Identification of electrode combination for efficacious electrical stimulation therapy

• US 9,545,521 B1
• Filed: 12/18/2014
• Issued: 01/17/2017
• Est. Priority Date: 03/12/2013
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Torgerson, Nathan A., Davenport, Lynn A.
• Primary Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US14/575,818
• Time in Patent Office: 761 Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/3727 characterised by the modulation technique

Abstract

One or more efficacious electrode combinations for delivering electrical stimulation therapy to a patient may be selected based on the delivery of electrical stimulation to the patient via a predefined set of test electrode combinations in a predetermined order. In some examples, the electrode combinations of the set are arranged in the predetermined order such that adjacent electrode combinations in the order include at least one shared anode electrode or cathode electrode. In addition, the electrode combinations in the predetermined order may define a predetermined sequence of electrode patterns, each electrode pattern defining a relative arrangement between one or more anodes and one or more cathodes of the respective electrode pattern. In some examples, the transition between electrode combinations in the predefined set is achieved by incrementally adjusting at least one of anodic amplitudes assigned to active anode electrodes or cathodic amplitudes assigned to active cathode electrodes.

Claims

1. A method comprising:

with one or more processors, selecting a predefined set of electrode combinations, wherein each electrode combination of the predefined set includes one or more anode electrodes and one or more cathode electrodes, a relative arrangement of the one or more anodes and the one or more cathodes defining an electrode pattern of the electrode combination; and

with the one or more processors, automatically controlling a medical device to deliver, in a predetermined order, electrical stimulation to a patient via each electrode combination of the predefined set of electrode combinations, wherein the electrode combinations in the predetermined order define a repeating sequence of electrode patterns.

2. The method of claim 1, wherein automatically controlling the medical device to deliver the electrical stimulation comprises controlling the medical device to deliver electrical stimulation according to a predefined sequence of amplitude adjustments that defines the predefined set of electrode combinations, the predefined sequence of amplitude adjustments including a plurality of steps and, for each step, active electrodes used by the medical device for delivery of electrical stimulation therapy, and, for each of the active electrodes, an anodic amplitude setting or a cathodic amplitude setting.

3. The method of claim 2, wherein controlling the medical device according to the predefined sequence of amplitude adjustments comprises controlling the medical device to transition between successive steps of the predefined sequence by at least increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by an amplitude adjustment increment, wherein the amplitude adjustment increments are substantially the same between successive steps of the predefined sequence.

4. The method of claim 2, wherein controlling the medical device according to the predefined sequence of amplitude adjustments comprises controlling the medical device to transition between successive steps of the predefined sequence by at least increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by an amplitude adjustment increment, wherein the predefined sequence includes at least two different amplitude adjustment increments, and wherein controlling the medical device to transition between successive steps of the predefined sequence comprises increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by one amplitude adjustment increment of the at least two different amplitude adjustment increments.

5. The method of claim 2, wherein the predefined sequence includes two different amplitude adjustment increments, wherein increasing or decreasing the at least one of the anodic amplitude or the cathodic amplitude for the at least one active electrode is by an amplitude adjustment increment of the two different amplitude adjustment increments that alternates between successive steps of the predefined sequence.

6. The method of claim 1, wherein the electrode patterns include a first simple bipole, a second simple bipole, a guarded cathode, and a guarded double cathode.

7. The method of claim 1, further comprising selecting an electrode combination from the predefined set of electrode combinations based on the delivery of the electrical stimulation by the medical device.

8. The method of claim 1, wherein the electrode combinations are defined by subsets of electrodes of an electrical stimulation lead, and wherein controlling the medical device to deliver, in the predetermined order, electrical stimulation to the patient via each electrode combination of the predefined set of electrode combinations comprises controlling the medical device to deliver electrical stimulation to the patient via at least two electrode patterns at two different axial positions along the electrical stimulation lead.

9. The method of claim 1, wherein the electrode combinations are defined by subsets of electrodes of an electrical stimulation lead, wherein the electrode combinations are arranged in the predetermined order such that electrode combinations are propagated along the electrical stimulation lead.

10. The method of claim 1, further comprising:

receiving a first user input;

controlling the medical device to one of pause delivering electrical stimulation or continue delivering electrical stimulation according to a currently selected electrode combination of the predefined set of electrode combinations in response to receiving the first user input;

subsequently receiving a second user input; and

controlling the medical device to transition from the currently selected electrode combination to a next electrode combination in the predetermined order in response to receiving the second user input.

11. The method of claim 1, further comprising:

receiving user input selecting a starting electrode;

selecting a starting electrode combination from the predefined set of electrode combinations based on the starting electrode selected by the user; and

automatically controlling the medical device to deliver electrical stimulation to the patient via the starting electrode combination and electrode combinations of the predefined set of electrode combinations following the starting electrode combination in the predetermined order.

12. The method of claim 1, further comprising:

receiving user input; and

modifying the predefined set of electrode combinations in response to receiving the user input.

13. The method of claim 1, wherein controlling the medical device to deliver electrical stimulation to the patient via the predefined set of electrode combinations in the predetermined order comprises controlling the medical device to transition between a first electrode combination and a second electrode combination adjacent to the first electrode combination in the predetermined order by at least incrementally adjusting at least one of anodic amplitudes assigned to anodes of the first electrode combination or cathodic amplitudes assigned to cathodes of the first electrode combination.

14. The method of claim 1, wherein at least one of the electrode combinations of the predefined set is defined by a subset of electrodes of an electrical stimulation lead.

15. The method of claim 1, wherein at least one of the electrode combinations of the predefined set is defined by an electrode of a housing of the medical device and at least one electrode of an electrical stimulation lead.

16. A system comprising:

a medical device,

a plurality of electrodes; and

a processor configured to control the medical device to deliver, in a predetermined order, electrical stimulation to a patient via each electrode combination of a predefined set of electrode combinations, wherein the electrode combinations of the predefined set of electrode combinations are defined by subsets of electrodes of the plurality of electrodes, wherein each electrode combination of the predefined set includes one or more anode electrodes and one or more cathode electrodes, a relative arrangement of the one or more anodes and the one or more cathodes defining an electrode pattern of the electrode combination, and wherein the electrode combinations in the predetermined order define a repeating sequence of electrode patterns.

17. The system of claim 16, wherein the processor is configured to control the medical device to deliver the electrical stimulation by at least controlling the medical device to deliver electrical stimulation according to a predefined sequence of amplitude adjustments that defines the predefined set of electrode combinations, the predefined sequence of amplitude adjustments including plurality of steps and, for each step, active electrodes used by the medical device for delivery of electrical stimulation therapy, and, for each of the active electrodes, an anodic amplitude setting or a cathodic amplitude setting.

18. The system of claim 17, wherein the processor is configured to control the medical device according to the predefined sequence of amplitude adjustments by at least controlling the medical device to transition between successive steps of the predefined sequence by at least increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by an amplitude adjustment increment, wherein the amplitude adjustment increments are substantially the same between successive steps of the predefined sequence.

19. The system of claim 17, wherein the processor is configured to control the medical device according to the predefined sequence of amplitude adjustments by at least controlling the medical device to transition between successive steps of the predefined sequence by at least increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by an amplitude adjustment increment, wherein the predefined sequence includes at least two different amplitude adjustment increments, and wherein controlling the medical device to transition between successive steps of the predefined sequence comprises increasing or decreasing at least one of the anodic amplitude or the cathodic amplitude for at least one active electrode by one amplitude adjustment increment of the at least two different amplitude adjustment increments.

20. The system of claim 17, wherein the predefined sequence includes two different amplitude adjustment increments, wherein increasing or decreasing the at least one of the anodic amplitude or the cathodic amplitude for the at least one active electrode is by an amplitude adjustment increment of the two different amplitude adjustment increments that alternates between successive steps of the predefined sequence.

21. The system of claim 16, wherein the electrode patterns include a first simple bipole, a second simple bipole, a guarded cathode, and a guarded double cathode.

22. The system of claim 16, wherein the processor is configured to select an electrode combination from the predefined set of electrode combinations based on the delivery of the electrical stimulation by the medical device.

23. The system of claim 16, further comprising an electrical stimulation lead comprising the plurality of electrodes, wherein the processor is configured to control the medical device to deliver, in the predetermined order, electrical stimulation to the patient via each electrode combination of the predefined set of electrode combinations by at least controlling the medical device to deliver electrical stimulation to the patient via at least two electrode patterns at two different axial positions along the electrical stimulation lead.

24. The system of claim 16, further comprising an electrical stimulation lead comprising the plurality of electrodes, wherein the electrode combinations are arranged in the predetermined order such that electrode combinations are transitioned along the electrical stimulation lead.

25. The system of claim 16, further comprising a user interface, wherein the processor is configured to receive a first user input via the user interface, control the medical device to one of pause electrical stimulation or continue delivering electrical stimulation according to a currently selected electrode combination of the predefined set of electrode combinations in response to receiving the first user input, subsequently receive a second user input, and control the medical device to transition from the currently selected electrode combination to a next electrode combination in the predetermined order in response to receiving the second user input.

26. The system of claim 16, further comprising a user interface, wherein the processor is configured to receive user input selecting a starting electrode via the user interface, select a starting electrode combination from the predefined set of electrode combinations based on the starting electrode selected by the user, and automatically control the medical device to deliver, in the predetermined order, electrical stimulation to the patient via the starting electrode combination and each electrode combination of the predefined set of electrode combinations following the starting electrode combination in the predetermined order.

27. The system of claim 16, further comprising a user interface, wherein the processor is configured to receive user input via the user interface and modify the predefined set of electrode combinations in response to receiving the user input.

28. The system of claim 16, wherein the processor is configured to control the medical device to deliver, in the predetermined order, electrical stimulation to the patient via each electrode combination of the predefined set of electrode combinations by at least controlling the medical device to transition between a first electrode combination and a second electrode combination adjacent to the first electrode combination in the order by incrementally adjusting at least one of anodic amplitudes assigned to anodes of the first electrode combination or cathodic amplitudes assigned to cathodes of the first electrode combination.

29. The system of claim 17, further comprising a memory that stores the predefined sequence of amplitude adjustments.

30. The system of claim 16, wherein the medical device comprises the processor.

31. The system of claim 16, further comprising a medical device programmer that comprises the processor.

32. The system of claim 16, further comprising an electrical stimulation lead comprising the plurality of electrodes.

33. The system of claim 16, wherein the medical device comprising a housing including a housing electrode, wherein at least one of the electrode combinations of the predefined set is defined by the housing electrode and at least one electrode of an electrical stimulation lead.

34. A system comprising:

means for delivering electrical stimulation to a patient; and

means for controlling the means for delivering electrical stimulation to deliver, in a predetermined order, electrical stimulation to the patient via each electrode combination of a predefined set of electrode combinations, wherein each electrode combination of the predefined set includes one or more anode electrodes and one or more cathode electrodes, a relative arrangement of the one or more anodes and the one or more cathodes defining an electrode pattern of the electrode combination, and wherein the electrode combinations in the predetermined order define a repeating sequence of electrode patterns.

35. The system of claim 34, wherein the means for controlling controls the means for delivering according to a predefined sequence of amplitude adjustments that defines the predefined set of electrode combinations, the predefined sequence of amplitude adjustments including plurality of steps and, for each step, active electrodes used by the medical device for delivery of electrical stimulation therapy, and, for each of the active electrodes, an anodic amplitude setting or a cathodic amplitude setting.

36. A non-transitory computer-readable storage medium comprising instructions that, when executed by a processor, cause the processor to:

control a medical device to deliver, in a predetermined order, electrical stimulation to a patient via each electrode combination of a predefined set of electrode combinations, wherein each electrode combination includes one or more anode electrodes and one or more cathode electrodes, a relative arrangement of the one or more anodes and the one or more cathodes defining an electrode pattern of the electrode combination, and wherein the electrode combinations in the predetermined order define a repeating sequence of electrode patterns; and

select an electrode combination from the predefined set of electrode combinations based on the delivery of the electrical stimulation by the medical device.

37. The non-transitory computer-readable storage medium of claim 36, wherein the instructions, when executed by the processor, cause the processor to control the medical device to deliver the electrical stimulation by at least controlling the medical device according to a predefined sequence of amplitude adjustments that defines the predefined set of electrode combinations, the predefined sequence of amplitude adjustments including plurality of steps and, for each step, active electrodes used by the medical device for delivery of electrical stimulation therapy, and, for each of the active electrodes, an anodic amplitude setting or a cathodic amplitude setting.