Point-and-click programming for deep brain stimulation using real-time monopolar review trendlines

• US 9,821,167 B2
• Filed: 01/31/2017
• Issued: 11/21/2017
• Est. Priority Date: 08/28/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Carcieri, Stephen, Chen, Dean, Moffitt, Michael A.
• Primary Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US15/420,842
• Publication Number:
  US 20170136247A1
• Time in Patent Office: 294 Days
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• 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: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A system and method for selecting leadwire stimulation parameters includes a processor iteratively performing, for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field: (a) shifting the current field longitudinally and/or rotationally to a respective plurality of locations about the leadwire; and (b) for each of the respective plurality of locations, obtaining clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and displaying a graph plotting the clinical effect information against values for the particular stimulation parameter and locations about the leadwire, and/or based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value.

Claims

1. A method for selecting electrical stimulation parameters for a leadwire implanted in patient tissue, the method comprising:

for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field, obtaining, by a computer processor, clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at each of a respective plurality of locations about the leadwire;

displaying a graph plotting the obtained clinical effect information against values for the particular stimulation parameter and the locations about the leadwire;

receiving a user selection of a point on the graph, wherein the point corresponds to a first value of the particular stimulation parameter and a first location about the leadwire;

initiating a signal, by the computer processor, to program an implantable pulse generator with the first value of the particular stimulation parameter and a selection of one or more electrodes on the leadwire corresponding to the first location about the leadwire to produce a stimulation; and

stimulating patient tissue using the programmed implantable pulse generator, the first value of the particular stimulation parameter, and the selection of the one or more electrodes on the leadwire.

2. The method of claim 1, wherein the graph is three dimensional, and further plots the obtained clinical effect information against values for a second stimulation parameter.

3. The method of claim 1, wherein the locations differ longitudinally and rotationally about the leadwire.

4. The method of claim 3, wherein the graph has three dimensions, variations in longitudinal location about the leadwire being plotted along a first one of the three dimensions of the graph and variations in rotational location about the leadwire being plotted along a second one of the three dimensions of the graph.

5. The method of claim 1, wherein the particular stimulation parameter is one of i) amplitude, ii) pulse width, or iii) frequency.

6. The method of claim 1, wherein the obtained clinical effect information includes therapeutic effect values and adverse side effect values.

7. The method of claim 6, further comprising identifying within the graph, a region whose plotted therapeutic effect values are lower than its adverse side effect values, with a greatest distance between the therapeutic effect values and the adverse side effect values.

8. The method of claim 7, further comprising determining, by the computer processor, values for the particular stimulation parameter for each of a plurality of electrodes of the leadwire.

9. The method of claim 8, further comprising displaying the determined values.

10. The method of claim 1, wherein the locations correspond to actual locations of electrodes of the leadwire or virtual locations of electrodes of the leadwire corresponding to a current field producible by a combination of a respective subset of the electrodes of the leadwire.

11. The method of claim 1, further comprising displaying on a monitor, by the computer processor, the first value for the particular stimulation parameter.

12. The method of claim 11, wherein the locations correspond to actual locations of electrodes of the leadwire or virtual locations of electrodes of the leadwire corresponding to a current field producible by a combination of a respective subset of the electrodes of the leadwire.

13. The method of claim 11, further comprising determining, by the computer processor, a combination of values for the particular stimulation parameter for each of a plurality of electrodes of the leadwire corresponding to the user-selected point, wherein a combination of the values of the particular stimulation parameter is applied by interleaving current supply to different ones of the plurality of electrodes.

14. The method of claim 11, wherein the graph is three dimensional, and further plots the obtained clinical effect information against values for a second stimulation parameter.

15. The method of claim 11, wherein the locations differ longitudinally and rotationally about the leadwire.

16. The method of claim 15, wherein the graph has three dimension, variations in longitudinal location about the leadwire being plotted along a first one of the three dimensions of the graph and variations in rotational location about the leadwire being plotted along a second one of the three dimensions of the graph.

17. The method of claim 1, further comprising positioning, by the computer processor, the respective current field at each of the respective plurality of locations about the leadwire.

18. The method of claim 17, wherein the positioning is performed by shifting the current field at least one of longitudinally and rotationally.

19. The method of claim 18, wherein the shifting is performed in response to user input of a shift instruction by selection of a control, each selection of which is interpreted by the computer processor as an instruction to shift in a respective direction by a predetermined amount.

20. A system for selecting electrical stimulation parameters for a leadwire implanted in patient tissue and stimulating the patient tissue using the selected electrical stimulation parameters, the system comprising:

a leadwire;

an implantable pulse generator coupleable to the leadwire and configured and arranged to stimulate the patient tissue; and

a computer processor configured to;

for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field, obtain clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at each of a respective plurality of locations about the leadwire;

display a graph plotting the obtained clinical effect information against values for the particular stimulation parameter and the locations about the leadwire;

receive a user selection of a point on the graph, wherein the point corresponds to a first value of the particular stimulation parameter and a first location about the leadwire; and

initiate a signal to program the implantable pulse generator with the first value of the particular stimulation parameter and a selection of one or more electrodes on the leadwire corresponding to the first location about the leadwire to produce a stimulation;

wherein the implantable pulse generator and leadwire are configured and arranged to stimulate the patient tissue, when programmed, using the first value of the particular stimulation parameter and the selection of the one or more electrodes on the leadwire.