System and method for determining a stimulation threshold for closed loop spinal cord stimulation

Abstract

System and methods are provided for determining a stimulation threshold for closed loop spinal cord stimulation (SCS). The system and methods provide a lead coupled to an implantable pulse generator (IPG). The system and methods deliver SCS pulses from the IPG to the lead electrodes in accordance with an SCS therapy and determine an evoked compound action potential (ECAP) amplitude based on an ECAP waveform resulting from the SCS therapy. The system and methods increase the SCS therapy by increasing at least one of an amplitude, a duration, and number of the SCS pulses associated with the SCS therapy. The system and methods also include iteratively repeat the delivering, determining and increasing operations until the ECAP amplitude exhibits a downward trend divergence. The system and methods define a stimulation threshold based on the ECAP amplitude at the trend divergence.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of U.S. patent application Ser. No. 15 / 345,163, filed Nov. 7, 2016, which is hereby incorporated by reference in its entirety.FIELD OF THE INVENTION[0002]Embodiments of the present disclosure generally relate to neurostimulation (NS) systems generating electric pulses proximate to nervous tissue, and more particularly to spinal cord stimulation (SCS) systems.BACKGROUND OF THE INVENTION[0003]NS systems are devices that generate electrical pulses and deliver the pulses to nervous tissue to treat a variety of disorders. For example, SCS has been used to treat chronic and intractable pain. Another example is deep brain stimulation, which has been used to treat movement disorders such as Parkinson's disease and affective disorders such as depression. While a precise understanding of the interaction between the applied electrical energy and the nervous tissue is not fully appreciated, it is known that applicat...

AI Technical Summary

Benefits of technology

The patent text describes two methods for determining the optimal stimulation settings for spinal cord stimulation therapy. The first method involves delivering a series of stimulation pulses to the nerve tissue and measuring the resulting evoked compound action potential (ECAP) waveform. The pathway of the nerve tissue is then determined using the measured ECAP waveform. The second method involves iteratively increasing the stimulation settings, such as pulse amplitude or frequency, until the ECAP waveform exhibits a trend divergence. The optimal stimulation settings determined by these methods can be used for safe and effective spinal cord stimulation therapy.

Problems solved by technology

A concern of SCS system designs are neural damage caused by the generated electrical pulses emitted from lead electrodes of the SCS system.

However, an electrode may be polarized during deliver of the pulse that irreversible tissue damage or electrode damage can occur.

Images