Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions

• US 10,179,241 B2
• Filed: 01/11/2018
• Issued: 01/15/2019
• Est. Priority Date: 01/29/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Walker, Andre B., Fang, Zi-Ping, Caparso, Anthony V.
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US15/868,861
• Publication Number:
  US 20180133483A1
• Time in Patent Office: 369 Days
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions are disclosed. A method in accordance with a particular embodiment includes selecting a target stimulation frequency that is above a threshold frequency, with the threshold frequency corresponding to a refractory period for neurons of a target sensory neural population. The method can further include producing a patient sensation of paresthesia by directing an electrical signal to multiple sensory neurons of the target sensory neural population at the stimulation frequency, with individual neurons of the sensory neural population completing corresponding individual refractory periods at different times, resulting in an asynchronous sensory neuron response to the electrical signal.

Claims

1. A method for automatically adjusting stimulation delivered to a patient, the method comprising:

applying an electrical stimulation signal to a neural population of a patient to evoke a neural response generated by the neural population, wherein the electrical stimulation signal has a first parameter value;

measuring, via an implanted signal detection device, the neural response evoked by the applied electrical stimulation signal;

comparing the measured neural response to a prior level; and

after comparing the measured neural response to the prior level, automatically adjusting the first parameter value to a second parameter value based at least in part on the measured neural response.

2. The method of claim 1, further comprising repeating, in a closed loop manner, the operations of applying, measuring, comparing, and adjusting until a target neural response is measured.

3. The method of claim 1 wherein the evoked neural response is an asynchronous response.

4. The method of claim 1 wherein measuring the neural response includes measuring a compound action potential of the neural population, and wherein comparing the measured neural response includes comparing the compound action potential to the prior level.

5. The method of claim 4 wherein comparing the compound action potential to the prior level is performed in part to determine whether the neural population is generating asynchronous action potentials.

6. The method of claim 1 wherein the prior level is a baseline level.

7. The method of claim 6 wherein the baseline level corresponds to a synchronous neural response generated by the neural population.

8. The method of claim 1 wherein adjusting the first parameter value includes adjusting a frequency of the electrical stimulation signal to be at or above 40 Hz.

9. The method of claim 1 wherein the signal detection device includes one or more diagnostic leads.

10. The method of claim 1 wherein the signal detection device is positioned proximate a spinal cord of the patient.

11. The method of claim 1 wherein measuring the neural response includes directly measuring the neural response.

12. A system for applying neural stimulation to a patient, the system comprising:

an implantable pulse generator configured to generate an electrical stimulation signal having at least a first parameter value;

an electrode array having one or more electrodes coupleable to the pulse generator; and

a sensor coupleable to the pulse generator and configured to be positioned proximate an anatomical feature of the patient,

wherein the pulse generator includes a machine-readable medium having instructions that, when executed, cause the pulse generator to—

deliver the electrical stimulation signal to a neural population of the patient via the one or more electrodes;

sense, via the sensor, a neural response generated by the neural population in response to the delivered electrical stimulation signal;

determine a feedback value based on the sensed neural response generated by the neural population; and

based on the determined feedback value, automatically adjust the first parameter value of the electrical stimulation signal to a second parameter value different than the first parameter value.

13. The system of claim 12 wherein the feedback value corresponds to a relationship between the sensed neural response and a baseline level.

14. The method of claim 12, further comprising iteratively performing the operations of delivering, sensing, determining, and automatically adjusting in a closed loop until a target neural response is sensed.

15. The method of claim 12 wherein the first and second parameter values each correspond to frequencies, and wherein automatically adjusting includes automatically decreasing a frequency of the delivered electrical stimulation signal by a preset increment until the sensed neural response increases to or changes by a threshold value.

16. The method of claim 12 wherein the neural response is an action potential generated by the neural population.

17. The method of claim 12 wherein the neural response is a compound action potential representing a sum of individual action potentials.

18. The system of claim 12 wherein the sensor includes one or more implantable epidural recording leads positioned adjacent the anatomical feature of the patient.

19. A method for delivering closed loop neuromodulation, the method comprising:

applying an electrical stimulation signal, having a first parameter value, to a neural population to evoke a neural response;

directly measuring, via an implanted sensor, the neural response evoked by the applied electrical stimulation signal;

comparing the measured neural response to a baseline level;

after comparing the measured neural response, adjusting the first parameter value to a second parameter value based at least in part on the measured neural response, wherein the first parameter value differs from the second parameter value; and

iteratively performing the operations of applying, measuring, comparing, and adjusting until a target neural response is measured.

20. The method of claim 19 wherein adjusting the first parameter value includes automatically adjusting one or more of a frequency, amplitude, pulse width, and/or current.

21. The method of claim 19 wherein the neural response corresponds to an action potential generated by the neural population.

22. The method of claim 19 wherein adjusting the first parameter value includes adjusting a frequency of the electrical stimulation signal to be in a range from 3 kHz to 10 kHz.