Selective stimulation systems and signal parameters for medical conditions
Devices, systems and methods are provided for targeted treatment of a variety of conditions, particularly conditions that are associated with or influenced by the nervous system, such as pain. Targeted treatment of such conditions is provided with minimal deleterious side effects, such as undesired motor responses or undesired stimulation of unaffected body regions. This is achieved by directly neuromodulating a target anatomy associated with the condition while minimizing or excluding undesired neuromodulation of other anatomies.
1. A method of treating a condition of a patient, wherein the condition is associated with a portion of a dorsal root ganglion and is not substantially associated with other portions of the dorsal root ganglion, the method comprising:
positioning a lead having at least one electrode so that at least one of the at least one electrode resides in proximity to the portion of a dorsal root ganglion; and
providing a stimulating signal to the at least one of the at least one electrode so as to stimulate the portion of the dorsal root ganglion in a manner that affects the condition while not substantially stimulating the other portions, wherein an amplitude of the stimulation signal is incrementally adjusted below and above a specified level of amplitude in response to user inputs accepted by an external programmer;
wherein the external programmer is configured such that, when said amplitude of the stimulation signal is at least the specified level, said amplitude is adjusted in the first increments of 50 μA or less in response to user inputs accepted by the external programmer, and when said amplitude is less than the specified level, said amplitude is adjusted in second increments of 25 μA or less in response to user inputs accepted by the external programmer;
wherein the second increments are less than the first increments;
wherein the first and second increments enable adjustments to the amplitude in small enough increments to identify a magnitude for the amplitude that stimulates the target dorsal root ganglion, to achieve the targeted treatment, without stimulating a ventral root associated with the target dorsal root ganglion.
2. A method as in claim 1 , wherein the condition comprises pain.
3. A method as in claim 1 , wherein affecting the condition comprises alleviating the pain without causing a perceptible motor response.
4. A method as in claim 1 , wherein the condition is sensed by a patient at a location within a dermatome, and wherein the other portions of the dorsal root ganglion are associated with other locations within the dermatome.
5. A method as in claim 1 , wherein positioning the lead comprises advancing the lead using an epidural approach.
6. A method as in claim 1 , further comprising:
storing a therapeutic amplitude value in a pulse generator implanted in the patient wherein the therapeutic amplitude value is determined during the providing.
7. A method as in claim 1 , further comprising:
mapping activated body regions for sensory responses for a plurality of amplitudes employed during the providing.
8. A method as in claim 7 , further comprising:
switching active electrodes applying the stimulation signal to the patient during the mapping.
9. A method as in claim 7 , further comprising:
stimulating multiple dorsal root ganglion during the mapping.