Devices and methods for determining the effectiveness of electrical stimulation
Methods for treating medical disorders, such as migraine or other primary headaches, or fibromyalgia, by electrical stimulation of a nerve. The method comprises applying a first stimulus to a patient having a medical condition and measuring a first baseline physiological response from the patient. An electrical impulse is applied to a nerve within the patient and second stimulus is applied to the patient. A second physiological response evoked by the second stimulus is measured and compared to the first baseline physiological response. The methods may be used to optimize the placement of a stimulator, to test whether a patient is a suitable candidate for treatment using nerve stimulation, and/or to select the stimulation parameters that optimize acute or chronic treatment.
1. A method comprising:
applying a first stimulus to a patient having a medical condition;
measuring a first baseline physiological response from the patient;
applying an electrical impulse to a nerve within the patient;
applying a second stimulus to the patient;
measuring a response of the patient to the second stimulus, wherein the response comprises a second physiological response evoked by the second stimulus, wherein the second baseline physiological response comprises a reduction in pain of the patient; and
comparing the second physiological response to the first baseline physiological response.
2. The method of claim 1 , wherein the second stimulus comprises at least one of a visual, auditory, somatosensory, painful, olfactory, gustatory, vestibular, or interoceptive stimulus.
3. The method of claim 1 , wherein the nerve is a vagus nerve.
4. The method of claim 1 , wherein the treatment comprises applying an electrical impulse transcutaneously through an outer skin surface of a neck of the patient to a vagus nerve of the patient.
5. The method of claim 4 , further comprising varying a plurality of different parameters of the electrical impulse based on comparing the response to the first baseline physiological response to determine whether the patient is a responder to the different parameters.
6. The method of claim 5 , wherein the different parameters comprise at least one of an amplitude or a frequency of the electrical impulse.
7. The method of claim 5 , wherein the different parameters comprise applying the electrical impulse to a different location on the patient.
8. The method of claim 5 , wherein the different parameters comprise applying the electrical impulse via a different orientation on the patient.
9. The method of claim 1 , wherein the medical condition comprises a primary headache.
10. The method of claim 1 , further comprising determining whether the nerve has fired an action potential based on the electrical impulse.
11. The method of claim 1 , further comprising determining whether the patient is a responder to the electrical impulse based on the first and second physiological responses.
12. A method comprising:
applying a stimulus to a patient having a medical condition;
measuring a first baseline physiological response from the patient;
applying an electrical impulse to a nerve within the patient in multiple doses per day for a period of time greater than 1 day and less than 3 months;
measuring a second baseline physiological response from the patient, wherein the second baseline physiological response is measured after the electrical impulse has been applied for multiple doses per day for a period greater than one day; and
comparing the second baseline physiological response to the first baseline physiological response.
13. The method of claim 12 , wherein the stimulus comprises at least one of a visual, auditory, somatosensory, painful, olfactory, gustatory, vestibular, or interoceptive stimulus.
14. The method of claim 12 , wherein the medical condition comprises a primary headache.
15. The method of claim 12 , wherein the second baseline physiological response comprises a reduction in pain of the patient.
16. The method of claim 12 , wherein the second baseline physiological response comprises a reduction in a number of headache days of the patient.
17. The method of claim 12 , wherein the electrical impulse increases a habituation of the second physiological response.
18. The method of claim 12 , wherein the electrical impulse is applied transcutaneously through an outer skin surface of a neck of the patient to a vagus nerve of the patient.