公开(公告)号：US20060241722A1

公开(公告)日：2006-10-26

申请号：US11115789

申请日：2005-04-26

申请人： James Thacker ,  Carla Woods ,  Sridhar Kothandaraman ,  John King ,  Kerry Bradley

发明人： James Thacker ,  Carla Woods ,  Sridhar Kothandaraman ,  John King ,  Kerry Bradley

IPC分类号： A61N1/34

CPC分类号： G06F19/3481 ,  A61N1/36071 ,  G06F19/00 ,  G16H40/63

摘要： A tissue stimulation system is provided that evaluates and/or scores stimulation sets based on both patient feedback and frequency of use. Stimulation sets and any associated scores and/or usage may be stored in a retrievable database. Upon subsequent stimulation sessions, a patient may select stimulation sets that have a high score and/or usage in order to effectively meet therapeutic objectives. Methods of determining patient satisfaction, which involve evaluating patient pain before and after stimulation pulses are applied, are also provided herein.

摘要翻译： 提供组织刺激系统，其基于患者反馈和使用频率来评估和/或评估刺激组。 刺激集和任何相关的分数和/或使用可以存储在可检索的数据库中。 在随后的刺激会话中，患者可以选择具有高得分和/或使用的刺激组，以便有效地满足治疗目标。 本文还提供了确定患者满意度的方法，其涉及在刺激脉冲之前和之后评估患者疼痛。

公开(公告)号：US20050209655A1

公开(公告)日：2005-09-22

申请号：US11026859

申请日：2004-12-30

申请人： Kerry Bradley ,  James Thacker ,  Carla Woods ,  John King

发明人： Kerry Bradley ,  James Thacker ,  Carla Woods ,  John King

IPC分类号： A61N1/18 ,  A61N1/34 ,  A61N1/372

CPC分类号： A61N1/36071 ,  A61N1/0551 ,  Y10S128/92

摘要： Methods for selecting stimulation parameter sets guide a clinician towards an effective set(s) of stimulation parameters. The clinician first evaluates the effectiveness of a small number of trial stimulation parameters sets from a Measurement Table comprising for example, four stimulation parameter sets, measuring the perception threshold and maximum threshold levels. The maximum comfortable step size and desired field shift resolution are determined, and are used along with the measured threshold levels to determine an appropriate step size to use in the current steering process. In order to maintain paresthesia at a relatively constant level during the steering process, a Superposition Equalization (SEQ) algorithm is used to compensate for the physical characteristics of the lead array, i.e., electrode separation and size. A multiplier is determined and a modifying function is used to apply this multiplier to the electrode energy output during transition to maintain a relatively constant current density.

摘要翻译： 用于选择刺激参数集的方法指导临床医生朝向有效的一组或多个刺激参数。 临床医生首先从包括例如四个刺激参数组，测量感知阈值和最大阈值水平的测量表中评估少量试验刺激参数集的有效性。 确定最大舒适的步长和期望的场移动分辨率，并且与测量的阈值水平一起使用以确定在当前转向过程中使用的适当步长。 为了在转向过程期间将感觉异常保持在相对恒定的水平，使用叠加均衡（SEQ）算法来补偿引线阵列的物理特性，即电极分离和尺寸。 确定乘法器，并且使用修改函数将该乘数应用于转换期间的电极能量输出，以维持相对恒定的电流密度。

公开(公告)号：US20070265679A1

公开(公告)日：2007-11-15

申请号：US11746405

申请日：2007-05-09

申请人： Kerry Bradley ,  James Thacker ,  Carla Woods ,  John King

发明人： Kerry Bradley ,  James Thacker ,  Carla Woods ,  John King

IPC分类号： A61N1/05

CPC分类号： A61N1/36071 ,  A61N1/0551 ,  Y10S128/92

摘要： A method for selecting Spinal Cord Stimulation (SCS) stimulation parameter sets guides a clinician towards an effective set of stimulation parameters. The clinician first evaluates the effectiveness of a small number of trial stimulation parameters sets from a Measurement Table comprising for example, four stimulation parameter sets. Based on the patient's assessment, the trial stimulation parameter sets are ranked. Then the clinician selects a starting or benchmark row in a Steering Table corresponding to the highest ranked trial stimulation parameter set. The clinician moves either up or down form the starting row, testing consecutive parameter sets. The clinician continues as long as the patient indicates that the stimulation results are improving. When a local optimum is found, the clinician returns to the benchmark row, and tests in the opposite direction for another local optimum. If an acceptable set of stimulation parameters is found, the selection process is complete. If an acceptable set is not found, a new starting row in the Steering Table is selected based on the next ranked trial set from the Measurement Table, and the process of searching for local optima is repeated.

摘要翻译： 用于选择脊髓刺激（SCS）刺激参数组的方法引导临床医生朝向有效的一组刺激参数。 临床医生首先从包括例如四个刺激参数组的测量表中评估少量试验刺激参数集的有效性。 根据患者的评估，对试验刺激参数集进行排序。 然后，临床医生在对应于最高排名的试验刺激参数集的转向表中选择起始或基准行。 临床医生从起始行向上或向下移动，测试连续的参数集。 只要患者表明刺激结果正在改善，临床医生就会继续进行。 当找到局部最佳值时，临床医生返回到基准行，并以相反方向测试另一个局部最佳值。 如果发现可接受的一组刺激参数，则选择过程完成。 如果没有找到可接受的集合，则基于从测量表中的下一个排序的试验集，选择转向表中的新起始行，并且重复搜索局部最优的处理。

公开(公告)号：US20050245987A1

公开(公告)日：2005-11-03

申请号：US11105643

申请日：2005-04-13

申请人： Carla Woods ,  James Thacker ,  David Peterson ,  Holly Segel ,  Susan Ford ,  Margaret Theriot ,  Kerry Bradley

发明人： Carla Woods ,  James Thacker ,  David Peterson ,  Holly Segel ,  Susan Ford ,  Margaret Theriot ,  Kerry Bradley

IPC分类号： A61N1/18 ,  A61N1/34 ,  A61N1/372

CPC分类号： A61N1/36071 ,  A61N1/08 ,  A61N1/36185 ,  A61N1/37241 ,  A61N1/37247

摘要： A method for selecting Spinal Cord Stimulation (SCS) stimulation parameter sets guides a clinician towards an effective set of stimulation parameters. The clinician first evaluates the effectiveness of a small number of trial stimulation parameters sets from a Measurement Table comprising for example, four stimulation parameter sets. Based on the patient's assessment, the trial stimulation parameter sets are ranked. Then the clinician selects a starting or benchmark row in a Steering Table corresponding to the highest ranked trial stimulation parameter set. The clinician moves either up or down form the starting row, testing consecutive parameter sets. The clinician continues as long as the patient indicates that the stimulation results are improving. When a local optimum is found, the clinician returns to the benchmark row, and tests in the opposite direction for another local optimum. If an acceptable set of stimulation parameters is found, the selection process is complete. If an acceptable set is not found, a new starting row in the Steering Table is selected based on the next ranked trial set from the Measurement Table, and the process of searching for local optima is repeated.

摘要翻译： 用于选择脊髓刺激（SCS）刺激参数组的方法引导临床医生朝向有效的一组刺激参数。 临床医生首先从包括例如四个刺激参数组的测量表中评估少量试验刺激参数集的有效性。 根据患者的评估，对试验刺激参数集进行排序。 然后，临床医生在对应于最高排名的试验刺激参数集的转向表中选择起始或基准行。 临床医生从起始行向上或向下移动，测试连续的参数集。 只要患者表明刺激结果正在改善，临床医生就会继续进行。 当找到局部最佳值时，临床医生返回到基准行，并以相反方向测试另一个局部最佳值。 如果发现可接受的一组刺激参数，则选择过程完成。 如果没有找到可接受的集合，则基于从测量表中的下一个排序的试验集，选择转向表中的新起始行，并且重复搜索局部最优的处理。

公开(公告)号：US20080021513A1

公开(公告)日：2008-01-24

申请号：US11829742

申请日：2007-07-27

申请人： James Thacker ,  John King ,  Kerry Bradley

发明人： James Thacker ,  John King ,  Kerry Bradley

IPC分类号： A61N1/00

CPC分类号： A61N1/36071 ,  A61N1/0551

摘要： A system and method for rapidly switching stimulation parameters of a Spinal Cord Stimulation (SCS) system increases the number of stimulation parameter sets that may be tested during a fitting procedure, or alternatively, reduces the time required for the fitting procedure. The switching method comprises selecting a new stimulation parameter set, and setting the initial stimulation levels to levels at or just below an estimated perception threshold of the patient. The estimated perception level is based on previous stimulation results. The stimulation level is then increased to determine a minimum stimulation level for effective stimulation, and/or an optimal stimulation level, and/or a maximum stimulation level, based on patient perception.

摘要翻译： 用于快速切换脊髓刺激（SCS）系统的刺激参数的系统和方法增加了在拟合过程期间可以测试的刺激参数集的数量，或者替代地减少了拟合过程所需的时间。 切换方法包括选择新的刺激参数集合，以及将初始刺激水平设置为等于或低于估计的患者感知阈值的水平。 估计的感知水平是基于以前的刺激结果。 然后根据患者的感知，增加刺激水平以确定有效刺激的最小刺激水平和/或最佳刺激水平和/或最大刺激水平。

公开(公告)号：US20070293914A1

公开(公告)日：2007-12-20

申请号：US11625281

申请日：2007-01-19

申请人： Carla Woods ,  James Thacker ,  David Peterson

发明人： Carla Woods ,  James Thacker ,  David Peterson

IPC分类号： A61N1/02

CPC分类号： A61N1/36071 ,  A61N1/0551 ,  A61N1/0553 ,  A61N1/36185 ,  A61N1/37235 ,  A61N1/37241 ,  A61N1/37247 ,  A61N1/37252 ,  A61N1/3787

摘要： The invention is a system and method for detecting the status of a rechargeable battery included within an implantable medical device. The medical device can incorporate a status indicator which signals the user concerning the battery status, e.g., low battery level. The signal may be audible or it may arise from an electrical stimulation that is perceptually distinguished from the operative, therapeutic stimulation. The external programmer may also incorporate a second battery status indicator that is visual, audible, or physically felt. Battery status data may be conveyed on visual displays on the external programmer by uploading this information from the medical device using a bidirectional telemetry link. Such battery status data are helpful to the user to indicate when the battery should be recharged and to the clinician to monitor patient compliance and to determine end-of-useful life of the rechargeable battery.

摘要翻译： 本发明是一种用于检测包括在可植入医疗装置内的可再充电电池的状态的系统和方法。 医疗设备可以包括状态指示器，其向用户通知有关电池状态的信号，例如电池电量低。 该信号可能是可听见的，或者它可能由感觉上区别于手术治疗刺激的电刺激引起。 外部编程器还可以包括视觉，听觉或物理感觉的第二电池状态指示器。 电池状态数据可以通过使用双向遥测链路从医疗设备上传该信息而在外部编程器上的视觉显示器上传送。 这样的电池状态数据有助于用户指示电池何时被充电，并且临床医师监测患者的依从性并确定可再充电电池的使用寿命。

公开(公告)号：US20060122654A1

公开(公告)日：2006-06-08

申请号：US11343007

申请日：2006-01-30

申请人： Kerry Bradley ,  James Thacker

发明人： Kerry Bradley ,  James Thacker

IPC分类号： A61N1/37

CPC分类号： A61N1/08 ,  A61B5/053 ,  A61N1/0551

摘要： Interelectrode impedance or electric field potential measurements are used to determine the relative orientation of one lead to other leads in the spinal column or other body/tissue location. Interelectrode impedance is determined by measuring impedance vectors. The value of the impedance vector is due primarily to the electrode-electrolyte interface, and the bulk impedance between the electrodes. The bulk impedance between the electrodes is, in turn, made up of (1) the impedance of the tissue adjacent to the electrodes, and (2) the impedance of the tissue between the electrodes. In one embodiment, the present invention makes both monopolar and bipolar impedance measurements, and then corrects the bipolar impedance measurements using the monopolar measurements to eliminate the effect of the impedance of the tissue adjacent the electrodes. The orientation and position of the leads may be inferred from the relative minima of the corrected bipolar impedance values. These corrected impedance values may also be mapped and stored to facilitate a comparison with subsequent corrected impedance measurement values. Such comparison allows a determination to be made as to whether the lead position and/or orientation has changed appreciably over time. In another embodiment, one or more electrodes are stimulated and the resulting electric field potential on the non-stimulated electrodes is measured. Such field potential measurements provide an indication of the relative orientation of the electrodes. Once known, the relative orientation may be used to track lead migration, to setup stimulation configurations and parameters for nominal stimulation and/or navigation. Also, such measurements allow automatic adjustment of stimulation energy to a previously-defined optimal potential field in the case of lead migration or postural changes.

公开(公告)号：US07853330B2

公开(公告)日：2010-12-14

申请号：US11938490

申请日：2007-11-12

申请人： Kerry Bradley ,  James Thacker ,  Michael Moffitt

发明人： Kerry Bradley ,  James Thacker ,  Michael Moffitt

IPC分类号： A61N1/00

CPC分类号： A61N1/08 ,  A61B5/053 ,  A61N1/0551 ,  A61N1/3605 ,  A61N1/37247

摘要： A method for determining whether the relative position of electrodes used by a neurostimulation system has changed within a patient comprises determining the amplitude of a field potential at each of at least one of the electrodes, determining if a change in each of the determined electric field amplitudes has occurred, and analyzing the change in each of the determined electric field amplitudes to determine whether a change in the relative position of the electrodes has occurred. Another method comprises measuring a first monopolar impedance between a first electrode and a reference electrode, measuring a second monopolar impedance between second electrode and the reference electrode, measuring a bipolar impedance between the first and second electrodes, and estimating an amplitude of a field potential at the second electrode based on the first and second monopolar impedances and the bipolar impedance.

摘要翻译： 一种用于确定神经刺激系统使用的电极的相对位置是否在患者内已经改变的方法包括确定每个电极中的每个电极处的场电位的幅度，确定每个确定的电场幅度是否发生变化 并且分析每个确定的电场幅度的变化，以确定是否发生了电极的相对位置的变化。 另一种方法包括测量第一电极和参考电极之间的第一单极阻抗，测量第二电极和参考电极之间的第二单极阻抗，测量第一和第二电极之间的双极性阻抗，以及估计第一和第二电极之间的场电位的振幅 基于第一和第二单极阻抗的第二电极和双极性阻抗。

公开(公告)号：US20060122653A1

公开(公告)日：2006-06-08

申请号：US11342989

申请日：2006-01-30

申请人： Kerry Bradley ,  James Thacker

发明人： Kerry Bradley ,  James Thacker

IPC分类号： A61N1/37

CPC分类号： A61N1/08 ,  A61B5/053 ,  A61N1/0551

摘要： Interelectrode impedance or electric field potential measurements are used to determine the relative orientation of one lead to other leads in the spinal column or other body/tissue location. Interelectrode impedance is determined by measuring impedance vectors. The value of the impedance vector is due primarily to the electrode-electrolyte interface, and the bulk impedance between the electrodes. The bulk impedance between the electrodes is, in turn, made up of (1) the impedance of the tissue adjacent to the electrodes, and (2) the impedance of the tissue between the electrodes. In one embodiment, the present invention makes both monopolar and bipolar impedance measurements, and then corrects the bipolar impedance measurements using the monopolar measurements to eliminate the effect of the impedance of the tissue adjacent the electrodes. The orientation and position of the leads may be inferred from the relative minima of the corrected bipolar impedance values. These corrected impedance values may also be mapped and stored to facilitate a comparison with subsequent corrected impedance measurement values. Such comparison allows a determination to be made as to whether the lead position and/or orientation has changed appreciably over time. In another embodiment, one or more electrodes are stimulated and the resulting electric field potential on the non-stimulated electrodes is measured. Such field potential measurements provide an indication of the relative orientation of the electrodes. Once known, the relative orientation may be used to track lead migration, to setup stimulation configurations and parameters for nominal stimulation and/or navigation. Also, such measurements allow automatic adjustment of stimulation energy to a previously-defined optimal potential field in the case of lead migration or postural changes.

公开(公告)号：US20070208394A1

公开(公告)日：2007-09-06

申请号：US11746748

申请日：2007-05-10

申请人： John King ,  James Thacker

发明人： John King ,  James Thacker

IPC分类号： A61N1/00

CPC分类号： A61N1/36139 ,  A61N1/08 ,  A61N1/36071 ,  A61N1/3615

摘要： A neural stimulation system automatically corrects or adjusts the stimulus magnitude (stimulation energy) in order to maintain a comfortable and effective stimulation therapy. Because the changes in impedance associated with the electrode-tissue interface can indicate obstruction of current flow and positional lead displacement, lead impedance can indicate the quantity of electrical stimulation energy that should be delivered to the target neural tissue to provide corrective adjustment. Hence, a change in impedance or morphology of an impedance curve may be used in a feedback loop to indicate that the stimulation energy needs to be adjusted and the system can effectively auto correct the magnitude of stimulation energy to maintain a desired therapeutic effect.

摘要翻译： 神经刺激系统自动校正或调整刺激量（刺激能量），以保持舒适有效的刺激疗法。 由于与电极 - 组织界面相关的阻抗变化可以指示电流和位置引线位移的阻塞，所以引线阻抗可以指示应该传送到目标神经组织的电刺激能量的量以提供校正调整。 因此，可以在反馈回路中使用阻抗曲线的阻抗或形态的变化，以指示需要调整刺激能量，并且系统能够有效地自动校正刺激能量的大小以维持所需的治疗效果。