SHORT DURATION PRE-PULSING TO REDUCE STIMULATION-EVOKED SIDE-EFFECTS

• US 20080294226A1
• Filed: 05/23/2007
• Published: 11/27/2008
• Est. Priority Date: 05/23/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Advanced Bionics Corporation (Sonova Holding AG)
• Inventors: Peterson, David K.L., Moffitt, Michael A.
• Granted Patent: US 7,742,810 B2
• Time in Patent Office: Days
• US Class Current: 607/74
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36164 Sub-threshold or non-excitatory signals non-excitatory signals to the heart A61N1/3628
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset

Abstract

A method and neurostimulation system of providing therapy to a patient is provided. At least one electrode is place in contact with tissue of a patient. A sub-threshold, hyperpolarizing, conditioning pre-pulse (e.g., an anodic pulse) is conveyed from the electrode(s) to render a first region of the tissue (e.g., dorsal root fibers) less excitable to stimulation, and a depolarizing stimulation pulse (e.g., a cathodic pulse) is conveyed from the electrode(s) to stimulate a second different region of the tissue (e.g., dorsal column fibers). The conditioning pre-pulse has a relatively short duration (e.g., less than 200 μs).

Claims

1. A method of providing therapy to a patient, comprising:

placing at least one electrode in contact with tissue of a patient;

conveying a sub-threshold, hyperpolarizing, conditioning pre-pulse from the at least one electrode to render a first region of the tissue less excitable to stimulation; and

conveying a depolarizing stimulation pulse from the at least one electrode to stimulate a second different region of the tissue.

2. The method of claim 1, wherein the at least one electrode comprises a first electrode and a second electrode, the conditioning pre-pulse is conveyed from the first electrode, and the stimulation pulse is conveyed from the second electrode.

3. The method of claim 1, wherein the conditioning pulse is anodic, and the depolarizing stimulation pulse is cathodic.

4. The method of claim 1, wherein the first tissue region comprises dorsal root nerve fibers, and the second tissue region comprises dorsal column nerve fibers.

5. The method of claim 1, wherein the conditioning pre-pulse has a duration less than 200 μ

s.

6. The method of claim 1, wherein the conditioning pre-pulse has a duration equal to or less than 150 μ

s.

7. The method of claim 1, wherein the conditioning pre-pulse has a duration equal to or less than 75 μ

s.

8. The method of claim 1, further comprising conveying a sub-threshold, hyperpolarizing conditioning post-pulse from the at least one electrode to further render the first tissue region less excitable to stimulation.

9. The method of claim 8, wherein the conditioning post-pulse overlaps the at least one stimulation pulse in time.

10. A method of providing therapy to a patient, comprising:

placing at least one electrode in contact with tissue of a patient;

conveying a sub-threshold, hyperpolarizing, conditioning pre-pulse from the at least one electrode to the tissue, wherein the conditioning pre-pulse has a duration less than 200 μ

s; and

conveying a depolarizing stimulation pulse from the electrode to the tissue.

11. The method of claim 10, wherein the at least one electrode comprises a first electrode and a second electrode, the conditioning pre-pulse is conveyed from the first electrode to the tissue, and the stimulation pulse is conveyed from the second electrode to the tissue.

12. The method of claim 10, wherein the conditioning pulse is anodic, and the depolarizing stimulation pulse is cathodic.

13. The method of claim 10, wherein the conditioning pre-pulse has a duration equal to or less than 150 μ

s.

14. The method of claim 10, wherein the conditioning pre-pulse has a duration equal to or less than 75 μ

s.

15. The method of claim 10, wherein the stimulation pre-pulse has a duration less than 200 μ

s.

16. The method of claim 10, further comprising conveying a sub-threshold, hyperpolarizing conditioning post-pulse from the at least one electrode to the tissue.

17. The method of claim 15, wherein the conditioning post-pulse overlaps the at least one stimulation pulse in time.

18. A neurostimulation system, comprising:

a plurality of electrical contacts;

analog output circuitry capable of outputting electrical pulses to the plurality of electrical contacts in accordance with a pulse pattern; and

control circuitry capable of defining the pulse pattern, such that the electrical pulses comprise a sub-threshold, conditioning, pre-pulse outputted to a first one of the electrical contacts, and a stimulation pulse outputted to a second different one of the electrical contacts, wherein the conditioning pre-pulse has a duration less than 200 μ

s.

19. The neurostimulation system of claim 18, wherein the conditioning pulse is anodic, and the depolarizing stimulation pulse is cathodic.

20. The neurostimulation system of claim 18, wherein the conditioning pre-pulse has a duration equal to or less than 150 μ

s.

21. The neurostimulation system of claim 18, wherein the conditioning pre-pulse has a duration equal to or less than 75 μ

s.

22. The neurostimulation system of claim 18, wherein the stimulation pre-pulse has a duration less than 200 μ

s.

23. The neurostimulation system of claim 18, wherein the control circuitry is capable of defining the pulse pattern, such that the electrical pulses further comprise a sub-threshold, conditioning, post-pulse outputted to the first one of the electrical contacts.

24. The neurostimulation system of claim 18, wherein the conditioning post-pulse overlaps the stimulation pulse in time.

25. The neurostimulation system of claim 24, further comprising one or more stimulation leads carrying a plurality of electrodes in electrical communication with the plurality of electrical contacts.

26. The neurostimulation system of claim 25, wherein the one or more stimulation leads comprises one or more spinal cord stimulation leads.

27. The neurostimulation system of claim 18, further comprising memory capable of storing a set of stimulation parameters, wherein the control circuitry is capable of defining the pattern in accordance with the stimulation parameter set.

28. The neurostimulation system of claim 18, further comprising an case, wherein the plurality of electrical contact, analog output circuitry, and control circuitry are contained in the case to form a an implantable neurostimulator.