Patient interactive neurostimulation system and method

• US 7,386,348 B2
• Filed: 09/24/2003
• Issued: 06/10/2008
• Est. Priority Date: 09/29/1999
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sieracki, Jeffrey Mark, North, Richard Boydston, Holland, Lon Hodges, Fowler, Kim Randal
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US10/669,392
• Publication Number:
  US 20040059395A1
• Time in Patent Office: 1,721 Days
• Field of Search: 607/46, 607/48, 607 55- 57
• US Class Current: 607/46
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/37241 providing test stimulations

Abstract

A fully automated computer controlled system is provided for adjustment of neurostimulation implants used in pain therapy and in treating neurological dysfunction which includes a patient interactive computer, and a universal transmitter interface integrally embedded in the patient interactive computer or built into the antenna which is capable of stimulating any type of implanted neurostimulation devices by imitating programming codes. The patient interacts with the system through the patient interactive computer. The universal transmitter interface includes a direct digital synthesizer, a transistor circuitry driving the antenna in ON-OFF fashion and a gating unit for driving the transistor circuitry under control of the processing means in the patient-interactive computer. Alternatively, the universal transmitting interface includes a balanced modulator for modulation of the carrier signal generated at the direct digital synthesizer.

Claims

1. A method comprising:

controlling an implantable neurostimulator to deliver neurostimulation to a patient according to a plurality of stimulation settings during a programming session;

displaying a list of the stimulation settings;

collecting information for each of the stimulation settings, wherein the collected information comprises;

rating information comprising;

a numeric rating for the stimulation setting; and

a degree of overlap between a paresthesia map for the stimulation setting and a pain map; and

a threshold amplitude value for the stimulation setting;

receiving input from a user choosing at least one criteria selected from the collected information; and

ordering the list according to the at least one user-chosen criteria selected from the collected information.

2. The method of claim 1, wherein each of the stimulation settings includes a pulse width, a pulse frequency, an identification of activated electrodes, and an identification of polarities of activated electrodes.

3. The method of claim 1, wherein the user-chosen criteria comprises the numeric ratings, and ordering the list comprises ordering the list according to the numeric ratings.

4. The method of claim 1, wherein the numeric ratings indicate a degree of pain-relief.

5. The method of claim 1, wherein the user-chosen criteria comprises tho degrees of overlap and ordering the list comprises ordering the list according to the degrees of overlap.

6. The method of claim 1, wherein collecting rating information comprises collecting rating information from the patient.

7. The method of claim 1, further comprising selecting at least one stimulation setting from the plurality for retesting based on the user-chosen criteria.

8. The method of claim 1, further comprising automatically programming the neurostimulator with at least one of the stimulation settings based on the user-chosen criteria.

9. The method of claim 1, wherein controlling the implantable neurostimulator to deliver neurostimulation to the patient according to the plurality of stimulation settings during the programming session comprises:

storing a plurality of predetermined programming codes;

identifying a type of an implantable neurostimulator;

selecting one of the plurality of programming codes based on the identified type; and

transmitting the selected programming code to the implantable neurostimulator to enable programming of the implantable neurostimulator.

10. The method of claim 9, wherein transmitting the selected programming code comprises modulating a carrier signal.

11. The method of claim 10, further comprising retrieving parameters for modulation of the carrier signal from a memory based on the identified type of the implantable neurostimulator.

12. The method of claim 1, further comprising receiving input from the patient indicative of a stimulation amplitude of the neurostimulation, wherein controlling the implantable neurostimulator to deliver neurostimulation to the patient comprises controlling the implantable neurostimulator to deliver neurostimulation to the patient at the stimulation amplitude indicated by the user.

13. The method of claim 1, further comprising determining the threshold amplitude value for each of the stimulation settings.

14. The method of claim 1, wherein collecting the threshold amplitude value for each of the stimulation settings comprises determining at least one of a perceptual threshold, a usage threshold, an area of interest threshold, a motor threshold or a discomfort threshold for each of the stimulation settings.

15. The method of claim 1, further comprising, for each stimulation setting, determining whether the rating information falls within boundaries based on the threshold amplitude value.

16. The method of claim 1, further comprising:

providing the collected information to at least one of a server or a database.

17. A device for programming an implantable neurostimulator comprising a display, wherein the device is adapted to control the implantable neurostimulator to deliver neurostimulation to a patient according to a plurality of stimulation settings during a programming session, display a list of the stimulation settings via the display, collect information for each of the stimulation settings, receive input from a user choosing at least one criteria selected from the collected information, and order the list according to the at least one user-chosen criteria, wherein the collected information comprises:

rating information comprising;

a numeric rating for each of the stimulation settings; and

a degree of overlap between a paresthesia map for the stimulation setting and a pain map; and

a threshold amplitude value for the stimulation setting.

18. The device of claim 17, wherein each of the stimulation settings includes a pulse width, a pulse frequency, an identification of activated electrodes, and an identification of polarities of activated electrodes.

19. The device of claim 17, wherein the user-chosen criteria comprises the numeric ratings, and the device orders the list according to the numeric ratings.

20. The device of claim 17, wherein the numeric rating indicates a degree of pain-relief.

21. The device of claim 17, wherein the display is a touch screen display, and the device collects the numeric rating via the display.

22. The device of claim 17, wherein the display is a touch screen display, and

wherein the user-chosen criteria comprises the degrees of overlap, and the device orders the list according to the degrees of overlap.

23. The device of claim 17, wherein the device selects at least one stimulation setting from the plurality for retesting based on the user-chosen criteria.

24. The device of claim 17, wherein the device is adapted to automatically program the neurostimulator with at least one of the stimulation settings based on the user-chosen criteria.

25. The device of claim 17, wherein the device comprises a portable computer.

26. The device of claim 17, wherein the device comprises a tablet computer.

27. The device of claim 17, wherein the device further comprises:

an antenna that identifies a type of the implantable neurostimulator; and

a transmitter interface that includes a memory to store a plurality of predetermined programming codes, wherein the transmitter interface is adapted to receive an indication of the identified type of the implantable neurostimulator, select one of the plurality of programming codes based on the identified type, and transmit the selected programming code to the implantable neurostimulator via the antenna to enable programming of the implantable neurostimulator to deliver neurostimulation to the patient.

28. The device of claim 27, wherein the transmitter interface transmits the selected programming code by modulating a carrier wave.

29. The device of claim 28, wherein the memory stores parameters for modulation of the carrier wave associated with each of the programming codes, and the transmitter interface further includes control interface circuitry that retrieves parameters from the memory based on the identified type of the implantable neurostimulator and controls modulation of the carrier wave according to the retrieved parameters.

30. The device of claim 28, wherein the transmitter interface includes at least one of a direct digital synthesizer, programmable gain/amplitude circuitry or a transistor circuit to modulate the carrier wave.

31. The device of claim 17, wherein the device presents an amplitude adjustment screen and receives input from the user adjusting a stimulation amplitude of the neurostimulation via the amplitude adjustment screen.

32. The device of claim 17, wherein the device determines the threshold amplitude value for each of the stimulation settings.

33. The device of claim 17, wherein the device provides the collected information to at least one of a server or a database.

34. A system for programming an implantable neurostimulator comprising:

means for controlling the implantable neurostimulator to deliver neurostimulation to a patient according to a plurality of stimulation settings during a programming session;

means for displaying a list of the stimulation settings;

means for collecting information for each of the stimulation settings, wherein the collected information comprises;

rating information comprising;

a numeric rating for the stimulation setting; and

a degree of overlap between a paresthesia map for the stimulation setting and a pain map;

a threshold amplitude value for the stimulation setting; and

means for receiving input from a user choosing at least one criteria from the collected information; and

means for ordering the list according to a least one user-chosen criteria selected from the collected information.

35. The system of claim 34, wherein the user-chosen criteria comprises the rating information, and the means for ordering the list comprises means for ordering the list according to the numeric ratings.

36. The system of claim 34, wherein the user-chosen criteria comprises the degrees of overlap, and the means for ordering the list comprises means for ordering the list according to the degrees of overlap.

37. The system of claim 34, further comprising means for selecting at least one stimulation setting from the plurality for retesting based on the user-chosen criteria.

38. The system of claim 34, further comprising means for automatically programming the neurostimulator with at least one of the stimulation settings based on the user-chosen criteria.

39. The system of claim 34, further comprising means for providing the collected information to at least one of a server or a database.