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：US20070156207A1

公开(公告)日：2007-07-05

申请号：US11324811

申请日：2006-01-04

申请人： Sridhar Kothandaraman ,  Kerry Bradley

发明人： Sridhar Kothandaraman ,  Kerry Bradley

IPC分类号： A61N1/36

CPC分类号： A61N1/36071

摘要： Tissue stimulation systems generally include a pulse generating device for generating electrical stimulation pulses, at least one implanted lead including at least one electrode for delivering the electrical stimulation pulses generated by the pulse generating device, and a programmer capable of communicating with the pulse generating device. In tissue stimulation systems, two or more electrical stimulation combinations may be delivered to a patient simultaneously through a reduced number of channels. Systems and methods described herein may combine the two or more stimulation combinations into a reduced number of new stimulation combinations for delivery of the stimulation combinations over a reduced number of channels.

摘要翻译： 组织刺激系统通常包括用于产生电刺激脉冲的脉冲产生装置，至少一个注入导线，包括至少一个用于传递由脉冲发生装置产生的电刺激脉冲的电极，以及能够与脉冲发生装置通信的编程器。 在组织刺激系统中，可以通过减少数量的通道将两个或多个电刺激组合同时传送给患者。 本文描述的系统和方法可以将两个或更多个刺激组合组合成减少数量的新刺激组合，以在减少数量的通道上递送刺激组合。

公开(公告)号：US20100121409A1

公开(公告)日：2010-05-13

申请号：US12614942

申请日：2009-11-09

申请人： Sridhar Kothandaraman ,  Carla Mann Woods ,  Kerry Bradley ,  James R. Thacker ,  Sivakumar Karnati

发明人： Sridhar Kothandaraman ,  Carla Mann Woods ,  Kerry Bradley ,  James R. Thacker ,  Sivakumar Karnati

IPC分类号： A61N1/08

CPC分类号： A61N1/37247 ,  A61N1/36071 ,  A61N1/36157 ,  A61N1/36185 ,  A61N1/37264

摘要： A method, computer medium, and system for programming a control device are provided. The control device is configured for controlling electrical stimulation energy provided to a plurality of electrode leads that are physically implanted within a patient in a side-by-side lead configuration. Electrical energy is conveying from the electrode leads to create a stimulation region within the patient. The stimulation region is automatically shifted along the electrode leads (e.g., by selecting and using at least one navigation table) in accordance with an electrical current shifting pattern that is based on a stagger of the side-by-side lead configuration. At least one stimulation parameter set is selected based on the effectiveness of the shifted stimulation region, and the control device is programmed with the selected stimulation parameter set(s).

摘要翻译： 提供了一种用于编程控制装置的方法，计算机介质和系统。 控制装置被配置为用于控制提供给以并排引线配置物理地植入患者体内的多个电极引线的电刺激能量。 电能从电极引线输送以在患者体内产生刺激区域。 刺激区域沿着电极引线自动移位（例如，通过选择和使用至少一个导航表），该电流移动模式是基于并排引线配置的交错。 基于移位的刺激区域的有效性来选择至少一个刺激参数集合，并且使用所选择的刺激参数集编程控制装置。

公开(公告)号：US07657317B2

公开(公告)日：2010-02-02

申请号：US11115789

申请日：2005-04-26

申请人： James R. Thacker ,  Carla M. Woods ,  Sridhar Kothandaraman ,  John D. H. King ,  Kerry Bradley

发明人： James R. Thacker ,  Carla M. Woods ,  Sridhar Kothandaraman ,  John D. H. King ,  Kerry Bradley

IPC分类号： A61N1/36

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：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。