Impedance-based allocation of electrical stimulation to electrode clusters

• US 10,300,285 B2
• Filed: 01/05/2017
• Issued: 05/28/2019
• Est. Priority Date: 01/05/2017
• Status: Active Grant

• Current Assignee: Medtronic Bakken Research Center B.V. (Medtronic Plc)
• Original Assignee: Medtronic Bakken Research Center B.V. (Medtronic Plc)
• Inventors: Astrom, Mattias Bengt Johan, Hage, Mark, Martens, Hubert Cecile Francois, Nanbakhsh, Kambiz, van Veenendaal, Erik
• Primary Examiner(s): Koharski, Christopher
• Assistant Examiner(s): So, Elizabeth K
• Application Number:
  US15/399,089
• Publication Number:
  US 20180185651A1
• Time in Patent Office: 873 Days
• Field of Search: None
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Electrical stimulation sources and amplitudes are allocated to implantable electrodes based on impedance values for controlled delivery of electrical stimulation therapy to a patient. Allocation may include assigning implantable electrodes, in a group of active electrodes, to clusters based on impedance values of the electrodes, coupling the electrode clusters to respective stimulation sources, and defining respective stimulation amplitudes delivered by the stimulation sources to the electrode clusters. Each cluster may include electrodes having relatively similar impedance values, such that electrodes in each cluster present less variation in impedance relative to impedance variation across the group of electrodes. With reduced variation in impedance, in some examples, variation in current outflow through electrodes in each cluster may be reduced, promoting more uniform distribution of stimulation current across the group of active electrodes and a more uniform stimulation field.

Claims

1. A method for delivering electrical stimulation to a patient via a plurality of implantable electrodes of an implantable medical device (IMD), the method comprising:

delivering a first portion of the electrical stimulation generated from a first electrical stimulation source of the IMD via a first cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the first cluster, the first cluster of one or more electrodes being in a group of the plurality of implantable electrodes selected for delivery of the electrical stimulation and comprising less than all of the electrodes in the group; and

delivering a second portion of the electrical stimulation generated from a second electrical stimulation source of the IMD via a second cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the second cluster, the second cluster of one or more electrodes being in the group of the plurality of implantable electrodes selected for delivery of the electrical stimulation, being different than the first cluster of one or more electrodes and comprising less than all of the electrodes in the group.

2. The method of claim 1, further comprising:

selecting the group of the plurality of implantable electrodes of the IMD for delivery of the electrical stimulation to the patient;

selecting the first cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the first cluster; and

selecting the second cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the second cluster.

3. The method of claim 2, further comprising selecting the group, the first cluster and the second cluster with one or more processors of at least one of the IMD or an external programmer in communication with the IMD.

4. The method of claim 3, further comprising measuring the impedance values of the electrodes, transmitting information representative of the measured impedance values of the electrodes from the IMD to the external programmer, and selecting the group, the first cluster, the second cluster, an amplitude of the first portion of the electrical stimulation, and an amplitude of the second portion of the electrical stimulation based on information received from the external programmer.

5. The method of claim 2, wherein selecting the first and second clusters comprises selecting the first and second clusters based on k-means clustering of the electrodes in the group of the plurality of implantable electrodes.

6. The method of claim 2, further comprising selecting amplitudes of the first and second portions of the electrical stimulation such that an average per-electrode amplitude of the electrical stimulation delivered to the one or more electrodes in the first cluster is substantially the same as an average per-electrode amplitude of the electrical stimulation delivered to the one or more electrodes in the second cluster.

7. The method of claim 6, wherein a number of the electrodes in the first cluster is different than a number of the electrodes in the second cluster, and wherein the amplitude of the first portion of the electrical stimulation is different than the amplitude of the second portion of the electrical stimulation.

8. The method of claim 2, wherein:

selecting the first cluster of one or more electrodes based on impedance values of the electrodes in the first cluster comprises selecting the first cluster of one or more electrodes based on output current values determined for each of the one or more electrodes in the first cluster as a function of the impedance values of the respective one or more electrodes in the first cluster; and

selecting the second cluster of one or more electrodes based on impedance values of the electrodes in the second cluster comprises selecting the second cluster of the one or more electrodes based on output current values determined for each of the one or more electrodes in the second cluster as a function of the impedance values of the respective one or more electrodes in the second cluster.

9. The method of claim 1, wherein an amplitude of the first portion of the electrical stimulation and an amplitude of the second portion of the electrical stimulation sum to an amplitude of the electrical stimulation to be delivered via the group of the plurality of implantable electrodes.

10. The method of claim 1, wherein the first cluster comprises a first plurality of the electrodes in the group of the plurality of implantable electrodes and the second cluster comprises a second plurality of the electrodes in the group of the plurality of implantable electrodes.

11. The method of claim 1, wherein one of the first cluster or second cluster comprises a single electrode of the group of the plurality of implantable electrodes.

12. The method of claim 1, wherein the plurality of implantable electrodes are coupled to an implantable pulse generator of the IMD via one or more implantable leads.

13. The method of claim 1, wherein the group of the plurality of implantable electrodes comprises less than all of the plurality of implantable electrodes of the IMD.

14. The method of claim 1, wherein a sum of a number of the electrodes of the first cluster of one or more electrodes and a number of the electrodes of the second cluster of one or more electrodes is equal to a number of the electrodes in the group of the plurality of implantable electrodes.

15. The method of claim 1, wherein the electrodes in the first cluster have a mean impedance value that is less than a mean impedance value of the electrodes in the second cluster.

16. The method of claim 1, further comprising delivering the first and second portions of the electrical stimulation substantially simultaneously.

17. The method of claim 1, further comprising measuring the impedance values of the electrodes.

18. The method of claim 1, further comprising controlling one or more switch devices to couple each of the electrodes of the first cluster of one or more electrodes to the first electrical stimulation source to deliver the first portion of the electrical stimulation from the first electrical stimulation source via the first cluster of one or more electrodes, and couple each of the electrodes of the second cluster of one or more electrodes to the second electrical stimulation source to deliver the second portion of the electrical stimulation from the second electrical stimulation source via the second cluster of one or more electrodes.

19. The method of claim 1, wherein the electrodes of the plurality of implantable electrodes comprise implantable electrodes coupled to an implantable pulse generator via one or more implantable leads, and wherein each of the impedance values of the electrodes is an impedance value measured between the respective electrode and a reference electrode of the implantable pulse generator.

20. An implantable medical device (IMD) for delivering electrical stimulation to a patient, the IMD comprising:

a plurality of implantable electrodes;

a first electrical stimulation source configured to generate a first portion of the electrical stimulation;

a second electrical stimulation source configured to generate a second portion of the electrical stimulation; and

one or more processors configured to;

control the first electrical stimulation source to deliver the first portion of the electrical stimulation via a first cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the first cluster, the first cluster of one or more electrodes being in a group of the plurality of implantable electrodes selected for delivery of the electrical stimulation and comprising less than all of the electrodes in the group; and

control the second electrical stimulation source to deliver the second portion of the electrical stimulation via a second cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the second cluster, the second cluster of one or more electrodes being in the group of the plurality of implantable electrodes selected for delivery of the electrical stimulation, being different than the first cluster of one or more electrodes and comprising less than all of the electrodes in the group.

21. The IMD of claim 20, wherein the one or more processors are configured to:

select the group of the plurality of implantable electrodes of the IMD for delivery of the electrical stimulation to the patient;

select the first cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the first cluster; and

select the second cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the second cluster.

22. The IMD of claim 21, further comprising a sensing circuit configured to measure the impedance values of the electrodes and a telemetry interface, wherein the one or more processors are configured to control the telemetry interface to transmit information representative of the measured impedance values of the electrodes from the IMD to an external programmer, and select the group, the first cluster, the second cluster, an amplitude of the first portion of the electrical stimulation, and an amplitude of the second portion of the electrical stimulation based on information received from the external programmer via the telemetry interface.

23. The IMD of claim 21, wherein the one or more processors are configured to select the first and second clusters based on k-means clustering of the electrodes in the group of the plurality of implantable electrodes.

24. The IMD of claim 21, wherein the one or more processors are configured to select amplitudes of the first and second portions of the electrical stimulation such that an average per-electrode amplitude of the electrical stimulation delivered to the one or more electrodes in the first cluster is substantially the same as an average per-electrode amplitude of the electrical stimulation delivered to the one or more electrodes in the second cluster.

25. The IMD of claim 24, wherein a number of the electrodes in the first cluster is different than a number of the electrodes in the second cluster, and wherein the amplitude of the first portion of the electrical stimulation is different than the amplitude of the second portion of the electrical stimulation.

26. The IMD of claim 21, wherein the one or more processors are configured to:

select the first cluster of one or more electrodes based on output current values determined for each of the one or more electrodes in the first cluster as a function of the impedance values of the respective one or more electrodes in the first cluster; and

select the second cluster of the one or more electrodes based on output current values determined for each of the one or more electrodes in the second cluster as a function of the impedance values of the respective one or more electrodes in the second cluster.

27. The IMD of claim 20, wherein an amplitude of the first portion of the electrical stimulation and an amplitude of the second portion of the electrical stimulation sum to an amplitude of the electrical stimulation to be delivered via the group of the plurality of implantable electrodes.

28. The IMD of claim 20, wherein the first cluster comprises a first plurality of the electrodes in the group of the plurality of implantable electrodes and the second cluster comprises a second plurality of the electrodes in the group of the plurality of implantable electrodes.

29. The IMD of claim 20, wherein one of the first cluster or second cluster comprises a single electrode of the group of the plurality of implantable electrodes.

30. The IMD of claim 20, further comprising:

an implantable pulse generator comprising the first and second stimulation sources; and

one or more implantable leads coupled to the implantable pulse generator,

wherein the electrodes comprise implantable electrodes coupled to the implantable pulse generator via the one or more implantable leads.

31. The IMD of claim 20, wherein the group of the plurality of implantable electrodes comprises less than all of the plurality of implantable electrodes of the IMD.

32. The IMD of claim 20, wherein a sum of a number of the electrodes of the first cluster and a number of the electrodes of the second cluster is equal to a number of the electrodes in the group of the plurality of implantable electrodes.

33. The IMD of claim 20, wherein the electrodes in the first cluster have a mean impedance value that is less than a mean impedance value of the electrodes in the second cluster.

34. The IMD of claim 20, wherein the one or more processors are configured to control the first and second electrical stimulation sources to deliver the first and second portions of the electrical stimulation substantially simultaneously.

35. The IMD of claim 20, further comprising a sensing circuit configured to measure the impedance values of the electrodes.

36. The IMD of claim 20, further comprising one or more switch devices, wherein the one or more processors are configured to control the one or more switch devices to couple each of the electrodes of the first cluster of one or more electrodes to the first electrical stimulation source to deliver the first portion of the electrical stimulation from the first electrical stimulation source via the first cluster of one or more electrodes, and couple each of the electrodes of the second cluster of one or more electrodes to the second electrical stimulation source to deliver the second portion of the electrical stimulation from the second electrical stimulation source via the second cluster of one or more electrodes.

37. The IMD of claim 20, further comprising:

an implantable pulse generator comprising the first and second stimulation sources; and

one or more implantable leads coupled to the implantable pulse generator,

wherein the plurality of implantable electrodes comprise implantable electrodes coupled to the implantable electrical stimulation generator via the implantable lead, and

wherein each of the impedance values of the electrodes is an impedance value measured between the respective electrode and a reference electrode of the implantable pulse generator.

38. A system for delivering electrical stimulation to a patient, the system comprising:

an implantable medical device (IMD) comprising;

a plurality of implantable electrodes,

a first electrical stimulation source configured to generate a first portion of the electrical stimulation,

a second electrical stimulation source configured to generate a second portion of the electrical stimulation, and

one or more processors configured to;

control the first electrical stimulation source to deliver the first portion of the electrical stimulation via a first cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the first cluster, the first cluster of one or more electrodes being in a group of the plurality of implantable electrodes selected for delivery of the electrical stimulation and comprising less than all of the electrodes in the group, and

control the second electrical stimulation source to deliver the second portion of the electrical stimulation via a second cluster of one or more electrodes selected based on impedance values of the one or more electrodes in the second cluster, the second cluster of one or more electrodes being in the group of the plurality of implantable electrodes selected for delivery of the electrical stimulation, being different than the first cluster of one or more electrodes and comprising less than all of the electrodes in the group; and

an external programmer comprising one or more processors configured to program one or more parameters of the electrical stimulation delivered by the IMD,

wherein one or more processors of at least one of the IMD or the external programmer are configured to;

select the group of the plurality of implantable electrodes of the IMD for delivery of the electrical stimulation to the patient,

select the first cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the first cluster, and

select the second cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on the impedance values of the one or more electrodes in the second cluster.

39. The system of claim 38, wherein the IMD further comprises a sensing circuit configured to measure the impedance values of the electrodes and a telemetry interface, wherein the one or more processors of the IMD are configured to control the telemetry interface to transmit information representative of the measured impedance values of the electrodes from the IMD to the external programmer, and select the group, the first cluster, the second cluster, an amplitude of the first portion of the electrical stimulation, and an amplitude of the second portion of the electrical stimulation based on information received from the external programmer via the telemetry interface.

40. A system for delivering electrical stimulation to a patient via a plurality of implantable electrodes of an implantable medical device (IMD), the system comprising:

means for selecting a group of the plurality of implantable electrodes of the IMD for delivery of the electrical stimulation to the patient;

means for selecting a first cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on impedance values of the electrodes in the first cluster, the first cluster of electrodes comprising less than all of the electrodes in the group of the plurality of implantable electrodes;

means for selecting a second cluster of one or more of the electrodes in the group of the plurality of implantable electrodes based on impedance values of the electrodes in the second cluster, the second cluster of electrodes being different than the first cluster of electrodes and comprising less than all of the electrodes in the group of the plurality of implantable electrodes;

means for delivering a first portion of the electrical stimulation from a first electrical stimulation source of the IMD via the first cluster of electrodes; and

means for delivering a second portion of the electrical stimulation from a second electrical stimulation source of the IMD via the second cluster of electrodes.

41. The system of claim 40, further comprising means for programming one or more parameters of the electrical stimulation delivered by the first and second electrical stimulation sources of the IMD.