Systems and methods for delivering therapy to the dorsal horn of a patient
First Claim
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1. A method of operating an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition, comprising:
- delivering an electrical waveform from the implantable modulator to at least some electrodes in the electrode array in accordance with a modulation parameter set to generate an electric field to stimulate dorsal horn neuronal elements of the patient more than dorsal column neuronal elements of the patient, wherein;
a first component of the electrical field generated using the electrical waveform extends along a spinal cord of the patient and a second component of the electrical field generated using the electrical waveform extends transverse to the spinal cord of the patient; and
a gradient across the first component of the electrical field renders the dorsal column neuronal elements less excitable than the dorsal horn neuronal elements are rendered by a gradient across the second component of the electrical field.
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Abstract
A method of operating an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition comprises conveying electrical modulation energy to tissue of the patient in accordance with a modulation parameter set, wherein conveying the electrical modulation energy to tissue of the patient in accordance with the modulation parameter set stimulates dorsal horn neuronal elements more than dorsal column neuronal elements.
69 Citations
19 Claims
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1. A method of operating an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition, comprising:
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delivering an electrical waveform from the implantable modulator to at least some electrodes in the electrode array in accordance with a modulation parameter set to generate an electric field to stimulate dorsal horn neuronal elements of the patient more than dorsal column neuronal elements of the patient, wherein; a first component of the electrical field generated using the electrical waveform extends along a spinal cord of the patient and a second component of the electrical field generated using the electrical waveform extends transverse to the spinal cord of the patient; and a gradient across the first component of the electrical field renders the dorsal column neuronal elements less excitable than the dorsal horn neuronal elements are rendered by a gradient across the second component of the electrical field. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method of operating an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition, comprising:
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determining a perception threshold for electrical modulation energy conveyed through each electrode of a plurality of electrodes on an electrical modulation lead; modifying a neuronal driving force indicator for the electrical modulation energy conveyed through each electrode of the plurality of electrodes based on the respective determined perception threshold; and modifying a modulation parameter set based on the modified neuronal driving force indicator for electrical modulation energy conveyed through each electrode of the plurality of electrodes, wherein the modified neuronal driving force indicator is an activating function; delivering an electrical waveform from the implantable modulator to at least some electrodes in the electrode array in accordance with the modified modulation parameter set to dorsal horn neuronal elements more than dorsal column neuronal elements; wherein the activating function is a continuous activating function determined by calculating the second-order spatial derivative of the extracellular potential along an axon or the activating function is a discrete activating function estimating by the formula AF(n)=Ga/(π
×
d×
l)×
[Ve(n−
1)−
2 Ve(n)+Ve(n+1)], wherein Ga is the axonal intermodal conductance,d is the axonal diameter, l is the length of the node of Ranvier, Ve(n) is the strength of the electric field at the node for which the activating function is determined, Ve(n−
1) is the strength of the electric field at the node preceding the node for which the activating function is determined, and Ve(n+1) is the strength of the electric field at the node following the node for which the activating function is determined.- View Dependent Claims (18)
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19. A method of operating an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition, comprising:
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implanting a first electrical modulation lead adjacent a dorsal horn of a spinal cord of the patient and a second electrical modulation lead adjacent a dorsal column of the spinal cord of the patient; and delivering an electrical waveform from the implantable neuromodulator to at least some electrodes in the implanted first and second electrical modulation leads to tissue of the patient in accordance with a modulation parameter set to provide an electric field over the spinal cord, wherein the electric field provided by the electrical waveform in accordance with the modulation parameter set stimulates dorsal horn neuronal elements more than dorsal column neuronal elements, wherein delivering the electrical waveform in accordance with the modulation parameter set generates a first driving force in dorsal horn neuronal elements that is stronger than a second driving force in dorsal column neuronal elements, and wherein the modulation parameter set defines a fractionalized electrode combination.
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Specification