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公开(公告)号：US08666506B2
公开(公告)日：2014-03-04
申请号：US11810941
申请日：2007-06-07
申请人： Gary W. King , Steven M. Goetz , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
发明人： Gary W. King , Steven M. Goetz , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy are described. The techniques include selecting one or more electrode combinations based on information associating a plurality of electrode combinations with at least one value of a therapy metric. The therapy metric comprises a quantifiable result of delivery of stimulation, and may be generated computer modeling of delivery of stimulation via the electrode combinations. In one embodiment, a clinician may deliver stimulation via a baseline electrode combination, receive patient feedback to the baseline electrode combination, select a therapy metric based on the patient feedback, and select additional electrode combinations based on the selected therapy metric and the information associating the electrode combinations with therapy metric values. In another embodiment, the clinician may select a therapy metric prior to providing a test stimulation and select additional electrode combinations based on the selected therapy metric and the information associating electrode combinations with metric values.
摘要翻译： 描述了用于选择用于刺激治疗的电极组合的技术。 所述技术包括基于将多个电极组合与治疗度量的至少一个值相关联的信息来选择一个或多个电极组合。 治疗指标包括刺激递送的可量化结果，并且可以产生经由电极组合递送刺激的计算机建模。 在一个实施例中，临床医生可以经由基线电极组合递送刺激，将患者反馈接收到基线电极组合，基于患者反馈选择治疗度量，并且基于所选择的治疗度量选择附加电极组合，并且将关于 电极组合与治疗度量值。 在另一个实施例中，临床医生可以在提供测试刺激之前选择治疗度量，并且基于所选择的治疗度量和将电极组合与度量值相关联的信息来选择附加电极组合。
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公开(公告)号：US20080004675A1
公开(公告)日：2008-01-03
申请号：US11810967
申请日：2007-06-07
申请人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
发明人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least two electrode combination classes during a therapy evaluation period. A first one of the classes comprises one or more electrode combinations that include electrodes within one or two columns of an implantable array of electrodes. The array may include at least three electrode columns. A second one of the classes comprises one or more electrode combinations that include electrodes within at least three electrode columns of the implantable array of electrodes. A preferred one of the electrode combination classes for a patient, and/or a number of leads to implant within the patient, may by selected based on feedback collected from the patient during the therapy evaluation period.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括在治疗评价期间通过至少两个电极组合类别中的每一个递送刺激。 这些类别中的第一个包括一个或多个电极组合，其包括在可植入的电极阵列的一列或两列内的电极。 阵列可以包括至少三个电极柱。 第二类包括一个或多个电极组合，其包括在可植入电极阵列的至少三个电极列内的电极。 可以通过基于在治疗评估期间从患者收集的反馈来选择用于患者的电极组合类别中的优选的一个，和/或患者内的植入物的数量。
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公开(公告)号：US08744597B2
公开(公告)日：2014-06-03
申请号：US11810967
申请日：2007-06-07
申请人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
发明人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least two electrode combination classes during a therapy evaluation period. A first one of the classes comprises one or more electrode combinations that include electrodes within one or two columns of an implantable array of electrodes. The array may include at least three electrode columns. A second one of the classes comprises one or more electrode combinations that include electrodes within at least three electrode columns of the implantable array of electrodes. A preferred one of the electrode combination classes for a patient, and/or a number of leads to implant within the patient, may by selected based on feedback collected from the patient during the therapy evaluation period.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括在治疗评价期间通过至少两个电极组合类别中的每一个递送刺激。 这些类别中的第一个包括一个或多个电极组合，其包括在可植入的电极阵列的一列或两列内的电极。 阵列可以包括至少三个电极柱。 第二类包括一个或多个电极组合，其包括在可植入电极阵列的至少三个电极列内的电极。 可以通过基于在治疗评估期间从患者收集的反馈来选择用于患者的电极组合类别中的优选的一个，和/或患者内的植入物的数量。
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公开(公告)号：US20080046036A1
公开(公告)日：2008-02-21
申请号：US11810943
申请日：2007-06-07
IPC分类号： A61N1/32
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least five combination groups. A first group of electrode combinations is characterized by the presence of a caudal anode. A second group of electrode combinations is characterized by the presence of a rostral anode. A third group of electrode combinations is characterized by the presence of a single anode above and a single anode below the cathode(s) of the combination. A fourth group of electrode combinations is characterized by the presence of multiple anodes above and below the cathode(s) of the combination. A fifth group of electrode combinations is characterized by the presence of transverse anodes. A sixth group of electrode combination is characterized by at least one off-center cathode. One or more preferred electrode combinations groups, and/or a number of leads to implant within the patient, may by selected based on patient feedback.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括通过至少五个组合组中的每一个递送刺激。 第一组电极组合的特征在于尾部阳极的存在。 第二组电极组合的特征在于存在罗氏阳极。 第三组电极组合的特征在于在组合的阴极下方存在单个阳极和单个阳极。 第四组电极组合的特征在于在组合的阴极上方和下方存在多个阳极。 第五组电极组合的特征在于存在横向阳极。 第六组电极组合的特征在于至少一个偏心阴极。 可以通过基于患者反馈来选择一个或多个优选的电极组合组和/或在患者体内植入的多个引线。
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公开(公告)号：US08620452B2
公开(公告)日：2013-12-31
申请号：US11810943
申请日：2007-06-07
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least five combination groups. A first group of electrode combinations is characterized by the presence of a caudal anode. A second group of electrode combinations is characterized by the presence of a rostral anode. A third group of electrode combinations is characterized by the presence of a single anode above and a single anode below the cathode(s) of the combination. A fourth group of electrode combinations is characterized by the presence of multiple anodes above and below the cathode(s) of the combination. A fifth group of electrode combinations is characterized by the presence of transverse anodes. A sixth group of electrode combination is characterized by at least one off-center cathode. One or more preferred electrode combinations groups, and/or a number of leads to implant within the patient, may by selected based on patient feedback.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括通过至少五个组合组中的每一个递送刺激。 第一组电极组合的特征在于尾部阳极的存在。 第二组电极组合的特征在于存在罗氏阳极。 第三组电极组合的特征在于在组合的阴极下方存在单个阳极和单个阳极。 第四组电极组合的特征在于在组合的阴极上方和下方存在多个阳极。 第五组电极组合的特征在于存在横向阳极。 第六组电极组合的特征在于至少一个偏心阴极。 可以通过基于患者反馈来选择一个或多个优选的电极组合组和/或在患者体内植入的多个引线。
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公开(公告)号：US09498622B2
公开(公告)日：2016-11-22
申请号：US12359656
申请日：2009-01-26
CPC分类号： A61N1/0553 , A61N1/36021 , A61N1/36071 , A61N1/36185 , A61N1/37247
摘要： Peripheral nerve field stimulation (PNFS) delivered by medical device to a patient may be programmed by specifying one or more characteristics of a stimulation field generated by the IMD to provide the PNFS. The characteristics of the stimulation field may include, for example, a direction of stimulation within the field, a breadth of the stimulation field, a focus of stimulation within the stimulation field, a depth of the stimulation field relative to a reference point, such as the epidermis of the patient, or a nerve fiber diameter selection.
摘要翻译： 可以通过指定由IMD产生的刺激场的一个或多个特征来提供PNFS，由医疗装置递送到患者的外周神经场刺激（PNFS）来编程。 刺激场的特征可以包括例如场内的刺激方向，刺激场的宽度，刺激区域内的刺激焦点，刺激场相对于参考点的深度，例如 患者的表皮，或神经纤维直径选择。
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公开(公告)号：US20090281596A1
公开(公告)日：2009-11-12
申请号：US12359712
申请日：2009-01-26
IPC分类号： A61N1/34
CPC分类号： A61N1/36071 , A61N1/0553 , A61N1/36021 , A61N1/36171 , A61N1/36182 , A61N1/36185 , A61N1/37247 , A61N1/37264
摘要： A therapy program for peripheral nerve field stimulation (PNFS) may be selected based on user input indicating a desired therapeutic effect for a user-specified region in which a patient feels pain. In other examples, PNFS may be programmed based on input from a user selecting at least one region from among a plurality of regions in which the patient experiences pain. In addition, the PNFS may be programmed based on user input defining an aspect of PNFS for the selected region, such as a relative intensity of PNFS delivered to at least two selected regions, a balance of PNFS between at least two regions, a desired shift in PNFS from a first region to a second region, or an extent to which a first stimulation field within a first region overlaps with a second stimulation field in a second region.
摘要翻译： 可以基于用户输入指示用于周围神经区域刺激（PNFS）的治疗程序，其指示患者感觉疼痛的用户指定区域的期望的治疗效果。 在其他示例中，PNFS可以基于来自用户的输入来编程，所述用户从患者经历疼痛的多个区域中选择至少一个区域。 另外，PNFS可以基于定义用于所选区域的PNFS的方面的用户输入来编程，例如递送到至少两个选择的区域的PNFS的相对强度，至少两个区域之间的PNFS的平衡，期望的移位 在PNFS中从第一区域到第二区域，或第一区域内的第一刺激场与第二区域中的第二刺激场重叠的程度。
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公开(公告)号：US20090281595A1
公开(公告)日：2009-11-12
申请号：US12359656
申请日：2009-01-26
IPC分类号： A61N1/36
CPC分类号： A61N1/0553 , A61N1/36021 , A61N1/36071 , A61N1/36185 , A61N1/37247
摘要： Peripheral nerve field stimulation (PNFS) delivered by a medical device to a patient may be programmed by specifying one or more characteristics of a stimulation field generated by the IMD to provide the PNFS. The characteristics of the stimulation field may include, for example, a direction of stimulation within the field, a breadth of the stimulation field, a focus of stimulation within the stimulation field, a depth of the stimulation field relative to a reference point, such as the epidermis of the patient, or a nerve fiber diameter selection.
摘要翻译： 可以通过指定由IMD生成的刺激场的一个或多个特征来提供PNFS来将编程由医疗装置传送到患者的外周神经场刺激（PNFS）。 刺激场的特征可以包括例如场内的刺激方向，刺激场的宽度，刺激区域内的刺激焦点，刺激场相对于参考点的深度，例如 患者的表皮，或神经纤维直径选择。
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公开(公告)号：US20090281594A1
公开(公告)日：2009-11-12
申请号：US12359001
申请日：2009-01-23
申请人： Gary W. King , Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Jordan J. Greenberg , Kenneth T. Heruth , Mark S. Lent , Paul W. Wacnik
发明人： Gary W. King , Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Jordan J. Greenberg , Kenneth T. Heruth , Mark S. Lent , Paul W. Wacnik
IPC分类号： A61N1/34
CPC分类号： A61N1/36139 , A61N1/36057 , A61N1/36071
摘要： Peripheral nerve field stimulation (PNFS) may be controlled based on detected physiological effects of the PNFS, which may be an efferent response to the PNFS. In some examples, a closed-loop therapy system may include a sensing module that senses a physiological parameter of the patient, which may be indicative of the patient's response to the PNFS. Based on a signal generated by the sensing module, the PNFS may be activated, deactivated or modified. Example physiological parameters of the patient include heart rate, respiratory rate, electrodermal activity, muscle activity, blood flow rate, sweat gland activity, pilomotor reflex, or thermal activity of the patient's body. In some examples, a patient pain state may be detected based on a signal generated by the sensing module, and therapy may be controlled based on the detection of the pain state.
摘要翻译： 可以基于PNFS的检测到的生理效应来控制外周神经区域刺激（PNFS），这可能是对PNFS的传出响应。 在一些示例中，闭环治疗系统可以包括感测患者的生理参数的感测模块，其可以指示患者对PNFS的反应。 基于由感测模块产生的信号，可以激活，去激活或修改PNFS。 患者的生理参数包括心率，呼吸频率，皮肤活动，肌肉活动，血流速度，汗腺活动，引导反射或患者身体的热活动。 在一些示例中，可以基于由感测模块生成的信号来检测患者疼痛状态，并且可以基于疼痛状态的检测来控制治疗。
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公开(公告)号：US08855777B2
公开(公告)日：2014-10-07
申请号：US12359712
申请日：2009-01-26
CPC分类号： A61N1/36071 , A61N1/0553 , A61N1/36021 , A61N1/36171 , A61N1/36182 , A61N1/36185 , A61N1/37247 , A61N1/37264
摘要： A therapy program for peripheral nerve field stimulation (PNFS) may be selected based on user input indicating a desired therapeutic effect for a user-specified region in which a patient feels pain. In other examples, PNFS may be programmed based on input from a user selecting at least one region from among a plurality of regions in which the patient experiences pain. In addition, the PNFS may be programmed based on user input defining an aspect of PNFS for the selected region, such as a relative intensity of PNFS delivered to at least two selected regions, a balance of PNFS between at least two regions, a desired shift in PNFS from a first region to a second region, or an extent to which a first stimulation field within a first region overlaps with a second stimulation field in a second region.
摘要翻译： 可以基于用户输入指示用于周围神经区域刺激（PNFS）的治疗程序，其指示患者感觉疼痛的用户指定区域的期望的治疗效果。 在其他示例中，PNFS可以基于来自用户的输入来编程，所述用户从患者经历疼痛的多个区域中选择至少一个区域。 另外，PNFS可以基于定义用于所选区域的PNFS的方面的用户输入来编程，例如递送到至少两个选择的区域的PNFS的相对强度，至少两个区域之间的PNFS的平衡，期望的移位 在PNFS中从第一区域到第二区域，或第一区域内的第一刺激场与第二区域中的第二刺激场重叠的程度。
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