Programming techniques for electrical stimulation

• US 10,376,699 B2
• Filed: 11/17/2016
• Issued: 08/13/2019
• Est. Priority Date: 12/15/2015
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Wechter, David Ernest
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US15/354,830
• Publication Number:
  US 20170165490A1
• Time in Patent Office: 999 Days
• Field of Search: 607 46, 607 59
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36189 using modulation techniques
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37264 Changing the program; Upgrading firmware

Abstract

An example includes machine-implemented method of providing therapy to a patient using a plurality of electrodes implanted within the patient that includes receiving, via a programmer for an electrical stimulator, user input that at least partially defines a neuromodulation field to provide the therapy, based on the received user input, determining a subset of the plurality of electrodes and current distributions for the subset to generate the field, comparing an electrode limit to a number of electrodes in the determined subset and eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes, and redistributing current associated with the at least one eliminated electrode to at least one of the electrodes in the reduced subset of electrodes.

Claims

1. A machine-implemented method of providing therapy to a patient using at least some of a plurality of electrodes implanted within the patient, the method comprising:

receiving, via a programmer for an electrical stimulator, user input that at least partially defines a neuromodulation field to provide the therapy;

based on the received user input, determining a subset of the plurality of electrodes and current distributions for the subset to generate the field;

comparing an electrode limit to a number of electrodes in the determined subset and eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes; and

redistributing current associated with the at least one eliminated electrode to at least one of the electrodes in the reduced subset of electrodes.

2. The method of claim 1, wherein the determined subset of the plurality of electrodes includes at least two anodic electrodes and at least two cathodic electrodes to provide the field, and wherein eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes includes at least one of:

eliminating one anodic electrode based on the anodic electrode having a lowest associated anodic current distribution for the subset; and

eliminating one cathodic electrode based on the cathodic electrode having a lowest associated cathodic current distribution for the subset.

3. The method of claim 1, wherein the determined subset of the plurality of electrodes includes at least two electrodes having a first polarity to provide the field, and wherein eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes includes:

eliminating one of the electrodes having a first polarity based on the electrode having the first polarity having a lowest associated current distribution for the subset; and

evenly redistributing a current distribution associated with the eliminated electrode to the remaining electrodes having the first polarity.

4. The method of claim 1, wherein the determined subset of the plurality of electrodes includes at least two electrodes having a first polarity to provide the field, and wherein eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes includes:

eliminating one of the electrodes having a first polarity based on the electrode having the first polarity having a lowest associated current distribution for the subset; and

proportionally redistributing a current distribution associated with the eliminated electrode to the remaining electrodes having the first polarity.

5. The method of claim 1, wherein eliminating at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes comprises:

receiving a user selection that allows a user to select the electrode limit.

6. The method of claim 5, wherein the electrode limit is two electrodes.

7. The method of claim 1, wherein the user input that at least partially defines a neurostimulation field causes the patient to perceive paresthesia, the method comprising:

receiving user input that modifies the neurostimulation field to not cause the patient to perceive paresthesia.

8. The method of claim 1, comprising:

conveying electrical current to the electrodes remaining in the determined subset of electrodes in accordance with the redistributed current distribution, thereby providing therapy to the patient.

9. The method of claim 1, further comprising:

performing a mapping procedure, the mapping procedure including the receiving user input that at least partially defines a neuromodulation field to provide the therapy and modifying the neuromodulation field to cause paresthesia to cover an area of pain experienced by the patient,

wherein determining the subset of the plurality of electrodes includes determining the electrodes and current distributions to cover the area of pain, and

delivering the therapy using the reduced subset at a frequency greater than 300 Hertz, the therapy being a sub-perception therapy.

10. The method of claim 1, comprising:

displaying, via the programmer, the determined current distributions for the subset; and

displaying, via the programmer, redistributed current distributions associated with the reduced subset of electrodes.

19. The system of claim 1, wherein the programmer is configured to perform a mapping procedure, the mapping procedure including the user interface being configured to receive user input that at least partially defines a neuromodulation field to provide the therapy and that modifies the neuromodulation field to cause paresthesia to cover an area of pain experienced by the patient,

wherein the at least one controller configured to determine the subset of the plurality of electrodes is configured to determine the electrodes and current distributions to cover the area of pain, and

wherein the electrical stimulator is configured to deliver the therapy using the reduced subset at a frequency greater than 300 Hertz, the therapy being a sub-perception therapy.

11. A system of providing therapy to a patient using at least some of a plurality of electrodes implanted within the patient, the system comprising:

a programmer for an electrical stimulator, the programmer including;

a user interface configured to receive user input that at least partially defines a neuromodulation field to provide the therapy; and

at least one controller in communication with the user interface, the at least one controller configured to determine a subset of the plurality of electrodes and current distributions for the subset to generate the field based on the received user input;

a comparator configured to compare an electrode limit to a number of electrodes in the determined subset and eliminate at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes, and

the at least one controller configured to redistribute current associated with the at least one eliminated electrode to at least one of the electrodes in the reduced subset of electrodes.

12. The system of claim 11, wherein the determined subset of the plurality of electrodes includes at least two anodic electrodes and at least two cathodic electrodes to provide the field, and wherein the at least one controller configured to eliminate at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes is configured to perform at least one of the following:

eliminate one anodic electrode based on the anodic electrode having a lowest associated anodic current distribution for the subset; and

eliminate one cathodic electrode based on the cathodic electrode having a lowest associated cathodic current distribution for the subset.

13. The system of claim 11, wherein the determined subset of the plurality of electrodes includes at least two electrodes having a first polarity to provide the field, and wherein the at least one controller configured to eliminate at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes is configured to:

eliminate one of the electrodes having a first polarity based on the electrode having the first polarity having a lowest associated current distribution for the subset; and

evenly redistribute a current distribution associated with the eliminated electrode to the remaining electrodes having the first polarity.

14. The system of claim 11, wherein the determined subset of the plurality of electrodes includes at least two electrodes having a first polarity to provide the field, and wherein the at least one controller configured to eliminate at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes is configured to:

eliminate one of the electrodes having a first polarity based on the electrode having the first polarity having a lowest associated current distribution for the subset; and

proportionally redistribute a current distribution associated with the eliminated electrode to the remaining electrodes having the first polarity.

15. The system of claim 11, wherein the at least one controller configured to eliminate at least one of the number of electrodes in the determined subset based on the comparison to provide a reduced subset of the electrodes is configured to:

receive a user selection that allows a user to select the electrode limit.

16. The system of claim 15, wherein the electrode limit is two electrodes.

17. The system of claim 11, wherein the user input that at least partially defines a neurostimulation field causes the patient to perceive paresthesia, and wherein the user interface is configured to:

receive user input that modifies the neurostimulation field to not cause the patient to perceive paresthesia.

18. The system of claim 11, comprising:

the electrical stimulator configured to convey electrical current to the electrodes remaining in the determined subset of electrodes in accordance with the redistributed current distribution, thereby providing therapy to the patient.

20. The system of claim 11, wherein the user interface is configured to:

display the determined current distributions for the subset; and

display redistributed current distributions associated with the reduced subset of electrodes.