Rule-based stimulation program search

• US 8,712,539 B2
• Filed: 04/12/2006
• Issued: 04/29/2014
• Est. Priority Date: 04/12/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Johnson, Donald R., Houchins, Andrew H., Keacher, Jeffrey T., Stone, Theodore J., Heruth, Kenneth T., King, Gary W., Testerman, Roy L.
• Primary Examiner(s): DIETRICH, JOSEPH M
• Application Number:
  US11/402,657
• Publication Number:
  US 20070245318A1
• Time in Patent Office: 2,939 Days
• Field of Search: 607/30, 607/31, 607/59, 607/117
• US Class Current: 607/59
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• 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: A61N 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Techniques that involve application of one or more rules to a “parent” program to generate a plurality of different “child” programs are described. Each of the rules may define a respective electrode configuration modification, and each child program may be a variation of the parent based on a modification of the electrode configuration of the parent according to one of the rules. The systems or devices may generate further generations of child programs from a previous generation child program using the same one or more rules. The child programs may be provided to a user, so that the user may test the efficacy of the new programs, assisting the user in identifying desirable programs. The child programs may be relatively minor variations of the parent program, and the user may “fine tune” a generally desirable parent program by testing the child programs.

Claims

1. A method comprising:

selecting a parent stimulation program, the parent stimulation program including a parent electrode configuration;

receiving an indication of a degree of program similarity from a user, the indication of the degree of program similarity being indicative of how similar a plurality of child programs are to the parent stimulation program;

applying each of a plurality of rules to the parent electrode configuration, each of the rules defining a respective electrode configuration modification based on at least one of proximity of active electrodes to each other, proximity of inactive electrodes to active electrodes, or number of active electrodes, wherein at least one aspect of the application of the rules to the parent electrode configuration is selected based on the indicated degree of program similarity; and

generating the plurality of child programs based on the application of the rules to the parent electrode configuration, wherein each of the child programs includes a respective child electrode configuration determined by application of one of the rules to the parent electrode configuration.

2. The method of claim 1, further comprising:

applying at least one of the rules to at least one of the child electrode configurations; and

generating at least one second generation child program based on the application of the rule to the child electrode configuration, the second generation child program including a second generation child electrode configuration.

3. The method of claim 1, further comprising:

based on the degree of program similarity, applying the rules to at least one of the parent electrode configuration or at least one of the child electrode configurations to generate Nth generation child programs, wherein a lower degree of program similarity corresponds to a larger N, and wherein N is selected based on the indicated degree of program similarity, and wherein N is greater than 1.

4. The method of claim 3, further comprising presenting only generated child programs of the Nth generation.

5. The method of claim 1, further comprising presenting the child programs to a user in a sequence.

6. The method of claim 5, further comprising scrolling through the sequence of child programs.

7. The method of claim 6, further comprising providing a user interface to allow the user to control at least one of the rate or direction of scrolling through the sequence of child programs.

8. The method of claim 6, further comprising automatically delivering stimulation according to current ones of the child programs during scrolling through the sequence of child programs.

9. The method of claim 1, further comprising:

delivering stimulation according to a first one of the child programs;

receiving input from a user adjusting an amplitude of the first child program to a final value;

automatically determining an initial value for an amplitude of a second one of the child programs based on the final value of the amplitude of the first child program; and

delivering stimulation according to the second child program including the determined initial value for the amplitude of the second child program.

10. The method of claim 9, wherein automatically determining an initial value comprises applying a predetermined percentage to the final value.

11. The method of claim 1, further comprising automatically determining an initial amplitude for one of the child programs based on the indicated degree of program similarity.

12. The method of claim 1, further comprising automatically determining an initial amplitude for one of the child programs based on at least one of perception or comfort thresholds for at least one of the parent program or previously delivered ones of the child programs.

13. The method of claim 1,

wherein selecting a parent stimulation program comprises selecting a parent program group, the parent program group including a plurality of parent stimulation programs, and each of the parent stimulation programs including a respective one of a plurality of parent electrode configurations,

wherein applying each of the plurality of rules to the parent electrode configuration comprises applying each of the plurality of rules to at least one of the parent electrode configurations, and

wherein generating a plurality of child programs comprises generating a plurality of child program groups based on the application of the rules to the parent electrode configuration.

14. The method of claim 13, further comprising providing the plurality of child program groups to at least one of an implantable medical device or a patient programming device for selection by a patient and delivery of therapy to the patient.

15. The method of claim 13, wherein applying each of the plurality of rules to the parent electrode configuration comprises applying each of the plurality of rules to a number of the parent electrode configurations selected based on the indicated degree of program similarity.

16. The method of claim 1, further comprising deleting any of the plurality of child programs that are duplicates.

17. The method of claim 16, further comprising tracking program use to identify duplicates over a plurality of programming sessions.

18. The method of claim 1, wherein one of the plurality of rules comprises placing one of an anode or a cathode as far from an active electrode as possible.

19. The method of claim 1, wherein one of the plurality of rules based on a number of active electrodes comprises removal of an anode when the parent electrode configuration comprises more than one anode.

20. The method of claim 1, wherein the plurality of applied rules are selected from amongst available rules based on the indicated degree of program similarity.

21. The method of claim 1, wherein generating the plurality of child programs comprises generating a plurality of generations of child programs in response to receiving the indication of the degree of program similarity.

22. A system comprising:

a memory that stores a plurality of rules, each of the rules defining a respective electrode configuration modification based on at least one of proximity of active electrodes to each other, proximity of inactive electrodes to active electrodes, or number of active electrodes; and

a processor that selects a parent stimulation program, the parent stimulation program including a parent electrode configuration, receives an indication of a degree of program similarity from a user via a user interface, the indication of the degree of program similarity being indicative of how similar a plurality of child programs are to the parent stimulation program, applies each of the plurality of rules to the parent electrode configuration, and generates the plurality of child programs based on the application of the rules to the parent electrode configuration, wherein;

at least one aspect of the application of the rules to the parent electrode configuration is selected based on the indicated degree of program similarity; and

each of the child programs includes a respective child electrode configuration determined by application of one of the rules to the parent electrode configuration.

23. The system of claim 22, wherein the processor applies at least one of the rules to at least one of the child electrode configurations, and generates at least one second generation child program based on the application of the rule to the child electrode configuration, the second generation child program including a second generation child electrode configuration.

24. The system of claim 22, wherein the processor, based on the degree of program similarity, applies the rules to at least one of the parent electrode configuration or at least one of the child electrode configurations to generate Nth generation child programs, wherein a lower degree of program similarity corresponds to a larger N, and wherein N is selected based on the indicated degree of program similarity, and wherein N is greater than 1.

25. The system of claim 22, wherein the processor presents the child programs to a user in a sequence via the user interface.

26. The system of claim 25, wherein the processor scrolls through the sequence of child programs.

27. The system of claim 26, wherein the user interface allows the user to control at least one of the direction or rate of scrolling through the sequence of child programs by the processor.

28. The system of claim 26, wherein the processor automatically controls delivery of stimulation by an implantable medical device according to current ones of the child programs during scrolling through the sequence of child programs.

29. The system of claim 22, wherein the processor controls delivery of stimulation by an implantable medical device according to a first one of the child programs, receives input from a user adjusting an amplitude of the first program to a final value via the user interface, automatically determines an initial value for an amplitude of a second one of the child programs based on the final value of the amplitude of the first child program, and controls the implantable medical device to deliver stimulation according to the second child program including the determined initial value for the amplitude of the second child program.

30. The system of claim 29, wherein the processor applies a predetermined percentage to the final value in order to determine the initial value.

31. The system of claim 22, wherein the processor automatically determines an initial amplitude for one of the child programs based on at least one of perception or comfort thresholds for at least one of the parent program or previously delivered ones of the child programs.

32. The system of claim 22, wherein the processor automatically determines an initial amplitude for one of the child programs based on the similarity of the child program to the parent program.

33. The system of claim 22, wherein the processor selects a parent program group, the parent program group including a plurality of parent stimulation programs, and each of the parent stimulation programs including a respective one of a plurality of parent electrode configurations, applies each of the plurality of rules to at least one of the parent electrode configurations, and generates a plurality of child program groups based on the application of the rules to the parent electrode configuration.

34. The system of claim 33, wherein the processor provides the plurality of child program groups to at least one of an implantable medical device or a patient programming device for selection by a patient and delivery of therapy to the patient.

35. The system of claim 22, wherein the processor deletes any of the plurality of child programs that are duplicates.

36. The system of claim 35, wherein the processor tracks program use to identify duplicates over a plurality of programming sessions.

37. The system of claim 22, further comprising a clinician programming device that includes the processor, the memory, a user interface and telemetry circuitry for communication with at least one of an implantable medical device or patient programming device.

38. A computer-readable storage medium comprising instructions that cause a programmable processor to:

select a parent stimulation program, the parent stimulation program including a parent electrode configuration;

receive an indication of a degree of program similarity from a user, the indication of the degree of program similarity being indicative of how similar a plurality of child programs are to the parent stimulation program;

apply each of a plurality of rules to the parent electrode configuration, each of the rules defining a respective electrode configuration modification based on at least one of proximity of active electrodes to each other, proximity of inactive electrodes to active electrodes, or number of active electrodes, wherein at least one aspect of the application of the rules to the parent electrode configuration is selected based on the indicated degree of program similarity; and

generate the plurality of child programs based on the application of the rules to the parent electrode configuration, wherein each of the child programs includes a respective child electrode configuration determined by application of one of the rules to the parent electrode configuration.

39. The computer-readable storage medium of claim 38, further comprising instructions that cause a programmable processor to:

apply at least one of the rules to at least one of the child electrode configurations; and

generate at least one second generation child program based on the application of the rule to the child electrode configuration, the second generation child program including a second generation child electrode configuration.

40. The computer-readable storage medium of claim 38, further comprising instructions that cause a programmable processor to, based on the degree of program similarity, apply the rules to at least one of the parent electrode configuration or at least one of the child electrode configurations to generate Nth generation child programs, wherein a lower degree of program similarity corresponds to a larger N, and wherein N is selected based on the indicated degree of program similarity, wherein N is greater than 1.

41. The computer-readable storage medium of claim 38, further comprising instructions that cause a programmable processor to present the child programs to a user in a sequence.

42. The computer-readable storage medium of claim 41, further comprising instructions that cause a programmable processor to scroll through the sequence of child programs.

43. The computer-readable storage medium of claim 42, further comprising instructions that cause a programmable processor to provide a user interface to allow the user to control at least one of the rate or direction of scrolling through the sequence of child programs.

44. The computer-readable storage medium of claim 42, further comprising instructions that cause a programmable processor to automatically control delivery stimulation according to current ones of the child programs during scrolling through the sequence of child programs.

45. The computer-readable storage medium of claim 38, further comprising instructions that cause a programmable processor to:

control delivery of stimulation according to a first one of the child programs;

receive input from a user adjusting an amplitude of the first child program to a final value;

automatically determine an initial value for an amplitude of a second one of the child programs based on the final value of the amplitude of the first child program; and

control delivery of stimulation according to the second child program including the determined initial value for the amplitude of the second child program.

46. A method comprising:

selecting a parent program group, the parent program group including a plurality of parent stimulation programs, and each of the parent stimulation programs including a respective one of a plurality of parent electrode configurations;

receiving an indication of a degree of program similarity from a user, the indication of the degree of program similarity being indicative of how similar a plurality of child programs are to the parent stimulation program;

applying a rule to each of the parent electrode configurations, the rule defining an electrode configuration modification based on at least one of proximity of active electrodes to each other, proximity of inactive electrodes to active electrodes, or number of active electrodes, wherein at least one aspect of the application of the rules to the parent electrode configuration is selected based on the indicated degree of program similarity; and

generating the plurality of child program groups based on the application of the rule to the parent electrode configurations, wherein each of the child program groups includes a respective child stimulation program and corresponding child electrode configuration determined by application of the rule to the parent electrode configuration.

47. A system comprising:

a memory that stores a rule that defines an electrode configuration modification based on at least one of proximity of active electrodes to each other, proximity of inactive electrodes to active electrodes, or number of active electrodes; and

a processor that selects a parent program group, the parent program group including a plurality of parent stimulation programs, and each of the parent stimulation programs including a respective one of a plurality of parent electrode configurations, receives an indication of a degree of program similarity from a user via a user interface, the indication of the degree of program similarity being indicative of how similar a plurality of child programs are to the parent stimulation program, applies the rule to each of the parent electrode configurations, and generates the plurality of child program groups based on the application of the rule to the parent electrode configurations, wherein;

at least one aspect of the application of the rules to the parent electrode configuration is selected based on the indicated degree of program similarity; and

each of the child program groups includes a respective child stimulation program and corresponding child electrode configuration determined by application of the rule to the parent electrode configuration.