Dual prophylactic and abortive electrical stimulation

Patent metadata

Field	Value
Publication number	US-11071861-B2
Application number	US-201916658368-A
Country	US
Kind code	B2
Filing date	Oct 21, 2019
Priority date	Apr 29, 2011
Publication date	Jul 27, 2021
Grant date	Jul 27, 2021

Abstract

Prophylactic stimulation and abortive electrical stimulation are delivered to a cranial nerve, including, e.g. an occipital or trigeminal nerve to treat symptoms of various conditions, including, e.g. occipital neuralgia or migraines.

First claim

The invention claimed is:

1. A system comprising:
a memory; and
one or more processors configured to program a medical device to deliver prophylactic electrical stimulation and abortive electrical stimulation to a patient, wherein the prophylactic stimulation is configured to inhibit onset of one or more symptoms of a patient condition and the abortive stimulation is configured to reduce an effect of one or more symptoms of the patient condition, wherein the one or more processors are configured to program the medical device by at least determining, for each electrode of a plurality of electrodes:
a first range of stimulation thresholds associated with the prophylactic stimulation, and
a second range of stimulation thresholds associated with the abortive stimulation, and

wherein the one or more processors are configured to store the first and second ranges of stimulation thresholds and the respective electrode in the memory.

2. The system of claim 1 , wherein the one or more processors are configured to determine the first range of stimulation thresholds based on patient perception in the absence of any symptoms of the patient condition, and determine the second range of stimulation thresholds based on patient perception while one or more of the patient condition are occurring.

3. The system of claim 1 , wherein the first and second ranges of stimulation thresholds are each bounded by a respective low stimulation threshold and a respective high stimulation threshold.

4. The system of claim 3 , wherein the low stimulation threshold is a perception threshold or a paresthesia threshold for the patient.

5. The system of claim 4 , wherein the high stimulation threshold is a discomfort threshold, a muscle recruitment threshold, or a pain threshold for the patient.

6. The system of claim 3 , wherein the high stimulation threshold is a discomfort threshold, a muscle recruitment threshold, or a pain threshold for the patient.

7. The system of claim 3 , wherein, for at least one electrode of the plurality of electrodes, the one or more processors are configured to:
determine the low stimulation threshold by at least controlling electrical stimulation generation circuitry to deliver electrical stimulation having a stimulation intensity via the at least one electrode and ramp the stimulation intensity from a baseline level of intensity up to a level at which the patient indicates the low stimulation threshold has been reached; and
determine the high stimulation threshold by at least controlling the electrical stimulation generation circuitry to deliver the electrical stimulation having the stimulation intensity, and ramp the stimulation intensity from the baseline level of intensity up to a level at which the patient indicates the high stimulation threshold has been reached.

8. The system of claim 1 , wherein, for each electrode, the first range of stimulation thresholds and the second range of stimulation thresholds are mutually exclusive.

9. The system of claim 1 , wherein, for each electrode, the first range of stimulation thresholds and the second range of stimulation thresholds partially overlap.

10. The system of claim 1 , wherein the one or more processors are configured to program the medical device to deliver the prophylactic electrical stimulation and the abortive electrical stimulation to the patient by at least transmitting a stimulation program determined based on the first and second ranges of stimulation thresholds to the medical device.

11. The system of claim 1 , wherein the one or more processors are configured to program the medical device by at least:
selecting a combination of electrodes of the plurality of electrodes,
determining the first and second ranges of stimulation thresholds associated with the electrodes of the selected combination in the memory,
programming the medical device to deliver the prophylactic electrical stimulation to the patient via the combination of electrodes and within the first ranges of stimulation thresholds associated with the electrodes of the combination in the memory, and
programming the medical device to deliver the abortive electrical stimulation to the patient via the combination of electrodes and within the second ranges of stimulation thresholds associated with the electrodes of the combination in the memory.

12. The system of claim 11 , further comprising the medical device, the medical device comprising electrical stimulation generation circuitry, wherein the one or more processors are configured to:
control the electrical stimulation generation circuitry to deliver the prophylactic stimulation to the patient via the combination of electrodes and within the first ranges of stimulation thresholds associated with the electrodes of the combination in the memory, and
control the electrical stimulation generation circuitry to deliver the abortive stimulation to the patient at least by reducing a stimulation intensity of the prophylactic stimulation from within the first ranges of stimulation thresholds to within the second ranges of stimulation thresholds associated with the electrodes of the combination in the memory.

13. The system of claim 1 , further comprising the medical device configured to deliver the prophylactic electrical stimulation and the abortive electrical stimulation to the patient.

14. The system of claim 1 , further comprising the medical device, the medical device comprising electrical stimulation generation circuitry, wherein the one or more processors are configured to control the electrical stimulation generation circuitry to deliver the abortive electrical stimulation by at least controlling the electrical stimulation generation circuitry to deliver a first abortive stimulation after onset of a symptom of the one or more symptoms of the patient condition is anticipated and deliver a second abortive stimulation while the symptom is occurring, and wherein the one or more processors are configured to control the electrical stimulation generation circuitry to deliver the second abortive stimulation after an intensity level of the symptom has increased above a predefined level during the onset of the symptom.

15. The system of claim 1 , further comprising the medical device, the medical device comprising electrical stimulation generation circuitry, wherein the one or more processors are configured to receive an indication of an anticipated onset of a symptom of the one or more symptoms of the patient condition, and wherein the one or more processors are configured to control the electrical stimulation generation circuitry to deliver the abortive stimulation in response to receiving the indication.

16. The system of claim 1 , further comprising a medical device programmer comprising at least one processor of the one or more processors.

17. A system comprising:
a memory; and
one or more processors configured to program a medical device to deliver prophylactic electrical stimulation and abortive electrical stimulation to a patient, wherein the prophylactic stimulation is configured to inhibit onset of one or more symptoms of a patient condition and the abortive stimulation is configured to reduce an effect of one or more symptoms of the patient condition, wherein the one or more processors are configured to program the medical device by at least determining, for each electrode of a plurality of electrodes, ranges of stimulation thresholds associated with the electrode, wherein each range of stimulation thresholds is bounded by a low stimulation threshold and a high stimulation threshold,
wherein the one or more

Assignees

• Medtronic Inc

Inventors

• Gerber Martin T
• Goetz Steven M
• Poletto Christopher

Classifications

• A61N1/36075 Primary

  Headache or migraine · CPC title

• A61N1/36082

  Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease · CPC title

• A61N1/36132

  using patient feedback · CPC title

• A61N1/36057

  adapted for stimulating afferent nerves · CPC title

• A61N1/36 Primary

  for stimulation · CPC title