SYSTEMS AND METHODS FOR PRODUCING ASYNCHRONOUS NEURAL RESPONSES TO TREAT PAIN AND/OR OTHER PATIENT CONDITIONS

• US 20100191307A1
• Filed: 01/29/2009
• Published: 07/29/2010
• Est. Priority Date: 01/29/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Fang, Zi-Ping, Walker, Andre B., Caparso, Anthony V.
• Granted Patent: US 8,255,057 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• 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 treating a patient'"'"'s pain, comprising:

based at least in part on the value of a threshold frequency that corresponds to a refractory period for neurons of a target sensory neural population, selecting a target stimulation frequency that is above the threshold frequency; and

producing a patient sensation of paresthesia by directing an electrical signal to multiple sensory neurons of the target sensory neural population at the target stimulation frequency, with individual neurons of the target sensory neural population completing corresponding individual refractory periods at different times, resulting in an asynchronous sensory neuron response to the electrical signal.

2-32. -32. (canceled)

33. A method for making a patient pain treatment device, comprising:

identifying a threshold frequency corresponding to a refractory period for neurons of a target sensory neural population;

based at least in part on identifying the threshold frequency, selecting a target stimulation frequency that is above the threshold frequency; and

programming a spinal cord stimulation device to deliver an electrical signal at the target stimulation frequency.

34-41. -41. (canceled)

42. A method for treating a patient'"'"'s pain, comprising:

implanting an electrical stimulation device proximate to a target sensory neural population of the patient'"'"'s spinal cord, the target sensory neural population including sensory neurons having a characteristic refractory period and a corresponding threshold frequency;

directing an electrical signal to multiple sensory neurons of the target sensory neural population at a target stimulation frequency that is greater than the threshold frequency, with individual neurons of the sensory neural population completing corresponding individual refractory periods at different times; and

producing a patient sensation of paresthesia resulting from an asynchronous, sensory neuron response to the electrical signals.

43-52. -52. (canceled)

53. A method for treating a patient'"'"'s pain, comprising:

directing a stream of pulses to a target neural population at a frequency of from about 3 kHz to about 10 kHz; and

as a result of the pulses directed to the patient, producing an asynchronous action potential response at the target neural population, and a patient sensation of paresthesia.

54. (canceled)

55. A method for treating a patient'"'"'s pain, comprising

directing an electrical signal to multiple sensory neurons of a target sensory neural population, the electrical signal having a stimulation frequency;

varying the simulation frequency; and

receiving an indication that the electrical signal produces an asynchronous sensory neuron response at one or more frequencies.

56-60. -60. (canceled)

61. A therapy system for treating a patient'"'"'s pain, comprising:

a pulse generator coupleable to a signal delivery element to transmit an electrical stimulation signal to the signal delivery element; and

a machine-readable medium containing instructions that, when executed, cause the pulse generator to transmit the electrical stimulation signal to multiple neurons of a target sensory neural population via the signal delivery element, wherein the electrical stimulation signal has a target stimulation frequency that is above a threshold frequency that corresponds to a refractory period for individual neurons of the target sensory neural population, and wherein the electrical stimulation signal produces an asynchronous sensory neuron response and a patient sensation of paresthesia.

62-79. -79. (canceled)

80. A system for treating a patient'"'"'s pain, comprising

a signal delivery element positionable to deliver an electrical stimulation signal to a target sensory neural population of a patient;

a pulse generator coupled to the signal delivery element to transmit the electrical stimulation signal to the signal delivery element;

a patient sensor positionable relative to the patient to detect a patient neural response to the electrical stimulation signal delivered by the signal delivery element; and

a machine-readable medium containing instructions that, when executed, adjust the frequency of the electrical stimulation signal and determine when the electrical stimulation signal produces an asynchronous sensory neuron response to the electrical stimulation signal.

81-85. -85. (canceled)

86. A method for treating a patient'"'"'s pain, comprising:

based at least in part on the value of a threshold frequency that corresponds to a refractory period for neurons of a target sensory neural population, selecting a target stimulation frequency that is above the threshold frequency and above 1,500 Hz; and

directing an electrical signal to multiple sensory neurons of the target sensory neural population at the target stimulation frequency, with individual neurons of the target sensory neural population completing corresponding individual refractory periods at different times, resulting in an asynchronous sensory neuron response to the electrical signal, without blocking afferent sensory signals from the target sensory neural population.

87. The method of claim 86 wherein directing electrical signals includes directing electrical signals without triggering a muscle response.

88. The method of claim 86 wherein selecting a target stimulation frequency includes selecting the target stimulation frequency to be from about 3 kHz to about 10 kHz.

89. The method of claim 86 wherein directing an electrical signal includes at least reducing the patient'"'"'s pain by directing the electrical signal and producing the asynchronous response for the duration over which the patient'"'"'s pain is at least reduced.

90. The method of claim 86 wherein directing an electrical signal includes:

initiating the asynchronous sensory neuron response by directing to the target sensory neural population a generally constant stream of pulses at a frequency greater than the threshold frequency; and

extending the duration of the asynchronous sensory response by;

directing a first electrical signal to the target sensory neural population, the first electrical signal having pulses spaced apart from each other at a first frequency that is at or above the threshold frequency; and

directing a second electrical signal to the target sensory neural population, the second electrical signal having pulses spaced apart from each other at a second frequency that is at or above the threshold frequency; and

wherein

pulses of the first and second signals are interleaved, with individual pulses of the first electrical signal being followed by individual pulses of the second electrical signal and being separated from the individual pulses of the second electrical signal by a first time interval less than the refractory period, and with individual pulses of the second electrical signal being followed by individual pulses of the first electrical signal and being separated from the individual pulses of the first electrical signal by a second time interval less than the refractory period.

91. The method of claim 86 wherein directing an electrical signal includes:

initiating the asynchronous sensory neuron response by directing to the target sensory neural population a generally constant stream of pulses at a frequency greater than the threshold frequency; and

extending the duration of the asynchronous sensory response by directing additional pulses spaced apart from each other by a quiescent period that is less than the refractory period.

92. The method of claim 86 wherein directing an electrical signal includes directing an electrical signal at a single, generally unvarying frequency.

93. The method of claim 86 wherein directing an electrical signal includes directing a first electrical signal at a first frequency and directing a second electrical signal at a second frequency, with pulses of the second electrical signal being spaced apart from neighboring pulses of the first electrical signal.

94. The method of claim 86 wherein selecting a target frequency includes selecting a target frequency to be at least an order of magnitude greater than the threshold frequency.

95. The method of claim 86 wherein selecting a target frequency includes selecting a target frequency to be at least twice the threshold frequency.

96. The method of claim 86 wherein directing an electrical signal includes directing a continuous stream of electrical pulses at the target stimulation frequency.

97. The method of claim 86 wherein directing an electrical signal includes directing an electrical signal having a 50% duty cycle.

98. The method of claim 86 wherein directing the electrical signal includes directing the electrical signal to first sensory neurons of the target sensory neural population while the first sensory neurons are refractory, and simultaneously directing the electrical signal to second sensory neurons of the target sensory neural population while the second sensory neurons are not refractory.

99. The method of claim 86, further comprising:

identifying the patient as having axial low back pain; and

positioning an elongated lead having multiple cylindrical electrodes so that at least one of the electrodes is at level T-10 or T-11.

100. The method of claim 86 wherein directing an electrical signal to multiple sensory neurons resulting in an asynchronous sensory neuron response includes reducing a tendency for the patient'"'"'s central nervous system to have a lesser response to effects of the electrical signal over time, when compared to an electrical signal that results in a synchronous sensory neuron response.