Calibration of stimulation circuitry in an implantable stimulator device using sensed neural responses to stimulation
Methods and circuitry for calibrating stimulation circuitry in an implantable stimulator device (ISD) is disclosed. The ISD can sense neural response to the stimulation, and use an algorithm to assess those responses and determine a therapeutic window for a particular stimulation parameter, such as amplitude. Stimulation circuitry in the ISD is programmed with information indicative of the determined therapeutic window, such as by programming a minimum and/or maximum current amplitude. As well as restricting operation of the stimulation circuitry to within the therapeutic amplitude window, such programming calibrates the stimulation circuitry and allows an expanded range of, or all of, amplitude values supported by the stimulation circuitry to be used, which allows the amplitude to be incremented in smaller current increments.
1 . A method for calibrating stimulation circuitry using at least one first input to the stimulation circuitry, wherein the stimulation circuitry is in a stimulator device comprising a plurality of electrodes configured to contact a tissue of a patient, the method comprising:
using a second input of the stimulation circuitry to control an amplitude of stimulation at a selected one or more of the plurality of electrodes;
using control circuitry of the stimulator device to measure a neural response to the stimulation;
determining information indicative of a window of amplitudes from the measured neural response; and
programming the stimulation circuitry at the at least one first input with the information to calibrate the amplitude of the stimulation at the selected one or more of the plurality of electrodes to within the window of amplitudes.
2 . The method of claim 1 , wherein determining the information indicative of the window of amplitudes from the measured neural response comprises:
determining one or more neural response features for the measured neural response; and
determining the information indicative of the window of amplitudes from the one or more neural response features.
3 . The method of claim 2 , wherein the one or more neural response features comprises a feature indicative of the size or shape of the measured neural response.
4 . The method of claim 2 , wherein the one or more neural response features comprises a neural response amplitude.
5 . The method of claim 2 , wherein the one or more neural response features comprises an Extracted Neural Threshold (ENT), wherein the ENT comprises a lowest amplitude of the stimulation provided at the selected one or more of the plurality of electrodes at which a neural response is detected.
6 . The method of claim 1 , wherein the information indicative of the window of amplitudes comprises a minimum amplitude and a maximum amplitude of the stimulation.
7 . The method of claim 1 , wherein the information indicative of the window of amplitudes comprises information from which a minimum amplitude and a maximum amplitude of the stimulation is ascertained.
8 . The method of claim 1 , wherein the second input comprises an amplitude bus configured to carry a plurality of amplitude values to control the amplitude of the stimulation.
9 . The method of claim 8 , wherein the window of amplitudes comprises a minimum amplitude and a maximum amplitude, and wherein all of the plurality of amplitude values are used to set the stimulation at the selected one or more of the plurality of electrodes to within the window of amplitudes.
10 . The method of claim 1 , wherein the stimulation circuitry is capable of producing a range of amplitudes of the stimulation, and wherein the window of amplitudes is within and smaller than the range of amplitudes.
11 . The method of claim 1 , comprising measuring the neural response at one or more of the electrodes different from the selected one or more of the plurality of electrodes that provide the stimulation.
12 . The method of claim 1 , wherein the stimulator device comprises a spinal cord stimulator.
13 . The method of claim 1 , wherein the neural response comprises an Evoked Compound Action Potential (ECAP).
14 . The method of claim 1 , comprising performing the method is periodically.
15 . The method of claim 1 , comprising performing the method is periodically within the stimulator device.
16 . A system, comprising:
a stimulator device comprising:
a plurality of electrodes configured to contact a tissue of a patient;
stimulation circuitry comprising at least one first input and a second input, wherein the stimulation circuitry is configured via the second input to control an amplitude of stimulation provided at a selected one or more of the plurality of electrodes;
control circuitry configured to:
measure a neural response to the stimulation,
determine information indicative of a window of amplitudes from the measured neural response, and
program the stimulation circuitry at the at least one first input with the information to calibrate the amplitude of the stimulation at the selected one or more of the plurality of electrodes to within the window of amplitudes.
17 . The system of claim 16 , wherein the information indicative of the window of amplitudes comprises a minimum amplitude and a maximum amplitude of the stimulation, or wherein the information indicative of the window of amplitudes comprises information from which a minimum amplitude and a maximum amplitude of the stimulation is ascertained.
18 . The system of claim 16 , wherein the stimulation circuitry is capable of producing a range of amplitudes of the stimulation, and wherein the window of amplitudes is within and smaller than the range of amplitudes.
19 . A system, comprising:
a stimulator device comprising:
a plurality of electrodes configured to contact a tissue of a patient;
stimulation circuitry comprising at least one first input and a second input, wherein the stimulation circuitry is configured to control an amplitude of stimulation provided at a selected one or more of the plurality of electrodes;
control circuitry configured to:
measure a neural response to the stimulation,
an external system in communication with the stimulator device, wherein the external system is configured to
receive the neural response from the stimulator device,
determine information indicative of a window of amplitudes from the received measured neural response, and
transmit the information indicative of the window of amplitudes to the stimulator device,
wherein the control circuitry is configured to
program the stimulation circuitry at the at least one first input with the information to calibrate the amplitude of the stimulation at the selected one or more of the plurality of electrodes to within the window of amplitudes.