Directional Stimulation Programming for Lead-Movement Adaptation
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Solution Overview
Problem
Existing electrical stimulation therapies for conditions like Parkinson's disease are less effective and can cause side effects due to lead movement and physiological changes over time, which affect the efficacy of the therapy and lead to undesirable outcomes.
Innovation Solution
An implantable medical device (IMD) monitors electrical signals from different electrode combinations to determine therapeutic windows, adjusting electrode combinations and stimulation parameters in response to lead movement and physiological changes, ensuring optimal therapy delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If fixed electrode combinations are used for stimulation therapy, then the device complexity is reduced, but the therapeutic efficacy deteriorates due to lead movement and physiological changes over time
Solution Approach 1:
The system dynamically adjusts electrode combinations based on real-time sensing of physiological signals and determined therapeutic windows. The IMD transitions from static, fixed electrode programming to dynamic, adaptive electrode selection that responds to lead movement and physiological changes, thereby maintaining therapeutic efficacy without requiring complex external reprogramming
Solution Approach 2:
The system implements closed-loop feedback by sensing electrical signals from tissue, determining therapeutic windows for different electrode combinations, and using this information to automatically select optimal electrode combinations for stimulation delivery. This feedback mechanism ensures therapeutic efficacy is maintained despite lead movement or physiological changes
2Reliability
If multiple electrode combinations are monitored and adjusted dynamically, then the therapeutic efficacy is improved, but the device complexity increases
Solution Approach 1:
The IMD performs self-adjustment by autonomously sensing electrical signals, determining therapeutic windows for multiple electrode combinations, and selecting optimal combinations without requiring external clinician intervention. This self-service capability maintains therapeutic efficacy while minimizing the need for complex external programming infrastructure
3Object-affected harmful factors
If electrode combinations are adjusted in response to lead movement, then the side effects are reduced, but the measurement precision requirements increase
Solution Approach 1:
The system uses feedback from sensed electrical signals to detect lead movement by comparing current therapeutic windows against baseline values. This feedback mechanism enables the system to identify lead displacement and adjust electrode combinations accordingly, reducing side effects while managing measurement precision requirements through adaptive thresholding
Solution Approach 2:
The system establishes baseline therapeutic window values during initial programming before lead movement occurs. These preliminary measurements serve as reference points for detecting future lead displacement, enabling the system to identify and correct positioning issues before they cause harmful side effects
4Adaptability or versatility
If therapeutic window monitoring is implemented for multiple electrode combinations, then the adaptability is improved, but the loss of time for data processing increases
Solution Approach 1:
The system monitors therapeutic windows for multiple electrode combinations simultaneously but selectively processes data only for combinations that show potential therapeutic benefit or indicate lead movement. This partial processing approach maintains adaptability across multiple electrodes while reducing overall data processing time by avoiding exhaustive analysis of all possible combinations
Data Source
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AI summary
Devices, systems, and techniques are disclosed for managing electrical stimulation therapy and/or sensing of physiological signals such as brain signals. For example, a system is configured to receive, for each electrode combination of a plurality of electrode combinations, information representing a signal sensed in response to first electrical stimulation delivered to a patient via a lead, wherein the plurality of electrode combinations comprise different electrode combinations comprising electrode disposed at different positions around a perimeter of the lead implanted in the patient. The system may also be configured to determine, based on the information for each electrode combination of the plurality of electrode combinations, values for a threshold at different locations around the perimeter of the lead and determine, based on the values for the threshold, one or more stimulation parameter values that at least partially define second electrical stimulation deliverable to the patient via the lead.