STIMULATION WITH UTILIZATION OF NON-SELECTED ELECTRODE

• US 20110270357A1
• Filed: 04/28/2010
• Published: 11/03/2011
• Est. Priority Date: 04/28/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Torgerson, Nathan A.
• Granted Patent: US 9,320,901 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

This disclosure describes techniques that support delivering electrical stimulation current via at least two user-selected electrodes of an implantable medical device (IMD) and automatically delivering balancing current below via at least one non-selected electrode. Balancing currents delivered via the at least one non-selected electrode may be configured with an amplitude below a perception threshold of a patient. Delivery of balancing current via the at least one third electrode may allow an implantable medical device to automatically balance the total current delivered to a patient.

Claims

1. A method comprising:

receiving, via a user interface of a programmer device for an implantable electrical stimulator, user input specifying at least one first user-selected electrode to deliver electrical stimulation of a first polarity and at least one second user-selected electrode to deliver electrical stimulation of a second polarity different than the first polarity for delivery of electrical stimulation from an implantable electrical stimulator to a patient;

receiving, via the user interface, user input specifying amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode;

automatically selecting at least one third electrode not specified as a user-selected electrode to deliver electrical stimulation to substantially balance the electrical stimulation current to be delivered via the at least one first user selected electrode and the at least one second user-selected electrode; and

defining a program to control delivery of the electrical stimulation by the stimulator based on the user input.

2. The method of claim 1, wherein automatically selecting the at least one third electrode includes automatically determining an amount of electrical stimulation to be delivered via the at least one third electrode.

3. The method of claim 2, wherein automatically determining an amount of electrical stimulation to be delivered via the at least one third electrode includes automatically determining the amount based on a difference between an amount of electrical stimulation delivered via the at least one first user selected electrode and the at least one second user-selected electrode.

4. The method of claim 3, wherein automatically determining an amount of electrical stimulation to be delivered via the at least one third electrode includes automatically determining the amount equal to the difference between the amount of electrical stimulation delivered via the at least one first user selected electrode and the at least one second user-selected electrode.

5. The method of claim 3, wherein automatically determining an amount of electrical stimulation to be delivered via the at least one third electrode includes automatically determining the amount equal to a portion of the difference between the amount of electrical stimulation delivered via the at least one first user selected electrode and the at least one second user-selected electrode.

6. The method of claim 2, wherein automatically determining an amount of electrical stimulation to be delivered via the at least one third electrode includes automatically determining a sub-threshold current to be delivered via the at least one third electrode.

7. The method of claim 1, wherein receiving, via the user interface of an electrical stimulator programmer device, user input specifying the at least one first user selected electrode and the at least one second user-selected electrode comprises:

receiving user input via a pointing media to select the at least one first user selected electrode and the at least one second user-selected electrode.

8. The method of claim 1, wherein receiving, via the user interface of an electrical stimulator programmer device, user input specifying the at least one first user selected electrode and the at least one second user-selected electrode comprises:

receiving user input that drags a stimulation field relative to at least one lead.

9. The method of claim 1, wherein automatically selecting the at least one third electrode includes automatically selecting at least one housing electrode.

10. The method of claim 1, wherein automatically selecting the at least one third electrode includes automatically selecting at least one lead electrode.

11. The method of claim 1, wherein automatically selecting the at least one third electrode comprises automatically selecting at least one lead electrode and at least one housing electrode.

12. The method of claim 11, further comprising:

receiving, from a user, input specifying relative contributions of the at least one lead electrode and the at least one housing electrode to deliver electrical stimulation below the perception threshold of the patient.

13. The method of claim 12, wherein receiving, from a user, input specifying relative contributions includes receiving user input adjusting a slideable medium within a range.

14. The method of claim 1, wherein automatically selecting at least one third electrode not specified as a user-selected electrode to deliver electrical stimulation to substantially balance the electrical stimulation current to be delivered via the at least one first user selected electrode and the at least one second user-selected electrode includes automatically selecting a plurality of third electrodes.

15. The method of claim 14, wherein automatically selecting a plurality of third electrodes includes automatically determining an amount of electrical stimulation to be delivered via each of the plurality of third electrodes.

16. The method of claim 1, wherein the program is a first program, and wherein a first sum of the amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode and the at least one third electrode substantially equals zero, the method further comprising:

receiving, via the user interface, user input specifying an adjustment to at least one of the at least one first user-selected electrode and the at least one second user-selected electrode;

automatically determining, for the at least one third electrode, an amount of electrical stimulation current such that a second sum of the electrical stimulation currents to be supplied by each of the first, second, and third electrodes equals zero; and

defining a second program to control delivery of the electrical stimulation by the stimulator based on the automatically determined amounts of electrical stimulation currents.

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

receive, via a user interface of a programmer device for an implantable electrical stimulator, user input specifying at least one first user-selected electrode to deliver electrical stimulation of a first polarity and at least one second user-selected electrode to deliver electrical stimulation of a second polarity different than the first polarity for delivery of electrical stimulation from an implantable electrical stimulator to a patient;

receive, via the user interface, user input specifying amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode;

automatically select at least one non user-selected third electrode to deliver electrical stimulation to substantially balance the electrical stimulation delivered by the at least one first user-selected electrode and the at least one second user-selected electrode; and

define a program to control delivery of the electrical stimulation by the stimulator based on the user input.

18. The computer-readable storage medium of claim 17, wherein the instructions further cause the processor to automatically determine an amount of electrical stimulation to be delivered via the at least one non user-selected third electrode.

19. The computer-readable storage medium of claim 18, wherein the instructions cause the processor to automatically determine the amount of electrical stimulation to be delivered via the at least one third electrode based on a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and the at least one second user-selected electrode.

20. The computer-readable storage medium of claim 18, wherein the instructions cause the processor to automatically determine the amount of electrical stimulation to be delivered via the at least one third electrode equal to a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and the at least one second user-selected electrode.

21. The computer-readable storage medium of claim 18, wherein the instructions cause the processor to automatically determine the amount of electrical stimulation to be delivered via the at least one third electrode equal to a portion of a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and the at least one second user-selected electrode.

22. The computer-readable storage medium of claim 18, wherein the instructions cause the processor to automatically determine the amount of electrical stimulation to be delivered via the at least one third electrode to be a sub-threshold current.

23. The computer-readable storage medium of claim 17, wherein the instructions further cause the processor to:

receive user input specifying the at least one first user-selected electrode and the at least one second user-selected electrode based on a user using a pointing media to select the at least one first user-selected electrode and the at least one second user-selected electrode.

24. The computer-readable storage medium of claim 17, wherein the instructions further cause the processor to:

receive user input specifying the at least one first user-selected electrode and the at least one second user-selected electrode based on user input that drags a stimulation field relative to at least one lead.

25. The computer-readable storage medium of claim 17, wherein the instructions cause the processor to automatically select the at least one third electrode that is one or more lead electrodes.

26. The computer-readable storage medium of claim 17, wherein the instructions cause the processor to automatically select the at least one third electrode that is a housing electrode.

27. The computer-readable storage medium of claim 17, wherein the instructions cause the processor to automatically select the at least one third electrode that is a combination of a housing electrode and at least one lead electrode.

28. The computer-readable storage medium of claim 27, wherein the instructions cause the processor to receive, from a user, input specifying relative contributions of the at least one lead electrode and at least one housing electrode.

29. The computer-readable storage medium of claim 28, wherein the instructions cause the processor to receive, from a user, input specifying relative contributions of the at least one lead electrode and the at least one housing electrode includes receiving user input based on the user adjusting a slideable medium within a range.

30. The computer-readable storage medium of claim 17, wherein the program is a first program, and wherein a first sum of the amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode and the at least one third electrode substantially equals zero, and wherein the instructions cause the processor to:

receive, via the user interface, user input specifying an adjustment to at least one of the at least one first user-selected electrode and the at least one second user-selected electrode;

automatically determine, for the at least one third electrode, an amount of electrical stimulation current such that a second sum of the electrical stimulation currents to be supplied by each of the first, second, and third electrodes equals zero; and

define a second program to control delivery of the electrical stimulation by the stimulator based on the automatically determined amounts of electrical stimulation currents.

31. The computer-readable storage medium of claim 17, wherein the instructions cause the processor to automatically select a plurality of third electrodes not specified as a user-selected electrode to deliver electrical stimulation to substantially balance the electrical stimulation current to be delivered via the at least one first user selected electrode and the at least one second user-selected electrode includes automatically selecting a plurality of third electrodes.

32. The method of claim 31, wherein the instructions cause the processor to automatically determine an amount of electrical stimulation to be delivered via each of the plurality of third electrodes.

33. A device, comprising:

a programmer for an implantable electrical stimulator, the programmer comprising;

a user interface that receives user input specifying at least one first user-selected electrode to deliver electrical stimulation of a first polarity and at least one second user-selected electrode to deliver electrical stimulation of a second polarity different than the first polarity for delivery of electrical stimulation from an implantable electrical stimulator to a patient, wherein the user interface further receives user input specifying amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode; and

a processor that automatically selects at least one non user-selected third electrode to deliver electrical stimulation to substantially balance the electrical stimulation delivered by the at least one first user-selected electrode and the at least one second user-selected electrode, wherein the processor defines a program to control delivery of the electrical stimulation by the implantable electrical stimulator based on the user input.

34. The device of claim 33, wherein the processor further automatically determines an amount of electrical stimulation to be delivered via the at least one non-user selected third electrode.

35. The device of claim 34, wherein the processor automatically determines the amount of electrical stimulation to be delivered via the at least one non-user selected third electrode based on a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and an amount of electrical stimulation delivered via the at least one second user-selected electrode.

36. The device of claim 34, wherein the processor automatically determines the amount of electrical stimulation to be delivered via the at least one non-user selected third electrode equal to a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and an amount of electrical stimulation delivered via the at least one second user-selected electrode.

37. The device of claim 34, wherein the processor automatically determines the amount of electrical stimulation to be delivered via the at least one non-user selected third electrode equal to a portion of a difference between an amount of electrical stimulation delivered via the at least one first user-selected electrode and an amount of electrical stimulation delivered via the at least one second user-selected electrode.

38. The device of claim 34, wherein the processor automatically determines the amount of electrical stimulation to be delivered via the at least one third electrode to be a sub-threshold current.

39. The device of claim 33, wherein the user interface receives user input specifying the at least one first user-selected electrode and the at least one second user-selected electrode based on a user using a pointing media to select the at least one first user-selected electrode and the at least one second user-selected electrode.

40. The device of claim 33, wherein the user interface receives user input specifying the at least one first user-selected electrode and the at least one second user-selected electrode based on user input that drags a stimulation field relative to at least one lead.

41. The device of claim 33, wherein the processor automatically selects the at least one third electrode that is one or more lead electrodes.

42. The device of claim 33, wherein the processor automatically selects the at least one third electrode that is a housing electrode.

43. The device of claim 33, wherein the processor automatically selects the at least one third electrode that is a combination of at least one lead electrode and at least one housing electrode.

44. The device of claim 33, wherein the user interface receives, from a user, input specifying relative contributions of the at least one lead electrode and at least one housing electrode.

45. The device of claim 44, wherein the user interface receives, from a user, input specifying relative contributions of the at least one lead electrode and at least one housing electrode includes the user interface receiving input based on the user adjusting a slideable medium within a range.

46. The device of claim 33, wherein the program is a first program, and wherein a first sum of the amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode and the at least one third electrode substantially equals zero, and wherein the processor receives, via the user interface, user input specifying an adjustment to at least one of the at least one first user-selected electrode and the at least one second user-selected electrode;

wherein the processor automatically determines, for the at least one third electrode, an amount of electrical stimulation current such that a second sum of the electrical stimulation currents to be supplied by each of the first, second, and third electrodes equals zero; and

wherein the processor defines a second program to control delivery of the electrical stimulation by the stimulator based on the automatically determined amounts of electrical stimulation currents.

47. The device of claim 33, wherein the processor that automatically selects a plurality of non user-selected third electrodes to deliver electrical stimulation to substantially balance the electrical stimulation delivered by the at least one first user-selected electrode and the at least one second user-selected electrode.

48. The device of claim 46, wherein the processor automatically determines an amount of electrical stimulation to be delivered via each of the plurality of electrodes.

49. A device comprising:

means for receiving, via a user interface of a programmer device for an implantable electrical stimulator, user input specifying at least one first user-selected electrode to deliver electrical stimulation of a first polarity and at least one second user-selected electrode to deliver electrical stimulation of a second polarity different than the first polarity for delivery of electrical stimulation from an implantable electrical stimulator to a patient;

means for receiving, via the user interface, user input specifying amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode;

means for automatically selecting at least one third electrode to deliver electrical stimulation to substantially balance electrical stimulation delivered by the at least one first user-selected electrode and the at least one second user-selected electrode; and

means for defining a program to control delivery of the electrical stimulation by the stimulator based on the user input.

50. A system comprising:

an implantable electrical stimulator; and

a programmer comprising;

a user interface that;

receives, via a user interface of a programmer device for an implantable electrical stimulator, user input specifying at least one first user-selected electrode to deliver electrical stimulation of a first polarity and at least one second user-selected electrode to deliver electrical stimulation of a second polarity different than the first polarity for delivery of electrical stimulation from an implantable electrical stimulator to a patient;

receives, via the user interface, user input specifying amounts of electrical stimulation current to be supplied via the at least one first user-selected electrode and the at least one second user-selected electrode;

wherein the programmer automatically selects at least one third electrode to deliver electrical stimulation to substantially balance electrical stimulation delivered by the at least one first user-selected electrode and the at least one second user-selected electrode; and

a processor that defines a program to control delivery of the electrical stimulation by the stimulator based on the user input.