Boston Scientific Neuromodulation Corporation

Natalie A Brill

Rosana Esteller

Michael A Moffitt

Changfang Zhu

Tianhe Zhang

Jianwen Gu

Dheerendra Raghavendra Kashyap

Bryan Allen Clark

Bradley Lawrence Hershey

Stephen Carcieri

Juan Gabriel Hincapie Ordonez

Hemant Bokil

Michael X Govea

Dennis Werner

Jessica Block

Pramodsingh Hirasingh Thakur

Jordi Parramon

Goran Nils Marnfeldt

Sridhar Kothandaraman

Joshua Dale Howard

Jacob B Leven

Lynne E Swanson

William Conrad Stoffregen

Dennis Zottola

Pujitha Weerakoon

David Michael Wagenbach

Sarvani Grandhe

Umang Anand

Raul Enrique Serrano Carmona

Barbara Huibregtse

Yue Li

Jun Park

Dennis B Werner

This document discusses, among other things, systems and methods for providing pain relief to a patient. Recording circuitry may receive electrical signals corresponding to evoked compound action potentials in the patient that may be produced in response to external stimulation of a location where the patient is experiencing pain. The received electrical signals may be stored in a memory. Internal stimulation may then be applied to the patient and control circuitry may receive electrical signals corresponding to evoked compound action potentials in the patient that may be produced in response to the internal stimulation. The control circuitry may then adjust electrical parameters of the internal stimulation, such as to reduce a difference between the electrical signals corresponding to evoked compound action potentials produced in response to the internal stimulation and electrical signals corresponding to evoked compound action potentials produced in response to the external stimulation.

Systems and methods for determining neuromodulation 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

Systems and methods for optimizing neuromodulation field design for pain therapy are discussed. An exemplary neuromodulation system includes an electrostimulator to stimulate target tissue to induce paresthesia, a data receiver to receive pain data including pain sites experiencing pain, and to receive patient feedback on the induced paresthesia including paresthesia sites experiencing paresthesia. The neuromodulation system includes a processor circuit configured to generate a spatial correspondence indication between the pain sites and the paresthesia sites over one or more dermatomes, determine an anodic weight and a cathodic weight for each of multiple electrode locations using the spatial correspondence indication, and generate a stimulation field definition for neuromodulation pain therapy.

Targeted electrostimulation fields based on focal dermatomal coverage

An Implantable Pulse Generator (IPG) or External Trial Stimulator (ETS) system is disclosed that is capable of sensing an Evoked Compound Action Potential (ECAP), and (perhaps in conjunction with an external device) is capable of adjusting a stimulation program while keeping a location of a Central Point of Stimulation (CPS) constant. Specifically, one or more features of measured ECAP(s) indicative of its shape and size are determined, and compared to thresholds or ranges to modify the electrode configuration of the stimulation program.

Adjustment of stimulation in a stimulator using detected evoked compound action potentials

Methods and systems for providing neuromodulation therapy are disclosed. The systems include an Implantable Pulse Generator (IPG) or External Trial Stimulator (ETS) that is capable of sensing an Evoked Compound Action Potential (ECAP), and (perhaps in conjunction with an external device) is capable of adjusting a stimulation program while based on the sensed ECAP. The stimulation program may include a pre-pulse component that may be adjusted based on the sensed ECAP. Moreover, stimulation may be applied to neural elements timed to coincide with the arrival of ECAPs at those neural elements. The stimulation may enhance or suppress activation of those neural elements.

Hybrid sensing and stimulation utilizing pre-pulsing of waveforms

A neuromodulation customization system includes a field definition user interface, a neuromodulation signaling engine, and a supervisor engine. The field definition user interface is to facilitate entry of a customized electrotherapy field definition, with the field definition user interface including a set of input controls for defining field shape, field intensity, and field steering parameters of the customized electrotherapy field. The neuromodulation signaling engine is to produce commands for neuromodulation output circuitry to control generation of a customized electrotherapy field via a set of electrodes based on the customized electrotherapy field definition. The supervisor engine is to assess compliance of the customized electrotherapy field to be generated with applicable predefined criteria, and to modify generation of the customized electrotherapy field in response to an assessed non-compliance with the criteria.

Customized targeted fields for electrotherapy applications

Methods and systems for programming implantable stimulation devices are disclosed. The disclosed techniques may be applied to a programming interface associated with a clinician's programmer, for example. A user interface allows a user to select stimulation waveforms to be applied at a plurality of electrodes implanted in a patient and to visualize how the waveforms interact with each other and with the patient's tissue. For example, the user interface can display a representation of constructive and destructive activation interactions and can also display time-resolved spatiotemporal behavior during stimulation.

Dynamic visualization of neuronal sub population interactions

Techniques for determining the trajectory of a one or more dorsal roots and utilizing the trajectories to improve a spinal cord stimulation model are disclosed. A first improvement constructs a target stimulation field along a path that is parallel with the determined trajectory that is nearest to a specified desired location of stimulation. An allocation of stimulation among the electrodes to mimic the target field is computed. A second improvement models a response of neural elements at evaluation positions that are parallel with the trajectories based on the electric field that is generated for the computed allocation of stimulation among the electrodes. The stimulation amplitude is adjusted based on the neural element modeling to maintain stimulation intensity, and the stimulation amplitude and allocation of stimulation among the electrodes are compiled into an electrode configuration that is communicated to a neurostimulator.

Virtual target pole adjustment based on nerve root trajectory

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for delivering therapy to an adrenal gland of a patient. The apparatuses, systems, and methods may include a plurality of stimulation elements arranged configured to deliver stimulation energy through at least one of the plurality of stimulation elements to modulate aldosterone levels within the patient.

Modulation of aldosterone via adrenal gland stimulation

A system for planning or conducting stimulation includes a display; and a processor that executes instructions configured for: displaying, on the display, a representation of a stimulation effect; obtaining and displaying, on the display, a path for migration of the stimulation effect; receiving a duration or rate for migration of the stimulation effect; and determining a selection of one of more electrodes or optical stimulators for one or more stimulation leads of a stimulation system to produce the stimulation effect and conduct the migration of the stimulation effect along the path according to the duration or rate.

Methods and systems for stimulation for glial modulation

Techniques for steering of target poles formed by implantable electrodes in a stimulator device are disclosed. The steering technique modifies the relative amplitude of target poles once they are steered to an electrode array boundary. Once a target pole is steered to an electrode array boundary, further steering in the direction of that boundary results in a gradual decrease in the relative amplitude of that target pole. Eventually, continued steering in that direction will cause that target pole to disappear. Thus, in the case of a target tripole, continued steering will eventually cause the target tripole to be automatically converted into a target bipole. In another example of steering, target poles defined linearly in one direction can be split in an orthogonal direction to create a target pole configuration that is two-dimensional.

Steering of target poles in an electrode array in a pulse generator system

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Sherman Oaks, CA, United States of America

Natalie A Brill