Adaptive Spinal Cord Stimulation for Sub-Perception Pain Relief
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Solution Overview
Problem
Existing spinal cord stimulation (SCS) systems often cause paresthesia, a sensation that can be uncomfortable for some patients, and there is a need for methods and systems that provide effective pain relief without paresthesia, particularly in sub-perception therapy.
Innovation Solution
The system employs a model to associate stimulation durations with no-stimulation durations, using control circuitry to adjust the stimulation parameters, including intensity, amplitude, and dose, to provide pain relief below the patient's perception threshold, with pain relief washing in quickly and not washing out too quickly, and incorporates sensors for adaptive therapy adjustment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional spinal cord stimulation is used to provide pain relief, then effective pain relief is achieved, but paresthesia occurs which is uncomfortable for patients
Solution Approach 1:
The patent changes the stimulation parameters from conventional supra-threshold levels to sub-perception threshold levels. By delivering electrical stimulation below the patient's sensory threshold, the system provides pain relief through neural modulation without causing the uncomfortable paresthesia sensation associated with traditional high-intensity stimulation.
Solution Approach 2:
The system employs periodic bolus stimulation delivered at strategically determined intervals rather than continuous stimulation. The control circuitry calculates optimal delivery intervals based on individual patient characteristics and pain patterns, providing periodic sub-threshold stimulation that maintains pain relief while avoiding sensory perception.
2Object-affected harmful factors
If sub-perception stimulation is used to avoid paresthesia, then patient comfort is improved, but pain relief duration and consistency become challenging to control
Solution Approach 1:
The system incorporates feedback mechanisms where the control circuitry monitors patient responses and pain levels over time. Based on this feedback, the system automatically adjusts stimulation parameters including intensity, duration, and delivery intervals to optimize pain relief duration while maintaining sub-threshold operation and avoiding paresthesia.
Solution Approach 2:
The stimulation parameters are made dynamic rather than static. The control circuitry continuously adapts the stimulation protocol based on individual patient characteristics, pain patterns, and treatment responses. This dynamic adjustment allows the system to maintain effective pain relief duration by optimizing each subsequent stimulation bolus based on previous outcomes.
3Reliability
If stimulation parameters are adjusted to optimize pain relief, then therapy effectiveness is improved, but device complexity increases
Solution Approach 1:
The control circuitry is designed to autonomously determine and adjust stimulation parameters without requiring complex external programming or manual intervention. The system self-calibrates by analyzing patient-specific data, calculating optimal delivery intervals, and automatically adjusting parameters to maintain effective pain relief, thereby reducing the need for complex user interfaces and external programming devices.
Data Source
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AI summary
Methods and systems for providing electrical stimulation to a patient's spinal cord using electrode leads implanted in the patient's spinal column are described. Embodiments involve cycling between durations during which stimulation is actively applied and durations when no stimulation is applied. The stimulation can be configured such that pain relief washes in during the active stimulation duration and continues for some part of the duration when no stimulation is being applied. Eventually the pain relief may wash out. The washout time may be modeled, so that stimulation may be resumed before the pain relief washes out. The stimulation may be below the patient's perception threshold.