73 results about "Spinal cord stimulation" patented technology

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.

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.

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.

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.

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 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 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.

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.

The present disclosure describes methods, sensors, and systems for detecting movement of a spine and stimulating specific regions of the spinal cord in response to the movement. The disclosure includes sensors having one or more sensing elements to sense movement of the spine and one or more stimulating elements configured to electrically stimulate an area proximate the spine. When a movement of the spine is detected via the sensor, the one or more stimulating elements modulate an electrical stimulus.

Various deformable thin film spinal cord stimulation devices that are deformable to conform to the shape and / or movement of the target spinal cord. Each device embodiment has an electrode body with at least one deformation section disposed longitudinally within the electrode body and at least one electrode contact. Some implementations have a distal structure that can be formed into a pusher receiving structure such as a pocket or a collar.

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.

This invention discloses a spinal cord stimulation pulse generator and a spinal cord stimulation system. The spinal cord stimulation pulse generator receives user information sent by a programmable device to obtain the target user's ECAP guidance range and target ECAP amplitude E. T The system acquires ECAP signals via stimulation electrodes. Based on whether the ECAP amplitude of the current cycle or the weighted ECAP amplitude of multiple adjacent cycles exceeds the range, a control algorithm is executed to determine the stimulation parameters for the next cycle, ultimately stabilizing the ECAP amplitude at the target ECAP amplitude within the ECAP guidance range. T This allows for dynamic and precise stimulation adjustment, enhancing the stability of spinal cord electrical stimulation.

A neuro-stimulation lead having a generally planar stimulation portion and a proximal connector portion for connecting to an implantable pulse generator (“IPG”). A method of forming a neuro-stimulation lead having a generally planar stimulation portion and a proximal connector portion for connecting to an IPG.

A method for ultrasound stimulation of spinal cord, the method comprising at least two stimulation cycles, each comprising the steps of: a) obtaining a first real-time spinal cord using a first set of ultrasound transducers; b) selecting a pre-determined stimulation area of the spinal cord from the first real-time spinal cord; c) calculating the position and orientation of the selected stimulation area relative to a second set of ultrasound transducers; and d) stimulating the selected stimulation area of the spinal cord at the calculated relative position and orientation using the second set of ultrasound transducers.

This application discloses a portable modular non-invasive spinal cord stimulation device and stimulation method. The stimulation device includes an electrode module and a stimulation module, with the stimulation module disposed on top of the electrode module and electrically connected to it. The electrode module includes a flexible substrate, a conductive contact layer, and a wire connection interface. The stimulation module includes a flexible encapsulation shell, a control unit, a power supply unit, and an electrical connection terminal. The electrical connection terminal is detachably connected to the wire connection interface and is equipped with a snap-fit ​​structure. Furthermore, the electrical connection terminal designed in this application can be located at the bottom or side of the flexible encapsulation shell; when located on the side, it is connected via a connecting wire with a cable protective sleeve. Through the above design, the integrated modular design of this application improves portability and fit, avoids motion interference, facilitates electrode consumable replacement, and is suitable for various scenarios. It can be used for pain intervention, motor function rehabilitation, etc., solving the problems of poor portability, significant motion interference, insufficient fit, and inconvenient consumable replacement of existing devices.

A transcutaneous electrical stimulation system is provided that can include a number of features. In one implementation, the system can include a plurality of electrodes configured to be in contact with a skin surface of a patient. The system can further include a flexible hub electrically connected to the electrodes and configured to be in contact with the patient. A bend sensor can be disposed in the hub and configured to measure a curvature of the hub. The system can include a signal processing device electrically coupled to the plurality of electrodes and the bend sensor, the signal processing device being configured to change stimulation settings of the plurality of electrodes based on the curvature of the hub. In some implementations, the system can include a multi-channel stimulator. Methods of use are also provided.

Provided is a closed-loop neuromodulation system involving coordinated intervention of the brain, the spinal cord, and the lumbosacral region, which comprises a deep brain stimulation unit (401), a deep brain field potential sensing unit (402), a spinal cord stimulation unit (501), an evoked potential sensing unit (502), a control decision-making unit (10), a deep brain electrode (403), a spinal cord electrode (503), a lumbosacral electrode (602), a docking lead (601), a radio frequency transmission unit (20), and a wireless charging and power management unit (30). By constructing an application strategy for coordinated regulation of the brain, the spinal cord, and the lumbosacral region, only one neurostimulator needs to be implanted. It can be used alone for brain diseases or spinal cord-related diseases, and can also be used for coordinated stimulation for motor function reconstruction and recovery in paralyzed patients and patients with motor dysfunction, as well as for the treatment of urinary system complications. The whole system is modular in application, can be selectively used according to disease conditions, and has a wider application range.