Neurostimulator Electrode Combination Shifting
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Solution Overview
Problem
The process of selecting optimal electrode combinations for neurostimulation therapy is time-consuming and labor-intensive, requiring clinicians to manually test numerous combinations, which can be tedious and inefficient, especially with modern neurostimulators that offer more complex parameter settings and larger electrode combinations.
Innovation Solution
The technique involves shifting stimulation energy between electrode combinations in an incremental and time-interleaved manner, allowing for gradual transitions between different electrode settings to identify efficacious combinations, either during testing or operational modes, using a programmer to control the amplitude adjustments and pulse delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual testing of electrode combinations is performed, then optimal therapy settings can be identified, but the process becomes time-consuming and labor-intensive
Solution Approach 1:
The system performs preliminary automated testing of electrode combinations by the clinician using a streamlined interface that presents combinations in a systematic sequence. The clinician's selections during this preliminary phase are stored and used to automatically generate optimized programs, eliminating the need for manual testing of all combinations later.
Solution Approach 2:
The neurostimulator automatically generates optimized therapy programs based on the clinician's preliminary selections without requiring manual configuration. The device self-configures by selecting electrode combinations and parameters based on the stored selection data, reducing subsequent programming time and effort.
2Adaptability or versatility
If the number of electrode combinations is increased to improve therapy options, then clinical efficacy can be enhanced, but the complexity of device programming increases
Solution Approach 1:
The electrode combinations are segmented into manageable groups or sequences that are presented to the clinician in an organized manner. This segmentation allows the clinician to systematically evaluate combinations without being overwhelmed by the total number of possibilities, while the system handles the complexity of managing all combinations internally.
Solution Approach 2:
The system automatically manages the complexity of multiple electrode combinations by self-configuring optimized programs based on clinician selections. The neurostimulator handles parameter optimization and program generation automatically, reducing the burden on the clinician to manually manage the complexity of numerous electrode combinations.
3Reliability
If extensive parameter testing is performed to optimize therapy, then treatment efficacy improves, but clinic time consumption increases
Solution Approach 1:
Extensive parameter testing is performed as a preliminary automated process during an initial programming session. The system systematically evaluates multiple electrode combinations and parameters in advance, storing the results for future use. This preliminary action ensures thorough optimization while confining the time investment to an initial setup phase rather than ongoing adjustments.
Solution Approach 2:
The neurostimulator performs self-optimization by automatically selecting and configuring therapy parameters based on stored selection data from preliminary testing. This self-service capability allows the device to maintain optimized therapy settings without requiring repeated extensive testing, thereby improving clinic throughput while preserving therapy effectiveness.
Data Source
AI summary
The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination. Additionally, the techniques may be used for shifting between different electrode combinations associated with different stimulation programs or program sets.