Neurostimulator configured to sense evoked potentials in peripheral nerves

Patent metadata

Field	Value
Publication number	US-2016144188-A1
Application number	US-201615001327-A
Country	US
Kind code	A1
Filing date	Jan 20, 2016
Priority date	Jul 2, 2013
Publication date	May 26, 2016
Grant date	—

Abstract

A patient is detected to be in a first posture state. In response to the patient being detected to be in the first posture state, a first electrical stimulation therapy is applied to a body region of the patient by a pulse generator implanted in the patient. The patient is detected to be in a second posture state. In response to the patient being detected to be in the second posture state that is different from the first posture state, a second electrical stimulation therapy is applied to the body region of the patient by the pulse generator. The second electrical stimulation therapy is different from the first electrical stimulation therapy.

First claim

What is claimed is:

1 . A method, comprising:
detecting that a patient is in a first posture state; applying, via a pulse generator implanted in the patient, a first electrical stimulation therapy to a body region of the patient in response to the detecting that the patient is in the first posture state; detecting that the patient is in a second posture state, the second posture state being different from the first posture state; and applying, via the pulse generator implanted in the patient, a second electrical stimulation therapy to the body region of the patient in response to the detecting that the patient is in the second posture state, the second electrical stimulation therapy being different from the first electrical stimulation therapy.

2 . The method of claim 1 , wherein:
the applying of the first electrical stimulation therapy comprises:
generating a first electrical stimulation signal;
measuring a first evoked potential in response to the first electrical stimulation signal; and
adjusting the first electrical stimulation signal until the measured first evoked potential reaches a first target evoked potential; and
the applying of the second electrical stimulation therapy comprises:
generating a second electrical stimulation signal;
measuring a second evoked potential in response to the second electrical stimulation signal; and
adjusting the second electrical stimulation signal until the measured second evoked potential reaches a second target evoked potential.

3 . The method of claim 2 , wherein:
the first electrical stimulation signal is generated using a first starting value of an electrical stimulation parameter; the adjusting of the first electrical stimulation signal comprises adjusting the first starting value of the electrical stimulation parameter until the measured first evoked potential reaches the first target evoked potential; the second electrical stimulation signal is generated using a second starting value of the electrical stimulation parameter; and the adjusting of the second electrical stimulation signal comprises adjusting the second starting value of the electrical stimulation parameter until the measured second evoked potential reaches the second target evoked potential.

4 . The method of claim 3 , further comprising:
performing a first calibration process to obtain the first starting value of the electrical stimulation parameter and the first target evoked potential, the first calibration process being performed while the patient is in the first posture state; and performing a second calibration process to obtain the second starting value of the electrical stimulation parameter and the second target evoked potential, the second calibration process being performed while the patient is in the second posture state.

5 . The method of claim 4 , wherein:
the performing of the first calibration process comprises determining the first starting value of the electrical stimulation parameter and the first target evoked potential that cause the patient to experience paresthesia in the first posture state; and the performing of the second calibration process comprises determining the second starting value of the electrical stimulation parameter and the second target evoked potential that cause the patient to experience paresthesia in the second posture state.

6 . The method of claim 1 , wherein the detecting that the patient is in the first posture state or the detecting that the patient is in the second posture state is performed at least in part via one or more sensors implemented on the pulse generator, the one or more sensors including an accelerometer, a pressure sensor, or a temperature sensor.

7 . The method of claim 1 , wherein the first posture state and the second posture state are selected from the group consisting of: a posture state where the patient is lying down, a posture state where the patient is stretching, a posture state where the patient is ambulatory, a posture state where the patient is running, and a posture state where the patient is applying pressure on the body region of the patient.

8 . A medical system, comprising:
a pulse generator configured to be implanted in a patient, the pulse generator being configured to generate electrical stimulation pulses to stimulate a body region of the patient; and an electronic programmer configured to program the pulse generator to generate the stimulation pulses, wherein the electronic programmer is further configured to perform operations comprising:
receiving a first detection that the patient is in a first posture state;
programming the pulse generator to produce a first electrical stimulation therapy to be applied to a body region of the patient in response to the receiving of the first detection;
receiving a second detection that the patient is in a second posture state, the second posture state being different from the first posture state; and
programming the pulse generator to produce a second electrical stimulation therapy to be applied to the body region of the patient in response to the receiving of the second detection, the second electrical stimulation therapy being different from the first electrical stimulation therapy.

9 . The medical system of claim 8 , wherein:
the programming the pulse generator to produce the first electrical stimulation therapy comprises:
programming the pulse generator to generate a first electrical stimulation signal;
measuring a first evoked potential in response to the first electrical stimulation signal; and
programming the pulse generator to adjust the first electrical stimulation signal until the measured first evoked potential reaches a first target evoked potential; and
the programming the pulse generator to produce the second electrical stimulation therapy comprises:
programming the pulse generator to generate a second electrical stimulation signal;
measuring a second evoked potential in response to the second electrical stimulation signal; and
programming the pulse generator to adjust the second electrical stimulation signal until the measured second evoked potential reaches a second target evoked potential.

10 . The medical system of claim 9 , wherein:
the first electrical stimulation signal is generated using a first starting value of an electrical stimulation parameter; the adjusting of the first electrical stimulation signal comprises adjusting the first starting value of the electrical stimulation parameter until the measured first evoked potential reaches the first target evoked potential; the second electrical stimulation signal is generated using a second starting value of the electrical stimulation parameter; and the adjusting of the second electrical stimulation signal comprises adjusting the second starting value of the electrical stimulation parameter until the measured second evoked potential reaches the second target evoked potential.

11 . The medical system of claim 10 , wherein the operations further comprise:
performing a first calibration process to obtain the first starting value of the electrical stimulation parameter and the first target evoked potential, the first calibration process being performed while the patient is in the first posture state; and performing a second calibration process to obtain the second starting value of the electrical stimulation parameter and the second target evoked potential, the second calibration process being performed while the patient is in the second posture state.

12 . The medical system of claim 11 , wherein:
the performing of the first calibration process comprises determining the first starting value of

Assignees

• Greatbatch Ltd

Inventors

• Chen Joey
• Bradley Kerry
• Halberg Leslie

Classifications

• A61N1/36071

  Pain · CPC title

• A61N1/36153

  Voltage (A61N1/3616 takes precedence) · CPC title

• A61B8/0841

  for locating instruments · CPC title

• A61B5/064

  using markers (A61B5/062 takes precedence) · CPC title

• A61N1/0551 Primary

  Spinal or peripheral nerve electrodes · CPC title