Tree-based electrical stimulator programming

• US 7,706,889 B2
• Filed: 04/30/2007
• Issued: 04/27/2010
• Est. Priority Date: 04/28/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gerber, Martin T., Rondoni, John C.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Kimball; Jeremiah T
• Application Number:
  US11/799,113
• Publication Number:
  US 20070265664A1
• Time in Patent Office: 1,093 Days
• Field of Search: 607/2, 607/54
• US Class Current: 607/59
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

The disclosure describes an implantable stimulation system that guides programming with a therapeutic tree. All possible stimulation parameters are arranged on the therapeutic tree, with each level of the therapeutic tree containing a different stimulation parameter type. Each level includes nodes that are connected to nodes of adjacent levels. A program path is created by moving through nodes of lower levels. The stimulation parameter types are arranged so that coarse adjustments occur at higher levels of the tree and fine adjustments occur at lower levels of the tree. The nodes of the program path define the stimulation parameters of the delivered stimulation therapy. Performance feedback may be used by the system to evaluate nodes of the therapeutic tree and define the program path. The performance feedback may include beneficial effects, adverse effects, and system performance related to the stimulation therapy. Additionally, one or more sensors may provide the performance feedback.

Claims

1. A method for providing electrical stimulation therapy, the method comprising:

defining a tree structure having a plurality of levels and a plurality of nodes in each of the levels, wherein each of the nodes is interconnected with at least one node above and at least two nodes below in the tree structure, each node defines respective values for a set of electrical stimulation parameters, the nodes in each level specify an adjustment to a value of at least one type of stimulation parameter, and the nodes in different levels specify adjustments to the value of different types of stimulation parameters;

defining a program path through the tree structure along a series of the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes exceeds a threshold level, wherein the performance feedback comprises system performance feedback indicative of power consumption of a medical device that delivers the stimulation therapy according to the stimulation parameters defined by the selected node;

selecting one of the nodes in the program path; and

delivering the stimulation therapy to a patient based on the parameters defined by the selected node to treat a patient.

2. The method of claim 1, wherein the performance feedback further comprises at least one of a beneficial effect or an adverse effect.

3. The method of claim 2, further comprising weighting at least one of the beneficial effect, the adverse effect, and the system performance feedback to indicate a relative importance of at least two of the beneficial effect, the adverse effect, and the system performance feedback to define the program path.

4. The method of claim 1, wherein the system performance feedback comprises a power usage value, and wherein defining the program path through the tree further comprises selecting at least one node to minimize the power usage value.

5. The method of claim 1, wherein the stimulation therapy comprises at least one of spinal cord stimulation, deep brain stimulation, peripheral nerve stimulation, or peripheral nerve field stimulation.

6. The method of claim 1, wherein the stimulation therapy treats a movement disorder.

7. The method of claim 1, further comprising specifying which stimulation parameters are adjusted at which levels of the tree based on user input.

8. The method of claim 1, further comprising:

prompting a user to provide the performance feedback input;

receiving the performance feedback input via an external programmer; and

displaying the performance feedback input to the user.

9. The method of claim 1, further comprising receiving the performance feedback input via at least one sensor that measures a physiological parameter.

10. The method of claim 9, wherein the sensor measures at least one of a gait, a tremor, a seizure, and posture.

11. The method of claim 1, wherein the therapeutic tree comprises at least four levels.

12. The method of claim 11, wherein a first, top level of the tree specifies an adjustment to stimulation electrode configuration, a second level specifies an adjustment to stimulation pulse rate, a third level specifies an adjustment to stimulation pulse width, and a fourth, bottom level specifies an adjustment to stimulation pulse amplitude.

13. The method of claim 12, wherein the first level of the tree comprises two sublevels of the tree including a first sublevel that specifies an adjustment to an electrode level of a complex electrode array geometry and a second sublevel that specifies an adjustment to an electrode perimeter position of the complex electrode array geometry.

14. The method of claim 1, wherein the stimulation parameters include stimulation electrode configuration, stimulation pulse rate, stimulation pulse width, and stimulation pulse amplitude.

15. The method of claim 1, further comprising defining the tree within an external programmer associated with an implantable electrical stimulator.

16. The method of claim 1, further comprising:

detecting an activity undertaken by the patient;

defining a program path specific to the activity through the tree structure along a series or the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes during the activity exceeds a threshold level;

subsequently detecting the activity; and

delivering the stimulation therapy to the patient according to the previously defined program path specific to the activity.

17. A system for providing electrical stimulation therapy, the system comprising:

a memory defining a tree structure having a plurality of levels and a plurality of nodes in each of the levels, wherein each of the nodes is interconnected with at least one node above and at least two nodes below in the tree structure, each node defines respective values for a set of electrical stimulation parameters, the nodes in each level specify an adjustment to a value of at least one type of stimulation parameter, and the nodes in different levels specify the adjustments to the value of different types of stimulation parameters; and

a processor configured to define a program path through the tree structure along a series of the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes exceeds a threshold level, selects one of the nodes in the program path, and controls delivery of the stimulation therapy to a patient based on the parameters defined by the selected node to treat a patient, wherein the performance feedback comprises system performance feedback indicative of power consumption of a medical device that delivers the stimulation therapy according to the stimulation parameters defined by the selected node.

18. The system of claim 17, wherein the performance feedback further comprises at least one of a beneficial effect or an adverse effect.

19. The system of claim 18, wherein the processor weights at least one of the beneficial effects, the adverse effects, and the system performance feedback to indicate a relative importance of at least two of the beneficial effects, the adverse effects, and the system performance feedback for defining the program path.

20. The system of claim 17, wherein the system performance feedback comprises a power usage value, and wherein the processor defines the program path by selecting at least one node to minimize the power usage value.

21. The system of claim 17, wherein the stimulation therapy comprises at least one of spinal cord stimulation, deep brain stimulation, peripheral nerve stimulation, or peripheral nerve field stimulation.

22. The system of claim 17, wherein the stimulation therapy treats a movement disorder.

23. The system of claim 17, wherein the processor specifies which stimulation parameters are adjusted at which levels of the tree based on user input.

24. The system of claim 17, wherein:

the processor prompts the user via the user interface to provide the performance feedback input; and

the processor receives the performance feedback input from a user via the user interface; and

the user interface displays the performance feedback input to the user.

25. The system of claim 17, further comprising a sensor that measures a physiological parameter of the patient, wherein the processor receives the performance feedback input from the sensor.

26. The system of claim 25, wherein the sensor is configured to measure at least one of a gait, a tremor, a seizure, and posture.

27. The system of claim 17, wherein the therapeutic tree comprises at least four levels.

28. The system of claim 27, wherein a first, top level of the tree specifies an adjustment to stimulation electrode configuration, a second level specifies an adjustment to stimulation pulse rate, a third level specifies an adjustment to stimulation pulse width, and a fourth, bottom level specifies an adjustment to stimulation pulse amplitude.

29. The system of claim 28, wherein the first level of the tree comprises two sublevels of the tree including a first sublevel that specifies an adjustment to an electrode level of a complex electrode array geometry and a second sublevel that specifies an adjustment to an electrode perimeter position of the complex electrode array geometry.

30. The system of claim 17, wherein the stimulation parameters include stimulation electrode configuration, stimulation pulse rate, stimulation pulse width, and stimulation pulse amplitude.

31. The system of claim 17, wherein the processor resides within an external programmer associated with an implantable electrical stimulator.

32. The system of claim 17, wherein the processor:

detects an activity undertaken by the patient;

defines a program path specific to the activity through the tree structure along a series of the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes during the activity exceeds a threshold level;

subsequently detects the activity; and

control delivery of the stimulation therapy to the patient according to the previously defined program path specific to the activity.

33. A computer-readable medium comprising instructions that cause a processor to:

define a tree structure having a plurality of levels and a plurality of nodes in each of the levels, wherein each of the nodes is interconnected with at least one node above and at least two nodes below in the tree structure, each node defines respective values for a set of electrical stimulation parameters, the nodes in each level specify an adjustment to a value of at least one type of stimulation parameter, and the nodes in different levels specify adjustments to the value of different types of stimulation parameters;

define a program path through the tree structure along a series of the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes exceeds a threshold level, wherein the performance feedback comprises system performance feedback indicative of power consumption of a medical device that delivers the stimulation therapy according to the stimulation parameters defined by the selected node;

select one of the nodes in the program path; and

deliver the stimulation therapy to a patient based on the parameters defined by the selected node to treat a patient.

34. The computer-readable medium of claim 33, wherein the performance further comprises at least one of a beneficial effect or an adverse effect.

35. The computer-readable medium of claim 34, further comprising instructions that cause the processor to weight at least one of the beneficial effects, the adverse effects, and the system performance feedback to indicate a relative importance of at least two of the beneficial effects, the adverse effects, and the system performance feedback for defining the program path.

36. The computer-readable medium of claim 33, further comprising instructions that cause the processor to receive the performance feedback input from a sensor that measures a physiological parameter of the patient.

37. The computer-readable medium of claim 36, further comprising instructions that cause the processor receive sensor measurements of at least one of a gait, a tremor, a seizure, and posture.

38. The computer-readable medium of claim 33, wherein the therapeutic tree comprises at least four levels.

39. The computer-readable medium of claim 38, wherein a first, top level of the tree specifies an adjustment to stimulation electrode configuration, a second level specifies an adjustment to stimulation pulse rate, a third level specifies an adjustment to stimulation pulse width, and a fourth, bottom level specifies an adjustment to stimulation pulse amplitude.

40. The computer-readable medium of claim 39, wherein the first level of the tree comprises two sublevels of the tree including a first sublevel that specifies an adjustment to an electrode level of a complex electrode array geometry and a second sublevel that specifies an adjustment to an electrode perimeter position of the complex electrode array geometry.

41. The computer-readable medium of claim 33, wherein the instructions cause the processor to define the tree within an external programmer associated with an implantable electrical stimulator.

42. The computer-readable medium of claim 33, wherein the stimulation therapy treats a movement disorder of the patient.

43. The computer-readable medium of claim 33, further comprising instructions that cause the processor to:

detect an activity undertaken by the patient;

define a program path specific to the activity through the tree structure along a series of the interconnected nodes for which performance feedback regarding stimulation therapy delivered according to the stimulation parameters defined by the nodes during the activity exceeds a threshold level;

subsequently detect the activity; and

control delivery of the stimulation therapy to the patient according to the previously defined program path specific to the activity.