System and method for selective and maintained activation of sensory peripheral nerve fibers

• US 9,636,497 B2
• Filed: 06/13/2016
• Issued: 05/02/2017
• Est. Priority Date: 07/02/2013
• Status: Expired due to Fees

• Current Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Original Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Inventors: Bradley, Kerry, Halberg, Leslie
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US15/180,613
• Publication Number:
  US 20160287878A1
• Time in Patent Office: 323 Days
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36153 Voltage A61N1/3616 takes precedence
• CPC Class Codes: A61N 1/37223 Circuits for electromagnetic coupling
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/3752 Details of casing-lead connections
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

Electrical stimulation is applied to a patient at least in part via a pulse generator. A motor fiber component of an action potential that is evoked in response to the electrical stimulation is measured. A sensory fiber component of the action potential is also measured. A relationship between the motor fiber component and the sensory fiber component is determined. For example, a ratio between the sensory fiber component and the motor fiber component may be calculated, or the absolute sizes of the sensory fiber component and the motor fiber component may be compared. Based on the determined relationship between the motor and sensory fiber components, a paresthesia of the patient is estimated.

Claims

1. A method, comprising:

applying electrical stimulation to a patient at least in part via a pulse generator;

measuring a motor fiber component of an action potential that is evoked in response to the electrical stimulation;

measuring a sensory fiber component of the action potential; and

determining a relationship between the motor fiber component and the sensory fiber component.

2. The method of claim 1, further comprising:

estimating a paresthesia of the patient based on the determining.

3. The method of claim 1, wherein the determining comprises:

calculating a ratio between the sensory fiber component and the motor fiber component.

4. The method of claim 1, wherein the determining comprises:

comparing absolute sizes of the sensory fiber component and the motor fiber component.

5. The method of claim 1, further comprising:

repeating the applying of the electrical stimulation, the measuring of the motor fiber component, the measuring of the sensory fiber component, and the determining the relationship between the motor fiber component and the sensory fiber component a plurality of times, wherein a different set of stimulation parameters is used for each of the times; and

selecting one or more of the sets of stimulation parameters as optimized sets of stimulation parameters based on the determined relationship between the motor fiber component and the sensory fiber component for each of the times.

6. The method of claim 1, wherein:

the measuring of the motor fiber component is performed within a first time window; and

the measuring of the sensory fiber component is performed within a second time window that occurs after the first time window.

7. The method of claim 1, wherein the applying of the electrical stimulation, the measuring of the motor fiber component, the measuring of the sensory fiber component, and the determining the relationship between the motor fiber component and the sensory fiber component are performed when the patient is in actual surgery.

8. The method of claim 1, wherein the applying of the electrical stimulation, the measuring of the motor fiber component, the measuring of the sensory fiber component, and the determining the relationship between the motor fiber component and the sensory fiber component are performed in an automated manner without requiring a voluntary feedback from the patient.

9. A medical system, comprising:

a pulse generator configured to apply electrical stimulation to a patient;

a measurement tool configured to measure a motor fiber component and a sensory fiber component of an action potential that is evoked from in response to the electrical stimulation; and

an electronic processor configured to determine a relationship between the motor fiber component and the sensory fiber component.

10. The medical system of claim 9, wherein the electronic processor is further configured to estimate a paresthesia of the patient based on the determined relationship between the motor fiber component and the sensory fiber component.

11. The medical system of claim 9, wherein the electronic processor is further configured to calculate a ratio between the sensory fiber component and the motor fiber component.

12. The medical system of claim 9, wherein:

the pulse generator is configured to apply a plurality of cycles of electrical stimulation, wherein a different set of stimulation parameters is used in each cycle;

the measurement tool is configured to measure the motor fiber component and the sensory fiber component corresponding to each cycle; and

the electronic processor is configured to determine the relationship between the motor fiber component and the sensory fiber component corresponding to each cycle.

13. The medical system of claim 12, wherein the electronic processor is configured to select one or more of the sets of stimulation parameters as optimized sets of stimulation parameters based on the determined relationship between the motor fiber component and the sensory fiber component corresponding to each cycle.

14. The medical system of claim 9, wherein:

the measurement tool is configured to measure the motor fiber component within a first time window; and

the measurement tool is configured to measure the sensory fiber component within a second time window that occurs after the first time window.

15. A medical device, comprising:

stimulation circuitry configured to apply electrical stimulation to a patient;

measurement circuitry configured to measure a motor fiber component and a sensory fiber component of an action potential that is evoked from in response to the electrical stimulation; and

controller circuitry configured to determine a relationship between the motor fiber component and the sensory fiber component.

16. The medical device of claim 15, wherein the controller circuitry is further configured to estimate a paresthesia of the patient based on the determined relationship between the motor fiber component and the sensory fiber component.

17. The medical device of claim 15, wherein the controller circuitry is further configured to calculate a ratio between the sensory fiber component and the motor fiber component.

18. The medical device of claim 15, wherein:

the stimulation circuitry is configured to apply a plurality of cycles of electrical stimulation, wherein a different set of stimulation parameters is used in each cycle;

the measurement circuitry is configured to measure the motor fiber component and the sensory fiber component corresponding to each cycle; and

the controller circuitry is configured to determine the relationship between the motor fiber component and the sensory fiber component corresponding to each cycle.

19. The medical device of claim 18, wherein the controller circuitry is configured to select one or more of the sets of stimulation parameters as optimized sets of stimulation parameters based on the determined relationship between the motor fiber component and the sensory fiber component corresponding to each cycle.

20. The medical device of claim 15, wherein:

the measurement circuitry is configured to measure the motor fiber component within a first time window; and

the measurement circuitry is configured to measure the sensory fiber component within a second time window that occurs after the first time window.