Threshold optimization for tissue stimulation therapy
First Claim
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1. A method, comprising:
- a) automatically delivering an electrical signal to a cranial nerve of a patient according to at least a first parameter and a second parameter;
b) automatically measuring an electrical response of the nerve to the electrical signal;
c) automatically adjusting the first parameter while keeping the second parameter at a first test setting;
d) automatically repeating operations a) through c) to acquire a first plurality of electrical responses;
e) determining a lower threshold for the first parameter with the second parameter at the first test setting and an upper threshold for the first parameter with the second parameter at the first test setting, based on the first plurality of electrical responses, wherein the upper threshold corresponds to an electrical signal level above which increasing the first parameter does not cause a significant increase in the electrical response;
automatically adjusting the second parameter to at least one different test setting and then automatically repeating operations (a) through (e) to determine lower and upper thresholds for the first parameter with the second parameter at the different test setting;
recording the determined lower and upper thresholds and the corresponding test settings for the first and second parameters;
determining customized treatment parameters for the patient, based on the recorded information; and
programming an implantable medical device (IMD) for the patient to treat the patient according to the customized treatment parameters.
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Abstract
Methods and systems for determining an optimal therapeutic window of parameter settings for nerve stimulation therapy are described herein. The disclosed techniques generally utilize one or more parameter sweeps to determine upper and lower threshold settings. The determination of the optimal therapeutic window may be performed during or after implantation.
661 Citations
18 Claims
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1. A method, comprising:
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a) automatically delivering an electrical signal to a cranial nerve of a patient according to at least a first parameter and a second parameter; b) automatically measuring an electrical response of the nerve to the electrical signal; c) automatically adjusting the first parameter while keeping the second parameter at a first test setting; d) automatically repeating operations a) through c) to acquire a first plurality of electrical responses; e) determining a lower threshold for the first parameter with the second parameter at the first test setting and an upper threshold for the first parameter with the second parameter at the first test setting, based on the first plurality of electrical responses, wherein the upper threshold corresponds to an electrical signal level above which increasing the first parameter does not cause a significant increase in the electrical response; automatically adjusting the second parameter to at least one different test setting and then automatically repeating operations (a) through (e) to determine lower and upper thresholds for the first parameter with the second parameter at the different test setting; recording the determined lower and upper thresholds and the corresponding test settings for the first and second parameters; determining customized treatment parameters for the patient, based on the recorded information; and programming an implantable medical device (IMD) for the patient to treat the patient according to the customized treatment parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A system, comprising:
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a processor; an amplifier and an analog-to-digital (A/D) converter coupled to the processor, the amplifier and A/D converter operable to convert data from a sensor electrode coupled to a cranial nerve of a patient into data for the processor; a transceiver coupled to the processor, the transceiver operable to communicate with an implantable medical device (IMD); a storage medium responsive to the processor; and software stored in the storage medium and executable on the processor, wherein the software, when executed, causes the processor to perform operations comprising; a) instructing the IMD to deliver a plurality of electrical signals to the cranial nerve according to at least first and second parameters, wherein the first parameter is iteratively adjusted automatically, while the second parameter remains fixed at a first test setting; b) automatically detecting a first plurality of electrical responses of the nerve to the plurality of electrical signals; c) automatically determining a lower threshold for the first parameter with the second parameter at the first test setting and an upper threshold for the first parameter with the second parameter at the first test setting, based on the first plurality of electrical responses, wherein the upper threshold corresponds to an electrical signal level above which increasing the first parameter does not cause a significant increase in the electrical response; automatically executing one or more iterations of a process comprising; i) adjusting the second parameter to a different test setting and then ii) repeating operations (a) through (c) to determine a lower threshold and an upper threshold for the first parameter with the second parameter at the different test setting; and automatically recording multiple sets of lower and upper thresholds and the corresponding test settings for the first and second parameters, with each set corresponding to a different setting for the second parameter; determining customized treatment parameters for the patient, based on the recorded information; and programming an implantable medical device (IMD) for the patient to treat the patient according to the customized treatment parameters. - View Dependent Claims (16, 17, 18)
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Specification