Boston Scientific Neuromodulation Corporation

Commissariat &#xc0; L'&#xc9;nergie Atomique Et Aux &#xc9;nergies Alternatives

Augusta University Research Institute, Inc.

Lowe Graham Jones Pllc

Michael A Moffitt

Kerry A Bradley

Changfang Zhu

Sridhar Kothandaraman

Stephen Carcieri

David K L Peterson

Hemant Bokil

Dongchul Lee

Bradley Lawrence Hershey

Dean Chen

Que T Doan

Rafael Carbunaru

Anne Margaret Pianca

Andrew DiGiore

Ismael Huertas Fernandez

Rosana Esteller

Keith R Carlton

Courtney C Lane

Jordi Parramon

G Karl Steinke

Jianwen Gu

Peter J Yoo

Richard Mustakos

David Blum

Kristen N Jaax

James R Thacker

Paul Milton Meadows

Tianhe Zhang

Goran Nils Marnfeldt

Dennis Zottola

Natalie A Brill

Todd K Whitehurst

Scott Kokones

John Michael Barker

Joseph M Bocek

Joshua Dale Howard

Juan Gabriel Hincapie Ordonez

Daniel Aghassian

Matthew Lee McDonald

Mun Pook Lui

Jeffery Van Funderburk

Alfred E Mann

Emanuel Feldman

Brett Daniel Schleicher

Michael Steven Colvin

Jacob B Leven

Christopher Ewan Gillespie

Dennis Allen Vansickle

Gustav Karl Steinke

Mark Pierre

David Karl Lee Peterson

Thomas A Oleksyn

Prakash Rao

John J Reinhold

Chirag Shah

James Carl Makous

Claude Chabrol

Adam Thomas Featherstone

John Rivera

Sarah Renault

Gregory Baldwin

Adrien Poizat

Vikrant Venkateshwar Gunna Srinivasan

Jim Cassidy

Michael Andrew Caruso

Christopher Britton Gould

Sarvani Grandhe

Jordan Barnhorst

Dheerendra Raghavendra Kashyap

Marco Henry Gin

Sherry Lin

Karl Steinke

David Ernest Wechter

David Lubensky

Brian Hoffer

Kenny Kinyen Chinn

Troy Sparks

Andrew James Haddock

Jim Makous

David Blake

Michael Onuscheck

David Arthur Blum

Brian James Hoffer

David Ari Lubensky

Hermant Bokil

David KI Peterson

Sridhar Kothandaram

David KL Peterson

Hemant Sharad Bokil

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during 'sweet spot searching' during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain. Beneficially, sub-perception stimulation at such low frequencies significantly lowers power consumption in the patient's neurostimulator.

Paresthesia-free spinal cord stimulation occurring at lower frequencies and sweet spot searching using paresthesia

An example of a neurostimulation system may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to program a stimulation device for delivering the neurostimulation according to a stimulation program specifying a present stimulation field set including stimulation field(s) each defined by a set of active electrodes selected from a plurality of electrodes. The stimulation control circuit may be configured to determine the stimulation program and may include field programming circuitry that may be configured to set the present stimulation field set to an initial stimulation field set specifying stimulation fields allowing for the delivery of the neurostimulation to produce an intended effect and to identify an optimal stimulation field set that satisfies one or more optimization criteria by removing stimulation field(s) from the initial stimulation field set.

Method and apparatus for subtraction-based programming of neurostimulation fields

Methods and systems for providing stimulation therapy are disclosed. Embodiments of the system include an implantable stimulator and an external controller configured to control the implantable stimulator. A clinician can prescribe a set amount of stimulation therapy to a patient. The external controller is programmed with the prescription. As the patient uses the external controller and the stimulator device the external controller tracks the amount of stimulation the patient uses. Once the patient has used all of the prescribed therapy the patient may return to the clinician for a follow-up appointment.

Prescribed neuromodulation dose delivery

Methods and systems for determining sub-perception stimulation for a patient having a spinal cord stimulator device are disclosed. In one example, an external device includes an algorithm configured to determine a stimulation program for the stimulator device. The algorithm includes a model that comprises pre-determined energy values that cause sub-perception stimulation. The algorithm is configured to determine stimulation parameters for the stimulation program that yield an energy value within the first model. The energy values in the model may be expressed as a function of frequency. The model in particular provides optimal sub-perception stimulation at low frequencies, such as at 1 kHz and below, or even at 400 Hz and below.

Spinal cord stimulation system determining optimal sub-perception therapy by using neural dose

An optical modulation system includes a user interface including a plurality of user-selectable controls to select or adjust values for each of a plurality of modulation parameters and estimating a modulation dosage or irradiance at a target based on, at least, the target, a location of an optical modulation lead, values of the modulation parameters, and estimated light attenuation by tissue between the optical modulation lead and the target. An optical modulation system can limit selection of the value of at least one of the modulation parameters by at least one of a) an estimation of a modulation dosage at the target or b) an estimation of a dosage, temperature change, temperature, heating, or delivering energy at non-target issue.

Systems and methods incorporating a light therapy user interface for optical modulation

An example method for delivering neurostimulation energy may include performing a training procedure by delivering the neurostimulation energy to a neural target of the patient when the patient is at one or more postures. Electrical activity is sensed from the spinal cord, such as an electrospinogram (ESG). A relationship is determined between the sensed electrical activity and neurostimulation intensity that reduces influence of noise in the sensed electrical activity caused by dynamically changing posture of the patient using mathematical or statistical modeling of the extracted features. Stimulation parameters are modulated according to the determined relationship.

Systems for noise-sensitive patient-specific adjustments of neuromodulation parameters

Software for providing a Graphical User Interface (GUI) for use in a clinician programmer for programming an implantable pulse generator (IPG) or external trial stimulator (ETS) is disclosed. A user may define in the GUI multiple pole configurations (e.g., monopoles, bipoles, etc.) which may be used independently to provide stimulation to a patient via the IPG or ETS's electrode array. Selected of the pole configurations can be linked or associated as a group in the GUI and used to concurrently provide stimulation. The pole configuration group may be steered or moved in the electrode array using a single movement instruction which moves all pole configurations in the group simultaneously. This allows the relative positions of the pole configurations in the group to remain constant as the group is moved.

Linking and concurrent steering of multiple pole configurations in a spinal cord stimulation system

A neuromodulation targeting system includes a GUI that facilitates selection of one or more neuromodulation target regions. The GUI provides an interactive display representing anatomy of a patient with user-selectable portions corresponding to a plurality of predefined anatomical regions associated with distinct localized clinical effects of neuromodulation. The system further includes a targeting selector engine that is responsive to user selection of a first portion of the interactive display by configuring delivery of neuromodulation therapy to a first target region to produce a first localized clinical effect in the patient at a location corresponding to the first portion of the display, upon administration of the neuromodulation therapy to the patient.

Anatomical targeting of neuromodulation

A method of stimulating the nucleus basalis of Meynert (NBM) includes implanting an electrical stimulation lead in a lateral-to-medial trajectory into a brain of a patient, wherein the electrical stimulation lead includes electrodes and at least one of the electrodes is disposed adjacent to or within the NBM of the patient; and delivering electrical stimulation to the NBM through at least one of the electrodes. Other methods include implanting multiple electrical stimulation leads in or near the NBM. Instead of, or in addition to, electrical stimulation leads, optical stimulation leads can be used to stimulate the NBM.

Methods and systems for deep brain stimulation of the nucleus basalis of Meynert

A system for stimulation of a nucleus basalis of Meynert (NBM) of a patient includes an implantable electrical stimulation lead including electrodes and configured for implantation of at least one of the electrodes adjacent to or within the NBM of the patient; and an implantable pulse generator coupleable to the implantable electrical stimulation lead and configured for delivering electrical stimulation to the NBM through at least one of the electrodes of the implantable electrical stimulation lead, the implantable pulse generator including at least one processor configured to, upon user request, during an initial stimulation period, which is at least 1 month in duration and has a start and an end, increase over time at least one of a duration or an amplitude of the electrical stimulation from an initial value at the start of the initial stimulation period to a final value at the end of the initial stimulation period.

An electrical stimulation system includes a control module that provides electrical stimulation signals to an electrical stimulation lead coupled to the control module for stimulation of patient tissue. The system also includes a sensor to be disposed on or within the body of the patient and to measure a biosignal; and a processor to communicate with the sensor to receive the biosignal and to generate an adjustment to one or more of the stimulation parameters based on the biosignal. The adjustment can be configured and arranged to steer the electrical stimulation signals to stimulate a region of the patient tissue that is different, at least in part, from a region of the patient tissue stimulated prior to the adjustment. Alternatively or additionally, the biosignal is indicative of a particular patient activity and the adjustment is a pre-determined adjustment selected for the particular patient activity.

Systems, devices, and methods for electrical stimulation using feedback to adjust stimulation parameters

An example of a system may include a processor and a memory device comprising instructions, which when executed by the processor, cause the processor to: access a patient metric of a subject; use the patient metric as an input to a machine learning algorithm, the machine learning algorithm to search a plurality of neuromodulation parameter sets and to identify a candidate neuromodulation parameter set of the plurality of neuromodulation parameter sets, the candidate neuromodulation parameter set designed to produce a non-regular waveform that varies over a time domain and a space domain; and program a neuromodulator using the candidate neuromodulation parameter set to stimulate the subject.

Machine learning to optimize spinal cord stimulation

A system and method for selecting leadwire stimulation parameters includes a processor iteratively performing, for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field: (a) shifting the current field longitudinally and/or rotationally to a respective plurality of locations about the leadwire; and (b) for each of the respective plurality of locations, obtaining clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and displaying a graph plotting the clinical effect information against values for the particular stimulation parameter and locations about the leadwire, and/or based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value.

Point-and-click programming for deep brain stimulation using real-time monopolar review trendlines

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Valencia, CA, United States of America

Michael A Moffitt