Use of stimulation pulse shape to control neural recruitment order and clinical effect

• US 9,238,138 B2
• Filed: 09/13/2011
• Issued: 01/19/2016
• Est. Priority Date: 07/20/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Lee, Dongchul, Moffitt, Michael, Gillespie, Christopher Ewan, Bradley, Kerry
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US13/231,493
• Publication Number:
  US 20120004707A1
• Time in Patent Office: 1,589 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36038 Cochlear stimulation
• CPC Class Codes: A61N 1/36046 of the eye
• 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 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/378 Electrical supply
• CPC Class Codes: A61N 1/3787 from an external energy source
• CPC Class Codes: A61N 1/3906 characterised by the form of the shockwave

Abstract

A method, electrical tissue stimulation system, and programmer for providing therapy to a patient are provided. Electrodes are placed adjacent tissue (e.g., spinal cord tissue) of the patient, electrical stimulation energy is delivered from the electrodes to the tissue in accordance with a defined waveform, and a pulse shape of the defined waveform is modified, thereby changing the characteristics of the electrical stimulation energy delivered from the electrode(s) to the tissue. The pulse shape may be modified by selecting one of a plurality of different pulse shape types or by adjusting a time constant of the pulse shape.

Claims

1. An implantable electrical tissue stimulation system, comprising:

one or more electrical terminals configured for being coupled to one or more stimulation leads;

output stimulation circuitry configured for outputting electrical stimulation energy to the one or more electrical terminals in accordance with a defined waveform; and

control circuitry configured for receiving a user input specifying one of a negatively sloping pulse and a positively sloping pulse, the control circuitry further configured for modifying a pulse shape of the defined waveform by selecting the specified one of the negatively sloping pulse and the positively sloping pulse, thereby changing the characteristics of the electrical stimulation energy outputted to the one or more electrical terminals.

2. The electrical stimulation system of claim 1, wherein the negatively sloping pulse is a negatively sloping exponential pulse, and the positively sloping pulse is a positively sloping exponential pulse.

3. The electrical stimulation system of claim 1, wherein the negatively sloping pulse is a negatively sloping linear ramp pulse, and the positively sloping pulse is a positively sloping linear ramp pulse.

4. The electrical stimulation system of claim 1, wherein the control circuitry is configured for modifying a pulse shape of the defined waveform and at least one other pulse parameter dependent on each other in response to the user input.

5. The electrical stimulation system of claim 4, wherein the control circuitry is configured for modifying the at least one other pulse parameter in response to the modification of the pulse shape to maintain a substantially uniform charge of the electrical stimulation energy.

6. The electrical stimulation system of claim 1, further comprising monitoring circuitry configured for measuring one or more electrical characteristics of the tissue, wherein the control circuitry is configured for modifying the pulse shape based on the measured one or more electrical characteristics.

7. The electrical stimulation system of claim 6, wherein the control circuitry is configured for modifying the pulse shape in response to a change in the measured one or more electrical characteristics.

8. The electrical stimulation system of claim 1, wherein the output stimulation circuitry comprises a plurality of different analog shaping circuits, and the control circuitry is configured for modifying the pulse shape by selecting one of the different analog shaping circuits.

9. The electrical stimulation system of claim 1, wherein the control circuitry is configured for modifying the pulse shape by adjusting a characteristic of at least one analog electrical component in the output stimulation circuitry.

10. The electrical stimulation system of claim 1, wherein the defined waveform is formed of a stepwise function of amplitude levels or sub-pulse durations, and wherein the control circuitry is configured for modifying the pulse shape by adjusting the amplitude levels or sub-pulse durations.

11. The electrical stimulation system of claim 1, further comprising a stimulation lead carrying at least one electrode electrically coupled to the one or more electrical terminals.

12. The electrical stimulation system of claim 1, further comprising memory capable of storing a parameter defining the pulse shape.

13. The electrical stimulation system of claim 1, further comprising telemetry circuitry capable of wirelessly receiving instructions from an external programmer to modify the pulse shape.

14. The electrical stimulation system of claim 1, further comprising a case containing the one or more electrical terminals, output stimulation circuitry, and control circuitry to form a neurostimulator.

15. The electrical stimulation system of claim 14, wherein the neurostimulator is implantable.

16. The electrical stimulation system of claim 1, wherein at least a portion of the negatively sloping pulse has an absolute magnitude that decreases relative to time, and at least a portion of the positively sloping pulse has an absolute magnitude that increases relative to time.

17. The electrical stimulation system of claim 1, wherein the negatively sloping pulse and the positively sloping pulse have the same polarity.

18. A programmer for a neurostimulator, comprising:

a user interface capable of receiving an input from a user that specifies one of a negatively sloping pulse and a positively sloping pulse;

a processor configured for generating a plurality of stimulation parameter sets defining a plurality of different pulse shapes by selecting the specified one of the negatively sloping pulse and the positively sloping pulse; and

output circuitry configured for transmitting the plurality of stimulation parameter sets to the neurostimulator.

19. The programmer of claim 18, wherein the negatively sloping pulse is a negatively sloping exponential pulse, and the positively sloping pulse is a positively sloping exponential pulse.

20. The programmer of claim 18, wherein the negatively sloping pulse is a negatively sloping linear ramp pulse, and the positively sloping pulse is a positively sloping linear ramp pulse.

21. The programmer of claim 18, wherein the processor is configured for defining the plurality of different pulse shapes and other pulse parameters in each stimulation parameter set dependent on each other.

22. The programmer of claim 21, wherein the processor is configured for defining at least one of the other pulse parameters in response to the definition of the pulse shape to maintain a substantially uniform charge between the respective stimulation parameter sets.

23. The programmer of claim 18, wherein the processor is configured for defining the plurality of different pulse shapes based on one or more measured electrical characteristics of tissue.

24. The programmer of claim 23, wherein the processor is configured for defining the plurality of different pulse shapes in response to a change in the measured one or more electrical characteristics.

25. The programmer of claim 18, wherein the user interface comprises an actuator, and wherein the processor is configured for generating the plurality of stimulation parameter sets in response to actuation of the actuator.

26. The programmer of claim 25, wherein the processor is configured for defining the plurality of different pulse shapes in response to actuation of the actuator.

27. The programmer of claim 18, wherein the output circuitry is telemetry circuitry capable of wirelessly transmitting the plurality of stimulation parameter sets to the neurostimulator.

28. The programmer of claim 18, wherein at least a portion of the negatively sloping pulse has an absolute magnitude that decreases relative to time, and at least a portion of the positively sloping pulse has an absolute magnitude that increases relative to time.

29. The programmer of claim 18, wherein the negatively sloping pulse and the positively sloping pulse have the same polarity.