (e.g., a deep neural network, convolutional neural network, support vector machine, etc.) can be used to enhance coarsely synchronized data sets and / or confirm synchronization accuracy. For example, a machine learning / artificial intelligence algorithm can be developed (e.g., trained) to synchronize the respective data sets by detecting and aligning recurrent correlated measurements. In at least some embodiments, coarsely synchronized data sets can be refined by aligning blinking artifacts in EEG measurements with eye movement measurements that are representative of blinking.

[0066] In some example embodiments, the processor 331 of the external component / device 304 (or the processor 383 of the external computing device 310) can be configured to diagnose a medical condition based on an analysis that combines the electrophysiological measurements (EEG) obtained from the recipient and the measurements representative of the movement of the eyes of the recipient (EMREO). In at least some embodiments, eye movement data can be combined with EEG measurements to confirm and / or classify seizure activity. For example, distinctive eye movement can be present during some forms of seizure, such that augmentingEEG measurements with eye movement data can increase the dimensionality of seizure pattern recognition algorithms, leading to improved diagnostic confidence. In some embodiments, eye movement data can be used to refine seizure characterizations inferred from EEG activity (e.g., eliminate false positive seizure characterizations).

[0067] In some example embodiments, the processor 331 of the external component / device 304 (or the processor 383 of the external computing device 310) can be configured to predict a medical event (in advance or at onset) and / or characterize a medical event (during or after occurrence) based on an analysis that combines the electrophysiological measurements (EEG) obtained from the recipient and the measurements representative of the movement of the eyes of the recipient (EMREO).

[0068] Incorporating the ear worn device 306 as the external component / device 304 provides the ability to detect eye movement even when the recipient’s eyes are closed (e.g., while sleeping or during some particular types of seizures), and eliminates a need for an additional external device to charge and wear (e.g., such as the smart glasses 206 of the first example embodiment of FIG. 2).

[0069] One drawback of using the ear worn device 306 as the external component / device 304 is the lack of an ability to track eyelid movement or detect other facial movement. This drawback can be remedied with supplementary sensors (e.g., sensors that are configured to sense activation of facial muscles associated with movement of the eyes and / or eyelids), or by using the first example embodiment described above with reference to FIG. 2 (either as a substitute for, or in combination with, the ear worn device 306), which utilizes direct tracking of eye movement (as well as eyelid movement or other facial movements) using the wearable device 206 (e.g., smart glasses or other smart eyewear) as the external component / device 204.EMREO + Inner Ear Implant

[0070] FIG. 4 depicts a simplified block diagram of a system 400 according to a third example embodiment. As shown in FIG. 4, the system 400 includes an implantable device 412 including an RF transceiver 440 and a stimulator unit 442 connected with an inner ear electrode array 446, and an external device 404 (also referred to as a processing device 404 in this embodiment) including an RF transceiver 422 and a memory 433.

[0071] The implantable device 412 can be a cochlear implant (CI) or a vestibular implant, for example, and can include a sensor 455 that is configured to obtain inner ear measurements (e.g., spontaneous neural activity measurements, evoked neural response measurements and / orimpedance measurements) from a recipient of the implantable device 412 via the stimulator unit 442 and the inner ear electrode array 446, and to transmit the inner ear measurements via the RF transceiver 440. The implantable device 412 can also include a processor 458.

[0072] The processing device 404 can be a sound processing unit 406 of a cochlear implant. For example, the sound processing unit 406 of a conventional cochlear implant can be configured with an in-the-ear microphone 418 capable of measuring EMREO, or an implantable sound processing unit (e.g., the sound processing unit of a totally implantable cochlear implant) can be configured with a middle ear microphone capable of detecting movement of the ossicles. The system 400 can be configured to generate a stimulus (e.g., an acoustic stimulus or an electrical stimulus) and receive inner ear measurements (representative of the recipient’s evoked neural response to the stimulus) via the implantable device 412. According to the third example embodiment of FIG. 4, the processing device 404 can include a sensor 435 (e.g., the microphone 418, or another dedicated sensor) that is configured to indirectly detect movement of the eyes of the recipient based on eye movement-related eardrum oscillations (EMREO). EMREO relates to oscillations synchronized with and covarying with the direction and amplitudes of saccades. Interactions between sensory pathways, such as the visual and auditory systems, are known to occur in the brain, but where they first occur in uncertain. Here, a multimodal interaction evident at the eardrum is used to track eye movements. In some example embodiments, the microphone 418 can be omitted if the sensor 435 is included and capable of capturing EMREO measurements. In some other example embodiments, the sensor 435 can be omitted if the microphone 418 is included and capable of capturing EMREO measurements. The processing device 404 (e.g., the sound processing unit 406) can be wirelessly paired with the implantable device 412 using an RF connection 448, for example, although example embodiments are not limited thereto.

[0073] In the example shown in FIG. 4, the processing device 404 of the system 400 can include a processor 431 configured to associate the inner ear measurements obtained from the recipient by the implantable device 412 with the measurements representative of movement of the eyes of the recipient (EMREO) obtained by the processing device 404, and a memory 433 configured to store the inner ear measurements in association with the measurements representative of movement of the eyes of the recipient (EMREO). Where the inner ear measurements represent an evoked neural response (e.g., cochlear microphonic measurements, summing potential measurements, electrically evoked action potential measurements, etc.), the processing device 404 can be configured to associate and store data about the stimulus used toevoke the neural response from the recipient with evoked response measurements and / or the EMREO data.

[0074] In some variations, the processing device 404 can include a wireless transceiver 420, and can be in communication with an external computing device 410 (e.g., a laptop / PC, a mobile device, a smartphone, etc.) that includes a wireless transceiver 486 configured to receive the inner ear measurements obtained from the recipient and the measurements representative of movement of the eyes of the recipient (EMREO) from the processing device 404. The external computing device 410 illustrated in FIG. 4 comprises a processor 483 configured to associate the inner ear measurements obtained from the recipient by the implantable device 412 with the measurements representative of movement of the eyes of the recipient (EMREO) obtained by the processing device 404, and a memory 484 configured to store the inner ear measurements in association with the measurements representative of movement of the eyes of the recipient (EMREO). The processor 483 can be configured to analyze the inner ear measurements obtained from the recipient in combination with the measurements representative of the movement of the eyes of the recipient (EMREO) to diagnose a medical condition and / or to predict or characterize a medical event. The external computing device 410 (e.g., a mobile device) can be wirelessly paired with the processing device 404 (e.g., the sound processing unit 406) via a wireless connection 426, and can be configured to perform various operations, including but not limited to, data logging, data analysis, user notification, and / or complementary data collection (e.g., fall detection, gait monitoring, etc.) using an inertial measurement unit (IMU), gyroscope, accelerometer, or other sensing means (not shown in FIG. 4) of the external computing device 410. The external computing device 410 can also include input devices 487 (e.g., keyboard, touchscreen, etc.) for receiving user input and output devices 488 (e.g., display screen, speakers, etc.) for providing user output. In some embodiments, the processing device 404 (e.g., the sound processing unit 406) can be configured to integrate some or all of the functions attributed to the external computing device 410. For example, the processing device 404 can log data to onboard memory 433 and / or derive complementary data from sensor 435.

[0075] Incorporating the sound processing unit 406 as the processing device 404 provides the ability to detect eye movement even when the recipient’s eyes are closed (e.g., while sleeping or during some particular types of seizures), and eliminates a need for an additional external device to charge and wear (e.g., such as the smart glasses 206 of the first example embodiment of FIG. 2).

[0076] One drawback of using the sound processing unit 406 as the processing device 404 is the lack of an ability to track eyelid movement or detect other facial movement. This drawback can be remedied with supplementary sensors (e.g., sensors that are configured to sense activation of facial muscles associated with movement of the eyes and / or eyelids), or by using the first example embodiment described above with reference to FIG. 2 (either as a substitute for, or in combination with, the sound processing unit 406), which utilizes direct tracking of eye movement (as well as eyelid movement or other facial movements) using the wearable device 206 (e.g., smart glasses or other smart eyewear) as the external component / device 204.

[0077] In at least some example embodiments, the processing device 404 can utilize EMREO measurements to track the recipient’s state of sleep. For example, the processing device 404 of a totally implantable cochlear implant can be configured to extract EMREO measurements from signals generated by a middle ear microphone. The processing device 404 and / or implantable device 412 can be configured to initiate evoked neural response measurements during periods of deep sleep (e.g., during Rapid Eye Movement (REM) sleep) when the recipient is less likely to be disturbed by supra-threshold stimulus. For example, the processing device 404 can track EMREO measurements to detect the onset of eye movement indicative of REM sleep and initiate EcochG and / or NRT measurements responsive to detect of REM sleep.

[0078] Some example embodiments can utilize EMREO measurements as additional input for scene classification, data logging, and / or system adaption, such as by tracking EMREO measurements to characterize the recipient’s visual habits. For example, the system 400 can learn from, and gradually adapt to, recipient behavior.

[0079] Some example embodiments can utilize EMREO measurements in conjunction with activity tracking from one or more other sensors. For example, the system 400 can be used to determine whether a recipient is the driver or passenger in a vehicle (e.g., EMREO measurements combined with accelerometer data), or detect when the recipient is asleep (e.g., EMREO measurements combined with accelerometer data and SCAN output).Example Process

[0080] FIG. 5 is a flowchart of a method 500 for multimodial neurological monitoring, according to an example embodiment. For example, the method 500 can be implemented using any one or more of the system 200 of FIG. 2, the system 300 of FIG. 3, and / or the system 400 of FIG. 4, respectively.

[0081] At operation 510, the method 500 includes obtaining a set of electrophysiological measurements captured by an implantable device, wherein the electrophysiological measurements originate from a recipient of the implantable device. At operation 520, the method 500 includes obtaining measurements representative of movement of the eyes of the recipient by an external device, wherein the measurements representative of movement of the eyes of the recipient are synchronized with the set of electrophysiological measurements obtained from the implantable device. At operation 530, the method 500 includes at least one of diagnosing a medical condition or predicting or characterizing a medical event based on an analysis that combines the electrophysiological measurements originating from the recipient and the measurements representative of the movement of the eyes of the recipient.

[0082] In some examples, the method 500 can further include associating the electrophysiological measurements obtained from the recipient by the implantable device with the measurements representative of movement of the eyes of the recipient, and storing the electrophysiological measurements obtained from the recipient in association with the measurements representative of movement of the eyes of the recipient in a memory.

[0083] In some examples, the set of electrophysiological measurements can comprise a plurality of electroencephalography (EEG) measurements, or a plurality of inner ear measurements (e.g., spontaneous neural activity measurements, evoked neural response measurements, impedance measurements), etc. In some examples, obtaining the measurements representative of movement of the eyes of the recipient at operation 520 can include directly tracking the movement of the eyes of the recipient using a wearable smart device . The wearable smart device can comprise smart glasses configured to be worn on the face of the recipient, for example. In some examples, obtaining the measurements representative of movement of the eyes of the recipient at operation 520 can include indirectly detecting the movement of the eyes of the recipient based on eye movement-related eardrum oscillations (EMREO) using a sound processing unit, or an ear worn device (e.g., a wireless earbud, a hearing aid), etc.

[0084] Utilizing the system and techniques according to the example embodiments described herein, it is possible to increase the dimensionality of data available for diagnosis (e.g., an epilepsy diagnosis) and / or prediction or characterization of neurological conditions (e.g., predicting an onset of a seizure, or performing seizure characterization during or after such an occurrence) in a relatively unobtrusive way. Synchronized eye movement data has the potential to improve diagnosis accuracy and / or reduce time to diagnosis.Variations and Alternatives

[0085] As previously described, the technology disclosed herein can be applied in any of a variety of circumstances and with a variety of different devices. Example devices that can benefit from technology disclosed herein are described in more detail in FIGS. 6 and 7. The techniques of the present disclosure can be applied to other devices, such as neurostimulators, seizure therapy stimulators, tinnitus management stimulators, and vestibular stimulation devices, as well as other medical devices that deliver stimulation to tissue. Further, technology described herein can also be applied to consumer devices. These different systems and devices can benefit from the technology described herein.

[0086] FIG. 6 illustrates an example vestibular stimulator system 602, with which embodiments presented herein can be implemented. As shown, the vestibular stimulator system 602 comprises an implantable component (vestibular stimulator) 612 and an external device / component 604 (e.g., external processing device, battery charger, remote control, etc.). The external device 604 comprises a transceiver unit 660. As such, the external device 604 is configured to transfer data (and potentially power) to the vestibular stimulator 612.

[0087] The vestibular stimulator 612 comprises an implant body (main module) 634, a lead region 636, and a stimulating assembly 616, all configured to be implanted under the skin / tissue (tissue) 615 of the recipient. The implant body 634 generally comprises a hermetically-sealed housing 638 in which RF interface circuitry, one or more rechargeable batteries, one or more processors, and a stimulator unit are disposed. The implant body 634 also includes an intemal / implantable coil 614 that is generally external to the housing 638, but which is connected to the transceiver via a hermetic feedthrough (not shown).

[0088] The stimulating assembly 616 comprises a plurality of electrodes 644(l)-(3) disposed in a carrier member (e.g., a flexible silicone body). In this specific example, the stimulating assembly 616 comprises three (3) stimulation electrodes, referred to as stimulation electrodes 644(1), 644(2), and 644(3). The stimulation electrodes 644(1), 644(2), and 644(3) function as an electrical interface for delivery of electrical stimulation signals to the recipient’s vestibular system.

[0089] The stimulating assembly 616 is configured such that a surgeon can implant the stimulating assembly adjacent the recipient’s otolith organs via, for example, the recipient’s oval window. It is to be appreciated that this specific embodiment with a single stimulation electrode is merely illustrative and that the techniques presented herein can be used withstimulating assemblies having different numbers of stimulation electrodes, stimulating assemblies having different lengths, etc.

[0090] In operation, the vestibular stimulator 612, the external device 604, and / or another external device, can be configured to implement the techniques presented herein. That is, the vestibular stimulator 612, possibly in combination with the external device 604 and / or another external device, can include an evoked biological response analysis system, as described elsewhere herein.

[0091] FIG. 7 illustrates a retinal prosthesis system 701 that comprises an external device 710 (which can correspond to the wearable device 100) configured to communicate with an implantable retinal prosthesis 700 via signals 751. The retinal prosthesis 700 comprises an implanted processing module 725 and a retinal prosthesis sensor-stimulator 790 is positioned proximate the retina of a recipient. The external device 710 and the processing module 725 can communicate via coils 708, 714.

[0092] In an example, sensory inputs (e.g., photons entering the eye) are absorbed by a microelectronic array of the sensor-stimulator 790 that is hybridized to a glass piece 792 including, for example, an embedded array of microwires. The glass can have a curved surface that conforms to the inner radius of the retina. The sensor-stimulator 790 can include a microelectronic imaging device that can be made of thin silicon containing integrated circuitry that convert the incident photons to an electronic charge.

[0093] The processing module 725 includes an image processor 723 that is in signal communication with the sensor-stimulator 790 via, for example, a lead 788 which extends through surgical incision 789 formed in the eye wall. In other examples, processing module 725 is in wireless communication with the sensor-stimulator 790. The image processor 723 processes the input into the sensor-stimulator 790, and provides control signals back to the sensor-stimulator 790 so the device can provide an output to the optic nerve. That said, in an alternate example, the processing is executed by a component proximate to, or integrated with, the sensor-stimulator 790. The electric charge resulting from the conversion of the incident photons is converted to a proportional amount of electronic current which is input to a nearby retinal cell layer. The cells fire and a signal is sent to the optic nerve, thus inducing a sight perception.

[0094] The processing module 725 can be implanted in the recipient and function by communicating with the external device 710, such as a behind-the-ear unit, a pair of eyeglasses,etc. The external device 710 can include an external light / image capture device (e.g., located in / on a behind-the-ear device or a pair of glasses, etc.), while, as noted above, in some examples, the sensor-stimulator 790 captures light / images, which sensor-stimulator is implanted in the recipient.

[0095] As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant to suggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. In general, additional configurations can be used to practice the processes and systems herein and / or some aspects described can be excluded without departing from the processes and systems disclosed herein.

[0096] This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

[0097] As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and / or some aspects described can be excluded without departing from the methods and systems disclosed herein.

[0098] According to certain aspects, systems and non-transitory computer readable storage media are provided. The systems are configured with hardware configured to execute operations analogous to the methods of the present disclosure. The one or more non-transitory computer readable storage media comprise instructions that, when executed by one or more processors, cause the one or more processors to execute operations analogous to the methods of the present disclosure.

[0099] Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosedsteps can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.[ooioo] Although specific aspects were described herein, the scope of the technology is not limited to those specific aspects. One skilled in the art will recognize other aspects or improvements that are within the scope of the present technology. Therefore, the specific structure, acts, or media are disclosed only as illustrative aspects. The scope of the technology is defined by the following claims and any equivalents therein.[ooioi] It is also to be appreciated that the embodiments presented herein are not mutually exclusive and that the various embodiments can be combined with another in any of a number of different manners.

Claims

CLAIMSWhat is claimed is:

1. A method comprising : obtaining a set of electrophysiological measurements captured by an implantable device, wherein the electrophysiological measurements originate from a recipient of the implantable device; obtaining measurements representative of movement of the eyes of the recipient by an external device, wherein the measurements representative of movement of the eyes of the recipient are synchronized with the set of electrophysiological measurements obtained from the implantable device; and at least one of diagnosing a medical condition or predicting or characterizing a medical event based on an analysis that combines the electrophysiological measurements originating from the recipient and the measurements representative of the movement of the eyes of the recipient.

2. The method of claim 1, further comprising: associating the electrophysiological measurements obtained from the recipient by the implantable device with the measurements representative of movement of the eyes of the recipient.

3. The method of claim 2, further comprising: storing the electrophysiological measurements obtained from the recipient in association with the measurements representative of movement of the eyes of the recipient in a memory.

4. The method of claim 1, 2, or 3, wherein the set of electrophysiological measurements comprises a plurality of electroencephalography (EEG) measurements or a plurality of inner ear measurements.

5. The method of claim 1, 2, or 3, wherein obtaining the measurements representative of movement of the eyes of the recipient comprises: directly tracking the movement of the eyes of the recipient using a wearable device.

6. The method of claim 5, wherein the wearable device comprises glasses configured to be worn on the face of the recipient to directly track the movement of the eyes of the recipient.

7. The method of claim 1, 2, or 3, wherein obtaining the measurements representative of movement of the eyes of the recipient comprises: indirectly detecting the movement of the eyes of the recipient based on eye movement-related eardrum oscillations (EMREO) using a sound processing unit or an ear worn device.

8. A system comprising: an implantable component configured to obtain electrophysiological measurements from a recipient of the implantable component; an external component configured to obtain measurements representative of movement of the eyes of the recipient; and at least one processor configured to associate the electrophysiological measurements obtained from the recipient by the implantable component with the measurements representative of movement of the eyes of the recipient obtained by the external component.

9. The system of claim 8, further comprising: at least one memory configured to store the electrophysiological measurements in association with the measurements representative of movement of the eyes of the recipient.

10. The system of claim 8, wherein the at least one processor is configured to: synchronize the measurements representative of movement of the eyes of the recipient with the electrophysiological measurements obtained from the implantable component.

11. The system of claim 8, 9, or 10, wherein the at least one processor is configured to: diagnose a medical condition based on an analysis that combines the electrophysiological measurements obtained from the recipient and the measurements representative of the movement of the eyes of the recipient.

12. The system of claim 8, 9, or 10, wherein the at least one processor is configured to:at least one of predict or characterize a medical event based on an analysis that combines the electrophysiological measurements obtained from the recipient and the measurements representative of the movement of the eyes of the recipient.

13. The system of claim 8, 9, or 10, wherein the external component is a wearable device including a sensor that is configured to directly track movement of the eyes of the recipient.

14. The system of claim 13, wherein the wearable device comprises glasses configured to be worn on the face of the recipient.

15. The system of claim 8, 9, or 10, wherein the external component is a sound processing unit or an ear worn device including a sensor that is configured to indirectly detect movement of the eyes of the recipient based on eye movement-related eardrum oscillations (EMREO).

16. The system of claim 8, 9, or 10, wherein the implantable component is an electroencephalography (EEG) implant, and the electrophysiological measurements comprise EEG measurements.

17. The system of claim 8, 9, or 10, wherein the implantable component is a cochlear implant, and the electrophysiological measurements comprise inner ear measurements.

18. The system of claim 9, wherein the at least one processor and the at least one memory are included in the external component.

19. The system of claim 9, wherein the at least one processor and the at least one memory are included in an external computing device that wirelessly communicates with the external component.

20. A system comprising: an implantable device including a wireless transmitter and an inner ear electrode array, wherein the implantable device is configured to obtain electrophysiological measurements from a recipient of the implantable device via the inner ear electrode array, and transmit the electrophysiological measurements via the wireless transmitter; andan external device including a wireless receiver and a memory module, wherein the external device is configured to receive the electrophysiological measurements from the implantable device via the wireless receiver, obtain measurements representative of movement of the eyes of the recipient that are synchronized with the electrophysiological measurements, and store the measurements representative of movement of the eyes of the recipient that are synchronized with the electrophysiological measurements in the memory module.

21. The system of claim 20, wherein the implantable device includes a stimulator unit connected with the inner ear electrode array.

22. The system of claim 19 or 20, wherein the external device is further configured to synchronize the measurements representative of movement of the eyes of the recipient with the electrophysiological measurements obtained from the recipient by the implantable device.

23. The system of claim 19 or 20, wherein the external device is further configured to analyze the electrophysiological measurements obtained from the recipient in combination with the measurements representative of the movement of the eyes of the recipient to diagnose a medical condition.

24. The system of claim 19 or 20, wherein the external device is further configured to: analyze the electrophysiological measurements obtained from the recipient in combination with the measurements representative of the movement of the eyes of the recipient to predict or characterize a medical event.

25. The system of claim 19 or 20, wherein the implantable device is a cochlear implant, and the electrophysiological measurements comprise inner ear measurements.

26. The system of claim 19 or 20, further comprising: an external computing device including a wireless transceiver and a processor, wherein the external computing device is configured to: receive the measurements representative of movement of the eyes of the recipient that are synchronized with the electrophysiological measurements from the external device via the wireless transceiver; andanalyze the electrophysiological measurements obtained from the recipient in combination with the measurements representative of the movement of the eyes of the recipient to diagnose a medical condition or predict or characterize a medical event.

27. The system of claim 19 or 20, wherein the measurements representative of the movement of the eyes of the recipient are obtained based on detecting eye movement-related eardrum oscillations (EMREO).

28. One or more non-transitory computer readable storage media comprising instructions that, when executed by a processor, cause the processor to: obtain a set of electrophysiological measurements from a recipient of an implantable device; obtain measurements representative of movement of the eyes of the recipient by an external device; and analyze the measurements representative of movement of the eyes of the recipient in association with the set of electrophysiological measurements obtained from the implantable device.

29. The one or more non-transitory computer readable storage media of claim 28, wherein the instructions to analyze the measurements representative of movement of the eyes of the recipient in association with the set of electrophysiological measurements obtained from the implantable device comprise instructions that, when executed by a processor, cause the processor to: generate an output representative of a medical condition associated with the recipient.

30. The one or more non-transitory computer readable storage media of claim 28, wherein the instructions to analyze the measurements representative of movement of the eyes of the recipient in association with the set of electrophysiological measurements obtained from the implantable device comprise instructions that, when executed by a processor, cause the processor to: at least one of predict or characterize a medical event associated with the recipient.

31. The one or more non-transitory computer readable storage media of claim 28, 29, or 30, further comprising instructions that, when executed by a processor, cause the processor to: synchronize the measurements representative of movement of the eyes of the recipient with the set of electrophysiological measurements obtained from the implantable device.

32. The one or more non-transitory computer readable storage media of claim 28, 29, or 30, further comprising instructions that, when executed by a processor, cause the processor to: associate the set of electrophysiological measurements obtained from the recipient by the implantable device with the measurements representative of movement of the eyes of the recipient; and store the set of electrophysiological measurements obtained from the recipient in association with the measurements representative of movement of the eyes of the recipient in a memory.

33. The one or more non-transitory computer readable storage media of claim 28, 29, or 30, wherein the instructions to obtain measurements representative of movement of the eyes of the recipient comprises instructions that, when executed by a processor, cause the processor to: obtain measurements representing a direct tracking the movement of the eyes of the recipient using a wearable device.

34. The one or more non-transitory computer readable storage media of claim 28, 29, or 30, wherein the instructions to obtain measurements representative of movement of the eyes of the recipient comprises instructions that, when executed by a processor, cause the processor to: obtain measurements representing an indirect tracking of the movement of the eyes of the recipient based on eye movement-related eardrum oscillations (EMREO) using a sound processing unit or an ear worn device.

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