METHOD AND APPARATUS FOR MEASUREMENT OF NEURAL RESPONSE

• US 20140296737A1
• Filed: 05/11/2012
• Published: 10/02/2014
• Est. Priority Date: 05/13/2011
• Status: Active Grant

• Current Assignee: Saluda Medical Pty Ltd.
• Original Assignee: Saluda Medical Pty Ltd.
• Inventors: Parker, John Louis, Karantonis, Dean Michael
• Granted Patent: US 10,568,559 B2
• Time in Patent Office: Days
• US Class Current: 600/554
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/40 Detecting, measuring or recording for evaluating the nervous system A61B5/4806, A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61B 5/4029 for evaluating the peripheral nervous systems A61B5/24 takes 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: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration

Abstract

A method for determining a desired location at which to apply a neural therapy. An array of electrodes is positioned proximal to neural tissue. A stimulus is applied from the array which evokes a neural compound action potential response in the neural tissue proximal to the array. A plurality of electrodes of the array simultaneously obtain respective measurements of the neural compound action potential response. From the measurements of the neural compound action potential response a desired location for a neural therapy is determined.

Claims

1. A method for determining a desired location at which to apply a neural therapy, the method comprising:

positioning an array of electrodes proximal to neural tissue;

applying a stimulus from the array which evokes a neural compound action potential response in the neural tissue proximal to the array;

using a plurality of electrodes of the array to simultaneously obtain respective measurements of the neural compound action potential response; and

determining from the measurements of the neural compound action potential response a desired location for a neural therapy.

2. The method of claim 1 wherein the array comprises a large number of electrodes configured to obtain simultaneous measurements of a neural response, in order to yield fine spatial resolution of the neural sensitivity map of the area alongside the array.

3. The method of claim 2 wherein the array comprises 24 electrodes arranged in 3 columns and 8 rows.

4. The method of claim 1 when applied intra-operatively in order to provide intra-operative information regarding the neural response.

5. The method of claim 4, when used for intra-operative DREZ localization, by generating a neural sensitivity map around the DREZ in order to guide DREZ lesioning.

6. The method of claim 5, wherein DREZ lesioning is performed in progressive increments, iteratively with neural sensitivity mapping, whereby the ongoing neural sensitivity mapping provides a progressive intra-operative gauge of the effects of lesioning.

7. The method of claim 5 wherein the DREZ lesioning is performed by RF ablation, applied from the same electrode array as is used for the sensitivity mapping.

9. The method of claim 7, when used iteratively with cortical lesioning, so as to give a progressive measure of the efficacy of incremental lesioning of the origin site.

10. The method of claim 1, when used intra-operatively in order to optimize the position of an electrode or electrode array being implanted.

11. The method of claim 10, when used for intra-operative positioning of an electrode array being implanted, laterally relative to the spinal cord.

12. The method of claim 10, when used for intra-operative caudorostral positioning of an electrode array being implanted, relative to the spinal cord.

13. The method of claim 1 when used intra-operatively and wherein intra-operative information representing the measurements of the neural compound action potential response is presented to a surgeon by way of an amplitude meter.

14. The method of claim 1 when used post-operatively to give ongoing guidance as to the suitability of the site of the neural therapy.

15. The method of claim 14, further comprising determining when manual or automated re-fitting of a therapeutic device is required, to cause a site of the neural therapy to be revised in response to the ongoing measurements.

16. The method of claim 14 wherein a selection of which electrode(s) to use to apply a therapeutic stimulus is post-operatively altered in response to an updated map of neural sensitivity as measured at each electrode.

17. The method of claim 1 wherein the stimulus is applied under the control of a remote control of the implanted array.

8. (not entered)

18. A system for determining a desired location at which to apply a neural therapy, the system comprising:

an array of electrodes configured to be positioned proximal to neural tissue;

a control unit configured to cause application of a stimulus from the array which evokes a neural compound action potential response in the neural tissue proximal to the array, the control unit further configured to simultaneously obtain a plurality of measurements of the neural compound action potential response from a plurality of electrodes of the array, and the control unit further configured to determine from the measurements of the neural compound action potential response a desired location for a neural therapy.