Spinal Cord Stimulation Guidance Using Evoked Synaptic Potentials
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Solution Overview
Problem
Existing spinal cord stimulation systems lack the capability to effectively sense and utilize evoked potentials for closed-loop feedback to optimize therapeutic stimulation, leading to suboptimal pain relief outcomes.
Innovation Solution
Incorporating evoked potential sensing capabilities into spinal cord stimulation systems, allowing for the use of electrode contacts to provide evoking stimulation at frequencies of 50 Hz or less and sense evoked synaptic potentials (ESPs) for closed-loop feedback to adjust therapeutic stimulation, ensuring paresthesia-pain overlap and optimal pain relief.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If evoked potential sensing capabilities are incorporated into spinal cord stimulation systems, then closed-loop feedback control and pain relief effectiveness are improved, but device complexity increases
Solution Approach 1:
The patent combines evoked potential sensing capabilities with existing spinal cord stimulation systems by integrating sensing electrodes into the electrode array. The control circuitry merges stimulation and sensing functions, allowing the same device to both deliver therapeutic stimulation and detect evoked potentials for closed-loop feedback control, thereby improving pain relief effectiveness without requiring entirely separate systems
Solution Approach 2:
The patent implements closed-loop feedback control by detecting evoked potentials in response to stimulation and using this information to dynamically adjust stimulation parameters. The control circuitry receives feedback signals from evoked potential detection and automatically modifies subsequent stimulation delivery, creating a self-regulating system that optimizes pain relief effectiveness in real-time
2Productivity
If evoked potential sensing is added to provide closed-loop feedback, then therapeutic stimulation optimization is improved, but measurement precision requirements increase
Solution Approach 1:
The patent uses evoked potentials as an intermediary signal that bridges the stimulation delivery and feedback control functions. By detecting these evoked potentials, the system obtains measurable information about neural response without requiring direct measurement of complex neural activity, thereby achieving therapeutic optimization through a practical and measurable intermediate parameter
Solution Approach 2:
The patent changes the measurement parameter from direct neural activity monitoring to evoked potential detection, which provides sufficient information for feedback control without requiring extremely high measurement precision. The system adjusts stimulation parameters based on evoked potential characteristics, achieving therapeutic optimization through parameter modification rather than requiring ultra-precise neural signal measurement
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
Enhances pain relief by dynamically adjusting stimulation based on sensed evoked potentials, maintaining therapeutic stimulation within a therapeutic window and achieving effective paresthesia-pain overlap.
Implementation Method 1
use a first one or more of the spinal electrode contacts to provide evoking stimulation to the patient's spinal cord, wherein the evoking stimulation has a frequency of 50 Hz or less
Implementation Method 2
use a second one or more of the spinal electrode contacts to sense and record the ESP
Data Source
AI summary
Methods and systems for spinal cord stimulation (SCS) are disclosed. The methods and systems involve using electrode leads implanted within the patient's spinal column to record neural responses evoked by the stimulation. The disclosed neural responses are different in several respects from electrical responses that have previously been measured in the context of SCS, such as stimulation artifacts and evoked compound action potentials (ECAPs). The disclosed neural responses typically occur later in time following the evoking stimulation pulse. Another distinguishing feature is that disclosed neural responses are generally most prominently observed with consistent, relatively unchanging amplitudes when the evoking stimulation frequency is ultra-low, for example, about 10 Hz or less. The disclosed methods and systems may use these neural responses as indications of pain, therapy, and/or another clinically relevant dimension, to direct/confirm stimulation placement, and for feedback control of stimulation parameters.