Neurostimulation system and method for providing therapy to patient with minimal side effects

• US 8,731,675 B2
• Filed: 10/05/2011
• Issued: 05/20/2014
• Est. Priority Date: 10/06/2010
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Hershey, Bradley L., Bradley, Kerry, Ranu, Emarit A. S.
• Primary Examiner(s): PATTON, AMANDA K
• Application Number:
  US13/253,735
• Publication Number:
  US 20120089200A1
• Time in Patent Office: 958 Days
• Field of Search: 607 45- 46
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode

Abstract

A method comprises conveying a pulsed waveform between an electrode and a stimulation site of a spinal cord, thereby evoking the antidromic propagation of action potentials along a first sensory neural fiber creating a therapeutic effect in the tissue region, evoking the orthodromic propagation of action potentials along the first sensory neural fiber potentially creating paresthesia corresponding to the tissue region, and evoking the antidromic propagation of action potentials along a second sensory neural fiber potentially creating a side-effect in another tissue region. The method further comprises conveying electrical energy between an electrode and a blocking site rostral to the stimulation site, thereby blocking the action potentials propagated along the first sensory neural fiber and reducing the paresthesia, and conveying electrical energy between an electrode and a blocking site caudal to the stimulation site, thereby blocking the action potentials propagated along the second sensory neural fiber and reducing the side-effect.

Claims

1. A method of providing therapy to a tissue region of a patient using first and second electrodes, comprising:

conveying an electrical pulsed waveform between the first electrode and a stimulation site of a spinal cord of the patient, thereby evoking the antidromic propagation of action potentials along at least one sensory neural fiber of the spinal cord that creates a therapeutic effect in the tissue region, and evoking the orthodromic propagation of action potentials along the at least one sensory neural fiber that potentially creates a sensation of paresthesia in the brain of the patient corresponding to the tissue region; and

conveying electrical energy between the second electrode and a blocking site of the spinal cord rostral to the stimulation site, thereby blocking the orthodromically propagated action potentials and reducing the paresthesia that would have otherwise been caused in the patient in the absence of the conveyed electrical energy.

2. The method of claim 1, wherein the electrical pulsed waveform between the first electrode and the stimulation site evokes the antidromic propagation of action potentials along at least another sensory neural fiber of the spinal cord that potentially creates a side-effect in another tissue region of the patient, the method further comprising conveying additional electrical energy between a third electrode and a blocking site of the spinal cord caudal to the stimulation site, thereby blocking the action potentials propagated along the at least other sensory neural fiber and reducing the side-effect that would have otherwise been caused in the patient in the absence of the additionally conveyed electrical energy.

3. The method of claim 2, wherein the side-effect is involuntary motor movement of the other tissue region.

4. The method of claim 1, wherein the action potentials antidromically propagated along the at least one sensory neuron reduce, via interneuronal interaction in a dorsal horn of the patient, antidromic propagation of action potentials in sensory neural fibers in the spinal cord innervating the tissue region.

5. The method of claim 1, wherein the therapeutic effect is pain relief.

6. The method of claim 1, wherein the electrical energy is sinusoidal.

7. The method of claim 6, wherein the sinusoidal energy has a frequency greater than a pulse rate of the electrical pulsed waveform.

8. The method of claim 7, wherein the pulse rate of the electrical pulsed waveform is within a range of 2 Hz-1200 Hz, and the frequency of the sinusoidal energy is greater than 1200 Hz.

9. The method of claim 8, wherein the frequency of the electrical energy is equal to or greater than 2000 Hz.

10. The method of claim 1, wherein the at least one sensory neural fiber is a plurality of sensory neural fibers.

11. The method of claim 1, wherein the blocking of the orthodromically propagated potentials eliminates the paresthesia that would have otherwise been caused in the patient in the absence of the conveyed electrical energy.

12. A method of providing therapy to a tissue region of a patient using first and second electrodes, comprising:

conveying an electrical pulsed waveform between the first electrode and a stimulation site of a spinal cord of the patient, thereby evoking the antidromic propagation of action potentials along at least a first sensory neural fiber of the spinal cord that creates a therapeutic effect in the tissue region, and evoking the antidromic propagation of action potentials along at least another sensory neural fiber of the spinal cord that potentially creates a side-effect in another tissue region, wherein the at least first sensory neural fiber terminates in a dorsal horn of the spinal cord at a first vertebral level, and the at least second sensory neural fiber terminates in the dorsal horn at a second vertebral level caudal to the first vertebral level; and

conveying electrical energy between the second electrode and a blocking site of the spinal cord between the first and second vertebral levels, thereby blocking the action potentials antidromically propagating along the at least second sensory neural fiber and reducing the side-effect that would have otherwise been caused in the patient in the absence of the conveyed electrical energy.

13. The method of claim 12, wherein the electrical pulsed waveform between the first electrode and the stimulation site evokes the orthodromic propagation of action potentials along the at least one sensory neural fiber that potentially creates a sensation of paresthesia in the brain of the patient corresponding to the tissue region, the method further comprising conveying additional electrical energy between a third electrode and a blocking site of the spinal cord rostral to the stimulation site, thereby blocking the orthodromically propagated action potentials and reducing the paresthesia that would have otherwise been caused in the patient in the absence of the conveyed electrical energy.

14. The method of claim 12, wherein the side-effect is involuntary motor movement of the other tissue region.

15. The method of claim 12, wherein the action potentials antidromically propagated along the at least one sensory neural fiber reduce, via interneuronal interaction in the dorsal horn of the patient, antidromic propagation of action potentials in sensory neural fibers in the spinal cord innervating the tissue region.

16. The method of claim 12, wherein the therapeutic effect is pain relief.

17. The method of claim 12, wherein the electrical energy is sinusoidal.

18. The method of claim 17, wherein the sinusoidal energy has a frequency greater than a pulse rate of the electrical pulsed waveform.

19. The method of claim 18, wherein the pulse rate of the electrical pulsed waveform is within a range of 2 Hz-1200 Hz, and the frequency of the sinusoidal energy is greater than 1200 Hz.

20. The method of claim 19, wherein the frequency of the electrical energy is equal to or greater than 2000 Hz.

21. The method of claim 12, wherein the at least one sensory fiber is a plurality of sensory neural fiber.

22. The method of claim 12, wherein the blocking of the action potentials antidromically propagated along the at least second sensory neural fiber eliminates the side-effect that would have otherwise been caused in the patient in the absence of the conveyed electrical energy.