CHARGE-BASED STIMULATION INTENSITY PROGRAMMING WITH PULSE AMPLITUDE AND WIDTH ADJUSTED ACCORDING TO A FUNCTION

• US 20100274320A1
• Filed: 04/24/2009
• Published: 10/28/2010
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Torgerson, Nathan A.
• Granted Patent: US 9,764,147 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/3615 Intensity
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Techniques for programming electrical stimulation therapy intensity based on electrical charge are described. In some examples, a display presents a stimulation intensity value in units of electrical charge, e.g., Coulombs. In such examples, a user may adjust the displayed charge value, rather than pulse amplitude or pulse width, to adjust the intensity of the electrical stimulation therapy. In some examples, a processor determines modifications to pulse amplitude and pulse width based on the modification to the charge value. In some examples, a processor modifies a pulse amplitude and width to achieve a desired charge, while maintaining a relationship between pulse amplitude and width specified by a predetermined function. In some examples, the function may be programmed, e.g., selected or adjusted, by a user.

Claims

1. A method comprising:

storing a predetermined function specifying a relationship between pulse amplitude and pulse width within a memory;

receiving input from a user modifying an electrical charge value of neurostimulation delivered by a medical device; and

modifying a pulse amplitude and a pulse width of the neurostimulation delivered by the medical device according to the function and based on the modification to the charge value.

2. The method of claim 1, wherein the function is programmable by the user.

3. The method of claim 1, further comprising:

receiving user input locking one of the pulse amplitude or the pulse width of the neurostimulation;

receiving subsequent input modifying the electrical charge value; and

modifying an unlocked one of the pulse amplitude or the pulse width of the neurostimulation based on the subsequent modification of the charge value.

4. The method of claim 1, further comprising:

determining that at least one of the pulse amplitude or the pulse width of the neurostimulation is proximate to a stimulation efficiency point; and

automatically adjusting the function based on the determination.

5. The method of claim 4, wherein determining that at least one of the pulse amplitude or the pulse width is proximate to a stimulation efficiency point comprises determining that the pulse amplitude is proximate an amplitude for which boosting a voltage of a power source of the medical device is required, and automatically adjusting the function comprises automatically decreasing a slope of the function based on the determination.

6. The method of claim 4, wherein automatically adjusting the function comprises temporarily adjusting the function.

7. The method of claim 1,

further comprising displaying the electrical charge value to the user,

wherein receiving input modifying the electrical charge value comprises receiving user-inputted modifications to the displayed electrical charge value.

8. The method of claim 7, wherein displaying an electrical charge value comprises:

displaying a representation of a plurality of electrodes implanted within the patient; and

displaying respective charge density values proximate to the electrodes.

9. The method of claim 8,

wherein receiving user-inputted modifications to the displayed electrical charge values comprises receiving user input adjusting the relative charge densities of the electrodes, and

wherein modifying the pulse amplitude and the pulse width of the stimulation comprises modifying the pulse amplitude and pulse width of stimulation delivered via cathodes of the electrodes according to the function based on modifications to the charge densities of the cathodes, and modifying the pulse amplitude of stimulation delivered via anodes of the electrodes without modifying the pulse width based on modifications to the charge densities of the anodes.

10. The method of claim 7, further comprising displaying at least one of the amplitude value or the pulse width value in addition to the electrical charge value.

11. The method of claim 7, wherein displaying the electrical charge value comprises displaying the electrical charge value via a display, and receiving the user-inputted modifications to the displayed electrical charge value comprises receiving the user-inputted modifications via the display.

12. The method of claim 1, further comprising:

receiving user-inputted modifications to one of the pulse amplitude or the pulse width;

determining a modification to both of the pulse amplitude and the pulse width according to the function with equivalent intensity to the user-inputted modification to the one of the pulse amplitude or pulse width; and

modifying the pulse amplitude and the pulse width according to the determination.

13. The method of claim 1, further comprising:

determining that a charge density for an electrode through which the medical device delivers the neurostimulation meets a predetermined threshold value;

receiving user input increasing the charge value subsequent to the determination that the charge density meets the predetermined threshold value; and

increasing the pulse amplitude and decreasing the pulse width in response to the subsequent user input.

14. The method of claim 1, wherein the neurostimulation comprises spinal cord stimulation or deep brain stimulation.

15. The method of claim 1, wherein receiving input from a user comprising receiving the input via a user interface of a programming device that communicates with the medical device.

16. A system comprising:

a memory that stores a predetermined function specifying a relationship between pulse amplitude and pulse width;

a medical device that delivers neurostimulation to a patient;

a user interface that receives input from a user modifying an electrical charge value of the neurostimulation; and

a processor that communicates with the memory, medical device and user interface, and modifies a pulse amplitude and a pulse width of the neurostimulation delivered by the medical device according to the function and based on the modification of the charge value.

17. The system of claim 16, wherein the function is programmable by the user via the user interface.

18. The system of claim 16, wherein the user interface receives user input locking one of the pulse amplitude or the pulse width of the neurostimulation, and subsequent input modifying the electrical charge value, and the processor modifies an unlocked one of the pulse amplitude or the pulse width of the neurostimulation delivered by the medical device based on the subsequent modifications of the charge value.

19. The system of claim 16, wherein the processor determines that at least one of the pulse amplitude or the pulse width of the stimulation is proximate to a stimulation efficiency point, and automatically adjusts the function based on the determination.

20. The system of claim 19, wherein the processor determines that the pulse amplitude is proximate an amplitude for which boosting a voltage of a power source of the medical device is required, and automatically decreases a slope of the function based on the determination.

21. The system of claim 16,

wherein the user interface displays the electrical charge value to a user, and receives user-inputted modifications to the displayed electrical charge value, and

wherein the processor modifies the pulse amplitude and the pulse width of the neurostimulation stimulation delivered by the medical device according to the function and based on the modifications to the displayed charge value.

22. The system of claim 21, wherein the user interface displays a representation of a plurality of electrodes implanted within the patient, and displays respective charge density values proximate to the electrodes.

23. The system of claim 21, wherein the user interface comprises a display and receives the user-inputted modifications via the display.

24. The system of claim 16,

wherein the processor determines that a charge density for an electrode through which the medical device delivers the stimulation meets a predetermined threshold value,

wherein the user interface receives user input increasing the charge value subsequent to the determination that the charge density meets the predetermined threshold value, and

wherein the processor controls the medical device to increase the pulse amplitude and decrease the pulse width of the neurostimulation in response to the subsequent user input.

25. The system of claim 16, further comprising an external programming device that comprises the user interface, the memory and the processor, wherein the medical device comprises an implantable medical device, and the programming device communicates with the implantable medical device.

26. A system comprising:

means for storing a predetermined function specifying a relationship between pulse amplitude and pulse width;

means for receiving input from a user modifying an electrical charge value of neurostimulation delivered by a medical device; and

means for modifying a pulse amplitude and a pulse width of the neurostimulation delivered by the medical device according to the function and based on the modification of the charge value.

27. The system of claim 26, further comprising means for receiving selection of the function from a user.

28. A computer-readable storage medium comprising instructions that cause a programmable processor to:

retrieve a predetermined function defining a relationship between pulse amplitude and pulse width from a memory;

receive input from a user modifying an electrical charge value of neurostimulation delivered by a medical device; and

modify a pulse amplitude and a pulse width of the neurostimulation delivered by the medical device according to the function and based on the modification of the charge value.

29. A method comprising:

storing a predetermined function specifying a relationship between pulse amplitude and pulse width within a memory;

receiving user-inputted modifications to one of a pulse amplitude or a pulse width of neurostimulation delivered from a medical device to a patient;

determining a modification to both of the pulse amplitude and the pulse width according to the function with equivalent intensity to the user-inputted modification to the one of the pulse amplitude or pulse width; and

modifying the pulse amplitude and pulse width of the stimulation according to the determination.