JP6181307B2 - 知覚なしに変調治療を与えるシステム - Google Patents
知覚なしに変調治療を与えるシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
- A61N1/3615—Intensity
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36071—Pain
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36135—Control systems using physiological parameters
- A61N1/36139—Control systems using physiological parameters with automatic adjustment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
- A61N1/3615—Intensity
- A61N1/36164—Sub-threshold or non-excitatory signals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37211—Means for communicating with stimulators
- A61N1/37235—Aspects of the external programmer
- A61N1/37241—Aspects of the external programmer providing test stimulations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36062—Spinal stimulation
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Neurosurgery (AREA)
- Neurology (AREA)
- Pain & Pain Management (AREA)
- Biophysics (AREA)
- Physiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Electrotherapy Devices (AREA)
Description
本出願は、その全体が引用によって本明細書に組込まれている2013年7月26日出願の米国仮特許出願第61/858,730号の「35 U.S.C.§119(e)」の下での優先権の利益を主張するものである。
Claims (15)
- 神経変調システムであって、
ターゲット組織部位に埋込まれる複数の電極にそれぞれ電気的に結合されるように構成された複数の電気端子と、
刺激の知覚なしに患者に治療を行うようにプログラムされた強度値の電気変調エネルギを患者のターゲット組織部位に送出するために、前記複数の電気端子に結合された変調出力回路と、
前記複数の電気端子に結合されたモニタ回路と、
メモリと、
制御/処理回路と、を有し、
前記制御/処理回路は、
イベントに応答して、電気変調エネルギを前記プログラムされた強度値に対して増分式に増大する一連の強度値で送出するように、前記変調出力回路に指示し、
電気変調エネルギを前記増分式に増大する一連の強度値で送出することに応答して、少なくとも1つの複合活動電位(CAP)を患者のターゲット組織部位のニューロン集団に誘発させるように、前記変調出力回路を駆動し、
2又は3以上の誘発させたCAP(eCAP)を感知するように、前記モニタ回路を駆動し、前記2又は3以上のeCAPは、電気変調エネルギを2又は3以上の強度値で送出することに応答してそれぞれ感知され、
前記メモリは、知覚閾値を示す基準eCAPの少なくとも1つの特性を格納するように構成され、
前記制御/処理回路は、更に、
前記感知した2又は3以上のeCAPの各々の特性を、それに対応する基準eCAPの特性と比較し、前記比較に基づいて、前記増分式に増大する一連の強度値のうちの1つを選択し、
前記比較すること及び前記選択することは、前記格納した基準eCAPの少なくとも1つの特性を取得することと、基準eCAPの特性に最も良く適合する特性を有する前記感知した2又は3以上のeCAPのうちの1つを決定することと、前記送出した電気変調エネルギの強度値を選択すること、を含み、かかる選択に応答して、前記決定したeCAPが感知され、
前記制御/処理回路は、更に、
減少値を前記選択した強度値の関数として自動的に計算し、
電気変調エネルギを患者のターゲット組織部位に前記計算した強度値で送出するように、前記変調出力回路に指示する、神経変調システム。 - 刺激の知覚は、異常知覚を含む、請求項1に記載の神経変調システム。
- 前記プログラムされた強度値は、プログラムされた振幅値を含み、
前記増分式に増大する強度値は、増分式に増大する振幅値を含む、請求項1に記載の神経変調システム。 - 前記プログラムされた強度値は、プログラムされたパルス幅値を含み、
前記増分式に増大する一連の強度値は、増分式に増大するパルス幅値を含む、請求項1〜3のいずれか1項に記載の神経変調システム。 - 前記選択した強度値は、前記送出した電気変調エネルギの強度値に一致し、前記送出した電気変調エネルギの強度値に応答して、前記2又は3以上のeCAPのうちの第1のeCAPを感知する、請求項1〜4のいずれか1項に記載の神経変調システム。
- 前記感知した2又は3以上のeCAPの各々の特性は、ピーク遅延、幅、振幅、及び波形形態のうちの少なくとも1つである、請求項1に記載の神経変調システム。
- 前記メモリは、基準eCAP特性のリストを格納するように更に構成され、前記基準eCAP特性の各々は、患者が特定の身体活動及び/又は姿勢に関わっている時の知覚閾値を各々が示し、
前記制御/処理回路は、更に、患者が現在関わっている身体活動及び/又は姿勢を特定し、前記特定した身体活動及び/又は姿勢に対応する前記基準eCAP特性を、前記基準eCAP特性のリストから選択し、前記感知した2又は3以上のeCAPの各々の前記特性を前記選択した基準eCAPと比較する、請求項1又は6に記載の神経変調システム。 - 前記イベントは、特定した身体活動及び/又は姿勢、ユーザ開始信号、電気変調エネルギを送出する電極の移動を示す信号、及び予め決められた周期的反復信号のうちの1つである、請求項1〜7のいずれか1項に記載の神経変調システム。
- 更に、前記ユーザ開始信号を発生させる外部制御デバイスを有する、請求項8に記載の神経変調システム。
- 前記計算した強度値は、前記選択した強度値の百分率である、請求項1〜9のいずれか1項に記載の神経変調システム。
- 前記百分率は30%〜70%の範囲にある、請求項10に記載の神経変調システム。
- 前記百分率は40%〜60%の範囲にある、請求項10に記載の神経変調システム。
- 前記百分率は10%〜90%の範囲にある、請求項10に記載の神経変調システム。
- 前記計算した強度値は、前記選択した強度値とある定数との差である、請求項1〜9のいずれか1項に記載の神経変調システム。
- 前記プログラムされた強度値で送出した電気変調エネルギ、及び、前記増分式に増大する一連の強度値で送出した電気エネルギは両方とも、電気パルス列を含み、
前記プログラムされた強度値、前記増分式に増大する一連の強度値、及び前記計算した強度値の各々は、パルス強度値である、請求項1に記載の神経変調システム。
Applications Claiming Priority (3)
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US201361858730P | 2013-07-26 | 2013-07-26 | |
US61/858,730 | 2013-07-26 | ||
PCT/US2014/047804 WO2015013398A1 (en) | 2013-07-26 | 2014-07-23 | Systems of providing modulation therapy without perception |
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JP2016525414A JP2016525414A (ja) | 2016-08-25 |
JP6181307B2 true JP6181307B2 (ja) | 2017-08-16 |
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JP2016529858A Active JP6181307B2 (ja) | 2013-07-26 | 2014-07-23 | 知覚なしに変調治療を与えるシステム |
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US (3) | US20150032181A1 (ja) |
EP (1) | EP3024540B1 (ja) |
JP (1) | JP6181307B2 (ja) |
CN (1) | CN105407964B (ja) |
AU (1) | AU2014293164B2 (ja) |
CA (1) | CA2917977A1 (ja) |
WO (1) | WO2015013398A1 (ja) |
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2014
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Publication number | Priority date | Publication date | Assignee | Title |
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US11524163B2 (en) | 2013-07-26 | 2022-12-13 | Boston Scientific Neuromodulation Corporation | Systems and methods of providing modulation therapy without patient-perception of stimulation |
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WO2015013398A1 (en) | 2015-01-29 |
JP2016525414A (ja) | 2016-08-25 |
EP3024540A1 (en) | 2016-06-01 |
US11524163B2 (en) | 2022-12-13 |
US20190217092A1 (en) | 2019-07-18 |
CN105407964B (zh) | 2018-05-04 |
EP3024540B1 (en) | 2018-10-17 |
AU2014293164B2 (en) | 2017-07-06 |
US20150032181A1 (en) | 2015-01-29 |
CN105407964A (zh) | 2016-03-16 |
AU2014293164A1 (en) | 2016-02-11 |
US20230072802A1 (en) | 2023-03-09 |
CA2917977A1 (en) | 2015-01-29 |
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