Systems and methods of providing modulation therapy without patient-perception of stimulation

Abstract

A neuromodulation system and method of providing sub-threshold modulation therapy. Electrical modulation energy is delivered to a target tissue site of the patient at a programmed intensity value, thereby providing therapy to a patient without perception of stimulation. In response to an event, electrical modulation energy is delivered at incrementally increasing intensity values. At least one evoked compound action potential (eCAP) is sensed in a population of neurons at the target tissue site of the patient in response to the delivery of the electrical modulation energy at the incrementally increasing intensity values. One of the incrementally increased intensity values is selected based on the sensed eCAP(s). A decreased intensity value is automatically computed as a function of the selected intensity value. Electrical modulation energy is delivered to the target tissue site of the patient at the computed intensity value, thereby providing sub-threshold therapy to the patient.

Description

CLAIM OF PRIORITY[0001]This application claims the benefit of priority under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 61 / 858,730, filed on Jul. 26, 2013, which is herein incorporated by reference in its entirety.FIELD OF THE INVENTION[0002]The present inventions relate to tissue modulation systems, and more particularly, to programmable neuromodulation systems.BACKGROUND[0003]Implantable neuromodulation systems have proven therapeutic in a wide variety of diseases and disorders. Pacemakers and Implantable Cardiac Defibrillators (ICDs) have proven highly effective in the treatment of a number of cardiac conditions (e.g., arrhythmias). Spinal Cord Stimulation (SCS) systems have long been accepted as a therapeutic modality for the treatment of chronic pain syndromes, and the application of tissue stimulation has begun to expand to additional applications such as angina pectoralis and incontinence. Deep Brain Stimulation (DBS) has also been applied therapeutical...

AI Technical Summary

Benefits of technology

[0025]In another embodiment, the neuromodulation system further comprises a memory configured to store at least one characteristic of a reference eCAP indicative of a perception threshold. The controller/processing circuitry may be further configured to compare a characteristic of each of the at least one sensed eCAP to a corresponding characteristic of a reference eCAP, and select one of the series of incrementally increased intensity values based on the comparison. The characteristic of the each sensed eCAP may be at least one a peak delay, width, amplitude and waveform morphology.

[0026]When the sensed eCAP comprises two or more eCAPs respectively sensed in response to the delivery of the electrical modulation energy at two or more of the intensity values, the control/processing circuitry may be further configured to obtain the characteristic from a stored reference eCAP, determine one of the two or more sensed eCAPs having the characteristic that best matches the characteristic of the reference eCAP, and select the intensity value of the delivered electrical modulation energy in response to which the determined eCAP is sensed.

[0027]When the a...

Problems solved by technology

However, the number of electrodes available combined with the ability to generate a variety of complex electrical pulses, presents a huge selection of modulation parameter sets to the clinician or patient.

Thus, correct lead placement can mean the difference between effective and ineffective pain therapy.

Although alternative or artifactual sensations are usually tolerated relative to the sensation of pain, patients sometimes report these sensations to be uncomfortable, and therefore, they can be considered an adverse side-effect to neuromodulation therapy in some cases.

However, because there is a lack of paresthesia that may otherwise indicate that the activated electrodes are properly located relative to the targeted tissue site, it is difficult to immediately determine if the delivered sub-threshold neuromodulation therapy is optimized in terms of both providing efficacious therapy and minimizing energy co...

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