High frequency electrostimulation treatment for restless legs syndrome or periodic limb movement disorder
Restless Leg Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) can be treated using high frequency (HF) electrostimulation. This can include selecting or receiving a subject presenting with RLS or PLMD. At least one electrostimulation electrode can be located at a location associated with at least one of, or at least one branch of, a sural nerve, a peroneal nerve, or a femoral nerve. HF electrostimulation can be delivered to the subject, which can include delivering subsensory, subthreshold, AC electrostimulation at a frequency that exceeds 500 Hz and is less than 15,000 Hz to the location to help reduce or alleviate the one or more symptoms associated with RLS or PLMD. A charge-balanced controlled-current HF electrostimulation waveform can be used.
1 . A method for performing neurostimulation therapy for a Restless Legs Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) patient, the method comprising:
determining a time period, during sleep, correlative to an increased likelihood of waking, the determining based on input data including at least one of patient position or movement data, a sensed heart rate, a respiration signal, sleep state information, or user input data;
activating electrostimulation or establishing or adjusting at least one electrostimulation signal parameter, upon the determining the increased likelihood of waking, the at least one electrostimulation signal parameter for treating one or more symptoms associated with RLS or PLMD using electrostimulation and controlled to stimulate n intensity subthreshold to the patient waking; and
delivering a high-frequency (HF) electrostimulation signal to a target location of the patient at a frequency between 500 Hz and 15,000 Hz using the at least one electrostimulation signal parameter.
2 . The method of claim 1 , comprising:
initiating a patient monitoring session, before the delivering the HF electrostimulation signal parameter, the patient monitoring session associated with a patient's sleeping or attempting to sleep;
wherein the determining the time period correlative to an increased likelihood of waking is based on input data collected during the patient monitoring session or within a specified time period following the delivering the HF electrostimulation signal.
3 . The method of claim 1 , wherein the establishing or adjusting the at least one electrostimulation signal parameter or determining the time period correlative to an increased likelihood of waking is based at least in part on historical data before or during previous RLS or PLMD therapy sessions corresponding with the patient.
4 . The method of claim 3 , wherein:
the historical data includes a user survey input ranking of efficacy received from the patient; and
the at least one electrostimulation signal parameter includes at least one of a start time, an intensity or a ramping duration of the electrostimulation signal.
5 . The method of claim 1 , comprising:
receiving patient leg movement data concurrently with the delivering the HF electrostimulation signal;
determining whether the patient is asleep and, based on the patient leg movement data, whether at least one RLS or PLMD symptom has decreased; and
ramping down energy of the HF electrostimulation signal toward ceasing electrostimulation based on determining that the patient is asleep and the symptom has decreased.
6 . The method of claim 5 , comprising:
monitoring, upon ramping down the energy of the HF electrostimulation signal, a patient leg movement; and
resuming delivery of the HF electrostimulation signal to the target location based on the monitored patient leg movement.
7 . The method of claim 1 , comprising determining whether a specified electrode-tissue impedance is present at the target location of the patient, the specified electrode-tissue impedance indicating an electrostimulation device is being worn by the patient in a manner suitable for delivering the HF electrostimulation signal.
8 . The method of claim 1 , wherein the at least one electrostimulation signal parameter is controlled to be perceived as subsensory by the patient.
9 . A system for performing neurostimulation therapy for a Restless Legs Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) patient, the system comprising:
a sensor circuit configured to determine a time period, during sleep, correlative to an increased likelihood of waking, the sensor circuit including at least one of a motion sensor, a sleep sensor configured to detect a sleep state, or a user input;
a controller circuit configured to initiate electrostimulation or establish or adjust at least one electrostimulation signal parameter, upon the determining the increased likelihood of waking, the at least one electrostimulation signal parameter for treating one or more symptoms associated with RLS or PLMD using electrostimulation and controlled to stimulate at an intensity subthreshold to the patient waking; and
a wearable device including an electrostimulation electronics unit including or coupled to first and second skin electrodes for delivering a high frequency (HF) electrostimulation signal to the patient at an external target body location, wherein the electrostimulation signal is delivered at a frequency of between 500 Hz and 15,000 Hz and at a current of between 5 mA and 40 mA.
10 . The system of claim 9 , wherein;
the controller circuit is configured to initiate an RLS or PLMD therapy session; and
the sensor circuit is configured to determine the time period correlative to an increased likelihood of waking based on input data collected prior to the RLS or PLMD therapy session and within a specified time frame following the initiating the therapy session.
11 . The system of claim 9 , wherein the controller circuit is configured to establish or adjust the at least one electrostimulation signal parameter or determining the time period correlative to an increased likelihood of waking is based at least in part on historical data before or during previous RLS or PLMD therapy sessions including at least one of previous timing, waveform, or efficacy data corresponding with the patient.
12 . The system of claim 11 , wherein:
the sensor circuit includes a user interface to receive historical data including a user survey input ranking of efficacy received from the patient; and
the controller circuit is configured to establish or adjust the at least one electrostimulation signal parameter including at least one of a start time, an intensity or a ramping duration of the electrostimulation signal.
13 . The system of claim 9 , wherein:
the sensor circuit includes the motion sensor for receiving leg movement data concurrently with the delivering the HF electrostimulation signal via the wearable device, wherein the sensor circuit is configured to determine whether at least one RLS or PLMD symptom has decreased based on the leg movement data; and
the controller circuit is configured to ramp down energy of the HF electrostimulation signal toward ceasing electrostimulation based on determining that the patient is asleep and the symptom has decreased.
14 . The system of claim 13 , wherein:
the sensor circuit is configured to monitor, upon ramping down the energy of the HF electrostimulation signal, a patient leg movement during the delivering the HF electrostimulation signal during a same therapy session; and
the controller circuit is configured to resume delivery of the HF electrostimulation signal to the target location based on the monitored patient leg movement.
15 . The system of claim 9 , wherein the sensor circuit includes impedance sensing circuitry configured to determine whether a specified electrode-tissue impedance is present at the target location of the patient, the specified electrode-tissue impedance indicating an electrostimulation device is being worn by the patient in a manner suitable for delivering the HF electrostimulation signal.
16 . The system of claim 9 , wherein the sensor circuit includes a heart rate variability (HRV)-based sensor.
17 . The system of claim 9 , wherein the sensor circuit includes an accelerometer.
18 . A method for performing neurostimulation therapy for a Restless Legs Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) patient, the method comprising:
determining a time period, during sleep, correlative to an increased likelihood of waking, the determining based on input data including at least one of patient position or movement data, a sensed heart rate, a respiration signal, sleep state information, or user input data;
activating electrostimulation or establishing or adjusting at least one electrostimulation signal parameter, upon the determining the increased likelihood of waking, the at least one electrostimulation signal parameter for treating one or more symptoms associated with RLS or PLMD using electrostimulation and controlled to stimulate at an intensity subthreshold to the patient waking; and
delivering a high-frequency (HF) electrostimulation signal to a target location of the patient at a frequency between 500 Hz and 15,000 Hz using the at least one electrostimulation signal parameter;
wherein the establishing or adjusting the at least one electrostimulation signal parameter or determining the time period correlative to an increased likelihood of waking is based at least in part on historical data including at least one of previous waveform or efficacy data corresponding with the patient.