Systems and methods for controlling spinal cord stimulation to improve stimulation efficacy for use by implantable medical devices
First Claim
1. A method for use with an implantable medical system for implant within a patient, the method comprising:
- delivering neurostimulation to the patient using the implantable system;
sensing spinal cord nerve impulse signals in response to the neurostimulation;
measuring a power spectral density (PSD) parameter of a heart rate variability (HRV) parameter using a cardiac sensing lead implanted within the patient and assessing patient mood based on the PSD of the HRV;
analyzing the spinal cord nerve impulse signals to determine whether the signals are indicative of effective neurostimulation sufficient to improve patient mood; and
controlling the delivery of additional neurostimulation based on the spinal cord nerve impulse signals and the assessed patient mood based on the PSD of the HRV to adjust neurostimulation efficacy to improve patient mood.
1 Assignment
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Accused Products
Abstract
Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HRV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described.
51 Citations
24 Claims
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1. A method for use with an implantable medical system for implant within a patient, the method comprising:
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delivering neurostimulation to the patient using the implantable system; sensing spinal cord nerve impulse signals in response to the neurostimulation; measuring a power spectral density (PSD) parameter of a heart rate variability (HRV) parameter using a cardiac sensing lead implanted within the patient and assessing patient mood based on the PSD of the HRV; analyzing the spinal cord nerve impulse signals to determine whether the signals are indicative of effective neurostimulation sufficient to improve patient mood; and controlling the delivery of additional neurostimulation based on the spinal cord nerve impulse signals and the assessed patient mood based on the PSD of the HRV to adjust neurostimulation efficacy to improve patient mood. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An implantable medical system for implant within a patient, the system comprising:
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a neurostimulation delivery system operative to deliver neurostimulation to the patient; a spinal cord nerve impulse signal sensing system operative to sense spinal cord nerve impulse signals in response to the neurostimulation; a detector operative to measure a power spectral density (PSD) of a heart rate variability (HRV) parameter using a cardiac sensing lead implanted within the patient and to assess patient mood based op the PSD of the HRV; a spinal cord nerve impulse signals analysis system operative to analyze the spinal cord nerve impulse signals to determine whether the signals are indicative of effective neurostimulation sufficient to improve patient mood; and a neurostimulation control system operative to control the delivery of additional neurostimulation based on the spinal cord nerve impulse signals and the assessed patient mood based on the PSD of the HRV to adjust neurostimulation efficacy to improve patient mood. - View Dependent Claims (20, 21)
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22. A system for use with an implantable spinal cord stimulation (SCS) device for implant within a patient, the method comprising:
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means for delivering neurostimulation to the patient using the implantable system; means for sensing spinal cord nerve impulse signals in response to the neurostimulation; means for measuring a power spectral density (PSD) of a heart rate variability (HRV) parameter using a cardiac sensing lead implanted within the patient and means for assessing patient mood based on the PSD of the HRV; means for analyzing the spinal cord nerve impulse signals to determine whether the signals are indicative of effective neurostimulation sufficient to improve patient mood; and means for controlling the delivery of additional neurostimulation based on the spinal cord nerve impulse signals and the assessment of patient mood based on the PSD of the HRV to adjust neurostimulation efficacy to improve patient mood. - View Dependent Claims (23)
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24. A method for use with an implantable medical system that includes a spinal cord stimulation (SCS) device for implant within a patient, the method comprising:
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delivering SCS to the patient using the implantable system; sensing spinal cord nerve impulse signals in response to the SCS; measuring cardiac electrical parameters using a sensing lead implanted within the patient, wherein the cardiac electrical parameters include heart rate variability (HRV) parameters including parameters representative of a power spectral density (PSD) of HRV and including one or more of a target PSD pattern indicative of a positive patient mood and a baseline PSD pattern indicative of a negative patient mood; analyzing the spinal cord nerve impulse signals to determine whether the signals are indicative of effective SCS sufficient to improve patient mood; and controlling the delivery of additional SCS based on the spinal cord nerve impulse signals and the target PSD pattern to adjust SCS efficacy to improve patient mood.
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Specification