Patient posture determination and stimulation program adjustment in an implantable stimulator device using impedance fingerprinting

• US 9,814,883 B2
• Filed: 09/15/2016
• Issued: 11/14/2017
• Est. Priority Date: 12/07/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Marnfeldt, Goran, Parramon, Jordi
• Primary Examiner(s): Tejani, Ankit D
• Application Number:
  US15/266,660
• Publication Number:
  US 20170001015A1
• Time in Patent Office: 425 Days
• Field of Search: None
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

Methods and circuitry for determining an implanted-neurostimulator patient'"'"'s position, and adjusting a situation program delivered by the neurostimulator based on the determined position, is disclosed. Impedance measurements of the patient'"'"'s tissue are taken at the neurostimulator'"'"'s electrodes, which measurements can comprise complex impedance measurements (magnitude and phase) taken at different frequencies. Such impedance measurements, which can be taken interleaved with stimulation therapy, are used to determine an “impedance fingerprint.” This fingerprint can be compared to other known fingerprints stored in the IPG, which known fingerprints are associated with particular stimulation programs. When a measured fingerprint matches one stored in the IPG, the stimulation program associated with the stored fingerprint is automatically used for patient therapy. As different measured fingerprints are encountered, the IPG can learn and store a new stimulation program for such fingerprint by remembering stimulation parameters selected by the patient when such fingerprint is encountered.

Claims

1. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation therapy to a tissue of a patient; and

impedance monitoring circuitry configured to apply at least one AC measurement signal different from the electrical stimulation therapy to a plurality of combinations of the electrodes and to determine an impedance between each of the plurality of combinations of the electrodes using the at least one AC measurement signal,

wherein the impedance monitoring circuitry is configured to apply the at least one AC measurement signal during quiet periods when electrical stimulation therapy is not occurring at any of the plurality of electrodes.

2. The device of claim 1, wherein the determined impedances are complex impedances.

3. The device of claim 1, wherein the impedance monitoring circuitry is configured to apply a plurality of AC measurement signals to each of the plurality of combinations of the electrodes.

4. The device of claim 3, wherein the plurality of AC measurement signals are each of a different frequency, and wherein the impedance between each of the plurality of combinations of the electrodes is determined using the AC measurement signals at each of the different frequencies.

5. The device of claim 1, wherein the impedance monitoring circuitry is further configured to set a stimulation program to be provided to the electrodes in accordance with the determined impedances.

6. The device of claim 5, wherein the determined impedances are indicative of a posture of the patient.

7. The device of claim 1, further comprising a database configured to store a plurality of stimulation programs, wherein the determined impedances are used to select a stimulation program to be provided to the electrodes from the database.

8. The device of claim 7, wherein the plurality of stimulation programs are stored in the database during a fitting procedure.

9. The device of claim 7, wherein the stimulation programs are learned as electrical stimulation is provided to the patient.

10. The device of claim 7, wherein the selected stimulation program comprises one or more stimulation parameters, including which electrodes are active, a polarity of the active electrodes, a magnitude of the electrical stimulation therapy at the active electrodes, a duration of electrical stimulation therapy, and a frequency of the electrical stimulation therapy.

11. The device of claim 1, wherein the impedance monitoring circuitry is configured to determine an impedance between each of the plurality of combinations of the electrodes by assessing responses to the at least one AC measurement signal at each of the plurality of combinations of the electrodes.

12. The device of claim 11, wherein the at least one AC measurement signal comprises an AC current, and the responses comprise AC voltages.

13. The device of claim 1, wherein the impedance monitoring circuitry is further configured to use the impedance determined between each of the plurality of combinations of the electrodes to derive values of electrical components in a tissue model.

14. The device of claim 1, further comprising a conductive case, wherein one of the plurality of electrodes comprises the case.

15. The device of claim 1, further comprising at least one lead, wherein the plurality of electrodes are positioned on the at least one lead.

16. An implantable stimulator device, comprising:

a plurality of electrodes configured to provide electrical stimulation therapy to a tissue of a patient; and

impedance monitoring circuitry configured to

generate a plurality of AC measurement signals each of a different frequency and different from the electrical stimulation therapy,

apply each of the plurality of AC measurement signals to a plurality of combinations of the electrodes during quiet periods when the electrical stimulation therapy is not occurring,

determine an impedance between each of the plurality of combinations of the electrodes using each of the plurality of AC measurement signals, and

derive values of electrical components in a tissue model using the impedances determined between each of the plurality of combinations of the electrodes.

17. The device of claim 16, wherein the impedance monitoring circuitry is further configured to set a stimulation program to be provided to the electrodes in accordance with the determined impedances.

18. The device of claim 17, wherein the selected stimulation program comprises one or more stimulation parameters, including which electrodes are active, a polarity of the active electrodes, a magnitude of the electrical stimulation therapy at the active electrodes, a duration of electrical stimulation therapy, and a frequency of the electrical stimulation therapy.

19. The device of claim 16, further comprising at least one lead, wherein the plurality of electrodes are positioned on the at least one lead.