External Controller for Sub-Perception Stimulation Sweet Spot Search
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Solution Overview
Problem
Spinal Cord Stimulation (SCS) therapy often causes paresthesia, and achieving sub-perception therapy without paresthesia is challenging due to the difficulty in selecting effective electrodes and the need for prolonged wash-in periods, which can inconvenience patients with frequent battery replacements or charging.
Innovation Solution
Employing supra-perception stimulation during the sweet spot search to quickly determine effective electrodes, followed by titrating to sub-perception levels, reduces the wash-in time and ensures immediate effectiveness of sub-perception therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If sub-perception stimulation is used to avoid paresthesia, then patient comfort is improved, but the wash-in period is prolonged and therapy effectiveness is delayed
Solution Approach 1:
The system performs preliminary supra-perception stimulation during the sweet spot search to identify effective electrodes before transitioning to sub-perception therapy. This preliminary action of electrode identification using supra-perception stimulation eliminates the need for prolonged wash-in periods when using sub-perception stimulation, as the effective electrodes are already determined beforehand.
Solution Approach 2:
The system dynamically changes the stimulation parameter (perception level) from supra-perception during electrode selection to sub-perception during therapy. By adjusting the perception threshold parameter, the system achieves both rapid electrode identification and patient comfort, resolving the contradiction between wash-in period duration and therapy effectiveness.
2Productivity
If supra-perception stimulation is used during sweet spot search, then electrode determination is accelerated, but battery drain increases
Solution Approach 1:
The system uses periodic supra-perception stimulation only during the initial sweet spot search phase to identify effective electrodes, then transitions to sub-perception stimulation for ongoing therapy. This periodic use of high-energy supra-perception stimulation minimizes battery drain while achieving rapid electrode determination when it is most needed.
Solution Approach 2:
The system performs the energy-intensive supra-perception stimulation as a preliminary step during sweet spot search to quickly identify effective electrodes. By concentrating the energy consumption in this preliminary phase rather than continuous use, the system accelerates electrode determination while managing overall battery drain through subsequent use of lower-energy sub-perception stimulation.
3Adaptability or versatility
If the entire electrode array is available for sub-perception stimulation, then therapy flexibility is improved, but difficulty in selecting effective electrodes increases
Solution Approach 1:
The system segments the electrode array into effective and non-effective portions by using supra-perception stimulation during sweet spot search to identify which electrodes provide therapeutic benefit. This segmentation approach maintains the flexibility of having access to the entire electrode array while simplifying the selection process by pre-identifying effective electrodes through the segmentation created during the search phase.
Data Source
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AI summary
The present invention relates to an external controller for controlling sub-perception stimulation provided by an implantable stimulator device having an electrode array. The external controller for controlling sub-perception stimulation comprises control circuitry configured to render a graphical user interface (GUI), including a location at which the sub-perception stimulation is provided within the electrode array pursuant to a stimulation program stored with the control circuitry. The stimulation program comprises a perception threshold. The control circuitry is configured to receive one or more inputs to move the location of the sub-perception stimulation within the electrode array, wherein moving the location causes the control circuitry to send programming instructions to the implantable stimulator device to move the sub-perception stimulation to the moved location in the electrode array. Furthermore, the control circuitry enables adjustment at the moved location of an amplitude of the sub-perception stimulation to a value that is less than or equal to the perception threshold.