Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy

• US 20060015153A1
• Filed: 07/15/2005
• Published: 01/19/2006
• Est. Priority Date: 07/15/2004
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Wyler, Allen, Fowler, Brad, Sheffield, W. Douglas, Gliner, Bradford Evan, Sloan, Leif R., Kuntz, Richard, Leyde, Kent
• Granted Patent: US 7,483,747 B2
• Time in Patent Office: Days
• US Class Current: 607/45
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/3606 adapted for a particular treatment
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36103 Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• 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: G06F 13/385 for adaptation of a particular data processing system to different peripheral devices
• CPC Class Codes: H04L 49/90 Buffering arrangements
• CPC Class Codes: H04L 49/901 using storage descriptor, e.g. read or write pointers
• CPC Class Codes: H04L 67/565 Conversion or adaptation of application format or content adding application control or application functional data H04L67/561
• CPC Class Codes: H04L 67/568 Storing data temporarily at an intermediate stage, e.g. caching
• CPC Class Codes: Y02D 10/00 Energy efficient computing, e.g. low power processors, power management or thermal management

Abstract

Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy are disclosed. In one embodiment, a system and/or method may apply electromagnetic stimulation to a patient'"'"'s nervous system over a first time domain according to a first set of stimulation parameters, and over a second time domain according to a second set of stimulation parameters. The first and second time domains may be sequential, simultaneous, or nested. Stimulation parameters may vary in accordance with one or more types of duty cycle, amplitude, pulse repetition frequency, pulse width, spatiotemporal, and/or polarity variations. Stimulation may be applied at subthreshold, threshold, and/or suprathreshold levels in one or more periodic, aperiodic (e.g., chaotic), and/or pseudo-random manners. In some embodiments stimulation may comprise a burst pattern having an interburst frequency corresponding to an intrinsic brainwave frequency, and regular and/or varying intraburst stimulation parameters. Stimulation signals providing reduced power consumption with at least adequate symptomatic relief may be applied prior to moderate or significant power source depletion.

Claims

1. A method for treating a neurological condition of a patient, comprising:

applying electromagnetic stimulation to a patient'"'"'s nervous system over a first time domain with a first waveform having a first set of parameters; and

applying electromagnetic stimulation to the patient'"'"'s nervous system over a second time domain with a second waveform having a second set of parameters, wherein at least one parameter of the second set is different than a corresponding parameter of the first set.

2. The method of claim 1 wherein the applying electromagnetic stimulation over at least one of the first and second time domains includes applying electromagnetic stimulation at sub-threshold levels.

3. The method of claim 1 wherein the applying electromagnetic stimulation over at least one of the first and second time domains includes applying electromagnetic stimulation at at least two of the following levels:

sub-threshold, threshold, and suprathreshold.

4. The method of claim 1, further comprising:

interrupting the application of electromagnetic stimulation between the first and second time domains; and

selecting the at least one parameter of the second set to reduce power consumption due to electrical stimulation during the second time domain compared with power consumption due to electrical stimulation during the first time domain.

5. The method of claim 4 wherein at least one of interrupting the application of electromagnetic stimulation and selecting the at least one parameter includes is performed before a power source that provides power for the electromagnetic stimulation is significantly depleted.

6. The method of claim 1 wherein applying electromagnetic stimulation over a second time domain includes applying electromagnetic stimulation over a second time domain that is sequential to the first time domain.

7. The method of claim 1 wherein applying electromagnetic stimulation over the first time domain includes applying electromagnetic stimulation at a first location and wherein applying electromagnetic stimulation over the second time domain includes applying electromagnetic stimulation at a second location different than the first location.

8. The method of claim 1 wherein applying electromagnetic stimulation over a second time domain includes applying electromagnetic stimulation over a second time domain that is initiated after initiation of the first time domain and completed before completion of the first time domain.

9. The method of claim 1 wherein applying electromagnetic stimulation includes applying electrical stimulation over multiple second time domains that are nested within the first time domain.

10. The method of claim 9 wherein the first time domain is hours-based and the second time domain is based on a time period less than hours.

11. The method of claim 1 wherein applying electromagnetic stimulation during at least one of the time domains includes applying the electromagnetic stimulation in a manner that varies aperiodically.

12. The method of claim 11 wherein applying electromagnetic stimulation includes applying electromagnetic stimulation in a manner that varies chaotically.

13. The method of claim 11 wherein applying electromagnetic stimulation includes applying electromagnetic stimulation signals in a manner that corresponds at least generally to an iterative function.

14. The method of claim 11 wherein applying electromagnetic stimulation includes applying electromagnetic stimulation signals in a manner that corresponds at least generally to a partial sum of an infinite series.

15. The method of claim 11 wherein applying electromagnetic stimulation includes applying electromagnetic stimulation signals in a manner that corresponds at least generally to a metastable attractor.

16. The method of claim 1 wherein selecting the at least one parameter includes selecting the at least one parameter to resume, at least approximately maintain, or resume and at least approximately maintain a benefit resulting from stimulation during the first time domain.

17. An apparatus for treating a neurological condition of a patient, comprising:

a stimulation device having at least one stimulator configured to be positioned in signal communication with neural tissue of a patient'"'"'s nervous system;

a signal generator;

a signal communication link operatively coupled between the stimulation device and the signal generator; and

a controller operatively coupled to the signal generator, the controller being configured to provide instructions to the signal generator that;

direct an application of electromagnetic stimulation to the patient'"'"'s nervous system over a first time domain with a first waveform having a first set of parameters; and

direct an application of electromagnetic stimulation to the patient'"'"'s nervous system over a second time domain with a second waveform having a second set of parameters, wherein at least one parameter of the second set is different than a corresponding parameter of the first set.

18. The apparatus of claim 17 wherein the signal generator is configured to direct application of electromagnetic stimulation at sub-threshold levels.

19. The apparatus of claim 17 wherein the controller includes stored instructions that direct electromagnetic stimulation over the first and second time domains.

20. The apparatus of claim 17 wherein the stimulation device includes an electrode device, and wherein the at least one stimulator includes at least one electrode.

21. The apparatus of claim 17 wherein the signal generator includes an implantable pulse generator configured to be implanted in the patient.

22. The apparatus of claim 17 wherein the signal generator includes an implantable housing configured to be implanted in the patient, and wherein the housing carries a first pulse generator and a second pulse generator.

23. The apparatus of claim 22 wherein the first pulse generator is configured to deliver electromagnetic stimulation over the first time domain, and the second pulse generator is configured to deliver electromagnetic stimulation over the second time domain.

24. The apparatus of claim 22 wherein the first pulse generator is configured to deliver electromagnetic stimulation to a first location of the patient'"'"'s body and the second pulse generator is configured to deliver electromagnetic stimulation to a second location of the patient'"'"'s body.

25. The apparatus of claim 17 wherein the controller is configured to provide instructions that direct the application of electromagnetic stimulation over a second time domain that is sequential to the first time domain.

26. The apparatus of claim 17 wherein the controller is configured to provide instructions that direct the application of electromagnetic stimulation over multiple second time domains that are nested within the first time domain.

27. The apparatus of claim 17 wherein the controller is configured to provide instructions that:

interrupt the application of electromagnetic stimulation between the first and second time domains; and

select the at least one parameter of the second set to reduce power consumption due to electrical stimulation during the second time domain compared with power consumption due to electrical stimulation during the first time domain.

28. The apparatus of claim 27, further comprising a power source coupled to the signal generator, and wherein at least one of the interrupt instruction and the select instruction is provided before the power source is significantly depleted.

29. An apparatus for treating a neurological condition of a patient, comprising:

an implantable stimulation device having at least one implantable stimulator configured to be positioned in signal communication with neural tissue of a patient'"'"'s nervous system, the stimulation device being configured to be implanted in the patient;

an implantable signal generator;

a signal communication link operatively coupled between the stimulation device and the signal generator; and

a controller operatively coupled to the signal generator, the controller being configured to provide instructions to the signal generator to direct an application of electromagnetic stimulation to the patient in a manner that varies aperiodically.

30. The apparatus of claim 29 wherein the signal generator is configured to direct application of electromagnetic stimulation at sub-threshold levels.

31. The apparatus of claim 29 wherein the signal generator is configured to direct application of electromagnetic stimulation at at least two of the following levels:

sub-threshold, threshold and suprathreshold.

32. The apparatus of claim 29 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation in a manner that varies chaotically.

33. The apparatus of claim 29 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation in a manner that corresponds to an iterative function.

34. The apparatus of claim 29 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation in a manner that corresponds to a partial sum of an infinite series.

35. The apparatus of claim 29 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation in a manner that corresponds to a metastable attractor.

36. An apparatus for treating a neurological condition of a patient, comprising:

an implantable stimulation device having at least one implantable stimulator configured to be positioned in signal communication with neural tissue of a patient'"'"'s nervous system, the stimulation device being configured to be implanted in the patient;

an implantable signal generator;

a signal communication link operatively coupled between the stimulation device and the signal generator; and

a controller operatively coupled to the signal generator, the controller being configured to provide instructions to the signal generator to direct an application of electromagnetic stimulation to the patient in a manner that varies at least generally similarly to naturally occurring brainwave variations.

37. The apparatus of claim 36 wherein the signal generator is configured to direct application of electromagnetic stimulation at sub-threshold levels.

38. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation having a burst frequency and an intra-burst frequency greater than the burst frequency.

39. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation having a burst frequency and an intra-burst frequency greater than the burst frequency, and wherein characteristics of the intra-burst stimulation vary from one burst to another.

40. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation with an inter-burst frequency that is generally similar to naturally occurring alpha brainwave frequencies, wherein the inter-burst frequency has a value of from about 8 Hz to about 13 Hz.

41. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation with an inter-burst frequency that is generally similar to naturally occurring beta brainwave frequencies, wherein the inter-burst frequency has a value of from about 13 Hz to about 30 Hz.

42. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation with an inter-burst frequency that is generally similar to naturally occurring gamma brainwave frequencies, wherein the inter-burst frequency has a value of greater than about 30 Hz.

43. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation with an inter-burst frequency that is generally similar to naturally occurring delta brainwave frequencies, wherein the inter-burst frequency has a value of less than about 4 Hz.

44. The apparatus of claim 36 wherein the controller is configured to provide instructions to direct an application of electromagnetic stimulation with an inter-burst frequency that is generally similar to naturally occurring theta brainwave frequencies, wherein the inter-burst frequency has a value of from about 4 Hz to about 8 Hz.