Coupled monopolar and multipolar pulsing for conditioning and stimulation

• US 9,974,961 B2
• Filed: 07/05/2016
• Issued: 05/22/2018
• Est. Priority Date: 05/23/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Moffitt, Michael A.
• Primary Examiner(s): Lee, Erica
• Application Number:
  US15/202,322
• Publication Number:
  US 20160339253A1
• Time in Patent Office: 686 Days
• Field of Search: None
• 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 1/36071 Pain
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset

Abstract

A method and neurostimulation system of providing therapy to a patient is provided. A plurality of electrodes are placed in contact with tissue of a patient, a conditioning pulse is conveyed from the plurality of electrodes in one of a monopolar manner and a multipolar manner, and a stimulation pulse is conveyed from the plurality of electrodes in a different one of the monopolar manner and the multipolar manner. As one example, the sub-threshold conditioning pulse may be a depolarizing pulse conveyed from the plurality of electrodes to render a first region of the tissue less excitable to stimulation, and the stimulation pulse may be conveyed from the plurality of electrodes to stimulate a second different region of the tissue.

Claims

1. A method of providing therapy to a patient using a pulse generator that includes pulse generation circuitry and using electrodes electrically connected to the pulse generation circuitry, the method comprising:

delivering at least one conditioning pulse pattern using the pulse generation circuitry of the pulse generator in one of a monopolar manner using one of the electrodes or in a multipolar manner using at least two of the electrodes, wherein the at least one conditioning pulse pattern includes at least one subthreshold pulse pattern to change tissue excitability to subsequent stimulation; and

delivering at least one stimulation pulse pattern using the pulse generation circuitry of the pulse generator in the other one of the monopolar manner using one of the electrodes or the multipolar manner using at least two of the electrodes,

wherein either;

the at least one conditioning pulse pattern is delivered in a monopolar manner using one of the electrodes and the at least one stimulation pulse pattern is delivered in a multipolar manner using at least two of the electrodes;

or

the at least one conditioning pulse pattern is delivered in a multipolar manner using at least two of the electrodes and the at least one stimulation pulse pattern is delivered in a monopolar manner using one of the electrodes;

wherein the at least one conditioning pulse pattern is either;

at least one depolarizing pulse pattern delivered from the plurality of electrodes to render a first region of the tissue less excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate a second different region of the tissue;

or

at least one hyperpolarizing pulse pattern delivered from the plurality of electrodes to render the first region of the tissue more excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate the first tissue region.

2. The method of claim 1, wherein the at least one conditioning pulse pattern is the at least one depolarizing pulse pattern to render the first region of the tissue less excitable to stimulation, and the at least one stimulation pulse pattern is to stimulate the second different region of the tissue.

3. The method of claim 2, wherein the first tissue region is one or more dorsal root nerve fibers, and the second tissue region is one or more dorsal column nerve fibers.

4. The method of claim 2, wherein the first tissue region is one or more dorsal column nerve fibers, and the second tissue region is one or more dorsal root nerve fibers.

5. The method of claim 1, wherein the at least one conditioning pulse pattern is the at least one hyperpolarizing pulse pattern to render the first region of the tissue more excitable to stimulation, and the at least one stimulation pulse pattern is to stimulate the first tissue region.

6. The method of claim 5, wherein the first tissue region is one or more dorsal column nerve fibers.

7. The method of claim 1, wherein the at least one conditioning pulse pattern is delivered in a monopolar manner, and the at least one stimulation pulse pattern is delivered in a multipolar manner.

8. The method of claim 1, wherein the at least one conditioning pulse pattern is delivered before the at least one stimulation pulse pattern is delivered.

9. A method of providing therapy to a patient using a pulse generator that includes pulse generation circuitry and using a plurality of electrodes electrically connected to the pulse generation circuitry, the method comprising:

delivering at least one conditioning pulse pattern using the pulse generation circuitry of the pulse generator from the plurality of electrodes in contact with tissue of a patient in one of a monopolar manner and a multipolar manner, wherein the at least one conditioning pulse pattern includes at least one subthreshold pulse to change tissue excitability to subsequent stimulation; and

delivering at least one stimulation pulse pattern using the pulse generation circuitry of the pulse generator from the plurality of electrodes in a different one of the monopolar manner and the multipolar manner,

wherein the at least one conditioning pulse pattern is delivered from the plurality of electrodes in a multipolar manner, and the at least one stimulation pulse is delivered from the plurality of electrodes in a monopolar manner.

10. The method of claim 9, wherein the at least one conditioning pulse pattern is at least one depolarizing pulse pattern delivered from the plurality of electrodes to render one or more dorsal root nerve fibers less excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate one or more dorsal column nerve fibers.

11. The method of claim 9, wherein the at least one conditioning pulse pattern is at least one depolarizing pulse pattern delivered from the plurality of electrodes to render one or more dorsal column nerve fibers less excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate one or more dorsal root nerve fibers.

12. The method of claim 9, wherein the at least one conditioning pulse pattern is at least one hyperpolarizing pulse pattern delivered from the plurality of electrodes to render one or more dorsal column nerve fibers more excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate the one or more dorsal column nerve fibers.

13. The method of claim 9, wherein the at least one conditioning pulse pattern is delivered from the plurality of electrodes before the at least one stimulation pulse pattern is delivered from the plurality of electrodes.

14. The method of claim 9, wherein the tissue is a spinal cord, and the plurality of electrodes are transversely arranged relative to the axis of the spinal cord.

15. A method of providing therapy to a patient using a pulse generator that includes pulse generation circuitry and using electrodes electrically connected to the pulse generation circuitry and transversely arranged relative to an axis of a spinal cord for a patient, the method comprising:

delivering at least one conditioning pulse pattern using the pulse generation circuitry of the pulse generator in one of a monopolar manner using one of the electrodes or in a multipolar manner using at least two of the electrodes, wherein the at least one conditioning pulse pattern includes at least one subthreshold pulse pattern to change tissue excitability to subsequent stimulation; and

delivering at least one stimulation pulse pattern using the pulse generation circuitry of the pulse generator from the plurality of electrodes in a different one of the monopolar manner and the multipolar manner.

16. The method of claim 15, wherein the at least one conditioning pulse pattern is at least one depolarizing pulse pattern conveyed from the plurality of electrodes to render one or more dorsal root nerve fibers less excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate one or more dorsal column nerve fibers.

17. The method of claim 15, wherein the at least one conditioning pulse pattern is at least one depolarizing pulse pattern conveyed from the plurality of electrodes to render one or more dorsal column nerve fibers less excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate one or more dorsal root nerve fibers.

18. The method of claim 15, wherein the at least one conditioning pulse is at least one hyperpolarizing pulse pattern conveyed from the plurality of electrodes to render one or more dorsal column nerve fibers more excitable to stimulation, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes to stimulate the one or more dorsal column nerve fibers.

19. The method of claim 15, wherein the at least one conditioning pulse pattern is delivered from the plurality of electrodes before the at least one stimulation pulse pattern is delivered from the plurality of electrodes.

20. The method of claim 15, wherein the at least one conditioning pulse pattern is delivered from the plurality of electrodes in a multipolar manner, and the at least one stimulation pulse pattern is delivered from the plurality of electrodes in a monopolar manner.