Nerve evoked potential measurement system using chaotic sequences for noise rejection

• US 5,792,212 A
• Filed: 03/07/1997
• Issued: 08/11/1998
• Est. Priority Date: 03/07/1997
• Status: Expired due to Term

• Current Assignee: Michael J. Jaro
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Weijand, Koen J.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/812,292
• Time in Patent Office: 522 Days
• Field of Search: 607/39-52, 607/62, 607/63, 607/72, 607/73, 607/117, 607/118, 128/741, 600/554
• US Class Current: 607/73
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/388 Nerve conduction study, e.g. detecting action potential of peripheral nerves
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7242 using integration
• CPC Class Codes: A61N 1/36071 Pain

Abstract

There is provided a measurement system for measuring signals evoked in response to stimulus pulses applied to a nerve, muscle or like physiological portion of a patient. The measurement system is characterized by delivering stimulus pulses at randomly generated intervals, and enabling the sense circuitry to track the timing of the stimulus pulse generation so as to aid in discriminating the evoked response pattern from surrounding noise. Specifically, after each stimulus pulse a delay is timed out for a time corresponding to the expected latency between the delivered pulse and the arrival of the evoked response at another location. The delay signal is then used to initiate time out of a window which controls operation of the sensing circuit for a window duration corresponding to when the evoked response pattern is appearing. Limiting the sensing operation to the window duration enables tracking of the response pattern, and minimizes power consumption. The sensed evoked response signals are further processed to provide control signals for adjustment of the delay and window, thereby optimizing the sensing operation. The measurement system is suitably part of a larger implantable stimulus system, which includes the ability to adjust pulse-to-pulse interval, or rate, and also pulse output level as a function of measured evoked response patterns. In a further embodiment, the stimulus system involves steering of stimulus pulses to selected nerve fibers or muscle tissue, and the measurement system provides feedback for adjusting the steering parameters.

Claims

1. An evoked potential measurement system in an implantable nerve stimulator apparatus, comprising:

stimulus generator means for generating and delivering stimulus pulses to a first location on a trunk of nerve fibers, having chaotic sequence means for controlling said generator means to generate said stimulus pulses in a chaotic sequence with random intervals,

electrode means for sensing evoked signals in said nerve fibers at a second location on said trunk, and circuit means for processing said sensed evoked signals,

sync means for synchronizing the timing of the operation of said circuit means with the timing of generating said stimulus pulses, and

measure means operative after each said stimulus pulse for obtaining from said processed signals a measure of the sensed evoked signals corresponding to said each stimulus pulse.

2. The system as described in claim 1, wherein said sync means comprises delay means connected to said generator means for providing a delay signal at a delay following each generated stimulus pulse, and enable means for enabling said circuit means to operate for a predetermined duration after said delay signal is generated.

3. The system as described in claim 1, further comprising a window circuit for generating a time window following each said delay signal, and wherein said sense means comprises circuit means for processing sensed evoked signals and said enable means has means for turning on said circuit means only during each said window.

4. The system as described in claim 3, wherein said measure means comprises integrator means for integrating said sensed evoked signals following each said stimulus pulse to obtain said measure.

5. The system as described in claim 4, comprising processing means for processing a plurality of said measures and for obtaining a delay adjustment signal as a function of said processing, and adjusting means for adjusting said delay with said delay adjustment signal.

6. The system as described in claim 3, further comprising data means for storing data representative of sensed evoked signals, adjust means for obtaining an output adjustment signal as a function of said data, and control means for controlling said stimulus generator means in a non-measurement mode, said control means having output control means for controlling the amplitude or width of said stimulus pulses with said output adjustment signal.

7. The system as described in claim 6, comprising means for determining from said data an effective time duration for said window, and window control means for controlling the time duration of said window to correspond to said effective time duration.

8. An implantable system for stimulating patient nerve fibers, comprising:

controllable stimulus means for generating and delivering nerve stimulus pulses of controllable rate and output level to a first patient nerve location, said generator normally operating at a controllable rate and output level;

evoked potential measurement means operative during a test period for obtaining measures of evoked potentials produced by said delivered pulses at a sense location, having

chaotic sequence means for controlling said generator to generate said stimulus pulses at substantially random intervals,

sense means for sensing and processing potentials evoked by said delivered stimulus pulses at a said sense location, said sense means having circuitry for processing said potentials,

window means for controlling said circuitry to process said evoked signals only during a window of time following each said stimulus pulse, said window means having delay means for delaying the start of said window by a delay with respect to each said stimulus pulse,

measure means for obtaining a measure of the evoked potentials sensed by said sensing means during each said window; and

adjust means for adjusting one or more parameters of said stimulus pulses as a function of said measures.

9. The system as described in claim 8, comprising measurement adjust means for adjusting said delay and said window as a function of said measures.

10. The system as described in claim 8, comprising means for initiating a test period.

11. The system as described in claim 8, wherein said controllable stimulus means comprises a plurality of electrodes, and configuration means for selecting a configuration of said electrodes as a function of said measures.

12. The system as described in claim 11, wherein said measure means comprises arrival means for determining arrival times of evoked responses.

13. The system as described in claim 8, wherein said controllable stimulus means comprises means for delivering plural pulses, each of said pulses being characterized by a set of output pulse parameters, and wherein said adjust means comprises means for adjusting each respective set of output pulse parameters so as to control steering of the stimulus electrical field.

14. The system as described in claim 8, wherein said adjust means comprises output means for adjusting one or both of the rate and output level of said stimulus pulses as a function of said measures.

15. The system as described in claim 14, wherein said output means comprises means for adjusting both amplitude and pulse width of said stimulus pulses.

16. A system for measuring the responses of a patient body portion to applied stimulus pulses, comprising:

controllable pulse generator means for generating and delivering stimulus pulses to a first location of said body portion, having random control means for controlling generation of said stimulus pulses at random pulse-to-pulse intervals,

delay means for generating a delay signal at a delay following each said stimulus pulse,

window means for generating a timing window initiated by each said delay signal, and

sense means for sensing, at a second location of said body portion, signals evoked by said stimulus pulses, circuit means for processing said sensed signals, and on-off means for turning said circuit means on only during each said timing window, whereby said processing is time synchronized to said random pulse-to-pulse intervals.

17. The system as described in claim 16, wherein said patient body portion is a group of nerve fibers, and said pulse generator means comprises first electrode means for delivering said stimulus pulses to said first location, and said said sense means comprises second electrode means for sensing evoked signals at said second location.

18. A method of measuring evoked responses to stimulus pulses applied to nerves of a patient, comprising:

generating stimulus pulses with random pulse-to-pulse intervals, and delivering said pulses to a first patient nerve location,

generating a window enable signal in timed relation to the delivery of each said stimulus pulse,

sensing signals evoked by said stimulus pulses at a second nerve patient location, and

processing said sensed signals only during each said window enable signal.

19. The method as described in claim 18, comprising timing out a delay following each said delivered pulse, and initiating said window enable signal upon time out of each said delay.

20. The method as described in claim 19, comprising obtaining and storing data representative of said evoked responses following a plurality of delivered stimulus pulses, and determining when sufficient data has been obtained to complete a measurement.

21. The method as described in claim 20, comprising adjusting said delay as a function of said data.

22. The method as described in claim 20, comprising adjusting the duration of said window enable signal as a function of said data.

23. The method as described in claim 20, comprising analyzing said data after a completed measurement, adjusting one or more parameters of said stimulus pulses and said window, and performing another measurement using said adjusted parameters.

24. A system for automatically controlling stimulation of nerve fibers, comprising:

stimulating means for stimulating nerve fibers,

determining means for determining characteristics of evoked responses in said nerve fibers due to said stimulating,

selecting means for selecting excitation of certain nerve fibers as a function of said determined characteristics, and

controlling means for controlling said stimulus means so as to selectively excite said selected certain nerve fibers.