DETERMINING NERVE LOCATION RELATIVE TO ELECTRODES

• US 20120277621A1
• Filed: 04/26/2012
• Published: 11/01/2012
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gerber, Martin T., Goetz, Steven M., Poletto, Christopher
• Granted Patent: US 10,448,889 B2
• Time in Patent Office: Days
• US Class Current: 600/554
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/4058 for evaluating the central nervous system A61B5/4806, A61B5/4821 take precedence
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6868 Brain
• CPC Class Codes: A61B 5/6877 Nerve
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

An implantable nerve stimulator is implanted in a patient near a nerve target. The implantable nerve stimulator has a plurality of electrodes through which stimulation is provided to the nerve target. The relative location of the nerve target and the electrodes may be determined by applying stimulation to the nerves via each of the electrodes, determining an effect of the stimulation for each of the electrodes, and mapping a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.

Claims

1. A method comprising:

applying stimulation to a nerve via each of a plurality of implantable electrodes arranged proximate to the nerve;

determining an effect of the stimulation for each of the electrodes; and

mapping a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.

2. The method of claim 1, wherein applying stimulation comprises increasing stimulation intensity delivered via each respective electrode from a base level to a threshold level.

3. The method of claim 1, wherein determining the effects of stimulation comprises determining at least one stimulation threshold for each of the electrodes that is capable of producing a stimulation threshold.

4. The method of claim 3, wherein determining the effects of stimulation comprises determining at least a parasthesia threshold and a upper threshold for each of the electrodes that is capable of producing a stimulation threshold.

5. The method of claim 4, wherein mapping the location of the nerve relative to the electrodes comprises mapping a location of the nerve relative to the electrodes based on a usability range for each of the electrodes, wherein the usability range for each of the electrodes is defined as the difference between the parasthesia threshold and the upper threshold for the electrode that is capable of producing a stimulation threshold.

6. The method of claim 4, wherein mapping the location of the nerve relative to the electrodes comprises mapping a relative distance between the nerve and each of the electrodes that is capable of producing a stimulation threshold.

7. The method of claim 3, wherein determining the effects of stimulation comprises determining at least one of a perception threshold and a paresthesia threshold for each of the electrodes that is capable of producing a stimulation threshold.

8. The method of claim 7, wherein mapping the location of the nerve relative to the electrodes comprises mapping a relative orientation between the nerve and each of the electrodes based on the at least one of the perception threshold or the parasthesia threshold of each of the electrodes that is capable of producing a stimulation threshold.

9. The method of claim 3, further comprising automatically selecting one or more of the electrodes to apply chronic stimulation to the tissue adjacent the nerve based on the location of the nerve relative to each of the one or more electrodes.

10. The method of claim 9, further comprising automatically selecting the one or more of the electrodes to apply chronic stimulation to the tissue adjacent the nerve based on at least one stimulation threshold for each of the one or more selected electrodes.

11. A system comprising:

an implantable electrical stimulator connected to a plurality of electrodes; and

a processor configured to control the electrical stimulator to apply stimulation to a nerve via each of a plurality of implantable electrodes arranged proximate to the nerve, determine an effect of the stimulation for each of the electrodes, and map a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.

12. The system of claim 11, wherein the processor is configured to control the electrical stimulator to apply stimulation at least by increasing stimulation intensity delivered via each respective electrode from a base level to a threshold level.

13. The system of claim 11, wherein the processor is configured to determine the effects of stimulation at least by determining at least one stimulation threshold for each of the electrodes capable of producing a stimulation threshold.

14. The system of claim 13, wherein the processor is configured to determine the effects of stimulation at least by determining at least a parasthesia threshold and an upper threshold for each of the electrodes that is capable of producing a stimulation threshold.

15. The system of claim 14, wherein the processor is configured to map the location of the nerve relative to the electrodes at least by mapping a location of the nerve relative to the electrodes based on a usability range for each of the electrodes, wherein the usability range for each of the electrodes is defined as the difference between the parasthesia threshold and the upper threshold for the electrode.

16. The system of claim 14, wherein the processor is configured to map the location of the nerve to the electrodes at least by mapping a relative distance between the nerve and each of the electrodes that is capable of producing a stimulation threshold.

17. The system of claim 13, wherein the processor is configured to determine the effects of stimulation at least by determining at least one of a perception threshold and a parasthesia threshold for each of the electrodes that is capable of producing a stimulation threshold.

18. The system of claim 17, wherein the processor is configured to map the location of the nerve relative to the electrode at least by mapping a relative orientation between the nerve and each of the electrodes based on the at least one of the perception threshold or the paresthesia threshold of each of the electrodes that is capable of producing a stimulation threshold.

19. The system of claim 13, wherein the processor is configured to automatically select one or more of the electrodes to apply chronic stimulation to the tissue adjacent the nerve based on the location of the nerve relative to each of the one or more electrodes.

20. A computer-readable storage medium comprising instructions for causing a programmable processor to:

apply stimulation to a nerve via each of a plurality of implantable electrodes arranged proximate to the nerve;

determine an effect of the stimulation for each of the electrodes; and

map a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.