Neurostimulation using one or more cycling parameters for a non-paresthesia stimulation pattern
This application is generally related to identifying or otherwise programming one or more cycling parameters for operation of an implantable pulse generator to provide a neurostimulation therapy to a patient using a non-paresthesia stimulation pattern. In some embodiments, the cycling parameter is selected by measuring physiological signals during trial stimulation. In other embodiments, multiple cycling parameters are identified for use by the patient using a patient controller device.
1 . A method of providing a neurostimulation therapy to a patient using a non-paresthesia stimulation pattern, the method comprising:
communicating one or more first control signals from a patient controller device to an implantable pulse generator to provide stimulation pulses for a regular mode of stimulation;
operating the implantable pulse generator, in response to the one or more first control signals, to apply stimulation pulses to nerve tissue of the patient using the non-paresthesia stimulation pattern with interleaved stimulation-on intervals and stimulation-off intervals arranged according to a first cycling parameter for the regular mode of stimulation;
communicating one or more second control signals from the patient controller device to the implantable pulse generator to provide stimulation pulses for a bolus mode of operation; and
operating the implantable pulse generator, in response to the one or more second control signals, to apply stimulation pulses to the nerve tissue of the patient using the non-paresthesia stimulation pattern with the interleaved stimulation-on intervals and stimulation-off intervals arranged according to a second cycling parameter for the bolus mode of stimulation, wherein the second cycling parameter provides greater relative provision of pulses of the non-paresthesia stimulation pattern than the first cycling parameter.
2 . The method of claim 1 wherein the patient controller device provides one or more user interface controls to allow the patient to select the first cycling parameter from a range of permitted values.
3 . The method of claim 1 wherein the patient controller device provides one or more user interface controls to allow the patient to select the second cycling parameter from a range of permitted values.
4 . The method of claim 1 wherein the bolus mode of operation is limited to a predetermined amount of time.
5 . The method of claim 4 wherein the implantable pulse generator automatically reverts to the regular mode of operation from the bolus mode of operation at an end of the predetermined amount of time.
6 . The method of claim 1 wherein the patient controller device limits a number of episodes of the bolus mode of operation per day according to a clinician parameter.
7 . The method of claim 1 wherein the patient controller device communicates a signal to a remote care network or a clinician system that the patient has selected a number of bolus episodes.
8 . The method of claim 1 wherein the non-paresthesia stimulation patterns are burst stimulation patterns that include groups of pulses separated by quiescent intervals.
9 . The method of claim 1 wherein the non-paresthesia stimulation patterns are high frequency stimulation patterns with a pulse repetition rate of at least 1,200 hertz (Hz).
10 . The method of claim 1 wherein the interleaved stimulation-on intervals and stimulation-off intervals are longer than one second.
11 . A system for providing a neurostimulation therapy to a patient using a non-paresthesia stimulation pattern, the system comprising:
an implantable pulse generator (IPG) for providing stimulation pulses to tissue of the patient using the non-paresthesia stimulation pattern, the IPG comprising: a processor for controlling operations of the IPG, pulse generating circuitry, and wireless communication circuitry; and a patient controller device for communicating with the IPG to control provision of the neurostimulation therapy to the patient, wherein the patient controller device comprises: a processor for controlling the patient controller device, wireless communication circuitry for communicating with the IPG, and one or more user interface components for interacting with the patient;
wherein the patient controller device is adapted to receive a first input from the patient to control the neurostimulation therapy according to a regular mode of operation and, in response to receiving the first input, to communicate one or more first control signals from the patient controller device to the IPG to provide stimulation pulses for the regular mode of operation using the non-paresthesia stimulation pattern with interleaved stimulation-on intervals and stimulation-off intervals arranged according to a first cycling parameter;
wherein the patient controller device is adapted to receive a second input from the patient to control the neurostimulation therapy according to a bolus mode of operation and, in response to receiving the second input, to communicate one or more second control signals from the patient controller device to the IPG to provide stimulation pulses for the bolus mode of operation using the non-paresthesia stimulation pattern with the interleaved stimulation-on intervals and stimulation-off intervals arranged according to a second cycling parameter;
wherein the second cycling parameter provides greater relative provision of pulses of the non-paresthesia stimulation pattern than the first cycling parameter.
12 . The system of claim 11 wherein the patient controller device provides one or more user interface controls to allow the patient to select the first cycling parameter from a range of permitted values.
13 . The system of claim 11 wherein the patient controller device provides one or more user interface controls to allow the patient to select the second cycling parameter from a range of permitted values.
14 . The system of claim 11 wherein the bolus mode of operation is limited to a predetermined amount of time.
15 . The system of claim 14 wherein the IPG automatically reverts to the regular mode of operation from the bolus mode of operation at an end of the predetermined amount of time.
16 . The system of claim 11 wherein the patient controller device limits a number of episodes of bolus mode of operation per day according to a clinician parameter.
17 . The system of claim 11 wherein the patient controller device communicates a signal to a remote care network or a clinician system that the patient has selected a number of bolus episodes.
18 . The system of claim 11 wherein the non-paresthesia stimulation patterns are burst stimulation patterns that include groups of pulses separated by quiescent intervals.
19 . The system of claim 11 wherein the first cycling parameter includes a first duty cycle associated with the interleaved stimulation-on intervals and stimulation-off intervals for application of the non-paresthesia stimulation pattern, and wherein the second cycling parameter includes a second duty cycle associated with the interleaved stimulation-on intervals and stimulation-off intervals for application of the non-paresthesia stimulation pattern, the second duty cycle greater than the first duty cycle.
20 . The system of claim 11 , wherein the IPG is further configured apply the non-paresthesia stimulation pattern, during both the regular mode and the bolus mode, without inducing perception of paresthesia in the patient.