Implantable Neurostimulation Adaptation for Age-Related Threshold Shifts
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Solution Overview
Problem
Existing neuromodulation systems face challenges in maintaining effective and comfortable neural recruitment due to age-related physiological changes, which can lead to increased energy consumption and frequent reprogramming needs, and are hindered by electrode migration and postural changes affecting therapeutic ranges.
Innovation Solution
Implantable devices capable of self-reprogramming to adapt therapy parameters over time based on age-related physiological characteristics, using a schedule of adjustments and measurements such as ECAP thresholds and patient sensitivity, to maintain optimal stimulus intensity and reduce energy expenditure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If stimulus intensity is increased to maintain therapeutic effect over time, then therapeutic efficacy is improved, but energy consumption increases and discomfort threshold is exceeded
Solution Approach 1:
The system performs preliminary measurements of age-related physiological characteristics (ECAP threshold, patient sensitivity) at implantation and uses these baseline values to predict future therapeutic needs. This allows the controller to proactively adjust stimulus parameters before efficacy deteriorates, avoiding the need for continuous high-intensity stimulation and reducing energy consumption.
Solution Approach 2:
The system dynamically adjusts stimulus intensity based on predicted age-related changes. Rather than using fixed high intensity, the controller modulates parameters (amplitude, pulse width, frequency) according to a schedule that anticipates physiological degradation, maintaining therapeutic effect while minimizing energy use by applying only the necessary intensity at each time point.
2Reliability
If stimulus intensity is increased to compensate for age-related changes, then therapeutic efficacy is maintained, but frequency of clinical reprogramming increases
Solution Approach 1:
The system performs self-adjustment by automatically measuring age-related physiological characteristics and autonomously modifying stimulus parameters. The controller uses measured ECAP thresholds and patient sensitivity data to self-program adjustments, eliminating the need for manual clinical reprogramming visits while maintaining therapeutic efficacy.
Solution Approach 2:
The system implements feedback control by continuously measuring neural responses (ECAP) and using this information to adjust stimulus parameters. This closed-loop approach allows the system to self-correct for age-related changes without external intervention, maintaining therapeutic effect and reducing the need for clinical visits.
3Reliability
If stimulus intensity is increased to maintain recruitment, then therapeutic effect is sustained, but discomfort and pain sensations increase
Solution Approach 1:
The system measures age-related changes in neural recruitment characteristics at implantation and uses this baseline data to predict future recruitment patterns. This allows the controller to proactively adjust stimulus intensity to match predicted physiological changes, maintaining adequate neural recruitment while avoiding excessive intensity that would cause discomfort or pain.
Solution Approach 2:
The system changes multiple stimulus parameters (amplitude, pulse width, frequency, waveform shape) in a coordinated manner to maintain therapeutic neural recruitment. By adjusting parameters according to predicted age-related physiological changes, the system optimizes the balance between achieving sufficient recruitment and staying below discomfort 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
The solution enables continuous adaptation to age-related changes, ensuring consistent therapeutic efficacy while minimizing energy consumption and reducing the need for frequent clinical reprogramming.
Implementation Method 1
An electrical pulse of sufficient intensity applied to the target neural fibres by a stimulus electrode causes the depolarisation of neurons in the fibres, which in turn generates a response known as an action potential in the fibres.
Implementation Method 2
Action potentials propagate along the fibres in orthodromic (in afferent fibres this means towards the head, or rostral) and antidromic (in afferent fibres this means towards the cauda, or caudal) directions.
Data Source
AI summary
Disclosed is a method of adapting the operation of an implantable device for delivering neurostimulation therapy to a patient. The method comprises: delivering the neurostimulation therapy to electrically excitable tissue of the patient according to at least one therapy parameter; measuring a physiological characteristic of the patient; adjusting the at least one therapy parameter according to a schedule of adjustment and the measured physiological characteristic; and repeating the delivering, measuring, and adjusting.