Neurostimulation Titration Using Remote Patient Feedback
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Solution Overview
Problem
Existing neuromodulation therapies, such as deep brain stimulation (DBS), lack effective methods for personalized and remote adjustment of stimulation parameters to accommodate varying patient states and evolving medical conditions.
Innovation Solution
A system comprising an implantable stimulator and a remotely controlled programming device that identifies an electrode configuration and parameter search space, evaluates clinical response indicators, and iteratively adjusts stimulation settings to optimize therapy based on patient-specific feedback and machine-learning predictions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If traditional neuromodulation therapy is used with fixed stimulation parameters, then the treatment can be provided to patients, but it cannot effectively accommodate varying patient states and evolving medical conditions
Solution Approach 1:
The patent implements dynamic stimulation parameter adjustment by enabling patients to modify therapy settings in real-time based on their current state. The system transitions from fixed, pre-programmed parameters to dynamically adjustable parameters that can be changed remotely via a mobile device, allowing the therapy to adapt to varying patient conditions throughout the day.
Solution Approach 2:
The patent enables patients to self-adjust their stimulation parameters using a mobile device without requiring clinician intervention. The system provides patients with the capability to independently modify therapy settings, select different programs, and optimize their treatment based on their own experience and understanding of their condition.
2Measurement precision
If stimulation parameters are adjusted remotely and iteratively, then personalized therapy optimization is achieved, but the programming system complexity increases
Solution Approach 1:
The patent implements a feedback-driven therapy optimization system where patients evaluate their clinical response to stimulation and use this information to iteratively adjust parameters. The system continuously cycles through parameter modification, stimulation delivery, and response evaluation, refining therapy based on actual patient outcomes rather than relying solely on initial clinician programming.
Solution Approach 2:
The patent provides patients with pre-configured stimulation programs and parameter ranges that have been initially optimized by clinicians. These preliminary settings serve as a foundation that patients can then safely explore and modify within predefined boundaries, reducing the complexity burden while enabling personalized optimization.
3Reliability
If multiple electrode configurations and parameter values are evaluated, then optimal stimulation settings can be determined, but the time and computational resources required increase
Solution Approach 1:
The patent divides the parameter optimization process into discrete, manageable programs, each representing a specific electrode configuration and parameter set. Patients can selectively activate and evaluate individual programs rather than testing all possible combinations, breaking down the complex optimization task into segmented, evaluable units that reduce time requirements.
Solution Approach 2:
The patent enables patients to evaluate and optimize a subset of electrode configurations and parameter values that are most relevant to their specific needs and symptoms. Rather than exhaustively testing all possible parameter combinations, the system allows patients to focus on partial optimization of key parameters that provide the greatest therapeutic benefit with minimal time investment.
Data Source
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AI summary
A system for providing electro stimulation to a patient, comprising an implantable stimulator configured to provide electrostimulation to a neural target of the patient via one or a plurality of leads each comprising a plurality of electrodes; a memory configured to store (i) a search space of electrode configurations and parameter values for the one or plurality of leads with respect to the neural target and (ii) at least one base stimulation setting associated with a corresponding clinical response indicator evaluated under a first patient state responsive to electrostimulation delivered using electrodes and stimulation parameter values within the search space, and a therapy titration device operable by a user and configured to: under a second patient state different from the first patient state, evaluate clinical response indicator responsive to electro stimulation in accordance with the at least one base stimulation setting; modify the at least one base stimulation setting based at least in part on the evaluated clinical response indicator under the second patient state; and generate a control signal to the implantable stimulator to deliver electro stimulation in accordance with the modified at least one base stimulation setting.