Adaptive Neuromodulation Controller Circuit Evoked Response Thresholds
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Solution Overview
Problem
Current medical systems for neurostimulation therapy lack the ability to selectively sense evoked responses and adjust stimulation parameters in real-time to optimize therapy effectiveness and minimize side effects.
Innovation Solution
A system comprising at least one lead with multiple electrodes, an electrostimulator, a sensing circuit, and a controller circuit that delivers electrostimulation, senses evoked responses, and determines stimulation thresholds to adjust therapy parameters based on patient state and therapy parameters.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If neurostimulation therapy is delivered using fixed stimulation parameters, then the device complexity is reduced and ease of operation is improved, but therapy effectiveness is insufficient and side effects cannot be minimized
Solution Approach 1:
The system employs a closed-loop feedback mechanism where evoked responses (ERs) are sensed following stimulation pulses, and these ERs are used to automatically adjust stimulation parameters. The controller circuit continuously monitors ER characteristics and modifies stimulation settings in real-time to optimize therapy effectiveness while maintaining manageable device complexity through automated control algorithms.
Solution Approach 2:
The patent implements dynamic adaptation of stimulation parameters based on real-time sensing of evoked responses. Instead of fixed parameters, the system continuously adjusts stimulation intensity, frequency, and other parameters according to the patient's neural response, transforming a static therapy delivery system into a dynamic one that adapts to changing physiological conditions.
2Reliability
If stimulation parameters are adjusted to maximize therapy effectiveness, then therapy effectiveness is improved, but side effects may increase
Solution Approach 1:
The system uses evoked response sensing as a feedback mechanism to determine optimal stimulation thresholds. By identifying the minimum stimulation level that produces the desired neural response (threshold determination), the system maximizes therapy effectiveness while minimizing excessive stimulation that could cause side effects. The feedback loop ensures parameters are adjusted only to the extent necessary for therapeutic effect.
3Reliability
If real-time sensing of evoked responses is implemented, then therapy effectiveness is improved through adaptive parameter adjustment, but device complexity and energy consumption increase
Solution Approach 1:
The system implements periodic sensing of evoked responses at strategically selected time points rather than continuous monitoring. Stimulation pulses are delivered in trains with specific inter-pulse intervals, and ER sensing occurs at defined periods following stimulation. This periodic approach reduces energy consumption compared to continuous operation while maintaining the ability to adapt parameters for effective therapy.
Data Source
AI summary
Systems and methods for adaptive neuromodulation based on evoked responses are disclosed. An exemplary system comprises at least one lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect sensed ERs to the electrostimulation using at least one sensing electrode on the at least one lead and determine a first stimulation threshold for a stimulation parameter based on a first sensed threshold of the collected sensed ERs. The first stimulation threshold can be a stimulation value at which a change in the collected sensed ERs occurs.