Fitting algorithm to determine best stimulation parameter from a patient model in a spinal cord stimulation system
Methods for determining stimulation for a patient having a stimulator device are disclosed. A model is received at an external system indicative of a range or volume of preferred stimulation parameters, which model is preferably specific to and determined for the patient. The external system receives a plurality of pieces of fitting information for the patient, including information indicative of a symptom of the patient, information indicative of stimulation provided by the stimulator device during a fitting procedure, and/or phenotype information for the patient. The external system determines one or more sets of stimulation parameters for the patient using the pieces of fitting information. In one example, training data is applied to the pieces of fitting information to select the one or more sets of stimulation parameters from the range or volume of preferred stimulation parameters in the model.
1 . A method for determining stimulation for a patient implanted with a stimulator device, the stimulation device comprising a plurality of electrodes configured as an electrode array, the method comprising:
determining using an external system a model for the patient during a testing procedure performed on the patient, wherein the testing procedure comprises providing test stimulation at a combination of the electrodes defining a single location in the electrode array, wherein the model is indicative of a range or volume of preferred stimulation parameter sets for the patient at the single location, wherein each preferred stimulation parameter sets comprises an amplitude, a pulse width, and a frequency; and
receiving at the external system a plurality of pieces of fitting information for the patient;
determining at the external system one or more best stimulation parameter sets to use at the single location for the patient using the pieces of fitting information, wherein the one or more best stimulation parameter sets are selected from the range or volume of the preferred stimulation parameter sets; and
wirelessly program from the external system the stimulator device with at least one of the best stimulation parameter sets; and
providing therapeutic stimulation at the single location by using the combination of the electrodes, wherein the therapeutic stimulation is provided to a tissue of the patient from the stimulator device in accordance with the at least one of the best stimulation parameter sets.
2 . The method of claim 1 , wherein the model is determined by providing test pulses to the patient.
3 . The method of claim 2 , further comprising determining a perception threshold for the test pulses.
4 . The method of claim 3 , wherein the test pulses are provided at different pulses widths to determine a function of perception threshold versus pulse width, wherein the function is used to determine the model.
5 . The method of claim 4 , wherein the function is used to determine the model by comparing the function to another model relating frequency, pulse width, and paresthesia threshold.
6 . The method of claim 1 , wherein the model comprises information indicative of a plurality of coordinates, wherein each coordinate comprises a frequency, a pulse width, and an amplitude within the range or volume of the preferred stimulation parameters.
7 . The method of claim 6 , wherein the model comprises a line in a three-dimensional space of frequency, pulse width and amplitude.
8 . The method of claim 6 , wherein the model comprises a volume in a three-dimensional space of frequency, pulse width and amplitude.
9 . The method of claim 1 , wherein the model is indicative of a range or volume of the preferred stimulation parameter sets that provide sub-perception stimulation.
10 . The method of claim 1 , wherein the pieces of fitting information comprise one or more of (i) information indicative of a symptom of the patient, and/or one or more of (ii) information indicative of stimulation provided by the stimulator device during a fitting procedure.
11 . The method of claim 10 , wherein the pieces of fitting information further comprise phenotype information for the patient.
12 . The method of claim 10 , wherein the pieces of fitting information comprise one or more of (i) information indicative of the symptom of the patient, and one or more of (ii) information indicative of the stimulation provided by the stimulator device during the fitting procedure.
13 . The method of claim 10 , wherein the information indicative of the symptom of the patient comprises one or more of a pain intensity, a pain sensation, or a pain type.
14 . The method of claim 12 , wherein the information indicative of the stimulation provided by the stimulator device during the fitting procedure comprises one or more of a perceived intensity of the stimulation, a measured neural response to the stimulation, or an effectiveness of the stimulation to treat a symptom of the patient.
15 . The method of claim 12 , wherein the information indicative of the stimulation provided by the stimulator device during the fitting procedure comprises information indicative of a field produced by the stimulation.
16 . The method of claim 15 , wherein the information indicative of the field produced by the stimulation comprises one or more of a pulse type of the stimulation, a pole configuration for the stimulation, and information indicative of the size of the pole configuration.
17 . The method of claim 1 , wherein the one or more best stimulation parameter sets are determined using training data applied to the pieces of fitting information.
18 . The method of claim 17 , wherein the training data comprises weights that are applied to the pieces of fitting information.
19 . An external system for a stimulator device implanted in a patient, the stimulation device comprising a plurality of electrodes configured as an electrode array, the external system comprising control circuitry configured to:
determine a model for the patient during a testing procedure performed on the patient, wherein the testing procedure comprises providing test stimulation at a combination of the electrodes defining a single location in the electrode array, wherein the model is indicative of a range or volume of preferred stimulation parameter sets for the patient at the single location, wherein each preferred stimulation parameter sets comprises an amplitude, a pulse width, and a frequency;
receive a plurality of pieces of fitting information for the patient;
determine one or more best stimulation parameter sets to use at the single location for the patient using the pieces of fitting information, wherein the one or more best stimulation parameter sets are selected from the range or volume of the preferred stimulation parameter sets; and
wirelessly program the stimulator device with at least one of the best stimulation parameter sets to provide therapeutic stimulation at the single location by using the combination of the electrodes, wherein the therapeutic stimulation is provided to a tissue of the patient.