63 results about "Evoked compound action potential" patented technology

A system for closed-loop control of sub-perception spinal cord stimulation therapy is provided. The system includes an implantable pulse generator (IPG) with an evoked compound action potential (ECAP) recording module and accelerometer. A regression model maps accelerometer data to optimal stimulation parameters for consistent nerve activation. This enables closed-loop therapy in the sub-perception domain where ECAP features are not visually detectable. A clinician programmer applies the model and sub-perception dose to therapy programs deployed to the IPG. The model can be customized to each patient by collecting ECAP and accelerometer data. The mapping reconciles ECAP -based control between perception and sub-perception domains by supplementing unavailable ECAP data with accelerometer data. This improves stimulation therapies for patients receiving sub-perception and multi-sensor paresthesia treatments.

Methods and systems for spinal cord stimulation (SCS) are disclosed. The methods and systems involve the use of electrode leads implanted within the spine of a patient to record nerve responses induced by a stimulus. The disclosed neural responses differ in various aspects from the electrical responses previously measured in the SCS context, such as stimulation artifacts and evoked compound action potentials (ECAPs). The disclosed neural responses typically occur at a later time after inducing the stimulation pulse. Another significant feature is that when the frequency of evoked stimulation is ultra-low, such as about 10 Hz or less, the disclosed neural response is most significantly observed at a consistent, relatively constant amplitude as a whole. The disclosed methods and systems may use these neural responses as indications of pain, treatment, and / or another clinically relevant dimension to guide / confirm stimulation placement, as well as feedback control for stimulation parameters.

A system for closed-loop control of sub-perception spinal cord stimulation therapy is provided. The system includes an implantable pulse generator (IPG) with an evoked compound action potential (ECAP) recording module and accelerometer. A regression model maps accelerometer data to optimal stimulation parameters for consistent nerve activation. This enables closed-loop therapy in the sub-perception domain where ECAP features are not visually detectable. A clinician programmer applies the model and sub-perception dose to therapy programs deployed to the IPG. The model can be customized to each patient by collecting ECAP and accelerometer data. The mapping reconciles ECAP-based control between perception and sub-perception domains by supplementing unavailable ECAP data with accelerometer data. This improves stimulation therapies for patients receiving sub-perception and multi-sensor paresthesia treatments.

A method of evaluating spinal cord stimulation (SCS), comprising obtaining neural response data generated by a spinal cord stimulator, where the neural response data describes one or more neural signals evoked in the spinal cord of a patient by applying diagnostic stimuli. One or more evoked compound action potentials (ECAPs) associated with the respective one or more neural signals are detected. The one or more detected ECAPs are processed to generate one or more evaluation metrics, and the one or more evaluation metrics are used to generate a confidence score indicating a degree of effectiveness of SCS on the patient.

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.

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a computing device includes a therapy-management application configured to assist a user to: capture a representative evoked compound action potential (ECAP) signal from a patient based; apply one or more filters to the representative ECAP signal to select one or more parameters of the representative ECAP signal; and control electrical stimulation therapy based at least in part on the one or more parameters.

Disclosed herein are of systems, methods, and computer-program products for determining if a response is an electrically evoked compound action potential (eCAP), refining raw data of an eCAP amplitude growth function (AGF) and utilizing maximum (i.e., steepest) slope from moving linear regression to effectively estimate cochlear nerve function, and determining quality of an electrode-neuron interface (ENI) using a model developed from eCAP attributes.

Sensing an evoked response to electrical stimulation of target tissue of a patient in conjunction with an intra-luminal electrode. The intra-luminal electrode may be implanted in a blood vessel or similar lumen proximal to the target tissue and the sensed signals and / or delivered stimulation may pass through the blood vessel. or other lumen, walls. In some examples the evoked response may be an evoked compound action potential (ECAP), which may also be evoked resonant neural activity (ERNA). The electrical stimulation may elicit a measurable response indicative of a thought pattern or neural state that would otherwise be undetectable using a non-evoked biopotential.

An apparatus for delivering stimulation energy to a patient is provided. The apparatus comprises an algorithm for determining a stimulation paradigm comprising one or more stimulation parameter settings, and an implantable system comprising an implantable device. The implantable device comprises at least one sensor for measuring evoked compound action potentials (eCAPs), muscle responses, and / or other neural responses, and multiple stimulation elements configured to deliver the stimulation energy to tissue based on the stimulation paradigm. The algorithm is configured to determine the stimulation paradigm based on the measured neural responses. Methods of delivering stimulation energy are also provided.

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a system includes a user interface and processing circuitry. The processing circuitry is configured to output, for display by the user interface, a message requesting the patient perform a set of actions, receive, from the user interface, user input indicative of a patient response associated with the set of actions, and determine, based on the user input, one or more adjustments to a control policy which controls electrical stimulation delivered by a medical device based on a plurality of evoked compound action potentials (ECAPs) sensed by the medical device.

Methods, systems, and computer-implementable algorithms for determining time-varying pulses for a patient with an implantable stimulator device (ISD) are disclosed. At least one time-invariant tonic stimulation pulse parameter (e.g., amplitude, pulse width, or frequency) is modified by a modulation function to produce a time-varying pulse (TVP), and one or more measurements are made to determine the effectiveness of the TVP. The measurements can be objective and taken from the patient, and / or subjective and determined based on feedback from the patient. In one example, the objective measurements can include one or more features determined from an epidural spinal cord electrogram (ESG) signal detected by the ISD, which can include an evoked compound action potential. The one or more measurements are used to determine a score for the TVP, which is useful in selecting the best TVP for use with the patient, or for adjusting the modulation function applied to the tonic stimulation parameters.

Methods and systems for using sensed neural responses for informing aspects of stimulation therapy are disclosed. For example, features of evoked neural responses, such as evoked compound action potentials (ECAPs) can be used for closed-loop feedback control of stimulation parameters. Aspects of the disclosed methods and systems can differentiate between changes in the sensed neural responses that are caused by the environment at stimulating electrodes and changes in the neural responses that are caused by the environment at sensing electrodes. Embodiments determine changes in the morphology of the neural responses, which morphology changes indicate a degree of change in the stimulating environment. Algorithms and systems for assigning and tracking likelihoods for underlying electrode-tissue changes based on sensed neural responses are disclosed. The feedback control modality may be updated based on such likelihoods. Also disclosed are methods and systems for determining which features of evoked neural responses are more sensitive to changes in the stimulating environment and less sensitive to changes in the sensing environment.

Therapy can be determined using evoked compound action potentials (ECAPs). For example, a medical device includes stimulation generation circuitry and processing circuitry. The processing circuitry is configured to determine whether a characteristic of a first ECAP is greater than a threshold ECAP characteristic value. Based on the characteristic of the first ECAP being greater than the threshold ECAP characteristic value, the processing circuitry is configured to decrease a parameter of a first set of pulses delivered by the stimulation generation circuitry after the first ECAP. Additionally, the processing circuitry is configured to determine whether a characteristic of a second ECAP is less than the threshold ECAP characteristic value, and based on the characteristic of the second ECAP being less than the threshold ECAP characteristic value, increase a parameter of a second set of pulses delivered by the stimulation generation circuitry after the second ECAP.

A neurostimulation system includes a plurality of stimulation electrodes, a plurality of recording electrodes, a waveform generator in electrical communication with the plurality of stimulation electrodes, and one or more computing devices in electrical communication with the plurality of recording electrodes and the waveform generator. The one or more computing devices cause the waveform generator to electrically excite the plurality of stimulation electrodes of the plurality of stimulation electrodes. After electrically exciting the stimulation electrodes, a neural signal is received from the plurality of recording electrodes. The neural signal is determined to be an electrically evoked compound action potential (“ECAP”) by determining one or more features of the neural signal. One or more stimulation parameters are determined based on one or more characteristics of the ECAP. The waveform generator is then caused to electrically excite the plurality of stimulation electrodes according to the one or more stimulation parameters.

This document discusses, among other things, systems and methods for providing pain relief to a patient. Recording circuitry may receive electrical signals corresponding to evoked compound action potentials in the patient that may be produced in response to external stimulation of a location where the patient is experiencing pain. The received electrical signals may be stored in a memory. Internal stimulation may then be applied to the patient and control circuitry may receive electrical signals corresponding to evoked compound action potentials in the patient that may be produced in response to the internal stimulation. The control circuitry may then adjust electrical parameters of the internal stimulation, such as to reduce a difference between the electrical signals corresponding to evoked compound action potentials produced in response to the internal stimulation and electrical signals corresponding to evoked compound action potentials produced in response to the external stimulation.

Systems and methods for programming a neuromodulation system are provided. One or more electrodes may be determined to enable at least one of a target stimulation therapy or a target alternative stimulation therapy. The device may be programmed with one or more parameters based on the target stimulation therapy or the target alternative stimulation therapy. A signal corresponding to the stimulation when a user performs an aggressor movement may be received and one or more parameters may be adjusted when the signal corresponding to the stimulation when the user performs the aggressor movement does not include an electrically evoked compound action potential (ECAP). Alternatively or additionally, one or more thresholds may be set when the signal corresponding to the stimulation when the user performs the aggressor movement includes the ECAP.

Evaluation and adjustment of time-varying pulse patterns in spinal cord stimulator systems are disclosed. Methods, systems, and computer-implemented algorithms are disclosed for determining time-varying pulses for a patient having an implantable stimulator device (ISD). At least one time-invariant stimuli pulse parameter (e.g., amplitude, pulse width, or frequency) is modified by a modulation function to produce a time-varying pulse (TVP), and one or more measurements are made to determine the effectiveness of the TVP. The measurements may be objective and taken from the patient, and / or subjective and determined based on feedback from the patient. In one example, the objective measurements may include one or more features determined from electrospinal cord (ESG) signals detected by the ISD, which may include evoked composite action potentials. One or more measurements are used to determine a score of TVP, which is useful in selecting an optimal TVP for use with a patient, or in adjusting a modulation function applied to an ankylosing stimulation parameter.

This application discloses a personalized rehabilitation system for cochlear implant surgery based on multimodal data fusion, belonging to the field of rehabilitation equipment technology. The system includes: a data acquisition and processing module for acquiring the original electrically evoked compound action potential (EEP) signals of the test subject and generating a neural response feature vector based on the original EEP signals; a personalized parameter mapping module for generating the test subject's subjective comfort threshold for the maximum electrical stimulation level based on the neural response feature vector and the test subject's clinical data; adjusting the subjective comfort threshold based on real-time biofeedback signals; and a rehabilitation training module for constructing a VR training scenario, electrically stimulating the test subject's cochlea according to the subjective comfort threshold, and acquiring the test subject's real-time biofeedback signals in the VR training scenario. This application effectively applies objective original EEP signals to personalized parameter mapping of the cochlear implant, reducing reliance on the test subject's subjective feedback and improving the accuracy and efficiency of mapping.

A pulse generator system that facilitates asynchronous ignition of recruited neurons includes an implantable pulse generator (IPG) that is capable of sensing a degree of synchronous ignition of recruited neurons in tissue of a patient and modifying a stimulation procedure to facilitate asynchronism and reduce sensory abnormalities. An evoked composite action potential (ECAP) of the recruited neurons is sensed by the at least one non-active electrode as a measure of synchronism. An ECAP algorithm operable in the IPG evaluates the shape of the ECAP and determines one or more ECAP shape parameters that indicate whether the recruited neurons are a synchronous fire or a non-synchronous fire. If the shape parameter indicates significant synchronism, the ECAP algorithm may adjust the stimulation procedure to facilitate non-synchronous firing.

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one embodiment, a system can be configured to: deliver an electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of treatment pulses at a predetermined pulse frequency over a period of time; and deliver a plurality of pulses over the period of time, the plurality of control pulses being interleaved with at least some of the plurality of treatment pulses. The system can also be configured to: sense a corresponding evoked compound action potential (ECAP) after one or more control pulses and before an immediately subsequent treatment pulse in the plurality of treatment pulses; adjust one or more parameter values ​​that at least partially define the plurality of treatment pulses based on at least one corresponding ECAP; and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

Systems, devices, and techniques for analyzing evoked compound action potentials (ECAP)signals to evaluate and select an electrode combination. A method includes controlling, by processing circuitry, deliver of a plurality of stimulation pulses via at least one stimulation electrode combination, receiving, by the processing circuitry, evoked compound action potential (ECAP) signal information representing different ECAP signals evoked from respective stimulation pulses of the plurality of stimulation pulses and obtained from respective different sensing electrode combinations, selecting by the processing circuitry and based on the ECAP signal information, one electrode combination from the different sensing electrode combinations.

A neural stimulation device is disclosed, including: a pulse generator, an evoked compound action potential (ECAP) sensor, and a neural stimulation controller. The neural stimulation controller instructs the ECAP sensor to sense an ECAP after a pulse is generated by the pulse generator within a first pulse generation cycle, adjust an amplitude of a pulse generated within a second pulse generation cycle in response to a peak-to-peak value of the ECAP being not in a comfort range, and adjust, according to an expected peak-to-peak value, an amplitude of a pulse generated within a third pulse generation cycle in response to a peak-to-peak value of the ECAP after the pulse is generated within the second pulse generation cycle being still not in the comfort range. The expected peak-to-peak value is in the comfort range including an amplitude dimension of the pulse and a peak-to-peak value dimension of the ECAP.

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a computing device includes a therapy-management application configured to assist a user to: capture a representative evoked compound action potential (ECAP) signal from a patient based; apply one or more filters to the representative ECAP signal to select one or more parameters of the representative ECAP signal; and control electrical stimulation therapy based at least in part on the one or more parameters.

Disclosed is an implantable device for lead offset determination, comprising first and second electrode leads. A stimulus is delivered from one lead to tissue, and a signal is sensed from the tissue by the other lead. The sensed signal is processed to produce a measure of a stimulus artefact present in the signal. The stimulus artefact measure is used to produce a measure of an offset between the first electrode lead and the second electrode lead, such as by applying a distance-squared analytical model to measures of stimulus artefact obtained from at least two sense electrodes. And / or, a compound action potential evoked by the stimulus is sensed from neural tissue, a latency of the evoked compound action potential is measured, and a measure of an offset between the first electrode lead and the second electrode lead is produced from the latency.

The present disclosure relates to devices, systems, and techniques for managing storage of sensing information. In some examples, a system includes a memory and a processing circuit. The processing circuit can be configured to: receive evoked compound action potential (ECAP) information, wherein the ECAP information includes information from a plurality of evoked compound action potential (ECAP) signals; receive a trigger signal requesting long-term storage of at least a portion of the ECAP information in the memory; and in response to receiving the trigger signal, store at least a portion of the ECAP information in the memory.

Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to determine an implant location for a lead. An example method includes receiving first information representative of a first evoked compound action potential (ECAP) signal sensed in response to a first control stimulus delivered to a first location adjacent to a spinal cord of a patient. The method also includes receiving, second information representative of a second ECAP signal in response to a second control stimulus delivered to a second location adjacent to the spinal cord of the patient. Additionally, the method includes outputting a first indication of the first information representative of the first ECAP signal and a second indication of the second information representative of the second ECAP signal.

A system and method for denervation of nerves of a blood vessel including a first catheter configured for navigation within a blood vessel of a patient, the catheter having a first plurality of electrodes for applying stimulation and therapy to nerves adjacent the blood vessel, a second catheter configured for navigation within the blood vessel of a patient, the second catheter having a second plurality of electrodes for detecting a signal emitted by nerves to which stimulation has been applied, a stimulation source in electrical communication with the first plurality of electrodes and configured to output a stimulation signal to the first plurality of electrodes of the first catheter, and a computing device including a memory and a processor, the memory storing instructions that when executed, cause the processor to receive the signal detected by the second plurality of electrodes and determine an evoked compound action potential (ECAP) value.

Methods, system, and computer-implementable algorithms are disclosed for determining time-varying pulses for a patient having an implantable stimulator device (ISD). At least one time-invariant tonic stimulation pulse parameter (e.g., amplitude, pulse width, or frequency) is modified by a modulation function to produce time-varying pulses (TVPs), and one or more measurements are taken to determine the effectiveness of the TVP. The measurements may be objective and taken from the patient, and / or subjective and determined based on feedback from the patient. In one example, objective measurements may comprise one or more features determined from an electrospinogram (ESG) signal detected by the ISD, which may include evoked compound action potentials. The one or more measurements are used to determine a score for the TVP, which is useful in selecting a best TVP for use with the patient, or for adjusting the modulation function applied to the tonic stimulation parameters.

Systems and methods are disclosed for conducting spinal cord stimulation or other neurostimulation and sensing evoked compound action potential (ECAP) signals. The sensed signals may be processed to isolate ECAP features from noise and / or interfering signals. The isolated ECAP features may be used to control neurostimulation therapy for the patient, such as to quantify or measure lead migration and adjust a neurostimulation therapy for the patient to account for an impact of any detected lead migration, or other purposes (e.g., to guide an implant procedure).

A system and method for modeling patient-specific spinal cord stimulation (SCS) is disclosed. The system and method acquire impedance and evoked compound action potential (ECAP) signals from a lead positioned proximate to a spinal cord (SC). The lead includes at least one electrode. The system and method determine a patient-specific anatomical model based on the impedance and ECAP signals, and transform a dorsal column (DC) map template based on a DC boundary of the patient-specific anatomical model. Further, the system and method map the transformed DC map template to the patient-specific anatomical model. The system and method may also include the algorithms to solve extracellular and intracellular domain electrical fields and propagation along neurons. The system and method may also include the user interfaces to collect patient responses and compare with the patient-specific anatomical model as well as using the patient-specific anatomical model for guiding SCS programming.