Charge-based stimulation intensity programming with pulse amplitude and width adjusted according to a function

• US 9,764,147 B2
• Filed: 04/24/2009
• Issued: 09/19/2017
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Torgerson, Nathan A.
• Primary Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US12/429,931
• Publication Number:
  US 20100274320A1
• Time in Patent Office: 3,070 Days
• Field of Search: 607 4, 607 5, 607 10, 607 46, 607 48, 607 59
• 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 1/36167 Timing, e.g. stimulation onset
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Techniques for programming electrical stimulation therapy intensity based on electrical charge are described. In some examples, a display presents a stimulation intensity value in units of electrical charge, e.g., Coulombs. In such examples, a user may adjust the displayed charge value, rather than pulse amplitude or pulse width, to adjust the intensity of the electrical stimulation therapy. In some examples, a processor determines modifications to pulse amplitude and pulse width based on the modification to the charge value. In some examples, a processor modifies a pulse amplitude and width to achieve a desired charge, while maintaining a relationship between pulse amplitude and width specified by a predetermined function. In some examples, the function may be programmed, e.g., selected or adjusted, by a user.

Claims

1. A method comprising:

storing a predetermined function specifying a relationship between pulse amplitude and pulse width within a memory;

receiving input from a user modifying an electrical charge value of neurostimulation therapy delivered by a medical device, wherein the input from the user indicates the modification with regard to electrical charge value;

modifying a pulse amplitude and a pulse width of the neurostimulation therapy delivered by the medical device according to the function and based on the modification to the charge value; and

controlling the delivery of the neurostimulation therapy to the patient according to the modified pulse amplitude and the modified pulse width,

wherein the neurostimulation therapy comprises a plurality of electrical stimulation pulses, and

wherein the modified pulse amplitude and the modified pulse width are defined for each of the plurality of electrical stimulation pulses.

2. The method of claim 1, wherein the function is programmable by the user.

3. The method of claim 1, further comprising:

receiving user input locking one of the pulse amplitude or the pulse width of the neurostimulation therapy;

receiving subsequent input modifying the electrical charge value; and

modifying an unlocked one of the pulse amplitude or the pulse width of the neurostimulation therapy based on the subsequent modification to the charge value.

4. The method of claim 1, further comprising:

determining that at least one of the pulse amplitude or the pulse width of the neurostimulation is proximate to a stimulation efficiency point; and

automatically adjusting the function based on the determination.

5. The method of claim 4, wherein determining that the at least one of the pulse amplitude or the pulse width is proximate to a stimulation efficiency point comprises determining that the pulse amplitude is proximate an amplitude for which boosting a voltage of a power source of the medical device is required, and automatically adjusting the function comprises automatically decreasing a slope of the function based on the determination.

6. The method of claim 4, wherein automatically adjusting the function comprises temporarily adjusting the function.

7. The method of claim 1, further comprising displaying the electrical charge value to the user via a user interface, wherein receiving input modifying the electrical charge value comprises receiving user-inputted modifications to the displayed electrical charge value via the user interface.

8. The method of claim 7, wherein displaying an electrical charge value comprises:

displaying, via the user interface, a representation of a plurality of electrodes implanted within the patient; and

displaying, via the user interface, respective charge density values proximate to the electrodes.

9. The method of claim 8,

wherein receiving user-inputted modifications to the displayed electrical charge values comprises receiving user input adjusting relative charge densities of the electrodes, and

wherein modifying the pulse amplitude and the pulse width of the stimulation comprises modifying the pulse amplitude and pulse width of stimulation delivered via cathodes of the electrodes according to the function based on modifications to charge densities of the cathodes, and modifying the pulse amplitude of stimulation delivered via anodes of the electrodes without modifying the pulse width based on modifications to charge densities of the anodes.

10. The method of claim 7, further comprising displaying, via the user interface, at least one of the amplitude value or the pulse width value in addition to the electrical charge value.

11. The method of claim 7, wherein displaying, via the user interface, the electrical charge value comprises displaying the electrical charge value via a display of the user interface, and receiving the user-inputted modifications to the displayed electrical charge value comprises receiving the user-inputted modifications via the display.

12. The method of claim 1, further comprising:

receiving user-inputted modifications to one of the pulse amplitude or the pulse width;

determining a modification to both of the pulse amplitude and the pulse width according to the function with equivalent intensity to the user-inputted modification to the one of the pulse amplitude or pulse width; and

modifying the pulse amplitude and the pulse width according to the determination.

13. The method of claim 1, further comprising:

determining that a charge density for an electrode through which the medical device delivers the neurostimulation therapy meets a predetermined threshold value;

receiving user input increasing the charge value subsequent to the determination that the charge density meets the predetermined threshold value; and

increasing the pulse amplitude and decreasing the pulse width in response to the subsequent user input.

14. The method of claim 1, wherein the neurostimulation therapy comprises spinal cord stimulation or deep brain stimulation.

15. The method of claim 1, wherein receiving input from a user comprises receiving the input via a user interface of a programming device that communicates with the medical device.

29. The method of claim 1, wherein the plurality of electrical stimulation pulses comprise a first electrical stimulation pulse and a second electrical stimulation pulse, wherein the modified pulse amplitude and the modified pulse width are defined for both the first electrical stimulation pulse and the second electrical stimulation pulse.

16. A system comprising:

a memory configured to store a predetermined function specifying a relationship between pulse amplitude and pulse width;

a medical device configured to deliver neurostimulation therapy including a plurality of electrical stimulation pulses to a patient;

a user interface configured to receive input from a user modifying an electrical charge value of the neurostimulation therapy, wherein the input from the user indicates the modification with regard to electrical charge value; and

at least one processor configured to modify a pulse amplitude and a pulse width for each of the plurality of electrical stimulation pulses delivered by the medical device according to the function and based on the modification to the charge value such that the modified pulse amplitude and the modified pulse width are defined for each of the plurality of electrical stimulation pulses, and control the delivery of the plurality of electrical stimulation pulses to the patient via the medical device according to the modified pulse amplitude and the modified pulse width for each of the plurality of electrical stimulation pulses.

17. The system of claim 16, wherein the function is programmable by the user via the user interface.

18. The system of claim 16, wherein the user interface receives user input locking one of the pulse amplitude or the pulse width of the neurostimulation therapy, and subsequent input modifying the electrical charge value, and the at least one processor modifies an unlocked one of the pulse amplitude or the pulse width of the neurostimulation therapy delivered by the medical device based on the subsequent modifications to the charge value.

19. The system of claim 16, wherein the at least one processor determines that at least one of the pulse amplitude or the pulse width of the neurostimulation therapy is proximate to a stimulation efficiency point, and automatically adjusts the function based on the determination.

20. The system of claim 19, wherein the at least one processor determines that the at least one of the pulse amplitude or the pulse width of the neurostimulation therapy is proximate to a stimulation efficiency point by at least determining that the pulse amplitude is proximate an amplitude for which boosting a voltage of a power source of the medical device is required, and wherein the processor automatically adjusts the function based on the determination by at least automatically decreasing a slope of the function based on the determination.

21. The system of claim 16,

wherein the user interface displays the electrical charge value to a user, and receives user-inputted modifications to the displayed electrical charge value, and

wherein the at least one processor modifies the pulse amplitude and the pulse width for each of the plurality of electrical stimulation pulses delivered by the medical device according to the function and based on the modifications to the displayed charge value for each of the plurality of electrical stimulation pulses.

22. The system of claim 21, wherein the user interface displays a representation of a plurality of electrodes implanted within the patient, and displays respective charge density values proximate to the electrodes.

23. The system of claim 21, wherein the user interface comprises a display and receives the user-inputted modifications via the display.

24. The system of claim 16,

wherein the processor determines that a charge density for an electrode through which the medical device delivers the neurostimulation therapy meets a predetermined threshold value,

wherein the user interface receives user input increasing the charge value subsequent to the determination that the charge density meets the predetermined threshold value, and

wherein the at least one processor controls the medical device to increase the pulse amplitude and decrease the pulse width of the neurostimulation therapy in response to the subsequent user input.

25. The system of claim 16, further comprising an external programming device that comprises the user interface, the memory and the at least one processor, wherein the medical device comprises an implantable medical device, and the programming device communicates with the implantable medical device.

30. The system of claim 16, wherein the plurality of electrical stimulation pulses comprise a first electrical stimulation pulse and a second electrical stimulation pulse, wherein the modified pulse amplitude and the modified pulse width are defined for both the first electrical stimulation pulse and the second electrical stimulation pulse.

26. A system comprising:

means for storing a predetermined function specifying a relationship between pulse amplitude and pulse width;

means for receiving input from a user modifying an electrical charge value of neurostimulation therapy comprising a plurality of electrical stimulation pulses delivered by a medical device, wherein the input from the user indicates the modification with regard to electrical charge value;

means for modifying a pulse amplitude and a pulse width for each of the plurality of electrical stimulation pulses delivered by the medical device according to the function and based on the modification to the charge value such that the modified pulse amplitude and the modified pulse width are defined for each of the plurality of electrical stimulation pulses; and

means for controlling the delivery of the plurality of electrical stimulation pulses to the patient according to the modified pulse amplitude and the modified pulse width for each of the plurality of electrical stimulation pulses.

27. The system of claim 26, further comprising means for receiving selection of the function from a user.

28. A non-transitory computer-readable storage medium comprising instructions that cause a programmable processor to:

retrieve a predetermined function defining a relationship between pulse amplitude and pulse width from a memory;

receive input from a user modifying an electrical charge value of neurostimulation therapy delivered by a medical device, wherein the input from the user indicates the modification with regard to electrical charge value;

modify a pulse amplitude and a pulse width of the neurostimulation therapy delivered by the medical device according to the function and based on the modification to the charge value; and

control the delivery of the neurostimulation therapy to the patient according to the modified pulse amplitude and the modified pulse width,

wherein the neurostimulation therapy comprises a plurality of electrical stimulation pulses, and

wherein the modified pulse amplitude and the modified pulse width are defined for each of the plurality of electrical stimulation pulses.