摘要:
Systems (10), devices (16), and methods may be used for treating bladder dysfunction, such as urgency and pelvic pain. In one example, a method includes administering a pharmacological agent to a patient (14) in a dosage sufficient to desensitize a C-afferent nerve fiber of the patient. Additionally, the method includes delivering stimulation to activate a nerve fiber proximate to the C-afferent nerve fiber via an electrode (19A, 19B, 21A, 21B, 29A-29D) electrically coupled to an implantable medical device (16). In some examples, the nerve fiber may be different than the C-afferent nerve fiber, the stimulation of the nerve fiber may elicit an inhibitory physiological response related to voiding in the patient, and/or the stimulation substantially may not activate the C-afferent nerve fiber after desensitization of the nerve fiber via the administration of the pharmacological agent.
摘要:
Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.
摘要:
The invention is directed to techniques and systems in which external brain monitoring is used to facilitate implantation and configuration of an implantable medical device. The techniques may create an open loop or closed loop system in which brain signals quantify the efficacy of electrical logical stimulation (or drug therapy via an implantable drug pump) at locations outside of the brain. The techniques may be used to improve placement of leads and electrodes during an implantation procedure, and/or to select or adjust stimulation parameters either during the implantation procedure or possibly following implantation of an implantable medical device. The described techniques have applications for the alleviation of pain, but may find other applications where EEG signals can quantify the efficacy of treatment via an implantable medical device.
摘要:
A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.
摘要:
Therapy delivery to a patient may be controlled based on a determined sleep stage of the patient. In examples, the sleep stage may be determined based on a frequency characteristic of a biosignal indicative of brain activity of the patient. A frequency characteristic may include, for example, a power level within one or more frequency bands of the biosignal, a ratio of the power level in two or more frequency bands, or a pattern in the power level of one or more frequency bands over time. A therapy program may be selected or modified based on the sleep stage determination. Therapy may be delivered during the sleep stage according to the selected or modified therapy program. In some examples, therapy delivery may be controlled after making separate determinations of a sleep stage based on the biosignal and another physiological parameter, and confirming that the sleep stage determinations are consistent.
摘要:
A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.
摘要:
A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.
摘要:
A patient controls the delivery of therapy through volitional inputs that are detected by a biosignal within the brain. The volitional patient input may be directed towards performing a specific physical or mental activity, such as moving a muscle or performing a mathematical calculation. In one embodiment, a biosignal detection module monitors an electroencephalogram (EEG) signal from within the brain of the patient and determines whether the EEG signal includes the biosignal. In one embodiment, the biosignal detection module analyzes one or more frequency components of the EEG signal. In this manner, the patient may adjust therapy delivery by providing a volitional input that is detected by brain signals, wherein the volitional input may not require the interaction with another device, thereby eliminating the need for an external programmer to adjust therapy delivery. Example therapies include electrical stimulation, drug delivery, and delivery of sensory cues.
摘要:
A wearable ambulatory data recorder that senses physiological parameters of a patient, and stores physiological parameter data for later retrieval, as well as techniques for using such a wearable ambulatory data recorder, are described. The data recorder includes one or more sensors located on or within a housing. The data recorder may include an adhesive layer for attachment to a patient. In some embodiments, the housing may be within a patch, e.g., bandage, which includes the adhesive layer. The housing may be waterproof. Features of the data recorder such as size, waterproofness, and inclusion of an adhesive may allow the data recorder to be unobtrusively worn by a patient during a variety of daily activities. The data recorder may be for single use and thereafter disposable.
摘要:
Implantable medical devices switch from a constant current mode of operation to a constant voltage mode of operation. The switching may be based on the device determining that tissue impedance stability has occurred. The determination may be a measurement of output voltage stability of the constant current source or based on other factors such as an amount of time that has elapsed. The switching may be as the result of an externally generated request such as by a clinician via an external device. The implantable medical device may begin constant voltage mode by utilizing stimulation parameters based on those initially programmed for constant current mode and based upon a measurement of voltage amplitude being output by the constant current source prior to the switch.