Method and system of bracketing stimulation parameters on clinician programmers

• US 10,668,276 B2
• Filed: 08/22/2013
• Issued: 06/02/2020
• Est. Priority Date: 08/31/2012
• Status: Active Grant

• Current Assignee: Cirtec Medical Corp.
• Original Assignee: Cirtec Medical Corp.
• Inventors: Kaula, Norbert, Iyassu, Yohannes
• Primary Examiner(s): Hulbert, Amanda K
• Application Number:
  US13/973,292
• Publication Number:
  US 20140067016A1
• Time in Patent Office: 2,476 Days
• Field of Search: 607 59, 607 30
• CPC Class Codes: A61N 1/08 Arrangements or circuits for monitoring, protecting, controlling or indicating for external stimulators A61N1/3603; for implantable neurostimulators A61N1/36128; for heart stimulators A61N1/37; for defibrillators A61N1/3925
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

The present disclosure involves a method of setting stimulation parameters for neurostimulation. A plurality of stimulation parameters available for bracketing is displayed. The stimulation parameters are selected from the group consisting of: stimulation current amplitude, pulse width, frequency, and contact location. Thereafter, in response to an input from a user, at least a subset of the stimulation parameters is selected for bracketing. A respective initial value is then obtained for each of the stimulation parameters in the selected subset. Thereafter, a bracketing process is used to generate a plurality of bracketed values for each of the stimulation parameters in the selected subset. The bracketed values are generated as a function of the initial value. A plurality of stimulation pulses is then delivered to a patient through a neurostimulator that is automatically programmed with a different combination of the bracketed values for the stimulation parameters for each stimulation pulse.

Claims

1. An electronic device for setting stimulation parameters of a neurostimulator to deliver neurostimulation to a patient, the electronic device comprising:

a user interface;

a memory storage component configured to store programming code; and

a computer processor configured to execute the programming code to perform the following tasks;

displaying a plurality of stimulation parameters available for bracketing, the stimulation parameters being selected from the group consisting of;

stimulation current amplitude, pulse width, frequency, and contact location;

selecting, in response to an input from a user, at least a subset of the stimulation parameters for bracketing;

obtaining a respective initial value for each of the stimulation parameters in the selected subset;

generating, through a bracketing process, a plurality of bracketed values for each of the stimulation parameters in the selected subset, wherein the bracketed values are generated as a function of the initial value, wherein a first subset of the bracketed values are each greater than the initial value, and wherein a second subset of the bracketed values are each less than the initial value;

receiving, via the user interface, a specified length of a pause between consecutive stimulation pulses; and

automatically programming the neurostimulator to deliver a plurality of stimulation pulses to the patient, wherein a different combination of the bracketed values is programmed into the neurostimulator for each stimulation pulse, and wherein the automatically programming is performed without requiring user input and includes automatically pausing stimulation according to the specified length between consecutive ones of the stimulation pulses.

2. The electronic device of claim 1, wherein the tasks further comprise:

receiving patient feedback for each of the stimulation pulses; and

recommending, based on the received patient feedback, one or more of the stimulation pulses as optimal stimulation pulses.

3. The electronic device of claim 1, wherein the selected subset contains at least two different types of stimulation parameters, and wherein at least one of the stimulation parameters is a stimulation frequency or a stimulation pulse width.

4. The electronic device of claim 1, wherein the bracketed values for each stimulation parameter include the initial value.

5. The electronic device of claim 1, wherein the tasks further comprise:

obtaining a respective step size for each of the stimulation parameters in the selected subset.

6. The electronic device of claim 5, wherein the generating the bracketed values comprises generating each bracketed value to be offset from the initial value by a different integer multiple of the step size associated with the stimulation parameter, and wherein the initial value is a median of the bracketed values.

7. The electronic device of claim 1, wherein the automatically programming is performed for a single contact having a first electrode polarity, and wherein the tasks further comprise:

assigning a second electrode polarity opposite the first electrode polarity to the single contact; and

thereafter repeating the automatically programming for the single contact.

8. The electronic device of claim 1, wherein the obtaining the respective initial value comprises receiving the respective initial value from the user or calculating the initial values using a Computer Assisted Stimulation Programming (CASP) technique.

9. The electronic device of claim 1, wherein the user interface comprises a touchscreen.

10. The electronic device of claim 9, wherein the user interface is configured to display a programming screen for programming one or more electrodes on an implanted lead, the programming screen containing a bracketing icon which, upon being pressed by the user, triggers the displaying of the plurality of stimulation parameters available for bracketing.

11. A medical system, comprising:

a neurostimulator configured to deliver electrical stimulation to a patient via one or more of a plurality of contacts located on a lead; and

a portable electronic programmer having an electronic processor and a touch-sensitive graphical user interface, wherein the electronic programmer is configured to;

display, through the touch-sensitive graphical user interface, a plurality of stimulation parameters available for bracketing, the stimulation parameters being selected from the group consisting of;

stimulation current amplitude, pulse width, frequency, and contact location;

select, in response to a user input received through the touch-sensitive graphical user interface, at least a subset of the stimulation parameters for bracketing;

obtain a respective initial value for each of the stimulation parameters in the selected subset;

generate, through a bracketing process performed by the electronic processor, a plurality of bracketed values for each of the stimulation parameters in the selected subset, wherein the bracketed values are generated as a function of the initial value, wherein at least some of the bracketed values are each greater than the initial value;

receiving, via the touch-sensitive graphical user interface, a specified length of a pause between consecutive stimulation pulses; and

automatically program, without requiring any user input, the neurostimulator to deliver a plurality of stimulation pulses to the patient, wherein a different combination of the bracketed values is programmed into the neurostimulator for each stimulation pulse, and wherein the neurostimulator is automatically programmed without requiring user input, and wherein the stimulation pulses are automatically paused according to the specified length between consecutive ones of the stimulation pulses.

12. The medical system of claim 11, further comprising a patient feedback tool, and wherein the electronic programmer is further configured to:

receive, through the patient feedback tool, patient feedback for each of the stimulation pulses; and

recommend, based on the received patient feedback, one or more of the stimulation pulses as optimal stimulation pulses.

13. The medical system of claim 11, wherein the selected subset contains at least two different types of stimulation parameters, and wherein at least one of the stimulation parameters is a stimulation frequency or a stimulation pulse width.

14. The medical system of claim 11, wherein the bracketed values for each stimulation parameter include the initial value.

15. The medical system of claim 11, wherein the electronic programmer is further configured to:

obtain a respective step size for each of the stimulation parameters in the selected subset.

16. The medical system of claim 15, wherein each bracketed value is offset from the initial value by a different integer multiple of the step size associated with the stimulation parameter, and wherein the initial value is a median of the bracketed values.

17. The medical system of claim 11, wherein the electronic programmer is configured to program a single contact of the neurostimulator having a first electrode polarity, and wherein the electronic programmer is further configured to:

assign a second electrode polarity opposite the first electrode polarity to the single contact; and

thereafter repeat a programming of the neurostimulator to deliver the plurality of stimulation pulses for the single contact.

18. The medical system of claim 11, wherein the respective initial values are received from the user or calculated using a Computer Assisted Stimulation Programming (CASP) technique.

19. The medical system of claim 11, wherein the electronic programmer has a touchscreen configured to display the touch-sensitive graphical user interface, and wherein the touch-sensitive graphical user interface includes a programming screen for programming one or more contacts on the lead, the programming screen containing a bracketing icon which, upon being pressed by the user, triggers the display of the plurality of stimulation parameters available for bracketing.

20. An electronic apparatus for setting stimulation parameters of a neurostimulator to deliver neurostimulation, the electronic apparatus comprising:

input/output means for communicating with a user, the input/output means including a touch-sensitive screen configured to detect an input from the user and display an output to the user;

memory storage means for storing executable instructions; and

computer processor means for executing the instructions to perform the following tasks;

displaying a plurality of stimulation parameters available for bracketing, the stimulation parameters being selected from the group consisting of;

stimulation current amplitude, pulse width, frequency, and contact location;

selecting, in response to an input from a user, at least a subset of the stimulation parameters for bracketing;

obtaining a respective initial value for each of the stimulation parameters in the selected subset;

generating, through a bracketing process, a plurality of bracketed values for each of the stimulation parameters in the selected subset, wherein the bracketed values are generated as a function of the initial value, wherein the bracketed values include values that are greater than the initial value and values that are less than the initial value;

receiving, via the input/output means, a specified length of a pause between consecutive stimulation pulses; and

automatically programming, without requiring user input, the neurostimulator to deliver a plurality of stimulation pulses to a patient, wherein a different combination of the bracketed values is programmed into the neurostimulator for each stimulation pulse, and wherein the automatically programming is performed without requiring user input and includes automatically pausing stimulation according to the specified length between consecutive ones of the stimulation pulses.

21. The electronic apparatus of claim 20, wherein the tasks further comprise:

receiving patient feedback for each of the stimulation pulses; and

recommending, based on the received patient feedback, one or more of the stimulation pulses as optimal stimulation pulses.

22. The electronic apparatus of claim 20, wherein the selected subset contains at least two different types of stimulation parameters, and wherein at least one of the stimulation parameters is a stimulation frequency or a stimulation pulse width.

23. The electronic apparatus of claim 20, wherein the bracketed values for each stimulation parameter include the initial value.

24. The electronic apparatus of claim 20, wherein the tasks further comprise:

obtaining a respective step size for each of the stimulation parameters in the selected subset.

25. The electronic apparatus of claim 24, wherein the generating the bracketed values comprises generating each bracketed value to be offset from the initial value by a different integer multiple of the step size associated with the stimulation parameter, and wherein the initial value is a median of the bracketed values.

26. The electronic apparatus of claim 20, wherein the automatically programming is performed for a single contact having a first electrode polarity, and wherein the tasks further comprise:

assigning a second electrode polarity opposite the first electrode polarity to the single contact; and

thereafter repeating the automatically programming for the single contact.

27. The electronic apparatus of claim 20, wherein the obtaining the respective initial value comprises receiving the respective initial value from the user or calculating the initial values using a Computer Assisted Stimulation Programming (CASP) technique.

28. The electronic apparatus of claim 20, wherein the touch-sensitive screen is configured to display a programming screen for programming one or more electrodes on an implanted lead, the programming screen containing a bracketing icon which, upon being pressed by the user, triggers the displaying of the plurality of stimulation parameters available for bracketing.

29. An electronic device for setting stimulation parameters of a neurostimulator to deliver neurostimulation to a patient, the electronic device comprising:

a graphical user interface configured to receive an input from, and display an output to, a user;

a memory storage component configured to store programming code; and

a computer processor configured to execute the programming code to perform operations comprising;

displaying, via the graphical user interface, a plurality of stimulation parameters eligible for bracketing, the stimulation parameters being selected from the group consisting of;

stimulation current amplitude, pulse width, frequency, and contact location;

selecting at least a subset of the stimulation parameters for bracketing;

obtaining a respective initial value for each of the stimulation parameters in the selected subset;

receiving, via the graphical user interface, a specified length of a pause between consecutive stimulation pulses of a plurality of stimulation pulses;

generating, through a bracketing process, a plurality of bracketed values for each of the stimulation parameters in the selected subset, wherein the bracketed values are generated based on the initial value, wherein a first subset of the bracketed values are each greater than the initial value, and wherein a second subset of the bracketed values are each less than the initial value; and

causing a pulse generator to deliver a plurality of stimulation pulses to a patient by automatically programming the pulse generator with a different combination of the bracketed values for the stimulation parameters for each stimulation pulse, and wherein the automatically programming is performed without requiring user input and includes automatically pausing stimulation according to the specified length between consecutive ones of the stimulation pulses.

30. The electronic device of claim 29, wherein the first subset of the bracketed values and the second subset of the bracketed values are symmetrically distributed with respect to the initial value.

31. The electronic device of claim 30, wherein the pulse generator is programmed to deliver the stimulation pulses for a single contact having a first electrode polarity, and wherein the operations further comprise:

assigning a second electrode polarity opposite the first electrode polarity to the single contact; and

thereafter causing the pulse generator to deliver the stimulation pulses again for the single contact.

32. The electronic device of claim 29, wherein the operations further comprise:

receiving patient feedback for each of the stimulation pulses; and

recommending, based on the received patient feedback, one or more of the stimulation pulses as optimal stimulation pulses.

33. The electronic device of claim 29, wherein the selected subset contains at least two different types of stimulation parameters, and wherein at least one of the stimulation parameters is a stimulation frequency or a stimulation pulse width.

34. The electronic device of claim 29, wherein the bracketed values for each stimulation parameter include the initial value.

35. The electronic device of claim 29, wherein the operations further comprise:

obtaining a respective step size for each of the stimulation parameters in the selected subset.

36. The electronic device of claim 35, wherein the generating the bracketed values comprises generating each bracketed value to be offset from the initial value by a different integer multiple of the step size associated with the stimulation parameter, and wherein the initial value is a median of the bracketed values.

37. The electronic device of claim 29, wherein the obtaining the respective initial value comprises receiving the respective initial value from the user or calculating the initial values using a Computer Assisted Stimulation Programming (CASP) technique.

38. The electronic device of claim 29, wherein the operations further comprise displaying a programming screen for programming one or more contacts on an implanted lead, the programming screen containing a bracketing icon which, upon being engaged by the user, triggers the displaying of the plurality of stimulation parameters eligible for bracketing.