Adaptive Spinal Cord Stimulation With Sub-Perception Duty Cycles
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Solution Overview
Problem
Existing spinal cord stimulation (SCS) systems often cause paresthesia, a tingling sensation, which can be a tradeoff for effective pain relief, and there is a need for methods and systems that can provide pain relief without paresthesia or minimize its occurrence.
Innovation Solution
The system employs adaptive neural stimulation techniques that modulate stimulation intensity and duration using a regulating function, informed by patient feedback and sensor data, to deliver sub-perception therapy that quickly washes in and out, minimizing paresthesia and optimizing therapy effectiveness.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional spinal cord stimulation is used to provide effective pain relief, then pain relief is achieved, but paresthesia (tingling sensation) occurs as a tradeoff
Solution Approach 1:
The patent changes the stimulation parameters from conventional high-intensity continuous stimulation to low-intensity intermittent stimulation with specific on/off duty cycles. By adjusting the stimulation intensity to be below the paresthesia threshold while maintaining pain relief effectiveness through optimized timing and duration parameters, the system resolves the contradiction between effective pain relief and avoidance of paresthesia.
Solution Approach 2:
The patent implements periodic stimulation delivery with specific duty cycles, where stimulation is delivered in intermittent bursts rather than continuously. This periodic action allows the nervous system to adapt and maintain pain relief without triggering continuous paresthesia, as the stimulation periods are optimized to provide therapeutic effect while allowing recovery periods below the perception threshold.
2Reliability
If stimulation intensity and duration are increased to improve pain relief, then pain relief effectiveness improves, but energy consumption increases
Solution Approach 1:
The patent applies partial action by delivering stimulation at intensities and durations that are sufficient to achieve pain relief but deliberately kept below the threshold for continuous paresthesia. This partial stimulation approach maintains therapeutic effectiveness while minimizing energy consumption, as the system uses just enough stimulation to achieve the desired effect without excessive energy expenditure.
Solution Approach 2:
The patent optimizes the balance between stimulation intensity, duration, and duty cycle parameters to achieve maximum pain relief with minimum energy consumption. By carefully tuning these parameters and using adaptive control based on patient response, the system finds the optimal energy-efficient operating point that maintains effective pain relief without wasteful energy usage.
3Stability of the object's composition
If stimulation is delivered continuously to maintain pain relief, then pain relief consistency improves, but the therapy washes out faster and energy consumption increases
Solution Approach 1:
The patent uses periodic intermittent stimulation with optimized duty cycles to maintain consistent pain relief over extended periods. By delivering stimulation in rhythmic bursts with appropriate on/off timing, the system prevents tolerance buildup and washout effects that occur with continuous stimulation, thereby maintaining stable pain relief consistency while extending the effective duration of action.
Solution Approach 2:
The patent maintains continuous therapeutic effect through carefully timed intermittent stimulation, where the off-periods are optimized to allow pain relief to persist without washing out. This approach ensures that the useful therapeutic action continues effectively over time, with each stimulation burst building upon the previous effect rather than allowing complete dissipation, thereby maintaining stability without requiring constant continuous stimulation.
Data Source
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.