Patient posture determination and stimulation program adjustment in an implantable stimulator device using impedance fingerprinting

• US 9,446,243 B2
• Filed: 09/11/2013
• Issued: 09/20/2016
• Est. Priority Date: 12/07/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Marnfeldt, Goran N., Parramon, Jordi
• Primary Examiner(s): Gedeon, Brian T
• Assistant Examiner(s): Tejani, Ankit D
• Application Number:
  US14/024,276
• Publication Number:
  US 20140163638A1
• Time in Patent Office: 1,105 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

Methods and circuitry for determining an implanted-neurostimulator patient'"'"'s position, and adjusting a situation program delivered by the neurostimulator based on the determined position, is disclosed. Impedance measurements of the patient'"'"'s tissue are taken at the neurostimulator'"'"'s electrodes, which measurements can comprise complex impedance measurements (magnitude and phase) taken at different frequencies. Such impedance measurements, which can be taken interleaved with stimulation therapy, are used to determine an “impedance fingerprint.” This fingerprint can be compared to other known fingerprints stored in the IPG, which known fingerprints are associated with particular stimulation programs. When a measured fingerprint matches one stored in the IPG, the stimulation program associated with the stored fingerprint is automatically used for patient therapy. As different measured fingerprints are encountered, the IPG can learn and store a new stimulation program for such fingerprint by remembering stimulation parameters selected by the patient when such fingerprint is encountered.

Claims

1. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation to a patient; and

circuitry comprising an impedance algorithm configured to determine an impedance between a plurality of combinations of the electrodes at a plurality of different frequencies during quiet periods when the electrical stimulation at a first frequency is not occurring, and to determine a measured impedance fingerprint from the determined impedances,

wherein the impedance algorithm is further configured to select a stimulation program to be provided to the electrodes in accordance with the measured impedance fingerprint.

2. The device of claim 1, wherein the determined impedances are complex impedances.

3. The device of claim 1, further comprising a database configured to store a plurality of pre-determined impedance fingerprints and a plurality of associated stimulation programs, wherein the measured impedance fingerprint is compared to pre-determined impedance fingerprints to select the stimulation program.

4. The device of claim 3, wherein the plurality of pre-determined impedance fingerprints are stored in the database during a fitting procedure.

5. The device of claim 3, wherein the plurality of pre-determined impedance fingerprints are learned as the electrical stimulation is provided to the patient.

6. The device of claim 1, wherein the selected stimulation program comprises one or more stimulation parameters, including which electrodes are active, a polarity of the active electrodes, a magnitude of the electrical stimulation at the active electrodes, a duration of the electrical stimulation, and a frequency of the electrical stimulation.

7. The device of claim 1, wherein the impedance algorithm provides a measurement signal to the plurality of combinations of the electrodes, and assesses responses to the measurement signals, to determine the impedances between the plurality of combinations of the electrodes.

8. The device of claim 7, wherein the measurement signals comprise AC currents, and the responses comprise AC voltages between the plurality of combinations of the electrodes.

9. The device of claim 1, wherein the measured impedance fingerprint comprises values of electrical components in a tissue model between the plurality of combinations of the electrodes.

10. The device of claim 1, wherein the measured impedance fingerprint is indicative of a posture of the patient.

11. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation to a patient;

circuitry comprising an impedance algorithm configured to determine an impedance between a plurality of combinations of the electrodes at a plurality of different frequencies during quiet periods when the electrical stimulation at a first frequency is not occurring, and to determine a measured impedance fingerprint from the determined impedances; and

a database configured to store a plurality of pre-determined impedance fingerprints and a plurality of associated stimulation programs,

wherein the impedance algorithm is further configured to match the measured impedance fingerprint with a pre-determined impedance fingerprint in the database, and to select the stimulation program associated with that pre-determined fingerprint to be provided to the electrodes.

12. The device of claim 11, wherein the determined impedances are complex impedances.

13. The device of claim 11, wherein the plurality of pre-determined impedance fingerprints and the plurality of associated stimulation programs are stored in the database during a fitting procedure.

14. The device of claim 11, wherein the plurality of pre-determined impedance fingerprints and the plurality of associated stimulation programs are learned as the electrical stimulation is provided to the patient.

15. The device of claim 11, wherein the selected stimulation program comprises one or more stimulation parameters, including which electrodes are active, a polarity of the active electrodes, a magnitude of the electrical stimulation at the active electrodes, a duration of the electrical stimulation, and a frequency of the electrical stimulation.

16. The device of claim 11, wherein the circuitry comprising the impedance algorithm provides a measurement signal to the plurality of combinations of the electrodes, and assesses responses to the measurement signals, to determine the impedances between the plurality of combinations of the electrodes.

17. The device of claim 16, wherein the measurement signals comprise AC currents, and the responses comprise AC voltages between the plurality of combinations of the electrodes.

18. The device of claim 11, wherein the measured and pre-determined impedance fingerprints comprise values of electrical components in a tissue model between the plurality of combinations of the electrodes.

19. The device of claim 11, wherein the measured and pre-determined impedance fingerprints are indicative of a posture of the patient.

20. The device of claim 19, wherein the database further stores a textual description of the posture with at least some of the pre-determined impedance fingerprints.

21. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation to a patient;

circuitry comprising an impedance algorithm configured to periodically determine an impedance between a plurality of combinations of the electrodes at a plurality of different frequencies during quiet periods when the electrical stimulation at a first frequency is not occurring, and to determine a measured impedance fingerprint from the determined impedances;

a log configured to store the measured impedance fingerprints; and

a database, wherein the impedance algorithm is further configured to assess the log to identify an impedance fingerprint from the measured impedance fingerprints, and to store that identified impedance fingerprint in a database.

22. The device of claim 21, wherein the determined impedances are complex impedances.

23. The device of claim 21, wherein the identified impedance fingerprint is associated with a stimulation program stored in the database.

24. The device of claim 23, wherein the stimulation program associated with the identified impedance fingerprint in the database comprises (i) default or currently-pending settings associated with the identified in impedance fingerprint, (ii) an average of the stimulation programs associated with the identified impedance fingerprint in the log, or (iii) a last stimulation program associated with the identified impedance fingerprint.

25. The device of claim 23, wherein the stimulation program comprises one or more stimulation parameters, including which electrodes are active, a polarity of the active electrodes, a magnitude of the electrical stimulation at the active electrodes, a duration of the electrical stimulation, and a frequency of the electrical stimulation.

26. The device of claim 21, wherein the circuitry comprising the impedance algorithm provides a measurement signal to the plurality of combinations of the electrodes, and assesses responses to the measurement signals, to determine the impedances between the plurality of combinations of the electrodes.

27. The device of claim 21, wherein the identified impedance fingerprint comprises values of electrical components in a tissue model between the plurality of combinations of the electrodes.

28. The device of claim 21, wherein the identified impedance fingerprint is indicative of a posture of the patient.

29. The device of claim 21, wherein the identified impedance fingerprint is identified by its frequency in the log.

30. The device of claim 29, wherein the identified impedance fingerprint'"'"'s frequency in the log is determined using statistical metrics.

31. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation to a patient; and

circuitry comprising an impedance algorithm configured to determine a complex impedance at a plurality of frequencies between at least two of the electrodes during quiet periods when the electrical stimulation at a first frequency is not occurring, wherein the impedance algorithm is further configured to use the determined complex impedances to determine values of electrical components in a tissue model between the two electrodes.

32. The device of claim 31, further comprising a conductive case, and wherein one of the at least two electrodes comprises the case.

33. The device of claim 31, further comprising a lead, wherein at least one of the at least two electrodes is positioned on the lead.

34. The device of claim 31, wherein the circuitry comprising the impedance algorithm provides a measurement signal to the at least two electrodes, and assesses responses to the measurement signals, to determine the impedances between the at least two electrodes.

35. The device of claim 34, wherein the measurement signals comprise AC currents, and the responses comprise AC voltages between the at least two electrodes.

36. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide stimulation to a patient; and

impedance monitoring circuitry for providing a plurality of measurement signals at different frequencies between at least two of the electrodes and for measuring responses between the at least two electrodes in response to the measurement signals during quiet periods when the electrical stimulation at a first frequency is not occurring,

the impedance monitoring circuitry further comprising an impedance algorithm for determining the complex impedance between at least the two electrodes using the measurement signals and the measured responses.

37. The device of claim 36, further comprising a conductive case, and wherein one of the at least two electrodes comprises the case.

38. The device of claim 36, further comprising a lead, wherein at least one of the at least two electrodes is positioned on the lead.