Determining nerve location relative to electrodes

Patent metadata

Field	Value
Publication number	US-10448889-B2
Application number	US-201213456829-A
Country	US
Kind code	B2
Filing date	Apr 26, 2012
Priority date	Apr 29, 2011
Publication date	Oct 22, 2019
Grant date	Oct 22, 2019

Abstract

An implantable nerve stimulator is implanted in a patient near a nerve target. The implantable nerve stimulator has a plurality of electrodes through which stimulation is provided to the nerve target. The relative location of the nerve target and the electrodes may be determined by applying stimulation to the nerves via each of the electrodes, determining an effect of the stimulation for each of the electrodes, and mapping a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.

First claim

The invention claimed is:

1. A method comprising:
applying electrical stimulation to a nerve of a patient via each of a plurality of implantable electrodes arranged in at least one row and at different axial positions along an axial length of a lead, the lead and the plurality of implantable electrodes having an orientation transverse to the nerve and crossing proximate to the nerve to position one or more of the plurality of implantable electrodes in proximity to the nerve, wherein each of the plurality of implantable electrodes is coupled to an implantable electrical stimulator configured to generate the electrical stimulation to deliver stimulation therapy via at least some of the plurality of implantable electrodes;
determining, respective intensity threshold levels for each of the plurality of implantable electrodes, the respective intensity threshold levels for each of the plurality of implantable electrodes including a first intensity threshold level corresponding to at least one of a perception stimulation threshold or a paresthesia stimulation threshold and a second intensity threshold level corresponding to an upper stimulation threshold of the nerve for electrical stimulation delivered by that respective electrode of the plurality of implantable electrodes, the determining comprising adjusting intensities of the electrical stimulation applied via each of the plurality of implantable electrodes to the first intensity threshold level corresponding to the at least one of the perception stimulation threshold or the paresthesia stimulation threshold and the second intensity threshold level corresponding to the upper stimulation threshold of the nerve; and
mapping a location of the nerve relative to each of the plurality of implantable electrodes based at least in part on the respective intensity threshold levels determined for each of the plurality of implantable electrodes.

2. The method of claim 1 , wherein adjusting intensities comprises increasing the intensities of the electrical stimulation applied via each respective electrode of the plurality of implantable electrodes from a base level to each of the respective intensity threshold levels.

3. The method of claim 1 , wherein mapping the location of the nerve relative to each of the plurality of implantable electrodes comprises mapping the location of the nerve relative to each of the plurality of implantable electrodes based on a usability range for the respective electrode of the plurality of implantable electrodes, wherein the usability range for the respective electrode of the plurality of implantable electrodes is defined as the difference between the first intensity threshold level corresponding to the at least one of the perception stimulation threshold or the paresthesia stimulation threshold and the second intensity threshold level corresponding to the upper stimulation threshold of the nerve for electrical stimulation delivered by that respective electrode of the plurality of implantable electrodes.

4. The method of claim 1 , wherein mapping the location of the nerve relative to each of the plurality of implantable electrodes comprises mapping a relative location derived in both an X and a Y direction between the nerve and the respective electrode of the plurality of implantable electrodes.

5. The method of claim 1 , wherein mapping the location of the nerve relative to the each of the plurality of implantable electrodes comprises mapping a relative orientation between the nerve and the respective electrode of the plurality of implantable electrodes.

6. The method of claim 1 , further comprising automatically selecting one or more of the plurality of implantable electrodes to apply chronic electrical stimulation to a tissue adjacent the nerve based on the location of the nerve relative to the one or more of the plurality of implantable electrodes.

7. The method of claim 1 , further comprising automatically selecting one or more of the plurality of implantable electrodes to apply chronic electrical stimulation to a tissue adjacent the nerve based on at least one of the first intensity threshold level corresponding to the at least one of the perception stimulation threshold or the paresthesia stimulation threshold and the second intensity threshold level corresponding to the upper stimulation threshold for each of the plurality of implantable electrodes.

8. The method of claim 1 , further comprising: displaying a graphical representation of the location of the nerve relative to the electrodes.

9. The method of claim 1 , wherein the upper stimulation threshold corresponds to a pain threshold or a discomfort threshold.

10. The method of claim 6 , further comprising: delivering the chronic electrical stimulation to the tissue adjacent the nerve based on the selection of the one or more of the plurality of implantable electrodes.

11. The method of claim 7 , further comprising: delivering the chronic electrical stimulation to the tissue adjacent the nerve based on the selection of the one or more of the plurality of implantable electrodes.

12. The method of claim 1 , wherein mapping the location of the nerve further comprises determining that an electrode of the plurality of implantable electrodes with a lowest respective first intensity threshold level corresponding to the at least one of the perception stimulation threshold or the paresthesia stimulation threshold is the electrode of the plurality of implantable electrodes that is closest to the nerve.

13. The method of claim 1 , wherein the at least one row of the plurality of implantable electrodes comprises only a single row extending along the axial length of the lead.

14. The method of claim 1 , wherein the at least one row of the plurality of implantable electrodes comprises a plurality of rows arranged on an implantable paddle lead.

15. A system comprising:
an implantable lead;
a plurality of implantable electrodes arranged in at least one row and at different axial positions along an axial length of the implantable lead, the lead and the plurality of implantable electrodes having an orientation transverse to a nerve of a patient and crossing proximate to the nerve to position one or more of the plurality of implantable electrodes in proximity to the nerve;
an implantable electrical stimulator connected to the plurality of implantable electrodes and configured to generate electrical stimulation to deliver stimulation therapy via at least some of the plurality of implantable electrodes; and
a processor configured to control the implantable electrical stimulator to:
apply electrical stimulation to the nerve of the patient via each of the plurality of implantable electrodes;
determine, respective intensity threshold levels for each of the plurality of implantable electrodes, the respective intensity threshold levels for each of the plurality of implantable electrodes including a first intensity threshold level corresponding to at least one of a perception stimulation threshold or a paresthesia stimulation threshold and a second intensity threshold level corresponding to an upper stimulation threshold of the nerve for electrical stimulation delivered by that respective electrode of the plurality of implantable electrodes, the determination comprising adjusting intensities of the electrical stimulation applied via each of the plurality of implantable electrodes to the first intensity threshold level corresponding to the at least one of the perception stimulation threshold or the paresthesia stimulation threshold and the second intensity threshold level corresponding to an upper stimulation threshold of the nerve

Assignees

• Gerber Martin T
• Goetz Steven M
• Poletto Christopher
• Medtronic Inc

Inventors

• Gerber Martin T
• Goetz Steven M
• Poletto Christopher

Classifications

• A61N1/36185

  Selection of the electrode configuration · CPC title

• A61B5/4893 Primary

  Nerves · CPC title

• A61B5/6877

  Nerve · CPC title

• A61N1/0551

  Spinal or peripheral nerve electrodes · CPC title

• A61N1/0529

  Electrodes for brain stimulation · CPC title