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 so that at least one electrode of the lead resides in proximity to the portion of a dorsal root ganglion; and
operating a programmer device to control provision of a plurality of stimulating signals by a pulse generator to the at least one electrode to select one or more stimulation parameters to stimulate the portion of the dorsal root ganglion in a manner that affects the condition while not substantially stimulating the other portions, wherein (1) the operating the programmer device comprises performing mapping operations to identify sets of parameters that activate distinct sub-dermatome regions associated with the dorsal root ganglion, (2) the plurality of signals including parameters above a dorsal root ganglion activation threshold and below a ventral root activation threshold, (3) amplitude values for the plurality of signals are automatically calculated by employing at least a first current step size and a second current step size, (4) the first current step size is used for parameters close to the dorsal root activation threshold, and (5) the first current step size is smaller than the second current step size and is sufficiently small to permit identification of sub-dermatomal stimulation.
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. The method of claim 1 further comprising:
performing mapping operations for a second dorsal root ganglion.
7. The method of claim 6 wherein the second dorsal root ganglion includes neural tissue for sub-dermatome regions that overlap with sub-dermatome regions of the dorsal root ganglion.
8. The method of claim 1 wherein the sub-dermatome regions include at least a lower back sub-dermatome region and a leg sub-dermatome region.