Apparatuses and methods for setting an electrical dose
Methods and apparatuses for setting a therapeutic dose of a neuromodulator implanted into a patient. The therapeutic dose typically includes a therapeutic dose duration including a ramp-up time to reach a peak modulation voltage and a sustained peak modulation time during which the voltage is sustained at the peak modulation voltage. The methods and apparatuses may use a testing ramp to identify a peak modulation voltage that is patient-specific and provides a maximized therapeutic effect while remaining comfortably tolerable by the patient during the application of energy by the neuromodulator.
1. A method of setting therapeutic doses of a neuromodulator implanted into a patient, wherein each of the therapeutic doses comprises a therapeutic dose duration including a therapy ramp-up time to reach a peak modulation voltage and a sustained peak modulation time during which voltage is sustained at the peak modulation voltage, the method comprising:
applying a test voltage ramp from the neuromodulator implanted into the patient;
determining a target sensation intensity modulation voltage that is specific to the patient from the test voltage ramp;
calculating an estimated peak modulation voltage as a function of the target sensation intensity modulation voltage and the therapy ramp-up time to reach the peak modulation voltage;
setting a first therapeutic dose using the estimated peak modulation voltage; and
setting a second therapeutic dose using a percentage of the estimated peak modulation voltage.
2. The method of claim 1 , wherein the therapeutic dose duration of the first therapeutic dose is the same as the therapeutic dose duration of the second therapeutic dose.
3. The method of claim 1 , wherein a duration of applying the estimated peak modulation voltage of the first therapeutic dose is greater than a duration of applying the estimated peak modulation voltage of the second therapeutic dose.
4. The method of claim 1 , wherein the therapeutic dose duration of the first therapeutic dose is the same as the therapeutic dose duration of the second therapeutic dose, and wherein a duration of applying the estimated peak modulation voltage of the first therapeutic dose is greater than a duration of applying the estimated peak modulation voltage of the second therapeutic dose.
5. The method of claim 1 , further comprising determining the therapy ramp-up time as a percentage of the therapeutic dose duration.
6. The method of claim 1 , further comprising determining a minimum patient-detectable modulation voltage that is specific to the patient from the test voltage ramp, and further wherein the minimum patient-detectable modulation voltage is used as a starting voltage for the test voltage ramp.
7. The method of claim 6 , wherein determining the minimum patient-detectable modulation voltage comprises receiving patient reported feedback during the application of the test voltage ramp.
8. The method of claim 1 , wherein the target sensation intensity modulation voltage is a maximum patient-tolerable modulation voltage.
9. The method of claim 1 , wherein the therapy ramp-up time to the peak modulation voltage is half of the therapeutic dose duration.
10. The method of claim 1 , wherein the therapeutic dose duration is set to be 30 minutes.
11. The method of claim 1 , further comprising setting a high-frequency component of the test voltage ramp applied and setting a high-frequency component of the first therapeutic dose to the high-frequency component of the test voltage ramp applied.
12. The method of claim 11 , wherein the high-frequency component of the test voltage ramp applied is between 1 kHz and 100 kHz.
13. A method of setting therapeutic doses of a neuromodulator implanted into a patient, wherein each of the therapeutic doses comprises a therapeutic dose duration including a therapy ramp-up time to reach a peak modulation voltage and a sustained peak modulation time during which voltage is sustained at the peak modulation voltage, the method comprising:
applying a test voltage ramp from the neuromodulator implanted into the patient;
determining a target sensation intensity modulation voltage that is specific to the patient from the test voltage ramp;
calculating a first estimated peak modulation voltage as a function of the target sensation intensity modulation voltage and the therapy ramp-up time to reach the peak modulation voltage;
setting a first therapeutic dose using the first estimated peak modulation voltage; and
setting a second therapeutic dose using a second estimated peak modulation voltage that is less than the first estimated peak modulation voltage, wherein a duration of applying the first estimated peak modulation voltage is greater than a duration of applying the second estimated peak modulation voltage.
14. The method of claim 13 , wherein the therapeutic dose duration of the first therapeutic dose is the same as the therapeutic dose duration of the second therapeutic dose.
15. The method of claim 13 , further comprising determining the therapy ramp-up time as a percentage of the therapeutic dose duration.
16. A system comprising:
an implantable neuromodulator;
a controller for controlling the application of a therapeutic dose by the neuromodulator, wherein each of the therapeutic doses comprises a therapeutic dose duration including a therapy ramp-up time to reach a peak modulation voltage and a sustained peak modulation time during which voltage is sustained at the peak modulation voltage, the controller comprising one or more processors;
memory coupled to the one or more processors, the memory configured to store computer-program instructions, that, when executed by the one or more processors, implement a computer-implemented method, the computer-implemented method comprising:
applying a test voltage ramp from the neuromodulator implanted into a patient;
determining a target sensation intensity modulation voltage that is specific to the patient from the test voltage ramp;
calculating an estimated peak modulation voltage as a function of the target sensation intensity modulation voltage and the therapy ramp-up time to reach the peak modulation voltage;
setting a first therapeutic dose using the estimated peak modulation voltage; and
setting a second therapeutic dose using a percentage of the estimated peak modulation voltage.
17. The system of claim 16 , wherein a duration of applying the estimated peak modulation voltage of the first therapeutic dose is greater than a duration of applying the estimated peak modulation voltage of the second therapeutic dose.
18. The system of claim 16 , wherein the therapy ramp-up time to the peak modulation voltage is half of the therapeutic dose duration.
19. The system of claim 16 , wherein the therapeutic dose duration is set to be 30 minutes.
20. The system of claim 16 , further comprising determining a minimum patient-detectable modulation voltage that is specific to the patient from the test voltage ramp, and further wherein the minimum patient-detectable modulation voltage is used as a starting voltage for the test voltage ramp.