Boston Scientific Neuromodulation Corporation

Boston Scientific Neuromodulation Corporaation

Richard Mustakos

G Karl Steinke

Stephen Carcieri

Michael A Moffitt

Hemant Bokil

Tianhe Zhang

Peter J Yoo

Joshua Dale Howard

Keith R Carlton

Dean Chen

Chirag Shah

Mark Pierre

Sridhar Kothandaraman

Vikrant Venkateshwar Gunna Srinivasan

Leon Mauricio Juarez Paz

Lisa Denise Moore

Hemant Sharad Bokil

An example of a system for delivering neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a stimulation configuration. The stimulation control circuit may be configured to specify the stimulation configuration, and may include volume definition circuitry and stimulation configuration circuitry. The volume definition circuitry may be configured to determine one or more test volumes, determine a clinical effect resulting from the one or more test volumes each being activated by the neurostimulation, and determine a target volume using the determined clinical effect. The stimulation configuration circuitry may be configured to generate the specified stimulation configuration for activating the target volume.

Method and apparatus for clinical effects-based targeting of neurostimulation

A system for adjusting neuromodulation parameters used by a neuromodulator operably connected to a plurality of electrodes to modulate a neural target, may comprise a translation trigger detector configured to determine that a translation trigger has occurred, a first parameter setting storage configured to store first parameter settings for use by the neuromodulator to modulate the neural target, and a neuromodulation parameter translator. The neuromodulation parameter translator may be operably connected to the translation trigger detector to automatically translate the first parameter settings into a second parameter settings in response to determining the translation trigger has occurred, and replace the first parameter settings with the second parameter settings, or store the second parameter settings in a second parameter setting storage. Automatically translating may include either automatically translating from cathodic parameter settings to anodic parameter settings, or automatically translating from anodic parameter settings to cathodic parameter settings.

Translation between cathodic and anodic neuromodulation parameter settings

A computer implemented system and method facilitates a cycle of generation, sharing, and refinement of volumes related to stimulation of anatomical tissue, such as brain or spinal cord stimulation. Such volumes can include target stimulation volumes, side effect volumes, and volumes of estimated activation. A computer system and method also facilitates analysis of groups of volumes, including analysis of differences and/or commonalities between different groups of volumes.

Systems and methods for stimulation-related biological circuit element analysis and use

A system for estimating a volume of activation around an implanted electrical stimulation lead for a set of stimulation parameters includes a display; and a processor coupled to the display and configured to: receive a set of stimulation parameters including a stimulation amplitude and a selection of one of more electrodes of the implanted electrical stimulation lead for delivery of the stimulation amplitude; determine an estimate of the volume of activation based on the set of stimulation parameters using the stimulation amplitude and a database including a plurality of planar distributions of stimulation threshold values and a map relating the planar distributions to spatial locations based on the one or more electrodes of the implanted electrical stimulation lead selected for delivery of the stimulation amplitude; and output on the display a graphical representation of the estimate of the volume of activation.

Systems and methods for estimating a volume of activation using a compressed database of threshold values

A system may comprise a controller configured to implement an algorithm on a received input to produce an output, and a system input operably connected to the controller and configured for use to enter at least one input into the algorithm. The at least one input may include: one or more sensor inputs or one or more inputs from smart appliances or one or more user inputs regarding at least one of time of day or mental or physical state; or at least one of a user-inputted disease, a user-inputted disease state, or a user-inputted symptom-related information into the algorithm. The controller may be configured to provide instructions through the system output to implement a system action. The algorithm implemented by the controller may be configured to identify one, or a combination of more than one, of the neuromodulation modes as a candidate neuromodulation mode based on the input(s).

Multiple mode neuromodulation responsive to patient information

Systems and methods for determining a parameter set and programming a neuromodulation system with the parameter set are disclosed. The system includes a user interface having a display screen to display simplified graphical representations (SGRs) of the lead with at least one virtual electrode (VE) that represents one or more electrodes, and control elements. The SGRs of the lead can provide longitudinal and circumferential representations of the VE, respectively representing longitudinal or circumferential position, size, shape, or spread of the VE. The control elements may include longitudinal and circumferential control elements to enable the user to respectively adjust the longitudinal or circumferential position, size, shape, or spread of the VE. The system may generate the neuromodulation parameter set using the longitudinal and circumferential representations of the VE, and program the neuromodulation system with the neuromodulation parameter set.

User interface for neuromodulation lead

This document discusses, among other things, systems and methods for delivering electrostimulation to specific tissue of a patient. An example of a system can receive a three-dimensional voxelized model representing a plurality of regions each specified as a target region or an avoidance region. The system includes control circuitry to determine a metric value using the voxelized model. The metric value indicates a clinical effect of electrostimulation on the plurality of regions according to a stimulation current and a current fractionalization. The control circuitry can determine a desired stimulation current that results in a first metric value satisfying a clinical effect condition. The system can generate a stimulation configuration including the desired stimulation current and the current fractionalization corresponding to the first metric value, and deliver tissue stimulation according to the stimulation configuration.

Systems and methods for clinical effect-based neurostimulation

A system or method for identifying sets of stimulation parameters can include receiving at least one image of a region of a patient; registering the at least one image with an anatomical or physiological atlas that identifies different anatomical or physiological structures; identifying a desired stimulation region using the at least one image; comparing the desired stimulation region with each of a plurality of predetermined estimated stimulation regions, where each of the estimated stimulation regions is a calculated estimate of a stimulation volume for a corresponding set of electrical stimulation parameters; selecting one of the predetermined estimated stimulation regions based on the comparing; and providing the corresponding set of electrical stimulation parameters for the selected one of the predetermined estimated stimulation regions to a user or an electrical stimulation device. Other systems or methods use functional maps or subregions of a region of synchronous neural activity to identify stimulation parameters.

Systems and methods for selecting stimulation parameters based on stimulation target region, effects, or side effects

Medical device systems, methods, and algorithms are disclosed for providing complex stimulation waveforms. The waveforms may selectively modulate or activate specific neural targets or selected ratios of specific neural targets. Some of the waveforms include pre-pulse phases defined by parameters, the value of which changes during the pre-pulse phase. Also disclosed herein are graphical user interfaces (GUIs) that allow the selection of waveforms configured to selectively modulate or activate specific neural targets or selected ratios of the neural targets. Adjustable parameters of the waveforms are adjusted automatically based on selection of user-defined parameters.

Neurostimulation system for delivering selectivity modes

A system for programming electrical stimulation by a lead includes a processor coupled to a display. The processor presents an interface on the display with user-selectable controls to define stimulation fields and repeating stimulation patterns for delivering the stimulation fields temporally-coordinated with each other. The user-selectable controls include a field control to define the number of stimulation fields, a location control to define locations of the stimulation fields relative to the lead, a repetition control to define a repetition frequency of the stimulation patterns, and a temporal-adjustment control to define temporal adjustments of the stimulation fields. The processor also receives selections of the user-selectable controls to define the stimulation fields and the repeating stimulation patterns; and initiate a signal that provides a pulse generator with instructions that enable the pulse generator to generate the stimulation fields according to the repeating stimulation patterns using the lead coupled to the pulse generator.

Systems and methods for controlling electrical stimulation using multiple stimulation fields

A method for determining a set of stimulation parameters for an electrical stimulation lead or steering electrical stimulation includes receiving a target geometrical parameter describing a stimulation field; receiving a first programming state; determining a first stimulation parameter for the first programming state that achieves the target geometrical parameter within at least 10% of the target geometrical parameter; and outputting set of stimulation parameters to be received by an electrical stimulation device for delivery of electrical stimulation to a patient via an electrical stimulation lead, wherein the set of stimulation parameters comprises the first stimulation parameter and represents the first programming state. In other embodiments, the target geometrical parameter is determined from either i) a first set of stimulation parameters or ii) a starting programming state and starting first stimulation parameter.

Systems and methods for steering electrical stimulation of patient tissue and determining stimulation parameters

A system for visualizing clinical effects can perform the following actions: obtain, for each of multiple stimulation instances, an estimation of a region stimulated during the stimulation instance and at least one assessment for at least one stimulation effect or stimulation side effect; assign, for each of the stimulation instances, a tag, selected from multiple tags, to each one of multiple voxels within the region stimulated during the stimulation instance, where the tag is selected based on the at least one assessment for the stimulation instance; and assign a voxel type, selected from multiple voxel types, to each of multiple voxels based on the tags assigned to the voxels. Optionally, the actions can also include display, on a display, a representation of multiple voxels with each of the displayed voxels having a graphical feature associated with the voxel type assigned to that voxel.

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Simi Valley, CA, United States of America

Richard Mustakos