Device, system, methods, and computer readable media for managing acute and chronic pain

• US 9,604,054 B2
• Filed: 03/13/2014
• Issued: 03/28/2017
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: University of North Carolina At Chapel Hill (University of North Carolina System)
• Original Assignee: Board of Trustees of The University of Illinois
• Inventors: Thieme, Kati, Gracely, Richard H, Maixner, William, Monbureau, Olivier Georges
• Primary Examiner(s): Flory, Christopher A
• Application Number:
  US14/776,040
• Publication Number:
  US 20160022988A1
• Time in Patent Office: 1,111 Days
• Field of Search: 607/2, 607/9, 607/46
• US Class Current: 1/1
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36034 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36075 Headache or migraine
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/3615 Intensity
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36178 Burst or pulse train parameters

Abstract

Methods, devices, control modules, and computer readable media are provided for managing acute and chronic pain in subjects. More specifically, a method is provided for reducing pain in a subject that includes delivering to the subject a series of stimuli consisting of both painful and non-painful stimuli. A portion of each of the painful and the non-painful stimuli is delivered to the subject during a systolic phase of the subject'"'"'s cardiac cycle and the remaining portion of each of the painful and the non-painful stimuli is delivered during a diastolic phase of the subject'"'"'s cardiac cycle.

Claims

1. A method for reducing pain in a subject comprising:

delivering to a subject with a stimulator a series of stimuli, wherein at least a fraction of the stimuli are below a non-painful threshold for the subject and at least a fraction of the stimuli are 50% to 100% of a pain tolerance for the subject, and wherein a portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli is delivered during the systolic phase of the subject'"'"'s cardiac cycle and the remaining portion of each is delivered during a diastolic phase of the subject'"'"'s cardiac cycle.

2. The method of claim 1, further comprising repeating one or more times delivering to the subject the series of stimuli, until the subject'"'"'s pain is reduced.

3. The method of claim 1, further comprising:

repeating one or more times the delivering to the subject the series of stimuli to the subject, wherein the stimuli having the non-painful threshold and 50% to 100% of the pain tolerance are re-determined for the subject prior to the repeating delivery, until the subject'"'"'s pain is reduced.

4. The method of claim 1, wherein the subject is characterized by one or more of fibromyalgia syndrome, migraine, osteoarthritis, low back pain, inflammatory arthritis, rheumatoid arthritis, or Parkinson'"'"'s.

5. The method of claim 1, wherein the portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli delivered during the systolic phase is one half.

6. The method of claim 1, wherein the stimuli delivered during the systolic phase of the cardiac cycle are delivered at a 20% value of an average inter-beat-interval and the stimuli delivered during the diastolic phase of the cardiac cycle are delivered at an 80% value of an average inter-beat-interval.

7. The method of claim 1, wherein the stimulus is selected from the group consisting of an electrical pulse stimulus, a punctate stimulus, and a laser stimulus.

8. The method of claim 1, wherein the stimulus is an electrical pulse stimulus delivered as a train consisting of multiple individual electrical pulses of the same amplitude.

9. A device, comprising:

a sensor for measuring cardiac cycle configured to indicate a systolic phase and a diastolic phase of a subject'"'"'s cardiac cycle;

a stimulator configured to deliver a stimulus to the subject; and

a control module in communication with the sensor for measuring cardiac cycle and the stimulator, the control module configured to;

direct the stimulator to deliver a series of the stimuli to the subject, wherein at least a fraction of the stimuli are below a non-painful threshold for the subject and at least a fraction of the stimuli are 50% to 100% of a pain tolerance for the subject, and wherein a portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli is delivered during the systolic phase of the subject'"'"'s cardiac cycle and the remaining portion of each is delivered during the diastolic phase of the subject'"'"'s cardiac cycle.

10. The device of claim 9, wherein the control module is configured to direct the stimulator to repeat one or more times the deliver function of the series of stimuli, until the subject'"'"'s pain is reduced.

11. The device of claim 9, wherein the control module is configured to direct the stimulator to repeat one or more times the deliver function to the subject the series of stimuli to the subject, wherein the stimuli having the non-painful threshold and having 50% to 100% of the pain tolerance are re-determined for the subject prior to the repeated deliver function, until the subject'"'"'s pain is reduced.

12. The device of claim 9, wherein the portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli delivered during the systolic phase is one half.

13. The device of claim 9, wherein the stimuli delivered during the systolic phase of the cardiac cycle are delivered at a 20% value of an average inter-beat-interval and the stimuli delivered during the diastolic phase of the cardiac cycle are delivered at an 80% value of an average inter-beat-interval.

14. The device of claim 9, wherein the stimulus is selected from the group consisting of an electrical pulse stimulus, a punctate stimulus, and a laser stimulus.

15. The device of claim 9, wherein the stimulus is an electrical pulse stimulus delivered as a train consisting of multiple individual electrical pulses of the same amplitude.

16. The device of claim 9, wherein the device facilitates pharmacotherapy in the subject by one or more of:

enabling reduced dose of chemotherapy in the subject having melanoma, enabling reduced dose of antiepileptic drugs in the subject having epilepsy, enabling reduced dose of anti-inflammatory drugs in the subject having arthritis, enabling reduced dose of sleep-inducing drugs in the subject having sleep apnea, enabling reduced dose of detoxification drugs in the subject having chronic pain and opioid addiction, enabling reduced dose of anesthesia in the subject during surgery, enabling reduced dose of blood pressure-lowering drugs in the subject having hypertension, or enabling reduced dose of anti-anxiety drugs in the subject having anxiety.

17. A control module in communication with a sensor for measuring cardiac cycle configured to indicate a systolic phase and a diastolic phase of the subject'"'"'s cardiac cycle and a stimulator, the control module configured to:

direct the stimulator to deliver a series of stimuli to a subject, wherein at least a fraction of the stimuli are below a non-painful threshold for the subject and at least a fraction of the stimuli are 50% to 100% of a pain tolerance for the subject, and wherein a portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli is delivered during the systolic phase of the subject'"'"'s cardiac cycle and the remaining portion of each is delivered during the diastolic phase of the subject'"'"'s cardiac cycle.

18. The control module of claim 17, wherein the control module is configured to direct the stimulator to repeat one or more times the deliver function of the series of stimuli to the subject, until the subject'"'"'s pain is reduced.

19. The control module of claim 17, wherein the control module is configured to direct the stimulator to repeat one or more times the deliver function of the series of stimuli to the subject, wherein the stimuli having the non-painful threshold and 50% to 100% of the pain tolerance are re-determined for the subject prior to the repeated deliver function, until the subject'"'"'s pain is reduced.

20. A computer program product for reducing pain in a subject, comprising:

a non-transitory computer readable storage medium having computer readable program code embodied therewith, the computer readable program code comprising;

computer readable program code configured to;

receive a response signal from a sensor for measuring cardiac cycle that indicates a systolic phase and a diastolic phase of a subject'"'"'s cardiac cycle;

direct a stimulator to deliver a series of stimuli to the subject, wherein at least a fraction of the stimuli are below a non-painful threshold for the subject and at least a fraction of the stimuli are 50% to 100% of a pain tolerance for the subject, and wherein a portion of each of the non-painful stimuli and the 50% to 100% of the pain tolerance stimuli is delivered during the systolic phase of the subject'"'"'s cardiac cycle and the remaining portion of each is delivered during the diastolic phase of the subject'"'"'s cardiac cycle.

21. The computer program product of claim 20, wherein the computer readable program code is further configured to direct the stimulator to repeat one or more times the deliver function of the series of stimuli to the subject, until the subject'"'"'s pain is reduced.

22. The computer program product of claim 20, wherein the computer readable program code is further configured to direct the stimulator to repeat one or more times the deliver function of the series of stimuli to the subject, wherein the stimuli having the non-painful threshold and the 50% to 100% of the pain tolerance are re-determined for the subject prior to the repeated deliver function, until the subject'"'"'s pain is reduced.