System and method for using impedance to determine proximity and orientation of segmented electrodes

• US 9,511,229 B2
• Filed: 06/26/2012
• Issued: 12/06/2016
• Est. Priority Date: 06/28/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Bradley, Kerry
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US13/533,532
• Publication Number:
  US 20130006324A1
• Time in Patent Office: 1,624 Days
• Field of Search: 607/45, 607/46, 607/62, 607/116, 607/117
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/068 using impedance sensors
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

A method for implanting a neurostimulation lead within a patient includes measuring impedances of electrodes on the lead in order to correctly position the lead relative to a target tissue region. The electrodes are circumferentially segmented electrodes that are spaced from each other about the longitudinal axis of the lead. When the difference between the impedances of the electrodes exceeds a threshold value, the lead is in the correct position. In accordance with another embodiment, impedance measurements are used to select which one of the electrodes is closest to the target tissue region. By determining which electrode has the highest impedance and which electrode has the lowest impedance, the type of tissue adjacent to each electrode can be determined based on the conductivity properties of the tissue. The target tissue region may be a spinal cord, a posterior longitudinal ligament, white matter, or gray matter.

Claims

1. A system for providing therapy to a patient, the system for use with a neurostimulation lead positioned relative to a target tissue region having different conductive properties than other tissue proximate the neurostimulation lead, the neurostimulation lead having a longitudinal axis and an electrode ring segmented into two segmented electrodes circumferentially spaced from each other about the longitudinal axis, the system comprising:

an impedance monitor configured for being coupled to the segmented electrodes and for measuring an impedance for each of the segmented electrodes to provide impedance data for each of the segmented electrodes, the impedance data for each of the segmented electrodes being dependent on conductive properties of tissue proximate to the segmented electrode;

a processor configured for analyzing the impedance data for each of the segmented electrodes to select the segmented electrode from the two segmented electrodes of the electrode ring that is closest to the target tissue region; and

a controller configured for instructing a neurostimulator to convey electrical stimulation energy from the selected segmented electrode.

2. The system of claim 1, wherein the processor is configured for selecting the segmented electrode that is closest to the target tissue region by selecting the segmented electrode from the two segmented electrodes of the electrode ring that has a lower impedance.

3. The system of claim 1, wherein the processor is configured for selecting the segmented electrode that is closest to the target tissue region by selecting the segmented electrode from the two segmented electrodes of the electrode ring that has a higher impedance.

4. The system of claim 1, wherein the neurostimulation lead is implanted within a ventral portion of an epidural space of the patient, wherein the target tissue region is a posterior longitudinal ligament, and wherein the processor is configured for selecting the segmented electrode that is closer to the posterior longitudinal ligament by selecting the segmented electrode from the two segmented electrodes of the electrode ring that has a higher impedance.

5. The system of claim 1, wherein the neurostimulation lead is implanted within an epidural space of the patient, wherein the target tissue region is a spinal cord of the patient, and wherein the processor is configured for selecting the segmented electrode that is closer to the spinal cord by selecting the segmented electrode from the two segmented electrodes of the electrode ring that has a lower impedance.

6. The system of claim 1, wherein the neurostimulation lead is implanted within a brain of the patient with one of the segmented electrodes of the electrode ring adjacent to white matter and the other segmented electrode of the electrode ring adjacent to gray matter, and-wherein the target tissue region is one of the white matter and the gray matter.

7. The system of claim 1, wherein the neurostimulation lead is implanted between a spinal cord and a dura, wherein the target tissue region is the spinal cord, and wherein the processor is configured for selecting the electrode closest to the spinal cord by selecting the segmented electrode in the electrode ring that has the higher impedance.

8. A system for providing therapy to a patient, the system for use with a neurostimulator and with a neurostimulation lead positioned relative to a target tissue region having different conductive properties than other tissue proximate the neurostimulation lead, the neurostimulation lead having a longitudinal axis and a circumference, and at least two segmented electrodes circumferentially spaced from each other around the circumference of the lead such that one of the segmented electrodes is closest to the target tissue region, the system comprising:

an impedance monitor configured to be operably connected to the neurostimulation lead to perform an impedance measurement for each of the segmented electrodes to provide impedance data for each of the segmented electrodes, the impedance data for each of the segmented electrodes being dependent on conductive properties of tissue proximate to the segmented electrode;

a processor configured to compare the impedance data to identify and select the segmented electrode closest to the target tissue region; and

a controller configured to instruct the neurostimulator to deliver electrical stimulation energy to the target tissue region using the selected segmented electrode.

9. The system of claim 8, wherein the targeted tissue region has a higher conductivity than tissue surrounding the targeted tissue region, and the processor is configured to compare the impedance measurements to determine which of the at least two segmented electrodes has a lowest impedance measurement in order to select the segmented electrode closest to the target tissue region.

10. The system of claim 9, wherein the neurostimulation lead is within an epidural space of the patient, and the target tissue region is a spinal cord of the patient.

11. The system of claim 9, wherein the target tissue region is gray matter.

12. The system of claim 8, wherein the targeted tissue region has a lower conductivity than tissue surrounding the targeted tissue region, and the processor is configured to compare the impedance measurements to determine which of the at least two segmented electrodes has a highest impedance measurement in order to select the segmented electrode closest to the target tissue region.

13. The system of claim 12, wherein the target tissue region is a posterior longitudinal ligament.

14. The system of claim 12, wherein the target tissue region is white matter.

15. The system of claim 12, wherein the neurostimulation lead is between a spinal cord and a dura, wherein the target tissue region is the spinal cord.

16. A system, comprising:

a neurostimulation lead positioned relative to a target tissue region having different conductive properties than other tissue proximate the neurostimulation lead, the neurostimulation lead having a longitudinal axis and a circumference, and at least two segmented electrodes circumferentially spaced from each other around the circumference of the lead;

an impedance monitor configured to be operably connected to the neurostimulation lead to perform an impedance measurement for each of the segmented electrodes to provide impedance data for each of the segmented electrodes, the impedance data for each of the segmented electrodes being dependent on conductive properties of tissue proximate to the segmented electrode;

a processor configured to compare the impedance data to identify and select a segmented electrode closest to the target tissue region;

a neurostimulator configured to be operably connected the neurostimulation lead; and

a controller configured to instruct the neurostimulator to deliver electrical stimulation energy to the target tissue region using the selected segmented electrode.

17. The system of claim 16, wherein the targeted tissue region has a higher conductivity than tissue surrounding the targeted tissue region, and the processor is configured to compare the impedance measurements to determine which of the at least two segmented electrodes has a lowest impedance measurement in order to select the segmented electrode closest to the target tissue region.

18. The system of claim 17, wherein the neurostimulation lead is within an epidural space of the patient, and the target tissue region is a spinal cord of the patient.

19. The system of claim 17, wherein the target tissue region is gray matter.

20. The system of claim 16, wherein the targeted tissue region has a lower conductivity than tissue surrounding the targeted tissue region, and the processor is configured to compare the impedance measurements to determine which of the at least two segmented electrodes has a highest impedance measurement in order to select the segmented electrode closest to the target tissue region.

21. The system of claim 20, wherein the target tissue region is a posterior longitudinal ligament.

22. The system of claim 20, wherein the target tissue region is white matter.

23. The system of claim 20, wherein the neurostimulation lead is between a spinal cord and a dura, wherein the target tissue region is the spinal cord.