Methods, devices and systems for programming neurostimulation

• US 8,249,701 B2
• Filed: 10/14/2009
• Issued: 08/21/2012
• Est. Priority Date: 10/15/2008
• Status: Active Grant

• Current Assignee: TC1 LLC (Abbott Laboratories Incorporated)
• Original Assignee: Spinal Modulation, Inc. (Abbott Laboratories Incorporated)
• Inventors: Imran, Mir A., Mossop, Brian J., Kishawi, Eyad
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): LEVICKY, WILLIAM J
• Application Number:
  US12/579,179
• Publication Number:
  US 20100121408A1
• Time in Patent Office: 1,042 Days
• Field of Search: 607/59, 607/2, 607 45- 46, 607 55- 57
• US Class Current: 607/2
• 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 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Methods, devices and systems are provided to efficiently identify, from among a plurality of possible neurostimulation parameter sets, one or more preferred neurostimulation parameter sets that treat a targeted pain of a patient. Each neurostimulation parameter set defines electrode parameters and neurostimulation signal parameters. A plurality of different neurostimulation parameter sets are tested on the patient to thereby identify those tested neurostimulation parameter sets that treat the targeted pain. Each of the tested neurostimulation parameter sets defines an electrode configuration that differs from the other tested neurostimulation parameter sets. All of the tested neurostimulation parameter sets comprise a same value for a specific neurostimulation signal parameter (e.g., pulse width) that if reduced reduces power consumption. If more than one of the tested neurostimulation parameter sets are identified as treating the targeted pain, then neurostimulation parameter sets identified as treating the targeted pain are retested, with the value for the specific neurostimulation signal parameter reduced by a same amount for each of the retested neurostimulation parameter sets, to thereby identify those neurostimulation parameter sets that treat the targeted pain at the reduced power consumption level.

Claims

1. A method for efficiently identifying, from among a plurality of possible neurostimulation parameter sets, one or more preferred neurostimulation parameter sets that treat a targeted pain of a patient, wherein each neurostimulation parameter set defines electrode parameters and neurostimulation signal parameters, the method comprising:

(a) testing on the patient a plurality of different neurostimulation parameter sets to thereby identify those tested neurostimulation parameter sets that treat the targeted pain,

wherein each of the tested neurostimulation parameter sets defines an electrode configuration that differs from the other tested neurostimulation parameter sets, and

wherein all of the tested neurostimulation parameter sets comprise a same value for a specific neurostimulation signal parameter that if reduced reduces power consumption; and

(b) retesting on the patient the neurostimulation parameter sets identified as treating the targeted pain, with the value for the specific neurostimulation signal parameter reduced by a same amount for each of the retested neurostimulation parameter sets, to thereby identify those neurostimulation parameter sets that treat the targeted pain at the reduced power consumption level;

wherein at step (b), the amount by which the value of the specific neurostimulation signal parameter is reduced for each of the retested neurostimulation parameter sets is dependent upon the number of neurostimulation parameter sets being retested, such that the greater the number of neurostimulation parameter sets being retested the greater the amount by which the value of the specific neurostimulation signal parameter is reduced.

2. The method of claim 1, wherein if more than one neurostimulation parameter set that treats the targeted pain is identified at step (b), then repeating step (b) until only one neurostimulation parameter set that treats the targeted pain is identified, wherein each time step (b) is repeated the value for the specific neurostimulation signal parameter is again reduced.

3. The method of claim 2, wherein each time step (b) is repeated, the amount by which the value for the specific neurostimulation signal parameter is reduced stays the same if the number of neurostimulation parameter sets being retested stays the same, or decreases if the number of neurostimulation parameter sets being retested decreases.

4. The method of claim 1, wherein at step (b), the amount by which the value of the specific neurostimulation signal parameter is reduced for each of the retested neurostimulation parameter sets is proportional to the number of neurostimulation parameter sets being retested.

5. The method of claim 1, wherein the specific neurostimulation signal parameter comprises pulse width.

6. The method of claim 1, wherein the specific neurostimulation signal parameter comprises pulse amplitude.

7. The method of claim 1, wherein the specific neurostimulation signal parameter comprises pulse repetition rate.

8. The method of claim 1, wherein the electrode parameters of each neurostimulation parameter set define which electrodes are used to provide neurostimulation.

9. The method of claim 8, wherein the electrode parameters of each neurostimulation parameter set define which one or more electrodes used to provide neurostimulation are connected as a cathode, and which one or more electrodes used to provide neurostimulation are connected as an anode.

10. The method of claim 1, wherein neurostimulation signal parameters of each neurostimulation parameter set define a value for each of pulse width, pulse amplitude and pulse repetition rate.

11. The method of claim 1, wherein if none of the neurostimulation parameter sets tested at step (a) treat the targeted pain, then prior to step (b), retesting on the patient the plurality of neurostimulation parameter sets with a value for the specific neurostimulation signal parameter or another neurostimulation parameter increased by a same amount for each of the retested neurostimulation parameter sets, to thereby identify those neurostimulation parameter sets that treat the targeted pain with the increased value.

12. The method of claim 1, wherein:

the plurality of neurostimulation parameter sets comprise dorsal root ganglion (DRG) neurostimulation parameter sets for DRG stimulation of the patient;

step (a) comprises testing on the patient the plurality of different DRG neurostimulation parameter sets to thereby identify those tested DRG neurostimulation parameter sets that treat the targeted pain; and

step (b) comprises retesting on the patient the DRG neurostimulation parameter sets identified as treating the targeted pain, with the value for the specific DRG neurostimulation signal parameter reduced by a same amount for each of the retested neurostimulation parameter sets, to thereby identify those DRG neurostimulation parameter sets that treat the targeted pain at the reduced power consumption level.

13. An external programmer configured to efficiently identify, from among a plurality of possible neurostimulation parameter sets, one or more preferred neurostimulation parameter sets that treat a targeted pain of a patient, wherein each neurostimulation parameter set defines electrode parameters and neurostimulation signal parameters, the external programmer including:

memory to store a plurality of different neurostimulation parameter sets to be tested on the patient, wherein all of the neurostimulation parameter sets to be tested comprise a same value for a specific neurostimulation signal parameter that if reduced reduces power consumption;

a controller configured to provide test instructions that instruct an implantable pulse generator (IPG), implanted within the patient, to test on the patient the plurality of different neurostimulation parameter sets;

telemetry circuitry configured to transmit the test instructions to the IPG implanted within the patient; and

a user interface configured to accept feedback that identifies those tested neurostimulation parameter sets that treat the targeted pain;

wherein the controller is also configured to provide retest instructions, in response to more than one of the tested neurostimulation parameter sets being identified as treating the targeted pain, wherein the retest instructions instruct the IPG to retest on the patient the neurostimulation parameter sets identified as treating the targeted pain, with the value for the specific neurostimulation signal parameter reduced by a same amount for each of the retested neurostimulation parameter sets;

wherein the amount by which the value of the specific neurostimulation signal parameter is reduced for each of the retested neurostimulation parameter sets is dependent upon the number of neurostimulation parameter sets being retested, such that the greater the number of neurostimulation parameter sets being retested the greater the amount by which the value of the specific neurostimulation signal parameter is reduced;

wherein the telemetry circuit is also configured to transmit the retest instructions to the IPG; and

wherein the user interface is also configured to accept feedback that identifies those retested neurostimulation parameter sets that treat the targeted pain at the reduced power consumption level.

14. The external programmer of claim 13, wherein the external programmer comprises a patient programmer.

15. The external programmer of claim 13, wherein the external programmer comprises a clinician programmer.

16. The external programmer of claim 13, wherein the controller is configured to repeatedly provide retest instructions, in response to more than one of the retested neurostimulation parameter sets being identified as treating the targeted pain, wherein each time the controller provides retest instructions, the value for the specific neurostimulation signal parameter is again reduced.

17. The external programmer of claim 16, wherein each time the controller provides retest instructions, the amount by which the value for the specific neurostimulation signal parameter is reduced stays the same if the number of neurostimulation parameter sets being retested stays the same, or decreases if the number of neurostimulation parameter sets being retested decreases.

18. The external programmer of claim 16, wherein each time the controller provides retest instructions, the amount by which the value of the specific neurostimulation signal parameter is reduced is proportional to the number of neurostimulation parameter sets being retested.

19. The external programmer of claim 13, wherein the specific neurostimulation signal parameter comprises pulse width.

20. The external programmer of claim 13, wherein the specific neurostimulation signal parameter comprises pulse amplitude.

21. The external programmer of claim 13, wherein the specific neurostimulation signal parameter comprises pulse repetition rate.

22. The external programmer of claim 13, wherein the electrode parameters of each neurostimulation parameter set define which electrodes are used to provide neurostimulation.

23. The external programmer of claim 13, wherein the electrode parameters of each neurostimulation parameter set define which one or more electrodes used to provide neurostimulation are connected as a cathode, and which one or more electrodes used to provide neurostimulation are connected as an anode.

24. The external programmer of claim 13, wherein neurostimulation signal parameters of each neurostimulation parameter set define a value for each of pulse width, pulse amplitude and pulse repetition rate.

25. The external programmer of claim 13, wherein the controller is configured to provide retest instructions, in response to none of the tested neurostimulation parameter sets being identified as treating the targeted pain, wherein the retest instructions instruct the IPG to retest on the patient the plurality of neurostimulation parameter sets, with a value for the specific neurostimulation signal parameter or another neurostimulation signal parameter increased by a same amount for each of the retested neurostimulation parameter sets.

26. The external programmer of claim 13, wherein the plurality of neurostimulation parameter sets comprise dorsal root ganglion (DRG) neurostimulation parameter sets for DRG stimulation of the patient.