IP Library › Granted Patent US 12,311,176
Granted Patent B2
US 12,311,176 · App. 18/422,636 · Granted May 27, 2025

Implantable lead location using ECAP

Inventors: David A. Dinsmoor (North Oaks, MN); Andrew L. Schmeling (Holmen, WI)
Assignee: Medtronic, Inc.
A61N1/36062A61B5/065A61B5/686A61N1/36128A61N1/0551
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Quick Facts
Patent No.
US 12,311,176
App. No.
18/422,636
Granted
May 27, 2025
Kind
B2
Abstract

Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to determine an implant location for a lead. An example method includes receiving first information representative of a first evoked compound action potential (ECAP) signal sensed in response to a first control stimulus delivered to a first location adjacent to a spinal cord of a patient. The method also includes receiving, second information representative of a second ECAP signal in response to a second control stimulus delivered to a second location adjacent to the spinal cord of the patient. Additionally, the method includes outputting a first indication of the first information representative of the first ECAP signal and a second indication of the second information representative of the second ECAP signal.

Claims (59)

1. A system comprising:

processing circuitry configured to:

control stimulation circuitry to deliver a first control stimulus via an electrode array positioned adjacent to a spinal cord of a patient, wherein the stimulation circuitry is configured to generate electrical stimulation deliverable via one or more electrode combinations of the electrode array;

receive, from sensing circuitry, first information representative of a first evoked compound action potential (ECAP) signal sensed in response to the first control stimulus;

control the stimulation circuitry to deliver a second control stimulus via the electrode array positioned adjacent to the spinal cord of the patient;

receive, from the sensing circuitry, second information representative of a second ECAP signal in response to the second control stimulus;

determine a first latency of the first ECAP signal and a second latency of the second ECAP signal;

compare the first latency of the first ECAP signal to the second latency of the second ECAP signal;

select, according to the comparison of the first latency to the second latency, at least one of a stimulation electrode combination from the one or more electrode combinations or a target position for implantation of the electrode array; and

output an indication of at least one of the stimulation electrode combination or the target position.

2. The system of claim 1 , wherein the first control stimulus is delivered to a first position adjacent to the spinal cord and the second control stimulus is delivered to a second position adjacent to the spinal cord.

3. The system of claim 2 , wherein the processing circuitry is configured to:

receive an indication that the electrode array has moved from the first position to the second position; and

control the stimulation circuitry to deliver the second control stimulus in response to receiving the indication that the electrode array has moved from the first position to the second position.

4. The system of claim 2 , wherein the processing circuitry is configured to:

control the stimulation circuitry to deliver a third control stimulus to the electrode combination of the electrode array positioned at a third location adjacent to the spinal cord of the patient;

receive, from the sensing circuitry, third information representative of a third ECAP signal in response to the third control stimulus; and

output an indication of the third information representative of the third ECAP signal.

5. The system of claim 1 , wherein when the electrode array is arranged to include an odd number of columns with respect to a lateral axis of the spinal cord, and wherein the processing circuitry is configured to control the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination consisting of two or more electrodes disposed in a lateral center column of the electrode array.

6. The system of claim 1 , wherein the processing circuitry is configured to control the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination consisting of two or more electrodes disposed in a single column adjacent a lateral center of the electrode array arranged to include an even number of columns with respect to a lateral axis of the spinal cord.

7. The system of claim 1 , wherein the first control stimulus is delivered from a first electrode combination of the one or more electrode combinations and the second control stimulus is delivered from a second electrode combination different than the first electrode combination.

8. The system of claim 1 , wherein the processing circuitry is configured to select the at least one of the stimulation electrode combination or the target position for implantation of the electrode array corresponding to a lowest latency according to the comparison of the first latency of the first ECAP signal to the second latency of the second ECAP signal.

9. The system of claim 1 , wherein the processing circuitry is configured to:

output, for presentation, at least one of a first visual representation or a first audio representation of at least one characteristic within the first information representative of the first ECAP signal to be displayed, and

output, for presentation, at least one of a second visual representation or a second audio representation of the at least one characteristic within the second information representative of the second ECAP signal to be displayed, a difference between the at least one of the first visual representation or the first audio representation and the at least one of the second visual representation or the second audio representation corresponding to a difference between the at least one characteristic within the first and second information.

10. The system of claim 1 , further comprising an implantable medical device comprising the stimulation circuitry and the sensing circuitry.

11. A method comprising:

controlling, by processing circuitry, stimulation circuitry to deliver a first control stimulus via an electrode array positioned adjacent to a spinal cord of a patient, wherein the stimulation circuitry is configured to generate electrical stimulation deliverable via one or more electrode combinations of the electrode array;

receiving, by the processing circuitry and from sensing circuitry, first information representative of a first evoked compound action potential (ECAP) signal sensed in response to the first control stimulus;

controlling, by the processing circuitry, the stimulation circuitry to deliver a second control stimulus via the electrode array positioned adjacent to the spinal cord of the patient;

receiving, by the processing circuitry and from the sensing circuitry, second information representative of a second ECAP signal in response to the second control stimulus;

determining, by the processing circuitry, a first latency of the first ECAP signal and a second latency of the second ECAP signal;

comparing, by the processing circuitry, the first latency of the first ECAP signal to the second latency of the second ECAP signal;

selecting, by the processing circuitry and according to the comparison of the first latency to the second latency, at least one of a stimulation electrode combination from the one or more electrode combinations or a target position for implantation of the electrode array; and

outputting, by the processing circuitry, an indication of at least one of the stimulation electrode combination or the target position.

12. The method of claim 11 , wherein the first control stimulus is delivered to a first position adjacent to the spinal cord and the second control stimulus is delivered to a second position adjacent to the spinal cord.

13. The method of claim 12 , further comprising:

receiving an indication that the electrode array has moved from the first position to the second position; and

wherein controlling the stimulation circuitry to deliver the second control stimulus comprises controlling the stimulation circuitry to deliver the second control stimulus in response to receiving the indication that the electrode array has moved from the first position to the second position.

14. The method of claim 12 , further comprising:

controlling the stimulation circuitry to deliver a third control stimulus to the electrode combination of the electrode array positioned at a third location adjacent to the spinal cord of the patient;

receiving, from the sensing circuitry, third information representative of a third ECAP signal in response to the third control stimulus; and

outputting an indication of the third information representative of the third ECAP signal.

15. The method of claim 11 , wherein when the electrode array is arranged to include an odd number of columns with respect to a lateral axis of the spinal cord, and wherein controlling the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination comprises controlling the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination consisting of two or more electrodes disposed in a lateral center column of the electrode array.

16. The method of claim 11 , wherein controlling the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination comprises controlling the stimulation circuitry to deliver the first control stimulus and the second control stimulus to the electrode combination consisting of two or more electrodes disposed in a single column adjacent a lateral center of the electrode array arranged to include an even number of columns with respect to a lateral axis of the spinal cord.

17. The method of claim 11 , wherein the first control stimulus is delivered from a first electrode combination of the one or more electrode combinations and the second control stimulus is delivered from a second electrode combination different than the first electrode combination.

18. The method of claim 11 , wherein selecting the at least one of the stimulation electrode combination or the target position for implantation of the electrode array comprises selecting the at least one of the stimulation electrode combination or the target position for implantation of the electrode array corresponding to a lowest latency according to the comparison of the first latency of the first ECAP signal to the second latency of the second ECAP signal.

19. The method of claim 11 , further comprising:

outputting, for presentation, at least one of a first visual representation or a first audio representation of at least one characteristic within the first information representative of the first ECAP signal to be displayed, and

outputting, for presentation, at least one of a second visual representation or a second audio representation of the at least one characteristic within the second information representative of the second ECAP signal to be displayed, a difference between the at least one of the first visual representation or the first audio representation and the at least one of the second visual representation or the second audio representation corresponding to a difference between the at least one characteristic within the first and second information.

20. A computer readable medium comprising instructions that, when executed, cause processing circuitry to:

control stimulation circuitry to deliver a first control stimulus via an electrode array positioned adjacent to a spinal cord of a patient, wherein the stimulation circuitry is configured to generate electrical stimulation deliverable via one or more electrode combinations of the electrode array;

receive, from sensing circuitry, first information representative of a first evoked compound action potential (ECAP) signal sensed in response to the first control stimulus;

control the stimulation circuitry to deliver a second control stimulus via the electrode array positioned adjacent to the spinal cord of the patient;

receive, from the sensing circuitry, second information representative of a second ECAP signal in response to the second control stimulus;

determine a first latency of the first ECAP signal and a second latency of the second ECAP signal;

compare the first latency of the first ECAP signal to the second latency of the second ECAP signal;

select, according to the comparison of the first latency to the second latency, at least one of a stimulation electrode combination from the one or more electrode combinations or a target position for implantation of the electrode array; and

output an indication of at least one of the stimulation electrode combination or the target position.

Assignments (1)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Jan 25, 2024
From: DINSMOOR, DAVID A.; SCHMELING, ANDREW L.
To: MEDTRONIC, INC.
Reel/Frame 066248/0652 →
Continuity (2)
Continuation 17085621 · Oct 30, 2020
Related Publication 20240189597A1 · Jun 13, 2024
References Cited (185)
US 5603726A · Schulman et al. · 1997 [cited by applicant]
US 5800465A · Thompson et al. · 1998 [cited by applicant]
US 6157861A · Faltys et al. · 2000 [cited by applicant]
US 6205360B1 · Carter · 2001 [cited by applicant]
US 6289247B1 · Faltys et al. · 2001 [cited by applicant]
US 6314325B1 · Fitz · 2001 [cited by applicant]
US 6421566B1 · Holsheimer · 2002 [cited by applicant]
US 6505078B1 · King et al. · 2003 [cited by applicant]
US 6675046B2 · Holsheimer · 2004 [cited by applicant]
US 6850802B2 · Holsheimer · 2005 [cited by applicant]
US 6988006B2 · King et al. · 2006 [cited by applicant]
US 7206640B1 · Overstreet · 2007 [cited by applicant]
US 7333858B2 · Killian et al. · 2008 [cited by applicant]
US 7577480B2 · Zeijlemaker · 2009 [cited by applicant]
US 7616999B2 · Overstreet et al. · 2009 [cited by applicant]
US 7657318B2 · King et al. · 2010 [cited by applicant]
US 7689289B2 · King · 2010 [cited by applicant]
US 7742810B2 · Moffitt et al. · 2010 [cited by applicant]
US 7792583B2 · Miesel et al. · 2010 [cited by applicant]
US 8504150B2 · Skelton · 2013 [cited by applicant]
US 8620441B2 · Greenberg et al. · 2013 [cited by applicant]
US 8676329B2 · Wacnik et al. · 2014 [cited by applicant]
US 8694108B2 · Alataris et al. · 2014 [cited by applicant]
US 8708934B2 · Skelton et al. · 2014 [cited by applicant]
US 8712533B2 · Alataris et al. · 2014 [cited by applicant]
US 8712534B2 · Wei · 2014 [cited by applicant]
US 8897888B2 · Parker et al. · 2014 [cited by applicant]
US 8923984B2 · Parker et al. · 2014 [cited by applicant]
US 9002460B2 · Parker · 2015 [cited by applicant]
US 9072910B2 · Parker et al. · 2015 [cited by applicant]
US 9089714B2 · Robinson · 2015 [cited by applicant]
US 9089715B2 · Parker et al. · 2015 [cited by applicant]
US 9138582B2 · Doan et al. · 2015 [cited by applicant]
US 9155892B2 · Parker et al. · 2015 [cited by applicant]
US 9283373B2 · Parker et al. · 2016 [cited by applicant]
US 9302112B2 · Bornzin et al. · 2016 [cited by applicant]
US 9339655B2 · Carbunaru · 2016 [cited by applicant]
US 9381356B2 · Parker et al. · 2016 [cited by applicant]
US 9386934B2 · Parker et al. · 2016 [cited by applicant]
US 9387325B1 · Min et al. · 2016 [cited by applicant]
US 9566439B2 · Single et al. · 2017 [cited by applicant]
US 9597507B2 · Johanek et al. · 2017 [cited by applicant]
US 9700713B2 · Robinson et al. · 2017 [cited by applicant]
US 9764141B2 · Moffitt et al. · 2017 [cited by applicant]
US 9872990B2 · Parker et al. · 2018 [cited by applicant]
US 10183168B2 · Baru et al. · 2019 [cited by applicant]
US 11311719B2 · Dubuclet et al. · 2022 [cited by applicant]
US 20040267333A1 · Kronberg · 2004 [cited by applicant]
US 20050119713A1 · Whitehurst et al. · 2005 [cited by applicant]
US 20080221640A1 · Overstreet et al. · 2008 [cited by applicant]
US 20110054570A1 · Lane · 2011 [cited by applicant]
US 20110071589A1 · Starkebaum et al. · 2011 [cited by applicant]
US 20110077712A1 · Killian · 2011 [cited by applicant]
US 20110125223A1 · Carbunaru et al. · 2011 [cited by applicant]
US 20120155188A1 · Buettner et al. · 2012 [cited by applicant]
US 20130208390A1 · Singh et al. · 2013 [cited by applicant]
US 20130268021A1 · Moffitt · 2013 [cited by applicant]
US 20130289664A1 · Johanek · 2013 [cited by applicant]
US 20130289683A1 · Parker et al. · 2013 [cited by applicant]
US 20140005753A1 · Carbunaru · 2014 [cited by applicant]
US 20140025146A1 · Alataris et al. · 2014 [cited by applicant]
US 20140031896A1 · Alataris et al. · 2014 [cited by applicant]
US 20140031905A1 · Irazoqui et al. · 2014 [cited by applicant]
US 20140074189A1 · Moffitt · 2014 [cited by applicant]
US 20140094886A1 · Lee · 2014 [cited by applicant]
US 20140142656A1 · Alataris et al. · 2014 [cited by applicant]
US 20140142673A1 · Alataris et al. · 2014 [cited by applicant]
US 20140194772A1 · Single et al. · 2014 [cited by applicant]
US 20140236042A1 · Parker et al. · 2014 [cited by applicant]
US 20140236257A1 · Parker et al. · 2014 [cited by applicant]
US 20140243924A1 · Zhu et al. · 2014 [cited by applicant]
US 20140243926A1 · Carcieri et al. · 2014 [cited by applicant]
US 20140243931A1 · Parker et al. · 2014 [cited by applicant]
US 20140277282A1 · Jaax · 2014 [cited by applicant]
US 20140288577A1 · Robinson et al. · 2014 [cited by applicant]
US 20140293737A1 · Parker et al. · 2014 [cited by applicant]
US 20140296737A1 · Parker et al. · 2014 [cited by applicant]
US 20140296936A1 · Alataris et al. · 2014 [cited by applicant]
US 20140324143A1 · Robinson et al. · 2014 [cited by applicant]
US 20140371813A1 · King et al. · 2014 [cited by applicant]
US 20140378941A1 · Su et al. · 2014 [cited by applicant]
US 20140379043A1 · Howard · 2014 [cited by applicant]
US 20150032181A1 · Baynham et al. · 2015 [cited by applicant]
US 20150057729A1 · Parker et al. · 2015 [cited by applicant]
US 20150127062A1 · Holley et al. · 2015 [cited by applicant]
US 20150179177A1 · Nagao · 2015 [cited by applicant]
US 20150282725A1 · Single · 2015 [cited by applicant]
US 20150313487A1 · Single et al. · 2015 [cited by applicant]
US 20150360031A1 · Bornzin et al. · 2015 [cited by applicant]
US 20150374999A1 · Parker et al. · 2015 [cited by applicant]
US 20160082252A1 · Hershey et al. · 2016 [cited by applicant]
US 20160082268A1 · Hershey et al. · 2016 [cited by applicant]
US 20160121124A1 · Johanek et al. · 2016 [cited by applicant]
US 20160136420A1 · Brink et al. · 2016 [cited by applicant]
US 20160157769A1 · Min et al. · 2016 [cited by applicant]
US 20160158550A1 · Hou et al. · 2016 [cited by applicant]
US 20160166164A1 · Obradovic et al. · 2016 [cited by applicant]
US 20160175594A1 · Min et al. · 2016 [cited by applicant]
US 20160206883A1 · Bornzin et al. · 2016 [cited by applicant]
US 20160287126A1 · Parker et al. · 2016 [cited by applicant]
US 20160287182A1 · Single · 2016 [cited by applicant]
US 20170001017A9 · Parker et al. · 2017 [cited by applicant]
US 20170049345A1 · Single · 2017 [cited by applicant]
US 20170071490A1 · Parker et al. · 2017 [cited by applicant]
US 20170135624A1 · Parker · 2017 [cited by applicant]
US 20170173332A1 · Overstreet · 2017 [cited by applicant]
US 20170209695A1 · Solomon · 2017 [cited by applicant]
US 20170216587A1 · Parker · 2017 [cited by applicant]
US 20170361101A1 · Single · 2017 [cited by applicant]
US 20180078769A1 · Dinsmoor et al. · 2018 [cited by applicant]
US 20180110987A1 · Parker · 2018 [cited by applicant]
US 20180117335A1 · Parker et al. · 2018 [cited by applicant]
US 20180132760A1 · Parker · 2018 [cited by applicant]
US 20180304075A1 · Su et al. · 2018 [cited by applicant]
US 20190388692A1 · Dinsmoor et al. · 2019 [cited by applicant]
US 20190388695A1 · Dinsmoor et al. · 2019 [cited by applicant]
US 20200289815A1 · Montgomery, Jr. et al. · 2020 [cited by applicant]
US 20220111211A1 · Li et al. · 2022 [cited by applicant]
US 20220134108A1 · Dinsmoor et al. · 2022 [cited by applicant]
EP 2396072B1 · 2013 [cited by applicant]
WO 2002009808A1 · 2002 [cited by applicant]
WO 2010058178A1 · 2010 [cited by applicant]
WO 2012155188A1 · 2012 [cited by applicant]
WO 2015143509A1 · 2015 [cited by applicant]
WO 2015179177A1 · 2015 [cited by applicant]
WO 2015179281A2 · 2015 [cited by applicant]
WO 2016090420A1 · 2016 [cited by applicant]
WO 2016090436A1 · 2016 [cited by applicant]
WO 2016191808A1 · 2016 [cited by applicant]
WO 2017100866A1 · 2017 [cited by applicant]
WO 2017106503A1 · 2017 [cited by applicant]
WO 2017173493A1 · 2017 [cited by applicant]
WO 2017184238A1 · 2017 [cited by applicant]
WO 2017219096A1 · 2017 [cited by applicant]
WO 2018080753A1 · 2018 [cited by applicant]
WO 2018106813A1 · 2018 [cited by applicant]
“St. Jude's Prodigy Neurostimulator with Burst Technology,” Medgadget, Mar. 20, 2014, 4 pp. [cited by applicant]
Abejon MD “Back pain coverage with spinal cord stimulation: A different treatment for each patient,” International Neuromodulation Society. Jun. 10, 2015; 567, Abstract Only, 1 pp. [cited by applicant]
Abeloos MD “High density stimulation as an alternative to uncomfortable cervical tonic spinal cord stimulation: case report,” International Neuromodulation Society 12th World Congress, Jun. 11-15, 2015, Abstract Only, 1… [cited by applicant]
Breel et al., “High Density Stimulation: A novel programming paradigm for the treatment of chronic pain,” International Neuromodulation Society (INS) 12th World Congress; Jun. 9, 2015, Abstract Only, 1 pp. [cited by applicant]
Cuellar MD PhD, et al., “Effect of high-frequency alternating current on spinal afferent nociceptive transmission,” Neuromodulation: Technology at the Neural Interface; Jul.-Aug. 2013;16(4): pp. 318-327. [cited by applicant]
Cui et al., “Effect of spinal cord stimulation on tactile hypersensitivity in mononeuropathic rats is potentiated by simultaneous GABA. sub B. and adenosine receptor activation,” Neuroscience Letters 247: Apr. 1998; pp.… [cited by applicant]
Cui et al., “Spinal cord stimulation attenuates augmented dorsal horn release of excitatory amino acids in mononeuropathy via a GABAergic mechanism,” Pain 73, Oct. 1997, pp. 87-95. [cited by applicant]
De Ridder et al., “Burst spinal cord stimulation for limb and back pain,” World neurosurgery, Nov. 2013; 80(5):642-649, e641. [cited by applicant]
De Ridder MD PhD et al., “Burst spinal cord stimulation: toward paresthesia-free pain suppression,” Neurosurgery. May 2010; 66(5): 986-990. [cited by applicant]
Downey, “Asynchronous Neuromuscular Electrical Stimulation,” University of Florida, 2015, accessed on Jul. 18, 2016, 107 pp. [cited by applicant]
Duyvendak MD et al., “High density stimulation: a novel programming paradigm for the treatment of chronic back and leg pain,” Abstracts, International Neuromodulation Society 12th World Congress: Jun. 11-15, 2015, 1 pp. [cited by applicant]
Extended Search Report from counterpart European Application No. 21201439.3, dated Mar. 23, 2022, 9 pp. [cited by applicant]
Fern et al., “The Relationship Between Ischaemic Conduction Failure and Conduction Velocity in Cat Myelinated Axoms,” Experimental Physiology, vol. 79, No. 4, Jul. 1, 1994, pp. 571-581. [cited by applicant]
Gao et al., “Effects of spinal cord stimulation with “standard clinical” and higher frequencies on peripheral blood flow in rats,” Brain Res., 1313: (2010) available online Dec. 3, 2009 pp. 53-61. [cited by applicant]
Grider DO/PhD et al., “High Frequency (1000 Hz) Stimulation Using Commercially Available Implantable Pulse Generator,” North American Neuromodulation Society. Dec. 2013, Abstract Only, 2 pp. [cited by applicant]
Guan MD PhD et al., “Spinal cord stimulation-induced analgesia: electrical stimulation of dorsal column and dorsal roots attenuates dorsal horn neuronal excitability in neuropathic rats,” Anesthesiology. Dec. 2010;113(6… [cited by applicant]
Guan, “Spinal Cord Stimulation: Neurophysiological and Neurochemical Mechanisms of Action” Curr Pain Headache Rep DOI 10.1007s11916-014-0260-4, Mar. 8, 2012, pp. 217-225. [cited by applicant]
Holsheimer, “Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy,” Spinal Cord Aug. 1998, 36: pp. 531-540. [cited by applicant]
Hubscher et al., “Convergence and cross talk in urogenital neural circuitries,” J. Neurophysiol 110: 1997-2005, first published Aug. 7, 2013, 9 pp. [cited by applicant]
Hunt et al. The molecular dynamics of pain control. Nat Rev Neurosci. Feb. 2001;2(2):83-91. [cited by applicant]
Jiang et al., “Hyperexcitability in Synaptic and Firing Activities of Spinal Motoneurons in an Adult Mouse Model of Amyotrophic Lateral Sclerosis,” Neuroscience, vol. 362, Oct. 24, 2017, pp. 33-46. [cited by applicant]
Kemler MD et al., “Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy,” N Engl J Med, Aug. 31, 2000; 343(9):pp. 618-624. [cited by applicant]
Kilgore PhD et al., “Reversible Nerve Conduction Block Using Kilohertz Frequency Alternating Current,” Neuromodulation. Aug. 2013, pp. 242-255. [cited by applicant]
Kumar et al., “Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome,” Pain Jul. 2007; 132(1-2): 179… [cited by applicant]
Likar et al., “High density spinal cord stimulation: a multi-center experience,” Abstracts, International Neuromodulation Society 12th World Congress; Jun. 11-15, 2015, 1 pp. [cited by applicant]
Maeda et al., “Increased c-fos immunoreactivity in the spinal cord and brain following spinal cord stimulation is frequency-dependent,” Brain Res. Mar. 9, 2009;1259: pp. 40-50, available online Jan. 6, 2009. [cited by applicant]
Maeda et al., “Low frequencies, but not high frequencies of bi-polar spinal cord stimulation reduce cutaneous and muscle hyperalgesia induced by nerve injury,” Pain; Feb. 2008; 138(1): pp. 143-152. [cited by applicant]
Maggi et al., “Effect of urethane anesthesia on the micturition reflex in capsaicin-treated rats.” Journal of the Autonomic Nervous System, Jan. 1990, 30(3): 247-251. [cited by applicant]
Matsuka et al., “Hyperosmolar Solutions Selectively Block Action Potentials in Rat Myelinated Sensory Fibers: Implications for Diabetic Neuropathy,” Journal of Neurophysiology, vol. 91, No. 1, Sep. 17, 2003, pp. 48-56. [cited by applicant]
Nicholls et al., “Reflexes, Fictive Respiration and Cell Division in the Brain and Spinal Cord of the Newborn Opossum, Monodelphis Domestica, Isolated and Maintained in Vitro,” Journal of Experimental Biology, vol. 152,… [cited by applicant]
North MD et al., “Clinical outcomes of 1 kHz subperception spinal cord stimulation (SCS): Results of a prospective randomized controlled crossover trial,” Abstracts, International Neuromodulation Society, Jun. 2015, 1 p… [cited by applicant]
North MD et al., “Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial,” Neurosurgery, Jan. 2005; 56(1): 98-106; discussion 106-107. [cited by applicant]
Nussbaumer et al., “Pharmacological properties of a C-Fibre Response Evoked by Saphenous Nerve Stimulation in an Isolated Spinal Cord-Nerve Preparation of the Newborn Rat,” British Journal of Pharmacology, vol. 98, No. … [cited by applicant]
Prosecution History from U.S. Appl. No. 17/085,621, dated May 12, 2022 through Oct. 5, 2023, 84 pp. [cited by applicant]
Ranck Jr. et al., “Which elements are excited in electrical stimulation of mammalian central nervous system: a review,” Brain Research, Nov. 21, 1975; 98(3): pp. 417-440. [cited by applicant]
Replogle MD. et al., “Case Series Comparing Moderate (1000 Hz) Versus Conventional Frequency Stimulation During Spinal Cord Stimulator Trials,” North American Neuromodulation Society. 2014, 1 pp. Applicant points out in… [cited by applicant]
Response to Extended Search Report dated Mar. 23, 2022, from counterpart European Application No. 21201439.3, filed Oct. 24, 2022, 5 pp. [cited by applicant]
Sato et al., “Spinal cord stimulation reduces hypersensitivity through activation of opioid receptors in a frequency-dependent manner,” Eur J Pain. Apr. 2013 (4): pp. 551-561, first published Oct. 5, 2012. [cited by applicant]
Schu MD, PhD. et al., “A prospective, randomised, double-blind, placebo-controlled study to examine the effectiveness of burst spinal cord stimulation patterns for the treatment of failed back surgery syndrome,” Neuromo… [cited by applicant]
Shechter MD et al., “Conventional and kilohertz-frequency spinal cord stimulation produces intensity- and frequency-dependent inhibition of mechnical hypersensitivity in a rat model of neuropathic pain,” Anesthesiology,… [cited by applicant]
Sluka, et al., “High-frequency, but not low-frequency, transcutaneous electrical nerve stimulation reduces aspartate and glutamate release in the spinal cord dorsal horn,” J Neurochem. Oct. 17, 2005; 95(6); pp. 1794-180… [cited by applicant]
Smith et al., “Successful use of high-frequency spinal cord stimulation following traditional treatment failure,” Stereotact Funct Neurosurg. Apr. 1, 2015; 93(3): pp. 190-193. [cited by applicant]
Snellings et al., “Effects of stimulation site and stimulation parameters on bladder inhibition by electrical nerve stimulation,” BJU International, Jul. 2012, pp. 136-143, first published Jan. 19, 2012. [cited by applicant]
Song MD Phd. et al., “Efficacy of kilohertz-frequency and conventional spinal cord stimulation in rat models of different pain conditions,” Neuromodulation Jan. 2014; 17(3): pp. 226-234. [cited by applicant]
Sweet MD et al., “High Frequency vs. Burst Stimulation Patterns for Dorsal Column Stimulation: The Importance of Charge,” American Association of Neurological Surgeons, Abstract, Apr. 4, 2014, 2 pp. [cited by applicant]
Walter et al., “Inhibiting the hyperreflexic bladder with electrical stimulation in a spinal animal model.” Neurourology and Urodynamics, 1993, 12:241-253. doi: 10.1002/nau.1930120306. Applicant points out in accordance… [cited by applicant]
Wille MD et al., “Altering Conventional to High Density Spinal Cord Stimulation: An Energy Dose-Response Relationship in Neuropathic Pain Therapy,” Neuromodulation 2016, Aug. 2016, 9 pp. [cited by applicant]
Woock et al., “Activation and inhibition of the micturition reflex by penile afferents in the cat,” Am J. Physiol Regul Intergre Comp Physiol, published Apr. 23, 2008, pp. R1880-R1889. [cited by applicant]
Youn et al., “The Effect of High Frequency Stimulation on Sensory Thresholds in Chronic Pain Patients,” North American Neuromodulation Society. 2014, 1 pp. Applicant points out in accordance with MPEP 609.04(a) that the… [cited by applicant]