Selecting electrode combinations for stimulation therapy

• US 8,666,506 B2
• Filed: 06/07/2007
• Issued: 03/04/2014
• Est. Priority Date: 06/30/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: King, Gary W., Goetz, Steven M., Tidemand, Kevin K., Wesselink, Wilbert A., Miyazawa, Gabriela C., Greenberg, Jordan J.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): LEE, ERICA SHENGKAI
• Application Number:
  US11/810,941
• Publication Number:
  US 20080004674A1
• Time in Patent Office: 2,462 Days
• Field of Search: 607/67, 607115-117, 607/152
• US Class Current: 607/116
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• 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
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation

Abstract

Techniques for selecting electrode combinations for stimulation therapy are described. The techniques include selecting one or more electrode combinations based on information associating a plurality of electrode combinations with at least one value of a therapy metric. The therapy metric comprises a quantifiable result of delivery of stimulation, and may be generated computer modeling of delivery of stimulation via the electrode combinations. In one embodiment, a clinician may deliver stimulation via a baseline electrode combination, receive patient feedback to the baseline electrode combination, select a therapy metric based on the patient feedback, and select additional electrode combinations based on the selected therapy metric and the information associating the electrode combinations with therapy metric values. In another embodiment, the clinician may select a therapy metric prior to providing a test stimulation and select additional electrode combinations based on the selected therapy metric and the information associating electrode combinations with metric values.

Claims

1. A computing device comprising:

a memory comprising a plurality of electrode combinations and, for each of the electrode combinations, associated numerical values for at least two different types of therapy metrics, the therapy metrics each comprising a quantifiable result of delivery of stimulation, wherein the numerical values for the therapy metrics are generated with experimental computer modeling of delivery of stimulation via the electrode combinations;

a user interface comprising a display and configured to receive input from a user indicating a selected type of therapy metric; and

a processor that selects an electrode combination from among the plurality of electrode combinations stored within the memory based on the selected type of therapy metric, and presents the selected electrode combination to the user via the display.

2. The computing device of claim 1, wherein the types of therapy metrics includes at least one of:

a dorsal column current;

usage range;

a ratio of dorsal column stimulation threshold voltage to dorsal root stimulation threshold voltage;

a recruitment area;

an area factor;

a maximum output voltage;

or a dorsal column stimulation threshold voltage.

3. The computing device of claim 1, wherein the processor presents a data structure via the display, wherein the data structure includes the plurality of electrode combinations and associated numerical values for the at least two different types of therapy metrics.

4. The computing device of claim 1, wherein the plurality of electrode combinations comprises electrode combinations within a first electrode combination class and a second electrode combination class, wherein the first electrode combination class is characterized by electrodes within one or two electrode columns of an implantable array of electrodes that includes at least three electrode columns, and the second electrode combination class is characterized by electrodes within at least three electrode columns of the implantable array of electrodes.

5. The computing device of claim 1, wherein the plurality of electrode combinations comprises at least one electrode combination from at least five groups of electrode combinations, the at least five groups comprising:

a first group characterized by a rostral anode electrode pattern;

a second group characterized by a caudal anode electrode pattern;

a third group characterized by a first cathode disposed between two anodes, the first cathode and anodes being located in a same column of electrodes;

a fourth group characterized by a second cathode disposed between a first row of anodes and a second row of anodes; and

a fifth group characterized by a transverse electrode combination, wherein anodes of the transverse electrode combination are displaced substantially transversely relative to a third cathode of the transverse electrode combination, and a stimulation field resulting from delivery of stimulation via the transverse combination is oriented substantially transversely relative to a target tissue for the stimulation.

6. The computing device of claim 5, wherein the at least five groups further comprises a sixth group comprising an off-center cathode.

7. The computing device of claim 1, wherein the selected electrode combination comprises a first electrode combination, and wherein the processor presents an interactive graphical display via the display, the graphical display comprising a first section for receiving user input relating to the selected type of therapy metric and a second section for outputting at least one of a group of electrode combinations based on the selected type of therapy metric or a second electrode combination based on the selected type of therapy metric.

8. The computing device of claim 7, wherein the selected electrode combination optimizes the selected type of therapy metric within the plurality of electrode combinations.

9. The computing device of claim 1, wherein the processor selects a plurality of selected electrode combinations from among the plurality of electrode combinations based on the selected type of therapy metric and controls a medical device to deliver stimulation to a patient according to each of the plurality of selected electrode combinations and receives patient feedback for each of the plurality of selected electrode combinations.

10. The computing device of claim 1, wherein the processor is configured to control a medical device to deliver electrical stimulation therapy to a patient via a baseline electrode combination and receive user input including patient feedback relating to the delivery of electrical stimulation therapy via the baseline electrode combination via the user interface.

11. The computing device of claim 10, wherein processor is configured to receive input from the user selecting the baseline electrode combination via the user interface.

12. The computing device of claim 10, wherein the memory stores the baseline electrode combination.

13. The computing device of claim 10, wherein the processor selects the selected electrode combination based on the selected type of therapy metric and the patient feedback.

14. The computing device of claim 1, wherein the processor is configured to program the selected electrode combination into a medical device to deliver chronic stimulation therapy to a patient.

15. The computing device of claim 1, wherein the processor is configured to determine a number of leads to implant in a patient based on the selected electrode combination.

16. The computing device of claim 1, wherein the therapy metric includes at least one of:

a ratio of dorsal column stimulation threshold to dorsal root stimulation threshold or a dorsal column stimulation threshold.

17. A computing device comprising:

means for storing a plurality of electrode combinations and, for each of the electrode combinations, associated numerical values for at least two different types of therapy metrics, the therapy metrics each comprising a quantifiable result of delivery of stimulation, wherein the numerical values for the therapy metrics are generated with experimental computer modeling of delivery of stimulation via the electrode combinations;

means for receiving user input selecting a type of therapy metric and presenting information to a user;

means for selecting an electrode combination from among the plurality of electrode combinations stored within the means for storing the plurality of electrode combinations based on the selected type of therapy metric; and

means for presenting the selected electrode combination to the user.

18. The computing device of claim 17, further comprising means for presenting a data structure via the means for presenting information to the user, wherein the data structure includes the plurality of electrode combinations and associated numerical values for the at least two different types of therapy metrics.

19. The computing device of claim 17, wherein the selected electrode combination comprises a first electrode combination, the computing device further comprising means for presenting an interactive graphical display via the means for presenting information to the user, the graphical display comprising a first section for receiving user input relating to the selected type of therapy metric and a second section for outputting at least one of a group of electrode combinations based on the selected type of therapy metric or a second electrode combination based on the selected type of therapy metric.

20. A computing device comprising:

a memory comprising a plurality of electrode combinations and at least one associated numerical therapy metric value, the numerical therapy metric value comprising a quantifiable result of delivery of stimulation, wherein the numerical therapy metric values are generated with experimental computer modeling of delivery of stimulation via the electrode combinations;

a user interface; and

a processor configured to control a medical device to deliver electrical stimulation therapy to a patient via a baseline electrode combination, receive user input including patient feedback relating to the delivery of electrical stimulation via the baseline electrode combination via the user interface, compare a baseline numerical value associated with the baseline electrode combination to respective numerical therapy metric values of the plurality of electrode combinations, and select an additional electrode combination from within the plurality of electrode combinations based on the patient feedback and the comparison between the baseline numerical value and the respective numerical therapy metric values of the plurality of electrode combinations.

21. The computing device of claim 20, wherein processor is configured to receive input from the user selecting the baseline electrode combination via the user interface.

22. The computing device of claim 20, wherein memory stores the baseline electrode combination.

23. The computing device of claim 20, wherein the numerical therapy metric value comprises at least one of:

a dorsal column current;

usage range;

a ratio of dorsal column stimulation threshold voltage to dorsal root stimulation threshold voltage;

a recruitment area;

an area factor;

a maximum output voltage;

or a dorsal column stimulation threshold voltage.

24. The computing device of claim 20, wherein the numerical therapy metric value includes at least one of:

a ratio of dorsal column stimulation threshold to dorsal root stimulation threshold or a dorsal column stimulation threshold.