Implantable system enabling responsive therapy for pain
An implantable neurostimulator system for treating pain includes scheduled and responsive therapy capabilities including responsive stimulation applied to the brain and peripheral sections of the nervous system. Methods for treating chronic nociceptive, neuropathic, and psychogenic pain employ an inventive system to advantageously reduce multiple symptoms and components of pain and to address underlying causes of pain.
1. An implantable apparatus for treating pain in a patient, the apparatus comprising:
a therapy subsystem coupled to at least one therapy output configured to be implanted at or near a therapy location;
at least one sensor configured to be implanted at or near a detection location and to sense signals at or near the detection location; and
a detection subsystem configured to:
receive the sensed signals;
process the sensed signals to identify a pain signature; and
control the therapy subsystem to initiate application of a therapy through the at least one therapy output in response to the identification of a pain signature.
2. The apparatus of claim 1 , wherein the at least one therapy output is configured to be located at a therapy location remote from the detection location.
3. The apparatus of claim 1 , wherein the at least one therapy output is configured to be located at a therapy location at or near the detection location.
4. The apparatus of claim 1 , wherein:
the at least one therapy output comprises a plurality of therapy outputs; and
the detection subsystem is configured to control the therapy subsystem so that each of the plurality of therapy outputs is controlled independently from every other therapy output.
5. The apparatus of claim 1 , wherein the at least one therapy output comprises an electrical stimulation electrode, a magnetic stimulator, a transcranial magnetic stimulator, an optical stimulator, a catheter coupled to a drug dispenser, or a thermal conductor coupled to a thermal stimulator.
6. The apparatus of claim 1 , wherein the pain signature comprises at least one of an electrical burst, an electrographic pattern indicative of activation, an electrographic pattern indicative of inhibition, and an oscillating signal.
7. The apparatus of claim 1 , wherein the detection subsystem processes the sensed signals to identify a pain signature by being further configured to:
obtain a measure of spectral energy in the sensed signals; and
compare the measure to a criterion indicative of a pain signature.
8. The apparatus of claim 1 , wherein the detection subsystem is configured to function as a master device and the therapy subsystem is configured to function as a slave device that receives commands from the master device.
9. The apparatus of claim 1 , wherein:
the at least one sensor comprises a plurality of sensors; and
the detection subsystem comprises a plurality of detection channels, each detection channel configured to process one or more of the plurality of signals received from the plurality of sensors and provide a corresponding output, wherein the detection subsystem controls the therapy subsystem based on a logic outcome derived from the outputs of one or more of the detection channels.
10. The apparatus of claim 9 , wherein the therapy subsystem controls one or more of therapy duration, therapy site and therapy stimulation type based on the logic outcome.
11. The apparatus of claim 9 , wherein the plurality of sensors comprises a local sensor located at or near the detection location and a remote sensor located remote from the detection location.
12. A method of treating pain in a patient using an implantable apparatus, the method comprising:
receiving sensed signals from at least one sensor implanted at or near a detection location;
processing the sensed signals to identify a pain signature using an implanted processor; and
controlling an implanted therapy subsystem coupled to at least one therapy output implanted at or near a therapy location so as to initiate application of a therapy through the at least one therapy output in response to the identification of a pain signature.
13. The method of claim 12 , wherein the at least one therapy output is located at a therapy location remote from the detection location.
14. The method of claim 12 , wherein the at least one therapy output is located at a therapy location that is at or near the detection location.
15. The method of claim 12 , wherein:
the at least one therapy output comprises a plurality of therapy outputs; and
controlling an implanted therapy subsystem comprises controlling the therapy subsystem so that each of the plurality of therapy outputs is controlled independently from every other therapy output.
16. The method of claim 12 , wherein the at least one therapy outputs comprises an electrical stimulation electrode, a magnetic stimulator, a transcranial magnetic stimulator, an optical stimulator, a catheter coupled to a drug dispenser, or a thermal conductor coupled to a thermal stimulator.
17. The method of claim 12 , wherein the pain signature comprises at least one of an electrical burst, an electrographic pattern indicative of activation, an electrographic pattern indicative of inhibition, and an oscillating signal.
18. The method of claim 12 , wherein processing the sensed signals to identify a pain signature comprises:
obtaining a measure of spectral energy in the sensed signals; and
comparing the measure to a criterion indicative of a pain signature.
19. The method of claim 12 , wherein detection subsystem functions as a master device and the therapy subsystem functions a remote therapy module configured to receive commands from the master device.
20. The method of claim 12 , wherein:
the at least one sensor comprises a plurality of sensors; and
the detection subsystem comprises a plurality of detection channels, each detection channel configured to process one or more of the plurality of signals received from the plurality of sensors and provide a corresponding output, wherein controlling an implanted therapy subsystem comprises controlling the therapy subsystem based on a logic outcome derived from the outputs of one or more of the detection channels.
21. The method of claim 20 , wherein the therapy subsystem controls one or more of therapy duration, therapy site and therapy stimulation type based on the logic outcome.
22. The method of claim 20 , wherein the plurality of sensors comprises a local sensor located at or near the detection location and a remote sensor located remote from the detection location.