System and method for improving nerve finding for peripheral nerve stimulation

Patent metadata

Field	Value
Publication number	US-10463852-B2
Application number	US-201715657968-A
Country	US
Kind code	B2
Filing date	Jul 24, 2017
Priority date	Jul 2, 2013
Publication date	Nov 5, 2019
Grant date	Nov 5, 2019

Abstract

Via a pulse generator, a trigger signal is generated. The trigger signal indicates one or more stimulation pulses are about to be delivered, or is being delivered, to a patient. The trigger signal is sent to a measurement instrument. Via the pulse generator, the one or more stimulation pulses are generated. The one or more stimulation pulses are delivered to the patient. With the measurement instrument and in response to the trigger signal, one or more action potentials are measured. The one or more action potentials are produced by the patient in response to the one or more stimulation pulses.

First claim

What is claimed is:

1. A method, comprising:
generating, via a pulse generator, a trigger signal that indicates one or more stimulation pulses are about to be delivered, or is being delivered, to a patient;
sending the trigger signal to a measurement instrument via a telecommunications link;
generating, via the pulse generator, the one or more stimulation pulses;
delivering the one or more stimulation pulses to the patient via a stimulation-delivering mechanism different from the telecommunications link; and
measuring, with the measurement instrument and in response to the trigger signal, one or more action potentials, wherein the one or more action potentials are produced by the patient in response to the one or more stimulation pulses.

2. The method of claim 1 , wherein:
the one or more stimulation pulses are delivered to a first body region of the patient;
the one or more action potentials are measured from a second body region of the patient; and
the first body region and the second body region are connected by a nerve.

3. The method of claim 2 , wherein:
the first body region includes a foot; and
the second body region includes a thigh.

4. The method of claim 2 , wherein the measuring comprises measuring a plurality of action potentials from a plurality of different fascicles of the nerve.

5. The method of claim 4 , further comprising:
identifying a first fascicle of the nerve as one of the fascicles that produced a greatest one of the action potentials; and
determining that the first fascicle corresponds to a target location for delivering a stimulation therapy for treating the second body region.

6. The method of claim 2 , further comprising: measuring, via an indifferent electrode placed on a third body region of the patient, a reference signal, and wherein the measuring comprises measuring the one or more action potentials with respect to the reference signal.

7. The method of claim 1 , further comprising: obtaining a moving average of the measured one or more action potentials.

8. The method of claim 1 , wherein the one or more stimulation pulses are generated no earlier than the trigger signal.

9. The method of claim 1 , wherein the delivering and the measuring are both performed at least in part via a paddle lead.

10. The method of claim 1 , wherein the generating the trigger signal and the generating the one or more stimulation pulses are performed by a pulse generator that is located external to a body of the patient.

11. A method, comprising:
generating, via a pulse generator located external to a patient, stimulation pulses and a trigger signal that defines a time window in which the stimulation pulses are generated;
delivering the stimulation pulses to a first body region of the patient via a stimulation-delivering mechanism;
sending the trigger signal to a measurement instrument via a telecommunications link different from the stimulation-delivering mechanism;
detecting, via the measurement instrument, the trigger signal; and
in response to the detecting, measuring, from a second body region, one or more action potentials produced by the patient in response to the stimulation pulses, wherein the first body region and the second body region are connected by a nerve.

12. The method of claim 11 , wherein the first body region includes a foot, the second body region includes a thigh, and wherein the method further comprises: measuring a reference signal via an indifferent electrode placed on a third body region of the patient, the third body region being located remotely from the first body region and the second body region, and wherein the measuring comprises measuring the one or more action potentials against the reference signal.

13. The method of claim 11 , wherein the measuring comprises measuring a plurality of action potentials from a plurality of different fascicles of the nerve, and wherein the method further comprises:
identifying a first fascicle of the nerve as one of the fascicles that produced a maximum action potential; and
determining that the first fascicle is a target location for delivering a stimulation therapy for treating the first body region.

14. The method of claim 11 , further comprising: calculating a moving average of the measured one or more action potentials.

15. The method of claim 11 , wherein the one or more stimulation pulses are generated after the trigger signal has been sent to the measurement instrument.

16. The method of claim 11 , wherein the delivering is performed at least in part via a stimulation patch as the stimulation-delivering mechanism.

17. A medical system, comprising:
a pulse generator configured to generate a trigger signal and electrical stimulation pulses;
a stimulation-delivery mechanism configured to deliver the electrical stimulation pulses to a patient;
a tool configured to:
engage with a plurality of fascicles of a nerve of the patient; and
receive a plurality of action potentials produced from the fascicles in response to the electrical stimulation pulses; and

a measurement instrument configured to:
receive and detect the trigger signal via a telecommunications link different from the stimulation-delivery mechanism; and
in response to the detected trigger signal, begin measuring the action potentials.

18. The medical system of claim 17 , wherein:
the pulse generator includes a pulse generator located external to the patient;
the tool includes a needle or a paddle lead; and
the measurement instrument includes an oscilloscope.

19. The medical system of claim 17 , wherein the trigger signal defines a time window in which the electrical stimulation pulses are generated.

20. The medical system of claim 17 , wherein the stimulation-delivery mechanism comprises:
a patch coupled to the pulse generator and configured to deliver the electrical stimulation pulses to a first body region of the patient; and wherein the medical system further comprises:
an indifferent electrode coupled to the measurement instrument and configured to measure a reference signal from a third body region of the patient; and
an implantable pulse generator configured to generate an electrical stimulation therapy;
wherein:
the tool is configured to receive the plurality of action potentials from a second body region of the patient; and
the measurement instrument is configured to measure the action potentials against the reference signal.

Assignees

• Greatbatch Ltd

Inventors

• Bradley Kerry
• Halberg Leslie

Classifications

• A61N1/36021

  for treatment of pain · CPC title

• A61N1/0551 Primary

  Spinal or peripheral nerve electrodes · CPC title

• A61N1/36146

  specified by the stimulation parameters · CPC title

• A61N1/36139

  with automatic adjustment · CPC title

• A61N1/3787

  from an external energy source · CPC title