Neural stimulation system providing auto adjustment of stimulus output as a function of sensed impedance

• US 8,626,312 B2
• Filed: 03/22/2011
• Issued: 01/07/2014
• Est. Priority Date: 02/12/2002
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: King, John D. H., Thacker, James R.
• Primary Examiner(s): DIETRICH, JOSEPH M
• Application Number:
  US13/069,143
• Publication Number:
  US 20110190847A1
• Time in Patent Office: 1,022 Days
• Field of Search: 607/28, 607/62, 13/28, 13/62
• US Class Current: 607/62
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/3615 Intensity

Abstract

A neural stimulation system automatically corrects or adjusts the stimulus magnitude (stimulation energy) in order to maintain a comfortable and effective stimulation therapy. Because the changes in impedance associated with the electrode-tissue interface can indicate obstruction of current flow and positional lead displacement, lead impedance can indicate the quantity of electrical stimulation energy that should be delivered to the target neural tissue to provide corrective adjustment. Hence, a change in impedance or morphology of an impedance curve may be used in a feedback loop to indicate that the stimulation energy needs to be adjusted and the system can effectively auto correct the magnitude of stimulation energy to maintain a desired therapeutic effect.

Claims

1. A method for controlling a neurostimulation system, comprising:

delivering a first electrical stimulus to neural tissue of a patient via at least one electrode of the neurostimulation system in accordance with a stimulus parameter having a first value;

taking at least two impedance samples over time indicative of a variation in coupling efficiency between the delivered electrical stimulus and the neural tissue;

computing an impedance change by comparing the at least two impedance samples to each other;

based at least in part on the computed impedance change, adjusting the value of the stimulus parameter from the first value to a second value different from the first value; and

delivering a second electrical stimulus to the neural tissue of the patient via the at least one electrode in accordance with the stimulus parameter having the second value.

2. The method of claim 1, wherein the stimulus parameter is one of an amplitude, pulse width, and frequency of the electrical stimulus.

3. The method of claim 1, wherein the neural tissue is spinal cord tissue.

4. The method of claim 1, further comprising delivering another electrical stimulus to the neural tissue of the patient via the at least one electrode in accordance with the stimulus parameter having the first value after the impedance change is computed, wherein the impedance change causes the other electrical stimulus to be delivered to the neural tissue at a decreased level relative to the level at which the first electrical stimulus is delivered to the neural tissue, and the second electrical stimulus is delivered to the neural tissue of the patient at a level greater than the level at which the other electrical stimulus is delivered to the neural tissue.

5. The method of claim 4, wherein the level at which the second electrical stimulus is delivered to the neural tissue is substantially equal to the level at which the first electrical stimulus is delivered to the neural tissue.

6. The method of claim 4, wherein adjusting the value of the stimulus parameter comprises correlating the computed impedance change to a stored adjustment in the value of the stimulus parameter.

7. The method of claim 1, further comprising delivering another electrical stimulus to the neural tissue of the patient via the at least one electrode in accordance with the stimulus parameter having the first value after the impedance change is computed, wherein the impedance change causes the other electrical stimulus to be delivered to the neural tissue at an increased level relative to the level at which the first electrical stimulus is delivered to the neural tissue, and the second electrical stimulus is delivered to the neural tissue of the patient at a level less than the level at which the other electrical stimulus is delivered to the neural tissue.

8. The method of claim 7, wherein the level at which the second electrical stimulus is delivered to the neural tissue is substantially equal to the level at which the first electrical stimulus is delivered to the neural tissue.

9. The method of claim 1, wherein the impedance change results from a build up of scar tissue on the at least one electrode.

10. The method of claim 1, wherein impedance change results from a change in position of the at least one electrode relative to the neural tissue.

11. The method of claim 1, wherein impedance change results from a change in impedance resulting from a change in the patient'"'"'s posture.

12. The method of claim 1, further comprising establishing a trend for future changes in impedance at least based in part on the computed impedance change.

13. The method of claim 1, wherein taking the at least two impedance samples over time comprises monitoring at least two electrical stimuli delivered to the neural tissue of the patient via the at least one electrode.

14. The method of claim 1, wherein taking the at least two impedance samples over time comprises applying at least two electrical signals independent of the electrical stimuli delivered to the neural tissue of the patient via the at least one electrode, and monitoring the at least two electrical signals.

15. The method of claim 1, wherein the value of the stimulus parameter is automatically adjusted from the first value to the second value without human intervention.

16. A neurostimulation system, comprising:

at least one electrode configured for being positioned in electrical communication with neural tissue of a patient when implanted;

an implantable pulse generator configured for delivering electrical stimuli to the neural tissue via the at least one electrode in accordance with a stimulus parameter;

an impedance detector configured for taking at least two impedance samples over time indicative of a variation in coupling efficiency between the delivered electrical stimulus and the neural tissue; and

a processor configured for receiving the at least two impedance samples from the impedance detector, computing an impedance change by comparing the at least two impedance samples to each other, and based at least in part on the computed impedance change, adjusting a value of the stimulus parameter.

17. The neurostimulation system of claim 16, wherein the stimulus parameter is one of an amplitude, pulse width, and frequency.

18. The neurostimulation system of claim 16, wherein the processor is configured for adjusting the value of the stimulus parameter in response to a computed increase in the impedance in a manner that increases the level at which an electrical stimulus generated in accordance with the adjusted value of the stimulation parameter.

19. The neurostimulation system of claim 16, further comprising memory storing an adjustment in the value of the stimulus parameter, wherein the processor is configured for adjusting the value of the stimulus parameter by correlating the computed impedance change to the stored adjustment in the value of the stimulus parameter.

20. The neurostimulation system of claim 16, wherein the processor is configured for adjusting the value of the stimulus parameter in response to a computed decrease in the impedance in a manner that decreases the level at which an electrical stimulus generated in accordance with the adjusted value of the stimulation parameter.

21. The neurostimulation system of claim 16, wherein the impedance detector is configured for taking the at least two impedance samples over time by monitoring at least two electrical stimuli delivered to the neural tissue of the patient via the at least one electrode.

22. The neurostimulation system of claim 16, wherein the impedance detector is configured for taking the at least two impedance samples over time comprises applying at least two electrical signals independent of the electrical stimuli delivered to the neural tissue of the patient via the at least one electrode, and monitoring the at least two electrical signals.

23. The neurostimulation system of claim 16, wherein the processor is configured for automatically adjusting the value of the stimulus parameter without human intervention.