Spinal Cord Stimulation Electrode Positioning for Evoked Potential Recording
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Solution Overview
Problem
Current neurostimulation systems face challenges in accurately recording evoked potentials due to proximity to stimulation sources, which results in measurement artifacts and limited recording of pain-related fiber signals, primarily capturing non-painful sensory information from the dorsal column.
Innovation Solution
A method and system for closed-loop spinal cord stimulation that positions a second electrode near the dorsal root to measure evoked potential waveforms, allowing for the recording of neural activity from both non-painful and painful sensory fibers, thereby improving recording fidelity and enabling precise identification of affected areas.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the electrode is positioned proximate to the dorsal column for recording evoked potentials, then the recording location is convenient and accessible, but the evoked potential signal includes stimulation artifacts and primarily corresponds to non-painful sensory fibers (Aβ) rather than pain-related fibers (Aδ and C)
Solution Approach 1:
The patent introduces an intermediary approach by using the dorsal root as a recording location that mediates between the stimulation source and the pain transmission pathways. The dorsal root serves as an intermediate structure that allows recording of evoked potentials from pain-related fibers without direct proximity to the stimulation artifacts at the dorsal column level.
2Device complexity
If the electrode is positioned proximate to the dorsal column for recording evoked potentials, then the setup is simple, but the thickness of the cerebrospinal fluid reduces the evoked potential signal amplitude
Solution Approach 1:
The patent extracts the recording location from the dorsal column area and relocates it to the dorsal root. This extraction removes the detrimental effect of the cerebrospinal fluid thickness that attenuates the signal at the dorsal column, while maintaining a relatively simple recording setup configuration.
3Ease of operation
If traditional dorsal column recording is used, then the recording process is straightforward, but it fails to capture pain-related fiber activity (Aδ and C fibers) that travel in different pathways
Solution Approach 1:
The patent transitions from recording at the dorsal column (one location/dimension) to recording at the dorsal root (another location/dimension). This dimensional change in recording location enables capture of pain-related fiber activity that travels through different anatomical pathways, while maintaining procedural simplicity.
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 enhances the recording fidelity of evoked potential waveforms, allows for precise identification of affected dermatomes, and provides an objective quantification of spinal cord stimulation effects, reducing reliance on subjective patient descriptions.
Implementation Method 1
The IPG is configured to deliver excitation pulses to the first electrodes based on a stimulation level. The excitation pulses are emitted from the first electrode.
Implementation Method 2
The evoked potential signals may be generated by neuronal transmembrane currents of neurons activated following or in response to the NS.
Data Source
AI summary
Systems and methods for closed loop spinal cord stimulation are provided. The systems and methods position a first electrode proximate to a dorsal column. The first electrode is electrically coupled to an implantable pulse generator (IPG). The systems and methods further program the IPG to deliver excitation pulses to the first electrode based on a stimulation level. The excitation pulses are emitted from the first electrode. The systems and methods further position a second electrode proximate to a dorsal root. The second electrode is electrically coupled to the IPG. The systems and methods further measure at the second electrode a first evoked potential waveforms resulting from the excitation pulses.