Systems and methods for delivering neural therapy correlated with patient status

• US 9,199,083 B2
• Filed: 01/14/2013
• Issued: 12/01/2015
• Est. Priority Date: 02/10/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Caparso, Anthony V., Parker, Jon, Walker, Andre B., Chitre, Yougandh
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US13/740,917
• Publication Number:
  US 20130261694A1
• Time in Patent Office: 1,051 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36062 Spinal stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• 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 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Therapy systems for treating a patient are disclosed. Representative therapy systems include an implantable pulse generator, a signal delivery device electrically coupled to the pulse generator, and a remote control in electrical communication with the implantable pulse generator. The pulse generator can have a computer-readable medium containing instructions for performing a process that comprises collecting the patient status and stimulation parameter; analyzing the collected patient status and stimulation parameter; and establishing a preference baseline containing a preferred stimulation parameter corresponding to a particular patient status.

Claims

1. A method for treating a patient, comprising:

collecting a data set at an implantable pulse generator, wherein the data set includes;

a plurality of impedance profiles, with individual impedance profiles including impedance data from multiple contacts of an implanted lead; and

a plurality of values of a spinal cord stimulation parameter;

identifying a particular value of the spinal cord stimulation parameter that corresponds to one of the individual impedance profiles; and

based at least in part on receiving impedance data corresponding to the individual impedance profile, automatically applying a therapy signal having the particular value of the spinal cord stimulation parameter to a spinal cord region of the patient, wherein collecting the data set includes collecting a value of a capacitive component of an impedance, and collecting a value of a resistive component of the impedance.

2. A method for treating a patient, comprising:

collecting a data set at an implantable pulse generator, wherein the data set includes;

a plurality of impedance profiles, with individual impedance profiles including impedance data from multiple contacts of an implanted lead, and wherein the plurality of impedance profiles include capacitive impedance values; and

a plurality of values of a spinal cord stimulation parameter;

identifying a particular value of the spinal cord stimulation parameter that corresponds to one of the individual impedance profiles;

based at least in part on receiving impedance data corresponding to the individual impedance profile, automatically applying a therapy signal having the particular value of the spinal cord stimulation parameter to a spinal cord region of the patient; and

determining the status of a patient based at least in part on the capacitive impedance values.

3. The method of claim 2 wherein the individual impedance profiles correspond to different postures of the patient.

4. The method of claim 2 wherein the plurality of values of a spinal cord stimulation parameter include values of a spinal cord stimulation parameter input by the patient.

5. A method for treating a patient, comprising:

collecting a data set at an implantable pulse generator, wherein the data set includes;

a plurality of impedance profiles, with individual impedance profiles including impedance data from multiple contacts of an implanted lead wherein the plurality of impedance profiles include resistive impedance values; and

a plurality of values of a spinal cord stimulation parameter;

identifying a particular value of the spinal cord stimulation parameter that corresponds to one of the individual impedance profiles; and

based at least in part on receiving impedance data corresponding to the individual impedance profile, automatically applying a therapy signal having the particular value of the spinal cord stimulation parameter to a spinal cord region of the patient; and

determining the status of a patient based at least in part on the resistive impedance values.

6. A method for treating a patient, comprising:

collecting a data set at an implantable pulse generator, wherein the data set includes;

a plurality of impedance profiles, with individual impedance profiles including impedance data from multiple contacts of an implanted lead; and

a plurality of values of a spinal cord stimulation parameter;

identifying a particular value of the spinal cord stimulation parameter that corresponds to one of the individual impedance profiles;

determining the status of the patient based at least in part on

     1) the impedance data, and

     2) a signal from a sensing element; and

based at least in part on receiving impedance data corresponding to the individual impedance profile, automatically applying a therapy signal having the particular value of the spinal cord stimulation parameter to a spinal cord region of the patient, wherein automatically applying a therapy signal is based on the determination of the status of the patient.

7. The method of claim 6 wherein the sensing element comprises a gyroscope.

8. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply a therapy signal to a spinal cord region of the patient, wherein the implantable pulse generator includes a memory to store therapy signal parameters and to store impedance data from a plurality of circuits, wherein individual circuits include at least one of the contacts, wherein the impedance data include values of capacitive impedance and values of resistive impedance, and wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

analyzing the stored therapy signal parameters and stored impedance data, wherein analyzing the stored impedance data includes determining a rate of change of impedance for at least one individual circuit; and

establishing a particular value of a particular therapy signal parameter corresponding to particular stored impedance data.

9. The therapy system of claim 8 wherein the impedance data comprise an impedance profile having a plurality of impedance values, with individual impedance values associated with corresponding individual circuits, and wherein the individual impedance values include a value of a resistive component and a value of a capacitive component.

10. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply a therapy signal to a spinal cord region of the patient, wherein the implantable pulse generator includes a memory to store therapy signal parameters and to store impedance data from a plurality of circuits, wherein individual circuits include at least one of the contacts, and wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

analyzing the stored therapy signal parameters and stored impedance data; and

establishing a particular value of a particular therapy signal parameter corresponding to particular stored impedance data, wherein the impedance data include an impedance profile having values of capacitive impedance, and wherein the values of capacitive impedance correspond to a posture of the patient.

11. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply a therapy signal to a spinal cord region of the patient, wherein the implantable pulse generator includes a memory to store therapy signal parameters and to store impedance data from a plurality of circuits, wherein individual circuits include at least one of the contacts, and wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

analyzing the stored therapy signal parameters and stored impedance data; and

establishing a particular value of a particular therapy signal parameter corresponding to particular stored impedance data, wherein the impedance data include an impedance profile having values of resistive impedance, and wherein the values of resistive impedance correspond to a posture of the patient.

12. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply a therapy signal to a spinal cord region of the patient, wherein the implantable pulse generator includes a memory to store therapy signal parameters and to store impedance data from a plurality of circuits, wherein individual circuits include at least one of the contacts, and wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

analyzing the stored therapy signal parameters and stored impedance data;

establishing a particular value of a particular therapy signal parameter corresponding to particular stored impedance data, wherein the impedance data include a plurality of values of capacitive impedance; and

receiving data corresponding to the plurality of values of capacitive impedance and automatically applying a therapy signal having the particular value of the particular therapy signal parameter.

13. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply a therapy signal to a spinal cord region of the patient, wherein the implantable pulse generator includes a memory to store therapy signal parameters and to store impedance data from a plurality of circuits, wherein individual circuits include at least one of the contacts, and wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

analyzing the stored therapy signal parameters and stored impedance data;

establishing a particular value of a particular therapy signal parameter corresponding to particular stored impedance data, wherein the impedance data include a plurality of values of resistive impedance; and

receiving data corresponding to the plurality of values of resistive impedance and automatically applying a therapy signal having the particular value of the particular therapy signal parameter.

14. An implantable pulse generator for treating a spinal cord region of a patient, the implantable pulse generator comprising:

a database module programmed to organize and store impedance data and stimulation parameters; and

a processing module programmed to analyze the stored impedance data and the stimulation parameters and establish a baseline containing a particular stimulation parameter corresponding to particular impedance data, wherein the impedance data include values of capacitive impedance and values of resistive impedance.

15. The implantable pulse generator of claim 14 wherein the processing module is further programmed to establish a patient status value based at least partially on the impedance data and corresponding to a patient activity.

16. The implantable pulse generator of claim 14 wherein the processing module is further programmed to establish a patient status value based at least partially on the impedance data and corresponding to a patient posture.

17. The implantable pulse generator of claim 14 wherein the impedance data include values of impedance as a function of time, and wherein the particular stimulation parameter corresponds to an activity of the patient.