Spinal Cord Stimulator Electrode Selection Using Stimulation Artifacts
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Solution Overview
Problem
Existing implantable neurostimulator devices, such as spinal cord stimulators, face challenges in optimizing electrode selection and sensing responses to provide effective therapy, particularly in varying patient postures, due to the complexity of neural responses and interference from stimulation artifacts.
Innovation Solution
The integration of sensing capabilities in the stimulator device allows for the selection of optimal electrode pairs or electrodes based on sensing stimulation artifacts and neural responses, such as Evoked Compound Action Potentials (ECAPs), by evaluating these responses in different patient postures to determine the most effective stimulation parameters.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple electrodes are used for stimulation, then coverage and therapeutic effect are improved, but device complexity and electrode selection optimization become more difficult
Solution Approach 1:
The system automatically selects optimal sensing electrodes by analyzing stimulation artifacts and neural responses, enabling the device to self-optimize without manual intervention. The processor identifies electrodes with optimal signal characteristics and configures them automatically, reducing programming complexity while maintaining effective therapy.
Solution Approach 2:
The system uses sensed neural responses and stimulation artifacts as feedback to automatically adjust electrode selection. By monitoring the quality of sensed signals and the characteristics of stimulation artifacts, the system iteratively optimizes which electrodes serve as sensing electrodes, ensuring optimal therapeutic effect without requiring manual trial-and-error configuration.
2Adaptability or versatility
If sensing capabilities are added to the stimulator, then adaptability to patient posture and therapy optimization are improved, but device complexity increases
Solution Approach 1:
The stimulator's existing electrodes serve dual functions: both stimulation delivery and signal sensing. The same electrode array used for spinal cord stimulation is also used to sense neural responses and stimulation artifacts, eliminating the need for separate sensing electrodes and reducing overall device complexity while enabling posture adaptation.
Solution Approach 2:
The system converts stimulation artifacts, which are typically considered noise or interference, into useful information for electrode selection and posture detection. By analyzing the characteristics of stimulation artifacts across different electrodes, the system identifies optimal sensing electrodes and adapts therapy to patient posture, transforming a harmful factor into a beneficial sensing mechanism.
3Measurement precision
If stimulation artifacts are used for electrode selection, then measurement precision for electrode optimization is improved, but signal interference and noise increase
Solution Approach 1:
The system transforms stimulation artifacts from interfering signals into useful measurement data for electrode selection. By analyzing the amplitude, timing, and spatial distribution of stimulation artifacts across different electrodes, the system identifies which electrodes provide the clearest neural responses, thereby using the artifact itself as a diagnostic tool for optimization.
Solution Approach 2:
The system varies stimulation parameters such as pulse amplitude, frequency, and duration to optimize the characteristics of stimulation artifacts for sensing purposes. By adjusting these parameters, the system enhances the signal-to-noise ratio of artifacts and neural responses, improving measurement precision for electrode selection while managing interference through controlled parameter changes.
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 precision and adaptability of spinal cord stimulation therapy by identifying optimal electrode configurations and adjusting stimulation based on patient posture, thereby improving therapeutic outcomes.
Implementation Method 1
The IPG 10 includes stimulation circuitry 28 to form prescribed stimulation at a patient's tissue
Implementation Method 2
the sensed response comprises a stimulation artifact, wherein the stimulation artifact comprises a signal formed by an electric field induced in the tissue by the stimulation
Data Source
AI summary
A sensing electrode selection algorithm is disclosed for use with an implantable pulse generator having an electrode array. The algorithm automatically selects optimal sensing electrodes in the array to be used with a pre-determined stimulation therapy appropriate for the patient. The algorithm preferably senses stimulation artifacts using different sensing electrodes, and more specifically different sensing electrode pairs as is appropriate when differential sensing is used. The algorithm further preferably senses these stimulation artifacts with the patient placed in two or more postures. The algorithm processes the stimulation artifact features measured at the different sensing electrodes and at the different postures to automatically determine one or more sensing electrode pairs that best distinguishes the two or more postures given the prescribed stimulation therapy.