Neuromodulation System Trolling Routine for Sub-Perception Therapy
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Solution Overview
Problem
Conventional spinal cord stimulation systems often cause uncomfortable paresthesia as a side effect, as they activate large sensory dorsal column nerve fibers, and there is a need for a method to deliver therapeutic neural modulation without patient perception of the stimulation.
Innovation Solution
The system employs a neuromodulation system with a controller that generates a modulation field using electrodes, implementing a trolling routine to identify patient-perceived modulation and adjust stimulation energy to achieve sub-perception therapy, selectively modulating dorsal horn or dorsal root tissue over dorsal column tissue at lower frequencies to minimize paresthesia.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional spinal cord stimulation is used to treat pain, then pain relief is achieved, but uncomfortable paresthesia occurs as a side effect
Solution Approach 1:
The patent changes the stimulation frequency parameter to below 1500 Hz (sub-perception threshold) and adjusts pulse width and amplitude parameters to selectively activate dorsal horn or dorsal root tissue rather than dorsal column fibers, thereby achieving pain relief without paresthesia
Solution Approach 2:
The patent applies selective neural tissue modulation by targeting specific neural structures (dorsal horn or dorsal root tissue) with different stimulation parameters than conventional approaches, creating localized therapeutic effect without activating the dorsal column pathways that cause paresthesia
2Reliability
If stimulation intensity is increased to improve pain relief, then therapeutic effect is enhanced, but patient perception of stimulation increases causing discomfort
Solution Approach 1:
The patent operates at stimulation frequencies below 1500 Hz (sub-perception threshold) where the neural tissue is modulated therapeutically without reaching the perception threshold that causes uncomfortable sensations, allowing higher effective doses without patient awareness
Solution Approach 2:
The patent uses a computational model to predict the modulation field and estimate relative excitation of neural tissue, allowing optimization of stimulation parameters to achieve therapeutic effects while staying below perception thresholds
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach allows for effective pain relief without the sensation of paresthesia, using sub-perception therapy that modulates neural tissue at frequencies below 1500 Hz, preferentially engaging dorsal horn or dorsal root tissue to reduce activation of dorsal column fibers, thereby enhancing therapeutic outcomes while minimizing adverse sensations.
Implementation Method 1
neural modulation and neural stimulation may be used interchangeably to describe excitatory stimulation that causes action potentials
Data Source
AI summary
An example of a system may include an electrode arrangement, a neural modulation generator configured to use electrodes in the electrode arrangement to generate a modulation field, a communication module configured to receive commands, a memory configured to store modulation field parameter data, and a controller configured to control the neural modulation generator to generate the modulation field. The controller may be configured to implement a trolling routine to troll the modulation field through neural tissue positions, and implement a marking routine multiple times as the modulation field is trolled through the neural tissue positions to identify when the modulation field provides patient-perceived modulation. The marking procedure implemented by the controller may receive a marking command that indicates that a modulation intensity achieved the patient-perceived modulation, and store in the memory the modulation field parameter data that affects the modulation intensity in response to receiving the marking command.