System and method for using impedance to determine proximity and orientation of segmented electrodes

• US 10,016,594 B2
• Filed: 11/29/2016
• Issued: 07/10/2018
• Est. Priority Date: 06/28/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Bradley, Kerry
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US15/363,557
• Publication Number:
  US 20170072192A1
• Time in Patent Office: 588 Days
• Field of Search: 607 45, 607 46, 607 62, 607116, 607117
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

A method for implanting a neurostimulation lead within a patient includes measuring impedances of electrodes on the lead in order to correctly position the lead relative to a target tissue region. The electrodes are circumferentially segmented electrodes that are spaced from each other about the longitudinal axis of the lead. When the difference between the impedances of the electrodes exceeds a threshold value, the lead is in the correct position. In accordance with another embodiment, impedance measurements are used to select which one of the electrodes is closest to the target tissue region. By determining which electrode has the highest impedance and which electrode has the lowest impedance, the type of tissue adjacent to each electrode can be determined based on the conductivity properties of the tissue. The target tissue region may be a spinal cord, a posterior longitudinal ligament, white matter, or gray matter.

Claims

1. A method for performing a medical procedure on a patient using a neurostimulation lead having a longitudinal axis and an electrode ring segmented into at least two electrodes circumferentially spaced from each other about the longitudinal axis, the method comprising:

positioning the electrode ring within the patient and proximate to a tissue volume that includes a target tissue region having different conductive properties than other proximate tissue in the tissue volume;

determining an electrical parameter of each of the at least two electrodes that form the electrode ring, the electrical parameter being based on the conductive properties of the tissue volume;

causing a difference in the electrical parameter to be determined and compared to a threshold value;

and

based on the comparison, re-positioning the electrode ring relative to the target tissue region.

2. The method of claim 1, wherein re-positioning the electrode ring comprises linearly displacing the electrode ring closer to the target tissue region.

3. The method of claim 1, wherein the target tissue region comprises at least one of a spinal cord, a posterior longitudinal ligament, a white matter, or a gray matter.

4. The method of claim 1, wherein re-positioning the electrode ring comprises rotating the electrode ring relative to a longitudinal axis to position one of the electrodes closer to the target tissue region.

5. The method of claim 1, wherein the target tissue region comprises a spinal cord, and wherein positioning the electrode ring within the patient comprises positioning the electrode ring in an epidural space.

6. The method of claim 1, wherein the target tissue region comprises a posterior longitudinal ligament, and wherein positioning the electrode ring within the patient comprises positioning the electrode ring in a ventral region of an epidural space.

7. The method of claim 1, wherein the target tissue region comprises the spinal cord, and wherein positioning the electrode ring within the patient comprises positioning the electrode ring between a spinal cord and a dura.

8. The method of claim 1, wherein the at least two electrodes include two electrodes diametrically disposed from each other.

9. The method of claim 1, further comprising affixing the electrode ring after re-positioning electrode ring.

10. The method of claim 1, wherein the target tissue region comprises gray matter or white matter, and wherein positioning the electrode ring within the patient comprises positioning the electrode ring in a brain.

11. The method of claim 1, wherein the electrical parameter comprises a field potential and the neurostimulation lead is rotated about an axis of the lead to re-position the electrode ring only if the difference in the field potential for the at least two electrodes is less than the threshold value which indicates that the lead is not correctly positioned.

12. The method of claim 1, wherein the electrical parameter comprises an impedance and the neurostimulation lead is rotated about an axis of the lead to re-position the electrode ring only if the difference in the impedance for the at least two electrodes is less than the threshold value which indicates that the lead is not correctly positioned.

13. A method for providing therapy to a patient using a neurostimulation lead implanted within the patient proximate to a tissue volume that includes a target tissue region having different conductive properties than other proximate tissue in the tissue volume, wherein the implanted neurostimulation lead has a longitudinal axis and an electrode ring segmented into at least two electrodes circumferentially spaced from each other about the longitudinal axis, the method comprising:

determining an electrical parameter of each of the at least two electrodes, the electrical parameter being based on the conductive properties of the tissue volume;

based on the determined electrical parameter, selecting an electrode from the at least two electrodes closest to the target tissue region; and

conveying electrical stimulation energy from the selected electrode.

14. The method of claim 13, wherein an electrode having a lowest electrical parameter relative to other electrodes is selected from the at least two electrodes to be the electrode closest to the target tissue region.

15. The method of claim 13, wherein an electrode having a highest electrical parameter relative to other electrodes is selected from the at least two electrodes to be the electrode closest to the target tissue region.

16. The method of claim 13, wherein the electrical parameter includes an impedance.

17. The method of claim 13, wherein the electrical parameter includes a field potential.

18. A system for providing therapy to a patient using a neurostimulation lead implanted within the patient proximate to a tissue volume that includes a target tissue region having different conductive properties than other proximate tissue in the tissue volume, wherein the implanted neurostimulation lead has a longitudinal axis and an electrode ring segmented into at least two electrodes circumferentially spaced from each other about the longitudinal axis, the system comprising:

circuitry configured to determine an electrical parameter of each of the least two electrodes of the segmented electrode ring circumferentially spaced from each other about the longitudinal axis of the neurostimulation lead, the electrical parameter being based on the conductive properties of the tissue volume;

a processor configured to select an electrode from the at least two electrodes closest to the target tissue region based on the determined electrical parameter, and cooperate with control output circuitry to convey electrical stimulation energy from the selected electrode.

19. The system of claim 18, wherein the processor is further configured to select an electrode having a lowest electrical parameter relative to other electrodes as the electrode closest to the target tissue region.

20. The system of claim 18, wherein the processor is further configured to select an electrode having a highest electrical parameter relative to other electrodes as the electrode closest to the target tissue region.