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

• US 20160375254A1
• Filed: 06/24/2016
• Published: 12/29/2016
• Est. Priority Date: 01/29/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Walker, Andre B., Fang, Zi-Ping, Caparso, Anthony V.
• Granted Patent: US 10,173,065 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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

1-85. -85. (canceled)

86. A system for producing an asynchronous neural response, comprising:

a pulse generator having a machine-readable medium containing instructions that, when executed, cause the pulse generator to transmit a first electrical stimulation signal having a first frequency, and a second electrical stimulation signal having a second frequency, wherein—

the first frequency is less than one half of a target stimulation frequency sufficient to produce the asynchronous neural response,

the second frequency is less than one half of the target stimulation frequency, and

the instructions, when executed, cause the pulse generator to transmit a plurality of paired pulses that produce the asynchronous neural response, wherein individual paired pulses comprise a first pulse of the first electrical stimulation signal separated by a phase shift from a second pulse of the second electrical stimulation signal; and

a signal delivery element couplable to the pulse generator to deliver the first electrical stimulation signal and the second electrical stimulation signal to a target neural population.

87. The system of claim 86 wherein the instructions further cause the pulse generator to transmit an initial electrical stimulation signal, prior to transmittal of the first electrical stimulation signal and the second electrical stimulation signal, and wherein the initial electrical stimulation signal has a frequency equal to the target stimulation frequency.

88. The system of claim 87 wherein the target stimulation frequency is at least an order of magnitude greater than a threshold frequency corresponding to a refractory period for neurons of the target neural population.

89. The system of claim 86 wherein the individual paired pulses have a corresponding combined period equal to the time between the start of the first pulse and the start of the second pulse, and wherein the inverse of the combined period is greater than 3.0 kHz.

90. The system of claim 86 wherein consecutive individual paired pulses are separated by a quiescent period, and wherein the quiescent period is longer than the phase shift.

91. The system of claim 90 wherein the quiescent period is less than a refractory period for the target neural population.

92. The system of claim 86 wherein the instructions, when executed, further cause the pulse generator to:

transmit the first electrical stimulation signal at a first amplitude; and

transmit the second electrical stimulation signal at a second amplitude, wherein the second amplitude is greater than the first amplitude.

93. A method for configuring a stimulation device to produce an asynchronous neural response, the method comprising:

determining a target stimulation frequency based on a threshold frequency corresponding to a refractory period for neurons of a target sensory neural population, and wherein the target stimulation frequency is greater than the threshold frequency; and

programming the stimulation device to deliver a first electrical stimulation signal having a plurality of first pulses at a first frequency, and a second electrical stimulation signal having a plurality of second pulses at a second frequency, wherein the first frequency and the second frequency are less than one half of the target stimulation frequency, and wherein the stimulation device is programmed to deliver the first pulses at an offset from the second pulses to produce the asynchronous neural response.

94. The method of claim 93 wherein the target stimulation frequency is in a range from 3.0 kHz to 10 kHz.

95. The method of claim 94 wherein the offset produces a paired pulse having an individual first pulse from the first electrical stimulation signal and an individual second pulse from the second electrical stimulation signal, wherein the paired pulse has a combined period equal to the time between the start of the individual first pulse and the start of the individual second pulse, and wherein the inverse of the combined period is greater than 3.0 kHz.

96. The method of claim 95 wherein the inverse of the combined period is at least an order of magnitude greater than the threshold frequency.

97. The method of claim 93 wherein the offset produces a plurality of paired pulses, and wherein consecutive individual paired pulses are separated by a quiescent period that is greater than the offset.

98. The method of claim 97 wherein the quiescent period is less than a refractory period for a target neural population.

99. The method of claim 93, further comprising programming the stimulation device to deliver a continuous stream of pulses at the target stimulation frequency prior to delivering the first electrical stimulation signal and the second electrical stimulation signal.

100. The method of claim 93, further comprising programming the stimulation device to deliver the first electrical stimulation signal at a first amplitude, and to deliver the second electrical stimulation signal at a second amplitude, wherein the second amplitude is greater than the first amplitude.

101. A system for initiating and maintaining an asynchronous neural response, the system comprising:

an implantable pulse generator having a machine-readable medium containing instructions that, when executed, cause the pulse generator to;

transmit an initial electrical stimulation signal to initiate the asynchronous neural response in a target neural population, wherein the initial electrical stimulation signal is transmitted at a target stimulation frequency, and wherein the target stimulation frequency is greater than a threshold frequency for the target neural population;

subsequent to transmitting the initial electrical stimulation signal, transmit a first electrical stimulation signal having a first frequency, wherein the first frequency is less than one half of the target stimulation frequency; and

concurrent with transmitting the first electrical stimulation signal, transmit a second electrical stimulation signal having a second frequency, wherein the second frequency is less than one half of the target stimulation frequency, wherein the first electrical stimulation signal and the second electrical stimulation signal are transmitted with an offset, wherein the offset is less than a refractory period for neurons of the target neural population, and wherein the offset is selected to maintain the asynchronous neural response; and

an implantable lead having a plurality of electrodes, wherein the lead is positionable to deliver the initial electrical stimulation signal, the first electrical stimulation signal, and the second electrical stimulation signal to the target neural population.

102. The system of claim 101 wherein the target stimulation frequency is at least 3.0 kHz.

103. The system of claim 102 wherein the threshold frequency is less than 1000 Hz.

104. The system of claim 101 wherein the first electrical stimulation signal and the second electrical stimulation signal are transmitted to produce a plurality of paired pulses, wherein consecutive paired pulses are separated by a quiescent period, and wherein the quiescent period is greater than the offset and less than the refractory period.

105. The system of claim 104 wherein the first frequency is not equal to the second frequency.