101 results about "Spinal cord stimulation" patented technology

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.

Provided herein are methods of treating a patient comprising providing a medical apparatus comprising an external system and an implantable system, implanting the implantable system, and delivering at least one of power or data to the implantable system with the external system. The external system comprises: at least one external antenna configured to transmit a first transmission signal to the implantable system; an external transmitter configured to drive the at least one external antenna; an external power supply; and an external controller. The implantable system comprises: at least one implantable antenna configured to receive the first transmission signal from the first external device; an implantable receiver; at least one implantable functional element configured to interface with the patient; an implantable controller; an implantable energy storage assembly; and an implantable housing surrounding at least the implantable controller and the implantable receiver. Medical apparatus are also provided.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which a stimulation location in an electrode array is determined. Preferably, the supra-perception stimulation comprises a bipole formed using actively-driven symmetric biphasic waveforms at active ones of the electrodes in the array. After determining the location, a perception threshold for the bipole at the location is determined and stored, and an amplitude of the stimulation is reduced below the perception threshold to provide a sub-perception stimulation bipole. The determined perception threshold may be used to compose one or more programs using stimulation amplitudes that are a percentage of the determined perception threshold. The one or more programs may run according to schedule. For example, the programs may be interleaved.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during "sweet spot searching" during which a stimulation location in an electrode array is determined. Preferably, the supra-perception stimulation comprises a bipole formed using actively-driven symmetric biphasic waveforms at active ones of the electrodes in the array. After determining the location, a perception threshold for the bipole at the location is determined and stored, and an amplitude of the stimulation is reduced below the perception threshold to provide a sub-perception stimulation bipole. The determined perception threshold may be used to compose one or more programs using stimulation amplitudes that are a percentage of the determined perception threshold. The one or more programs may run according to schedule. For example, the programs may be interleaved.

The present technology provides systems and methods for delivering electrical stimulation having relatively long pulse widths to a patient’s spinal cord region to treat autonomic nervous system dysfunction. For example, some embodiments include delivering an electrical therapy signal having individual pulses with pulse widths of between about 2 milliseconds and about 10 seconds. The electrical therapy signals may treat autonomic nervous system dysfunction by normalizing activity of the patient’s parasympathetic nervous system, normalizing activity of the patient’s sympathetic nervous system, and / or normalizing a balance of activity between the patient’s parasympathetic and sympathetic nervous systems.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which a stimulation location in an electrode array is determined. Preferably, the supra-perception stimulation comprises a bipole formed using actively-driven symmetric biphasic waveforms at active ones of the electrodes in the array. After determining the location, a perception threshold for the bipole at the location is determined and stored, and an amplitude of the stimulation is reduced below the perception threshold to provide a sub-perception stimulation bipole. The determined perception threshold may be transmitted to the patient's remote controller, where it is used to limit amplitude adjustments to the sub-perception bipole by the patient.

Systems, methods, and devices disclosed herein include a transcutaneous spinal cord stimulation (tSCS) system with a stimulation electrode grid. The stimulation electrode grid includes a plurality of anodes and a plurality of cathodes, and the stimulation electrode grid is operable for placement proximate to a spinous process. The system also includes a particularized electrical field generated by selective activation of the stimulation electrode grid. Moreover, a localized tSCS, provided by the particularized electrical field is operable to cause a neuromodulation effect. Also, the stimulation electrode grid includes a substrate material. The plurality of cathodes and the plurality of anodes are both arranged as rows or columns on the substrate material to form an integrated unit. The stimulation electrode grid includes a plurality of selectively activated electrode array activation configurations, and the neuromodulation effect generated by the system can be used to enhance voluntary extremity function and pain management.

Methods and devices for implanting spinal cord stimulation devices, including thin-film spinal cord stimulation devices and devices for assisting with the implantation of such spinal cord stimulation devices. In some embodiments, the devices and methods include an introduction needle and / or sheath, a stylet, a guide device, and a pushing device for urging a stimulation device into the epidural space by controlling the proximal end of the device, including, in some cases, deformable thin-film spinal cord stimulation devices.

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.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain. Beneficially, sub-perception stimulation at such low frequencies significantly lowers power consumption in the patient's neurostimulator.

Systems and methods for controlling autonomic symptoms or side effects via spinal cord stimulation are discussed. An exemplary neuromodulation system comprises an electrostimulator to provide spinal cord stimulation (SCS) to a neural target, a user interface device to receive a user input including an autonomic symptom and affected anatomy, and a controller circuit to determine or adjust a stimulation parameter based at least on the autonomic symptoms and the affected anatomy. Spinal cord stimulation can be delivered in accordance with the determined or adjusted stimulation parameter to alleviate the autonomic symptom, or to treat or alleviate autonomic disorders.

Methods and devices for implanting spinal cord stimulation devices, including thin-film spinal cord stimulation devices and devices for assisting with the implantation of such spinal cord stimulation devices. In some embodiments, the devices and methods include an introduction needle and / or sheath, a stylet, a guide device, and a pushing device for urging a stimulation device into the epidural space by controlling the proximal end of the device, including, in some cases, deformable thin-film spinal cord stimulation devices.

The invention discloses an electrical stimulation physiotherapy device based on multi-mode multi-point stimulation, and the device comprises a control module which is used for determining a physiotherapy mode corresponding to a user, and outputting a control instruction according to the physiotherapy mode; and the at least two electrode modules are connected to the control module, are arranged in a cortex stimulation area and a spinal cord stimulation area of the user, and are used for synchronously outputting current to a plurality of stimulation target spots of the cortex stimulation area and the spinal cord stimulation area according to the control instruction so as to realize collaborative physiotherapy. Therefore, the multiple electrode modules arranged in the cortex area and the spinal cord area can be controlled according to different physiotherapy modes based on the control module, so that multi-mode and multi-target synchronous synergistic electrical stimulation physiotherapy is realized, and the intelligent degree and the treatment effect of the overall electrical stimulation physiotherapy are improved.

Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.

An algorithm for determining optimal sub-perception stimulation parameters for a Spinal Cord Stimulation patient is disclosed. The algorithm uses various modelling information, including a model determined based on empirical testing that relates optimal frequencies and pulse widths with perception thresholds reported by patients at those frequencies and pulse widths. A patient's perception threshold is then measured at different pulse widths, with the result compared to the model to determine a range or volume in the model that best relates frequency pulse width and perception threshold for that patient. Further modeling allows the perception thresholds to be related to an optimal amplitudes, thus resulting in optimal situation parameters (F, PW, and A) for the patient. The optimal stimulation parameters may be provided to a patient's external controller to allow the patient to adjust stimulation within a range of volume of these parameters.

Methods and systems for proving spinal cord stimulation (SCS) for treating pain in a patient are described. Embodiments of the described methods and systems can provide sub-perception SCS that has a fast wash-in time by using stimulation parameters that activate surround inhibition in the patient. Measuring retrograde potentials evoked by the stimulation can be performed to facilitate choosing the best stimulation parameters, in particular, the best stimulating electrode contact configurations for activating surround inhibition. For example, peripheral electrodes may be placed at the center of the patient's pain (within a local receptive field (LRF), with respect to the patient's pain center) and within an area surrounding the patient's pain center (within a surrounding receptive field (SRF), with respect to the patient's pain center). Retrograde evoked potentials measured and the SRF and / or the LRF can be used to guide the selection of the stimulation parameters.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which a stimulation location in an electrode array is determined. Preferably, the supra-perception stimulation comprises a bipole formed using actively-driven symmetric biphasic waveforms at active ones of the electrodes in the array. After determining the location, a perception threshold for the bipole at the location is determined and stored, and an amplitude of the stimulation is reduced below the perception threshold to provide a sub-perception stimulation bipole. The determined perception threshold may be transmitted to the patient's remote controller, where it is used to limit amplitude adjustments to the sub-perception bipole by the patient.

Apparatus and methods for managing pain uses a single composite modulation / stimulation signal with variable characteristics to achieve the same results as separate varying electromagnetic signals, including spinal cord stimulation or peripheral nerve stimulation.

The embodiment of the invention discloses an integrated spinal cord electrical stimulation system, a spinal cord electrical stimulation method, a medium and a product. According to one specific embodiment, the system comprises a brain-computer device, a spinal cord stimulation device, an exoskeleton device and a main control unit, the brain-computer device is configured to collect electroencephalogram signals; the spinal cord stimulation device is configured to generate an electric pulse and transmit the electric pulse to a target spinal cord segment through the spinal cord stimulation electrode; the exoskeleton device is configured to start a motor of a corresponding joint to execute a preset action; the main control unit is configured to obtain an electroencephalogram signal; generating motion intention information; generating control parameter information; controlling a spinal cord stimulation device to execute spinal cord electrical stimulation operation according to the spinal cord electrical stimulation parameter information; according to the exoskeleton action parameter information, the exoskeleton device is controlled to execute exoskeleton driving operation. According to the embodiment, parameter adjustment can be carried out by utilizing the motion intention of the user, mechanical assistance of the exoskeleton is well coordinated, the applicability and experience of the user are improved, and user operation is simplified.

A kit for treating lung disease includes at least one lead having at least one contact, and a pulse generator configured to connect to the least one lead. The pulse generator is programmed to generate electrical signals for transmission through the at least one lead and for release by the at least one contact in a predetermined location of an epidural space to mitigate lung disease symptoms.

A system may include a neuromodulator and a processing system. The neuromodulator may be configured to be programmed with a set of more than one program to deliver neuromodulation. The processing system may be configured to: receive sensed data indicative of activity, motion and / or posture of a patient; analyze the activity, motion and / or posture of the patient; and perform a process, based on the analyzed activity, motion and / or posture, for switching from one program in the set of more than one program to another program from the set of more than one program. The process may include automatically implementing the other program from the set of more than one program or suggesting to switch to the other program from the set of more than one program.

The invention discloses a spinal cord electrical stimulation prognosis prediction system for a patient with disturbance of consciousness based on neurovascular coupling, and belongs to the technical field of brain-computer interfaces. The system synchronously acquires electroencephalogram and cerebral blood flow signals of the patient through electroencephalogram acquisition equipment and transcranial Doppler ultrasound; brain network connections are calculated by using weighted pairwise phase congruency indexes, neurovascular coupling parameters are calculated based on a phase-amplitude coupling method, and finally results are presented through a display module to predict prognosis. The system can solve the problem of clinical lack of prognosis evaluation indexes of SCS treatment consciousness disorder patients, has the advantages of simple acquisition equipment, reusability and the like, and can assist doctors in providing personalized clinical schemes and reducing the treatment cycle; the system relates to a data acquisition, processing and result display module, a key parameter calculation process is clear, and the system is suitable for prognosis evaluation after SCS implantation of a consciousness disorder patient.

The present technology provides systems and methods for delivering electrical stimulation having relatively long pulse widths to a patient’s spinal cord region to treat autonomic nervous system dysfunction. For example, some embodiments include delivering an electrical therapy signal having individual pulses with pulse widths of between about 2 milliseconds and about 10 seconds. The electrical therapy signals may treat autonomic nervous system dysfunction by normalizing activity of the patient’s parasympathetic nervous system, normalizing activity of the patient’s sympathetic nervous system, and / or normalizing a balance of activity between the patient’s parasympathetic and sympathetic nervous systems.

Methods and systems for recording evoked potentials evoked during electrical stimulation of nervous tissue of a patient are disclosed. These methods and systems can be used in therapeutic regimens, such as spinal cord stimulation (SCS). The disclosed methods and systems allow for reduction or removal of stimulation artifacts in recorded signals. The remainder of the stimulation artifacts may be modeled and subtracted from the recorded signal that includes the artifacts and the neural response contributions.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain. Beneficially, sub-perception stimulation at such low frequencies significantly lowers power consumption in the patient's neurostimulator.

In various embodiments, methods are provided to improve motor function, and / or to improve motor control, and / or to improve sensory function, and / or to reduce pain in subjects with nerve root palsies (e.g., radiculopathies including, but not limited to cauda equina syndrome). In certain embodiments, methods are provided for the magnetic stimulation of the spinal cord or regions thereof to improve motor function of upper and / or lower extremities in subjects with impaired extremity motor function due to spinal cord or brain injury or pathology.

In various embodiments, methods are provided for applying transcutaneous and / or epidural spinal cord stimulation with and without selective pharmaceuticals to restore voluntary control of hand function in tetraplegic subjects.

Methods and systems for performing spinal cord stimulation in the cervical vertebra while sensing evoked responses, such as evoked burst actuation potentials (ESAPs) at locations different from the stimulation location. The first lead may be positioned in the cervical vertebra for emitting a therapy pulse and performing sensing at a thoracic or lumbar location, or at a cervical caudal location relative to a stimulation location. The first and second leads may be used in a single system, or two separate systems may be used, one for stimulation and the other for sensing.

A method for programming a stimulator device for a patient using an external device is disclosed. The method obtains information such as a model at the external device, wherein the information is specific to the patient, wherein the information includes a range or volume of stimulation parameters determined based on testing of the patient preferably providing subperceptual treatment; and provides instructions for execution at the stimulator device from the external device, the instructions specifying the amplitude, pulse width, and frequency of stimulation pulses to be provided at one of a plurality of electrodes in an electrode array of the patient's stimulator device, wherein the instructions change at least one of the amplitude, pulse width, and frequency over time within the range or volume. Changing at least one of these parameters helps prevent the patient's neural tissue from becoming habituated compared to stimulation provided without change.

Spinal cord stimulation systems without paresthesia are disclosed. Ultimately, sub-perception (no paresthesia) therapy is used for patient therapy. However, super-perception stimulation is used during a "sweet spot search" to select the active electrodes for the patient. This allows the sweet spot search to occur much more quickly and does not require wash-in of the various electrode combinations tried. After the electrodes are selected using super-perception therapy, the selected electrodes are used to titrate the therapy to a sub-perception level. This sub-perception therapy has been studied using pulses at or below 10 kHz, and a statistically significant correlation has been determined between pulse width (PW) and frequency (F) within the frequency range that SCS patients experience significant reduction in symptoms such as back pain. Advantageously, sub-perception stimulation at such low frequencies significantly reduces power consumption in the patient's neurostimulator.