CN107613861B - 运动纤维神经调节 - Google Patents

运动纤维神经调节 Download PDF

Info

Publication number
CN107613861B
CN107613861B CN201680030927.7A CN201680030927A CN107613861B CN 107613861 B CN107613861 B CN 107613861B CN 201680030927 A CN201680030927 A CN 201680030927A CN 107613861 B CN107613861 B CN 107613861B
Authority
CN
China
Prior art keywords
stimulation
neural
response
muscle
computing device
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201680030927.7A
Other languages
English (en)
Other versions
CN107613861A (zh
Inventor
约翰·路易斯·帕克
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Closed Loop Medical Pty Ltd
Original Assignee
Closed Loop Medical Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2015902393A external-priority patent/AU2015902393A0/en
Application filed by Closed Loop Medical Pty Ltd filed Critical Closed Loop Medical Pty Ltd
Publication of CN107613861A publication Critical patent/CN107613861A/zh
Application granted granted Critical
Publication of CN107613861B publication Critical patent/CN107613861B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1104—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb induced by stimuli or drugs
    • A61B5/1106—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb induced by stimuli or drugs to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4519—Muscles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/20—Applying electric currents by contact electrodes continuous direct currents
    • A61N1/205—Applying electric currents by contact electrodes continuous direct currents for promoting a biological process
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36057—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for stimulating afferent nerves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128—Control systems
    • A61N1/36135—Control systems using physiological parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128—Control systems
    • A61N1/36146—Control systems specified by the stimulation parameters
    • A61N1/3615—Intensity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/20—Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
    • A61B5/202—Assessing bladder functions, e.g. incontinence assessment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4041—Evaluating nerves condition
    • A61B5/4052—Evaluating nerves condition efferent nerves, i.e. nerves that relay impulses from the central nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/4238—Evaluating particular parts, e.g. particular organs stomach
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/4255—Intestines, colon or appendix
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
    • A61B5/4566—Evaluating the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A61B5/4893—Nerves

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Neurosurgery (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physiology (AREA)
  • Rheumatology (AREA)
  • Anesthesiology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Medicinal Chemistry (AREA)
  • Chemical & Material Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Electrotherapy Devices (AREA)

Abstract

评估肌肉对神经刺激的运动反应。将电刺激从第一电极施加到所选定的神经通路以诱发传出神经反应。在所述神经通路由所述电刺激诱发时观察缓慢神经反应。基于所述缓慢神经反应，评估至少一块肌肉对所述刺激的运动反应。

Description

运动纤维神经调节
相关申请的交叉引用
本申请要求于2015年6月1日提交的澳大利亚临时专利申请号2015902393的权益，所述临时专利申请通过引用结合在此。
技术领域
本发明涉及递送至运动纤维的神经调节，并且具体地涉及一种用于通过神经反应测量来评估运动纤维和肌肉募集的方法和设备。
背景技术
存在许多期望施加神经刺激以便引起复合动作电位(CAP)的情境。神经调节系统向组织施加电脉冲以便产生治疗效果。这种系统通常包括植入式电脉冲发生器以及如电池等可通过经皮感应传输进行再充电的电源。电极阵列连接至脉冲发生器并且被定位在(多条)靶神经通路附近。由电极施加到神经通路的电脉冲引起神经元的去极化以及传播动作电位的生成。在几乎所有神经调节应用中，虽然期望单一类别的纤维反应，但是所采用的刺激波形可能在其他类别的纤维上募集可能引起不想要的副作用的动作电位。
所有类型的神经调解系统面临的另一个控制问题是以治疗效果所需的充足电平但以最小的能量消耗实现神经募集。刺激范式的电力消耗对电池要求有直接影响，其进而影响设备的物理尺寸和生存期。对于可再充电系统，增加的电力消耗导致更频繁的充电，并且假设电池仅允许有限数量的充电周期，则这最终减小设备的植入生存期。
可以应用神经调节来激活所选定的肌肉群。这种神经调节的一个示例是骶神经刺激，其中，刺激频率通常较低(＜20Hz)，并且电流通常相当高(高达7mA)。在不旨在受限于理论的情况下，通常认为骶神经刺激通过骶神经中的传入和传出纤维来引起对膀胱的逼尿肌的反射抑制效果。在植入骶神经神经调节器之后，调整当前刺激系统中的刺激振幅和频率是试错程序。将所述刺激幅值调高，直到运动反应被记录或者患者告知程序员感觉异常已产生为止。然后将所述振幅降至感知阈值以下并设定到那个水平，但是降低多少足以避免不期望的运动反应或感觉异常同时仍保持适当的治疗效果是不知道的。
本说明书中已包括的文件、行为、材料、设备、物品等的任何讨论仅用于为本发明提供上下文的目的。不能由于它在本申请的各项权利要求的优先日期之前就存在，而承认任何或所有这些事项形成现有技术基础的一个部分，或在与本发明相关的领域中是一般常识。
贯穿本说明书，“包括(comprise)”一词或变化形式(例如“包括了(comprises)”或“包括着(comprising)”)应被理解为意指包括所陈述的要素、整体或步骤，或者多个要素、整体或步骤的群组，但不排除任何其他要素、整体或步骤，或者多个要素、整体或步骤的群组。
在本说明书中，要素可以是选项列表中的“至少一个”的陈述应被理解为所述要素可以是所列出的选项中的任意一项，或者可以是所列出的选项中的一项或多项的任何组合。
发明概述
根据第一方面，本发明提供了一种评估对神经刺激的运动反应的方法，所述方法包括：
将电刺激从第一电极施加到所选定的神经通路以诱发传出神经反应；
在所述神经通路由所述电刺激诱发时测量缓慢神经反应；
基于所述缓慢神经反应，评估至少一块肌肉对所述刺激的运动反应。
根据第二方面，本发明提供一种神经刺激器设备，所述神经刺激器设备包括：
至少一个刺激电极，被配置成定位在神经通路附近并且用于将电刺激施加到所述神经通路以诱发传出神经反应；
至少一个感测电极，被配置成定位在所述神经通路附近并且用于在所述神经通路由所述电刺激诱发时测量缓慢神经反应；以及
处理器，用于基于所述缓慢神经反应来评估至少一块肌肉对所述刺激的运动反应。
本发明进一步提供计算机软件、或者一种包括计算机程序代码装置的计算机程序产品、或者一种非暂时计算机可读介质、或者一种在所述软件或产品的控制下进行操作的计算设备，所述计算设备被配置用于将电刺激从第一电极施加到所选择的神经通路以诱发传出神经反应，进一步被配置用于在所述神经通路由所述电刺激诱发时测量缓慢神经反应，并且进一步被配置用于基于所述缓慢神经反应来评估至少一块肌肉对所述刺激的运动反应。
本发明的一些实施例可以在手术中应用，以便使用观察到的缓慢反应来定位所述神经并且最佳地定位(多个)电极。
本发明的一些实施例可以进一步包括：在足以使相关联肌肉纤维群的一个募集部分疲劳的时间段上施加处于第一水平上的刺激，并且然后施加处于已增加水平上的刺激以便募集并评估所述肌肉纤维群的另一部分。这类实施例可以进一步包括：在各种刺激水平上使所述肌肉纤维疲劳，以便探索所述肌肉纤维群的每一部分的募集特征。
一些实施例可以进一步包括：评估所述缓慢反应的模式或形态，以便判定哪些肌肉群是由所述刺激募集的。
优选实施例进一步测量对所述刺激的快速神经反应。所述快速反应可以被定义为在刺激后的0ms至2ms或0ms至2.5ms的时间段内所观察到的神经反应。在一些实施例中，所述缓慢反应可以包括在刺激后的2ms至15ms或者在刺激后的2.5ms至8ms的时间段期间所观察到的神经反应。
在一些实施例中，施加所述刺激以便优先诱发运动反应，无论是刺激运动活动还是抑制运动活动。因此，应当认识到的是，由本发明评估的所述至少一块肌肉对所述刺激的运动反应可以包括肌肉反应的增加或开始或者肌肉反应的减少或不存在中的任一者或两者。
需注意的是，肌肉纤维或群可以由多个神经支配，并且“神经通路”在本文中被定义为涵盖这类情况。具体地，在一些实施例中，所诱发的传出神经反应可能在支配肌肉的一个神经上产生，而可能在与同一块肌肉相关联并携带从所述肌肉返回的迟发反应的另一神经上观察到所述迟发反应。例如，可以将刺激施加到身体的第一侧的神经通路，并且可以在身体的对侧第二侧的神经通路上观察所述迟发反应。
在一些实施例中，所述神经通路包括骶神经。所述肌肉可以包括逼尿肌。
在一些实施例中，所述神经通路用于胃起搏，并且所述肌肉包括胃肌肉。
在一些实施例中，所述神经通路用于功能性电刺激(functional electricalstimulation，FES)。
在一些实施例中，所述神经通路用于多裂肌起搏，并且所述肌肉包括多裂肌。
附图简要说明
现在将参照以下附图对本发明的实例进行描述，在附图中：
图1示意性地展示了植入式骶神经刺激器；
图2是植入式神经刺激器的框图；
图3是示意图，展示了植入式刺激器与神经的交互；
图4展示了健康受试者的电诱发复合动作电位(ECAP)的典型形式；
图5示出了从绵羊脊髓获得的快速反应和缓慢反应；
图6是由刺激引起的快速反应和缓慢反应的曲线图；
图7示出了缓慢反应振幅中的疲劳；
图8示出了缓慢反应在肌肉纤维群的不同部分中具有不同形态；
图9展示了神经纤维束中的神经束分布；并且
图10示出了用于膀胱控制的骶神经刺激的解剖结构。
具体实施方式
图1示意性地展示了植入式骶神经刺激器100。刺激器100包括：电子器件模块110，所述电子器件模块植入在患者的下腹部区域或后臀上部区域中的合适位置处；以及电极组件150，所述电极组件植入在骶骨内并通过适合的引线连接至模块110。植入式神经设备100的操作的许多方面可由外部控制设备192重新配置。此外，植入式神经设备100充当数据收集角色，其中，收集的数据被传送到外部设备192。
图2是植入式神经刺激器100的框图。模块110包含电池112和遥测模块114。在本发明的实施例中，遥测模块114可以使用任何适当类型的经皮通信190(比如，红外(IR)传输、电磁传输、电容性传输和感应传输)来在外部设备192与电子设备模块110之间传输电力和/或数据。
模块控制器116具有存储患者设置120、控制程序122等的相关联存储器118。控制器116根据患者设置120和控制程序122控制脉冲发生器124以便生成电流脉冲形式的刺激。电极选择模块126将所生成的脉冲切换到电极阵列150的(多个)适当电极，以便将电流脉冲递送至(多个)所选电极周围的组织。其他电极阵列也可以被提供并且可以类似地由电极选择模块126来寻址，例如，如以下在图5和图6的情况下进一步讨论的。测量电路系统128被配置用于捕获在电极阵列的如由电极选择模块126选择的(多个)感测电极处感测到的神经反应的测量结果。
图3是示意图，展示了植入式刺激器100与神经180的交互，然而，在这种情况下，骶神经替代性实施例可以定位在任何期望神经组织(包括外围神经、内脏神经、副交感神经或大脑结构)附近。电极选择模块126选择电极阵列150的刺激电极2以便向包括神经180的周围组织递送电流脉冲，并且还选择阵列150的返回电极4以便进行刺激电流恢复从而维持零净电荷转移。
向神经180递送适当刺激诱发神经反应，所述神经反应包括将如所展示的为了治疗目的而沿着神经180进行传播的复合动作电位，在骶神经刺激器的情况下，所述复合动作电位可能用于刺激逼尿肌的期望肌肉纤维的运动功能。为此，刺激电极用于以<20Hz的频率递送刺激。
设备100进一步被配置用于感测沿着神经180传播的复合动作电位(CAP)的存在和强度，无论这种CAP是由来自电极2和4的刺激诱发还是以其他方式诱发。为此，电极选择模块126可以选择阵列150的任何电极充当测量电极6和测量参考电极8。测量电极6和8感测到的信号被传递到测量电路系统128，所述测量电路系统例如可以根据本申请人的国际专利申请公开号WO2012155183的教导运行，所述专利申请的内容通过引用结合在此。
图4展示了健康受试者的电诱发复合动作电位(ECAP)的典型形式。图4中示出的复合动作电位的形状和持续时间是可预测的，这是因为其是由响应于刺激而生成动作电位的全体轴突产生的离子电流的结果。在大量纤维当中生成的动作电位合计起来形成复合动作电位(CAP)。CAP是由大量单一纤维动作电位引起的反应之和。所记录的CAP是大量不同纤维去极化的结果。动作电位在每个纤维上的传播速度在很大程度上由所述纤维的直径决定。由一组类似纤维的激动产生的CAP被测量为正峰电位P1，然后是负峰N1，随后是第二正峰P2。这由在动作电位沿着单独纤维传播时经过记录电极的激活的区域引起。观察到的电诱发CAP信号通常将具有在微伏范围内的最大振幅以及2ms至3ms的持续时间。
CAP曲线采取典型形式并且可由任何适当的(多个)参数(图4中指示了其中一些参数)表征。根据记录的极性，正常记录曲线可以采取图4中示出的形式的相反形式，即，具有两个负峰N1和N2以及一个正峰P1。
本实施例认识到，在骶神经180上测量到的神经反应不仅提供图4中所示的信息，而且还在稍后时间揭示关于诱发运动反应的信息。也就是说，来自骶神经的ECAP记录展示了快速反应和缓慢反应两者。所述快速反应如图4所示，并且是对神经束中的大直径Aβ纤维进行刺激的结果。所述缓慢反应在递送刺激之后大约2.5ms至7ms的时间帧内发生，并且在不旨在受限于理论的情况下被认为是由于通过直接刺激运动纤维或者通过激活脊髓反射弧对肌肉群进行的激活。缓慢反应与上述理论一致，即骶神经调节激活可能为逼尿肌的肌肉。本发明认识到，进一步可能的是从缓慢反应的模式来判定哪些肌肉群被募集。
为此，已经从绵羊脊髓实验地测量到缓慢反应，并且已经注意到，取决于反应的起源，所观察到的反应存在差异。图5示出了来自绵羊脊髓的快速510传播神经反应和缓慢520传播神经反应两者。图5中的X射线图示出了电极的位置，并且动物图示出了由来自那些皮区中的每个皮区的纤维所支配的皮区。
图6是由在阵列顶部进行刺激产生的ECAP(快速反应)和缓慢反应的曲线图。在这种情况下，三条电极引线用于进行刺激和测量。在图6的x射线中，顶部的两条电极引线被放置在法线方向上(在头端方向上插入)，而底部电极引线被放置在逆行方向上。所述刺激是在T13处，并且因此底部电极引线测量正在被刺激的皮区后部(尾部)的反应。这在记录中被观察为反应630相对于记录610和620的极性反转。也就是说，从电极E13至E16获得的记录示出了正振幅，而进一步来自脊髓顶部的反应610和620示出了负反应。
这展示了缓慢反应的符号和形状，即图6中在3ms至5ms范围内的这些峰值，可以用于标识对刺激做出响应的肌肉群的位置。可以以多种不同的方式来分析信号，以便提取关于激活强度和源的信息。
这在寻求影响肌肉群以实现特异性(即选择靶向群并且仅选择那个群)的所有神经调节应用中是非常希望的。在骶神经刺激的情况下，根据理论，这是逼尿肌。需注意，即使当前理论是不正确的，它也将适用于其他肌肉群，例如盆底肌。
本实施例进一步通过增大刺激电流的振幅、分析缓慢反应并标识其所产生的缓慢反应模式来提供对适当肌肉群的标识。在此上下文中，应当理解，缓慢反应允许理解从神经测量中的迟发反应得出的肌肉纤维激活，从而提供与肌电图(EMG)类似的信息。
由本实施例在对适当肌肉群进行标识时利用的另一特性是：重复的肌肉纤维刺激引起肌肉疲劳以及缓慢反应信号丢失。在此方面，图7示出了缓慢反应和快速反应两者(左图)的振幅以及右图上的两个非刺激性通道的反应。在此实验中，振幅增加，并且然后保持在9mA下长达两分钟。如在右图中可见的，当肌肉在两分钟时间段期间发生疲劳时，将反应的振幅下降到零。因此，可以以固定振幅利用重复刺激使单独的肌肉群发生疲劳。如果刺激振幅(或图7中的“触发”)从该点进一步增加，则募集附加的肌肉纤维，并且如图7所示，当振幅增加超过9mA处的第一疲劳点和在11mA处的第二疲劳点时，即使来自已经疲劳的那些肌肉纤维的反应不再是可观察到的，也诱发新的反应。在图8中，需注意，缓慢反应具有不同的形态，从而表明一些纤维源自于替代性肌肉群位置。
通过测量刺激部位处或附近的神经反应来标识与肌肉群激活相关联的缓慢反应模式是在下一电流步骤之前，随着时间推移用增大的振幅来进行刺激并在每个选定的电流处等待直到在此刺激水平上募集的肌肉群已经疲劳为止的问题。肌肉群激活的刺激位置感知或其他测量可能与所述反应相关。在逼尿肌的情况下，这例如可以通过使用测量膀胱压力的导管来容易地检测和相关。膀胱倾向于最初用快速收缩，随后是缓慢、持久的放松来对神经刺激做出反应。由于快速收缩将仅在刺激已达到激活逼尿肌的适当水平时发生，因此可以通过用导管测量压力变化来确定从神经观察得出的缓慢反应。以这种方式，可以通过将观察到的缓慢反应与导管压力结果进行比较来确定那个肌肉群的缓慢反应的靶模式。
用于过滤所述反应的上述阶梯技术可以用于确定来自独立肌肉群的反应。然后可以将来自所有纤维的贡献与在刺激振幅增大时获得的反应之和进行比较。
这种技术具有用于包括脊神经根的任何神经结构的效用。当考虑神经束的结构时，可以进一步进行细化。如图9所示，神经束中的单独神经束弯曲通过所述束的长度，并且因此特定神经束对刺激的敏感度将根据沿着纤维长度的位置而改变。上述技术可以用于确定期望靶向的肌肉群的特征，并且然后选择电极和或位置以便最佳地募集那个纤维群。
诱发反应的连续测量可以在骶神经刺激中用作反馈靶，由此所述刺激应当被设置用于在已使肌肉疲劳之后实现不存在缓慢反应或较小的缓慢反应。存在多种方法来实现这一点。可以调节刺激速率，并且反馈算法可用于控制内部刺激间隔，从而使得不产生反应。这是通过对所述反应进行刺激和测量来实现的，并且如果存在缓慢反应，则缩短时间直到下一个刺激为止。在一个长得多的时间尺度上，可以进行刺激之间的时间递增，这样使得反应开始出现，并且以这种方式实现最佳刺激速率。该此过程可以在编程时、或者由植入物实时连续地完成。
参考图10，神经的位置可以在特别是针对膀胱控制、膀胱充盈的治疗过程期间发生变化，内脏或患者将移动骶骨孔内的神经，并且因此刺激的功效将在神经相对于电极进行移动时发生变化。
快速反应510由Aβ纤维产生，并且在以与来自肌肉群的反应相同的方式进行刺激时不发生疲劳。Aβ反应510也根据反应纤维与电极的距离而随着振幅发生变化。因此，可以基于Aβ反应的振幅对最佳运动纤维募集进行刺激电流调节，以便说明神经的运动。
刺激电流的这种变化可以用于确定膀胱的状态(充盈或排空)，并且对刺激进行进一步修改以便说明这一点。
本领域技术人员应理解，在不偏离广泛描述的本发明的精神或范围的情况下，可以对如具体实施例所示的发明做出众多的变化和/或修改。因此，本发明实施例将在所有方面被视为是说明性而非限制性或约束性的。

Claims (26)

1.一种非暂时性计算机可读介质，其上存储有计算机程序代码，当所述计算机程序代码由计算设备执行时使所述计算设备执行以下操作：
将电刺激从第一电极施加到所选定的神经通路以诱发传出神经反应；
在所述神经通路由所述电刺激诱发时测量缓慢神经反应；以及
基于所述缓慢神经反应，评估至少一块肌肉对所述电刺激的运动反应，其中所述评估包括评估所述缓慢神经反应的模式或形态，以确定哪些肌肉群正被所述电刺激募集。
2.如权利要求1所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：使用所测量的缓慢神经反应来定位所述神经通路并且最佳地定位电极。
3.如权利要求1所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：在足以使相关联肌肉纤维群的一个募集部分疲劳的时间段上施加处于第一水平上的刺激，并且然后施加处于已增加水平上的刺激以便募集并评估所述肌肉纤维群的另一部分。
4.如权利要求2所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：在足以使相关联肌肉纤维群的一个募集部分疲劳的时间段上施加处于第一水平上的刺激，并且然后施加处于已增加水平上的刺激以便募集并评估所述肌肉纤维群的另一部分。
5.如权利要求3所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：在各种刺激水平上使所述肌肉纤维群疲劳，以便探索所述肌肉纤维群的每一部分的募集特征。
6.如权利要求4所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：在各种刺激水平上使所述肌肉纤维群疲劳，以便探索所述肌肉纤维群的每一部分的募集特征。
7. 如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：测量对所述电刺激的快速神经反应，所述快速神经反应是在刺激之后的0 ms至2.5 ms的时间段内所观察到的神经反应。
8. 如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，所述缓慢神经反应包括在刺激之后的2 ms至15 ms的时间段期间所观察到的神经反应。
9.如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，当所述计算机程序代码由所述计算设备执行时还使所述计算设备执行以下操作：施加所述电刺激以便优先诱发运动反应，从而刺激运动活动或者抑制运动活动。
10.如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，所述神经通路包括骶神经。
11.如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，所述神经通路用于胃起搏。
12.如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，所述神经通路用于功能性电刺激（FES）。
13.如权利要求1至6中任一项所述的非暂时性计算机可读介质，其中，所述神经通路用于多裂肌起搏。
14.一种神经刺激器设备，包括：
至少一个刺激电极，被配置成定位在神经通路附近并且用于将电刺激施加到所述神经通路以诱发传出神经反应；
至少一个感测电极，被配置成定位在所述神经通路附近并且用于在所述神经通路由所述电刺激诱发时测量缓慢神经反应；以及
处理器，用于基于所述缓慢神经反应来评估至少一块肌肉对所述电刺激的运动反应，其中所述处理器还被配置成评估所述缓慢神经反应的模式或形态，以确定哪些肌肉群正被所述电刺激募集。
15.如权利要求14所述的神经刺激器设备，其中，所述处理器还被配置成使用所测量的缓慢神经反应来定位所述神经通路并且最佳地定位所述电刺激。
16.如权利要求14所述的神经刺激器设备，其中，所述处理器还被配置成在足以使相关联肌肉纤维群的一个募集部分疲劳的时间段上施加处于第一水平上的刺激，并且然后施加处于已增加水平上的刺激以便募集并评估所述肌肉纤维群的另一部分。
17.如权利要求15所述的神经刺激器设备，其中，所述处理器还被配置成在足以使相关联肌肉纤维群的一个募集部分疲劳的时间段上施加处于第一水平上的刺激，并且然后施加处于已增加水平上的刺激以便募集并评估所述肌肉纤维群的另一部分。
18.如权利要求16所述的神经刺激器设备，其中，所述处理器还被配置成在各种刺激水平上使所述肌肉纤维群疲劳，以便探索所述肌肉纤维群的每一部分的募集特征。
19.如权利要求17所述的神经刺激器设备，其中，所述处理器还被配置成在各种刺激水平上使所述肌肉纤维群疲劳，以便探索所述肌肉纤维群的每一部分的募集特征。
20. 如权利要求14至19中任一项所述的神经刺激器设备，其中，所述处理器还被配置成测量对所述电刺激的快速神经反应，所述快速神经反应是在刺激之后的0 ms至2.5 ms的时间段内所观察到的神经反应。
21. 如权利要求14至19中任一项所述的神经刺激器设备，其中，所述缓慢神经反应包括在刺激之后的2 ms至15 ms的时间段期间所观察到的神经反应。
22.如权利要求14至19中任一项所述的神经刺激器设备，其中，所述处理器还被配置成施加所述电刺激以便优先诱发运动反应，从而刺激运动活动或者抑制运动活动。
23.如权利要求14至19中任一项所述的神经刺激器设备，其中，所述神经通路包括骶神经。
24.如权利要求14至19中任一项所述的神经刺激器设备，其中，所述神经通路用于胃起搏。
25.如权利要求14至19中任一项所述的神经刺激器设备，其中，所述神经通路用于功能性电刺激（FES）。
26.如权利要求14至19中任一项所述的神经刺激器设备，其中，所述神经通路用于多裂肌起搏。
CN201680030927.7A 2015-06-01 2016-06-01 运动纤维神经调节 Active CN107613861B (zh)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
AU2015902393 2015-06-01
AU2015902393A AU2015902393A0 (en) 2015-06-01 Motor Fibre Neuromodulation
PCT/AU2016/050439 WO2016191815A1 (en) 2015-06-01 2016-06-01 Motor fibre neuromodulation

Publications (2)

Publication Number Publication Date
CN107613861A CN107613861A (zh) 2018-01-19
CN107613861B true CN107613861B (zh) 2021-10-26

Family

ID=57439743

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201680030927.7A Active CN107613861B (zh) 2015-06-01 2016-06-01 运动纤维神经调节

Country Status (7)

Country Link
US (1) US11006857B2 (zh)
EP (1) EP3261533A4 (zh)
JP (1) JP7204325B2 (zh)
CN (1) CN107613861B (zh)
AU (1) AU2016269843B2 (zh)
CA (1) CA2980482C (zh)
WO (1) WO2016191815A1 (zh)

Families Citing this family (49)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9265431B2 (en) 2010-06-18 2016-02-23 Cardiac Pacemakers, Inc. Methods and apparatus for controlling neurostimulation using evoked physiologic events
US9872990B2 (en) 2011-05-13 2018-01-23 Saluda Medical Pty Limited Method and apparatus for application of a neural stimulus
WO2012155189A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for estimating neural recruitment - f
CA2835486C (en) 2011-05-13 2022-07-19 Saluda Medical Pty Limited Method and apparatus for measurement of neural response - a
WO2012155185A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for measurement of neural response
WO2012155184A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for measurement of neural response - c
EP2908904B1 (en) 2012-11-06 2020-09-23 Saluda Medical Pty Limited System for controlling electrical conditions of tissue
US9895539B1 (en) 2013-06-10 2018-02-20 Nevro Corp. Methods and systems for disease treatment using electrical stimulation
US11172864B2 (en) 2013-11-15 2021-11-16 Closed Loop Medical Pty Ltd Monitoring brain neural potentials
JP6671021B2 (ja) 2013-11-22 2020-03-25 サルーダ・メディカル・ピーティーワイ・リミテッド 神経測定において神経反応を検出するための方法およびデバイス
ES2801348T3 (es) 2014-05-05 2021-01-11 Saluda Medical Pty Ltd Medición neurológica mejorada
EP3838331B1 (en) 2014-07-25 2024-05-22 Saluda Medical Pty Limited Neural stimulation dosing
AU2015349614B2 (en) 2014-11-17 2020-10-22 Saluda Medical Pty Ltd Method and device for detecting a neural response in neural measurements
EP4285985A3 (en) 2014-12-11 2024-01-17 Saluda Medical Pty Ltd Method and device for feedback control of neural stimulation
WO2016090420A1 (en) 2014-12-11 2016-06-16 Saluda Medical Pty Ltd Implantable electrode positioning
WO2016115596A1 (en) 2015-01-19 2016-07-28 Saluda Medical Pty Ltd Method and device for neural implant communication
AU2016245335B2 (en) 2015-04-09 2020-11-19 Saluda Medical Pty Ltd Electrode to nerve distance estimation
EP3302692B1 (en) 2015-05-31 2024-07-24 Closed Loop Medical Pty Ltd Brain neurostimulator electrode fitting
JP2018516150A (ja) 2015-05-31 2018-06-21 サルーダ・メディカル・ピーティーワイ・リミテッド 脳神経活動の監視
CA2980482C (en) 2015-06-01 2023-09-26 Saluda Medical Pty Ltd Motor fibre neuromodulation
CA3019701A1 (en) 2016-04-05 2017-10-12 Saluda Medical Pty Ltd Improved feedback control of neuromodulation
US10406368B2 (en) 2016-04-19 2019-09-10 Boston Scientific Neuromodulation Corporation Pulse generator system for promoting desynchronized firing of recruited neural populations
EP3474747A4 (en) 2016-06-24 2020-01-22 Saluda Medical Pty Ltd NERVOUS STIMULATION FOR REDUCED ARTIFACT
US11123555B2 (en) 2017-04-21 2021-09-21 Medtronic, Inc. Lead placement for nerve stimulation
US11612751B2 (en) 2017-08-11 2023-03-28 Boston Scientific Neuromodulation Corporation Stimulation configuration variation to control evoked temporal patterns
US10933242B2 (en) * 2017-09-29 2021-03-02 Medtronic, Inc. Therapy parameter selection based on ECAP feedback
EP3691744B1 (en) 2017-10-04 2021-07-28 Boston Scientific Neuromodulation Corporation Adjustment of stimulation in a stimulator using detected evoked compound action potentials
CA3087693C (en) 2018-01-08 2022-11-08 Boston Scientific Neuromodulation Corporation Automatic adjustment of sub-perception therapy in an implantable stimulator using detected compound action potentials
US20190275331A1 (en) 2018-03-12 2019-09-12 Boston Scientific Neuromodulation Corporation Neural Stimulation with Decomposition of Evoked Compound Action Potentials
US10974042B2 (en) 2018-03-26 2021-04-13 Boston Scientific Neuromodulation Corporation System and methods for heart rate and electrocardiogram extraction from a spinal cord stimulation system
US11040202B2 (en) 2018-03-30 2021-06-22 Boston Scientific Neuromodulation Corporation Circuitry to assist with neural sensing in an implantable stimulator device
CN112334184A (zh) * 2018-04-27 2021-02-05 萨鲁达医疗有限公司 混合神经的神经刺激
WO2019231796A1 (en) 2018-06-01 2019-12-05 Boston Scientific Neuromodulation Corporation Artifact reduction in a sensed neural response
EP3810261A1 (en) 2018-06-21 2021-04-28 Medtronic, Inc. Ecap based control of electrical stimulation therapy
JP7387650B2 (ja) 2018-06-21 2023-11-28 メドトロニック，インコーポレイテッド 電気刺激療法のｅｃａｐによる制御
EP3873335A4 (en) * 2018-11-02 2022-07-27 Saluda Medical Pty Ltd CHARACTERIZATION OF THERAPEUTIC EFFECTIVENESS OF NEUROSTIMULATION
AU2020256033B2 (en) 2019-03-29 2022-11-24 Boston Scientific Neuromodulation Corporation Neural sensing in an implantable stimulator device during the provision of active stimulation
WO2020205234A1 (en) 2019-03-29 2020-10-08 Boston Scientific Neuromodulation Corporation Circuitry to assist with neural sensing in an implantable stimulator device in the presence of stimulation artifacts
WO2020243096A1 (en) 2019-05-30 2020-12-03 Boston Scientific Neuromodulation Corporation Methods and systems for discrete measurement of electrical characteristics
EP3986539A1 (en) 2019-06-20 2022-04-27 Boston Scientific Neuromodulation Corporation Methods and systems for interleaving waveforms for electrical stimulation and measurement
US12053632B2 (en) 2019-07-26 2024-08-06 Boston Scientific Neuromodulation Corporation Methods and systems for making electrical stimulation adjustments based on patient-specific factors
US11931582B2 (en) 2019-10-25 2024-03-19 Medtronic, Inc. Managing transient overstimulation based on ECAPs
US11547855B2 (en) 2019-10-25 2023-01-10 Medtronic, Inc. ECAP sensing for high frequency neurostimulation
US11857793B2 (en) 2020-06-10 2024-01-02 Medtronic, Inc. Managing storage of sensed information
US12097373B2 (en) 2020-06-10 2024-09-24 Medtronic, Inc. Control policy settings for electrical stimulation therapy
US11707626B2 (en) 2020-09-02 2023-07-25 Medtronic, Inc. Analyzing ECAP signals
US11896828B2 (en) 2020-10-30 2024-02-13 Medtronic, Inc. Implantable lead location using ECAP
WO2023086672A1 (en) * 2021-11-15 2023-05-19 Nevro Corp. Systems and methods for treating motor dysfunction, including by selectively activating and/or suppressing motor neurons and/or motor responses
WO2023102554A1 (en) * 2021-12-03 2023-06-08 Advanced Neuromodulation Systems, Inc. Systems and methods for detecting evoked compound action potential (ecap) features in response to neurostimulation

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012155188A1 (en) * 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for controlling a neural stimulus - e
WO2015070281A1 (en) * 2013-11-15 2015-05-21 Saluda Medical Pty Ltd Monitoring brain neural potentials

Family Cites Families (296)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3736434A (en) 1971-06-07 1973-05-29 Westinghouse Air Brake Co Fail-safe electronic comparator circuit
US3817254A (en) 1972-05-08 1974-06-18 Medtronic Inc Transcutaneous stimulator and stimulation method
US3898472A (en) 1973-10-23 1975-08-05 Fairchild Camera Instr Co Occupancy detector apparatus for automotive safety system
US4158196A (en) 1977-04-11 1979-06-12 Crawford George E Jr Man-machine interface system
FR2419720A1 (fr) 1978-03-14 1979-10-12 Cardiofrance Co Stimulateur cardiaque implantable a fonctions therapeutique et diagnostique
US4474186A (en) 1979-07-17 1984-10-02 Georgetown University Computerized electro-oculographic (CEOG) system with feedback control of stimuli
US4807643A (en) 1982-08-16 1989-02-28 University Of Iowa Research Foundation Digital electroneurometer
US4628934A (en) 1984-08-07 1986-12-16 Cordis Corporation Method and means of electrode selection for pacemaker with multielectrode leads
CA1279101C (en) 1985-10-10 1991-01-15 Christopher Van Den Honert Multichannel electrical stimulator with improved channel isolation
US4817628A (en) 1985-10-18 1989-04-04 David L. Zealear System and method for evaluating neurological function controlling muscular movements
DE3831809A1 (de) 1988-09-19 1990-03-22 Funke Hermann Zur mindestens teilweisen implantation im lebenden koerper bestimmtes geraet
US5143081A (en) 1990-07-27 1992-09-01 New York University Randomized double pulse stimulus and paired event analysis
US5172690A (en) 1990-10-26 1992-12-22 Telectronics Pacing Systems, Inc. Automatic stimulus artifact reduction for accurate analysis of the heart's stimulated response
US5139020A (en) 1991-03-08 1992-08-18 Telectronics Pacing Systems, Inc. Method and apparatus for controlling the hemodynamic state of a patient based on systolic time interval measurements detecting using doppler ultrasound techniques
US5188106A (en) 1991-03-08 1993-02-23 Telectronics Pacing Systems, Inc. Method and apparatus for chronically monitoring the hemodynamic state of a patient using doppler ultrasound
US5184615A (en) 1991-03-08 1993-02-09 Telectronics Pacing Systems, Inc. Apparatus and method for detecting abnormal cardiac rhythms using evoked potential measurements in an arrhythmia control system
US5156154A (en) 1991-03-08 1992-10-20 Telectronics Pacing Systems, Inc. Monitoring the hemodynamic state of a patient from measurements of myocardial contractility using doppler ultrasound techniques
US5215100A (en) 1991-04-29 1993-06-01 Occupational Preventive Diagnostic, Inc. Nerve condition monitoring system and electrode supporting structure
CA2110686A1 (en) 1991-07-15 1993-02-04 Terrence R. Hudrlik Medical stimulator with operational amplifier output circuit
US5324311A (en) 1992-09-04 1994-06-28 Siemens Pacesetter, Inc. Coaxial bipolar connector assembly for implantable medical device
US5497781A (en) 1992-10-30 1996-03-12 Chen; Yunquan Recording biological signals using Hilbert transforms
AU688294B2 (en) 1992-12-22 1998-03-12 Cochlear Limited Telemetry system and apparatus
GB9302335D0 (en) 1993-02-05 1993-03-24 Macdonald Alexander J R Electrotherapeutic apparatus
US5417719A (en) 1993-08-25 1995-05-23 Medtronic, Inc. Method of using a spinal cord stimulation lead
US5431693A (en) 1993-12-10 1995-07-11 Intermedics, Inc. Method of verifying capture of the heart by a pacemaker
US5476486A (en) 1994-03-04 1995-12-19 Telectronics Pacing Systems, Inc. Automatic atrial pacing pulse threshold determination utilizing an external programmer and a V-sense electrode
US5458623A (en) 1994-03-04 1995-10-17 Telectronics Pacing Systems, Inc. Automatic atrial pacing threshold determination utilizing an external programmer and a surface electrogram
JP2596372B2 (ja) 1994-04-21 1997-04-02 日本電気株式会社 誘発電位測定装置
AUPM883794A0 (en) 1994-10-17 1994-11-10 University Of Melbourne, The Multiple pulse stimulation
US5785651A (en) 1995-06-07 1998-07-28 Keravision, Inc. Distance measuring confocal microscope
US6066163A (en) 1996-02-02 2000-05-23 John; Michael Sasha Adaptive brain stimulation method and system
US6463328B1 (en) 1996-02-02 2002-10-08 Michael Sasha John Adaptive brain stimulation method and system
FR2796562B1 (fr) 1996-04-04 2005-06-24 Medtronic Inc Techniques de stimulation d'un tissu vivant et d'enregistrement avec commande locale de sites actifs
EP0892654B1 (en) 1996-04-04 2003-06-11 Medtronic, Inc. Apparatus for living tissue stimulation and recording techniques
US5702429A (en) 1996-04-04 1997-12-30 Medtronic, Inc. Neural stimulation techniques with feedback
US6493576B1 (en) 1996-06-17 2002-12-10 Erich Jaeger Gmbh Method and apparatus for measuring stimulus-evoked potentials of the brain
US6157861A (en) 1996-06-20 2000-12-05 Advanced Bionics Corporation Self-adjusting cochlear implant system and method for fitting same
US6246912B1 (en) 1996-06-27 2001-06-12 Sherwood Services Ag Modulated high frequency tissue modification
US5792212A (en) 1997-03-07 1998-08-11 Medtronic, Inc. Nerve evoked potential measurement system using chaotic sequences for noise rejection
US5873898A (en) 1997-04-29 1999-02-23 Medtronic, Inc. Microprocessor capture detection circuit and method
US6216039B1 (en) * 1997-05-02 2001-04-10 Medtronic Inc. Method and apparatus for treating irregular gastric rhythms
US7628761B2 (en) 1997-07-01 2009-12-08 Neurometrix, Inc. Apparatus and method for performing nerve conduction studies with localization of evoked responses
US5999848A (en) 1997-09-12 1999-12-07 Alfred E. Mann Foundation Daisy chainable sensors and stimulators for implantation in living tissue
US6522932B1 (en) 1998-02-10 2003-02-18 Advanced Bionics Corporation Implantable, expandable, multicontact electrodes and tools for use therewith
CA2223668C (en) 1998-02-23 2000-07-11 James Stanley Podger The strengthened quad antenna structure
US6421566B1 (en) 1998-04-30 2002-07-16 Medtronic, Inc. Selective dorsal column stimulation in SCS, using conditioning pulses
US6027456A (en) 1998-07-10 2000-02-22 Advanced Neuromodulation Systems, Inc. Apparatus and method for positioning spinal cord stimulation leads
US7277758B2 (en) 1998-08-05 2007-10-02 Neurovista Corporation Methods and systems for predicting future symptomatology in a patient suffering from a neurological or psychiatric disorder
US7231254B2 (en) 1998-08-05 2007-06-12 Bioneuronics Corporation Closed-loop feedback-driven neuromodulation
US6212431B1 (en) 1998-09-08 2001-04-03 Advanced Bionics Corporation Power transfer circuit for implanted devices
US20060217782A1 (en) 1998-10-26 2006-09-28 Boveja Birinder R Method and system for cortical stimulation to provide adjunct (ADD-ON) therapy for stroke, tinnitus and other medical disorders using implantable and external components
US6253109B1 (en) 1998-11-05 2001-06-26 Medtronic Inc. System for optimized brain stimulation
US6114164A (en) 1998-12-07 2000-09-05 The Regents Of The University Of Michigan System and method for emulating an in vivo environment of a muscle tissue specimen
US6898582B2 (en) 1998-12-30 2005-05-24 Algodyne, Ltd. Method and apparatus for extracting low SNR transient signals from noise
CA2382039C (en) 1999-07-21 2009-12-15 Med-El Elektromedizinische Gerate Gmbh Multichannel cochlear implant with neural response telemetry
US6381496B1 (en) 1999-10-01 2002-04-30 Advanced Bionics Corporation Parameter context switching for an implanted device
US6473649B1 (en) 1999-12-22 2002-10-29 Cardiac Pacemakers, Inc. Rate management during automatic capture verification
US8467874B2 (en) * 2000-04-11 2013-06-18 The Board Of Regents Of The University Of Texas System Gastrointestinal electrical stimulation
US20020055688A1 (en) 2000-05-18 2002-05-09 Jefferson Jacob Katims Nervous tissue stimulation device and method
WO2001097906A2 (en) 2000-06-20 2001-12-27 Advanced Bionics Corporation Apparatus for treatment of mood and/or anxiety disorders by electrical brain stimulation and/or drug infusion
US7305268B2 (en) 2000-07-13 2007-12-04 Northstar Neurscience, Inc. Systems and methods for automatically optimizing stimulus parameters and electrode configurations for neuro-stimulators
US7831305B2 (en) 2001-10-15 2010-11-09 Advanced Neuromodulation Systems, Inc. Neural stimulation system and method responsive to collateral neural activity
JP2004509714A (ja) * 2000-09-26 2004-04-02 トランスニューロニックス　インコーポレイテッド 検知された活動を利用した胃腸道の電気刺激による肥満の治療方法および装置
AU2001237911A1 (en) 2000-10-30 2002-05-21 Neuropace, Inc. System and method for determining stimulation parameters for the treatment of epileptic seizures
US7089059B1 (en) 2000-11-03 2006-08-08 Pless Benjamin D Predicting susceptibility to neurological dysfunction based on measured neural electrophysiology
US6594524B2 (en) 2000-12-12 2003-07-15 The Trustees Of The University Of Pennsylvania Adaptive method and apparatus for forecasting and controlling neurological disturbances under a multi-level control
US6600954B2 (en) 2001-01-25 2003-07-29 Biocontrol Medical Bcm Ltd. Method and apparatus for selective control of nerve fibers
US8060208B2 (en) 2001-02-20 2011-11-15 Case Western Reserve University Action potential conduction prevention
US20050101878A1 (en) 2001-04-18 2005-05-12 Daly Christopher N. Method and apparatus for measurement of evoked neural response
US6658293B2 (en) 2001-04-27 2003-12-02 Medtronic, Inc. Method and system for atrial capture detection based on far-field R-wave sensing
CN1287729C (zh) 2001-05-29 2006-12-06 生殖健康技术公司 用于检测和分析产妇子宫,及产妇和胎儿心脏与胎儿脑活动的系统
US6936012B2 (en) 2001-06-18 2005-08-30 Neurometrix, Inc. Method and apparatus for identifying constituent signal components from a plurality of evoked physiological composite signals
US6449512B1 (en) * 2001-08-29 2002-09-10 Birinder R. Boveja Apparatus and method for treatment of urological disorders using programmerless implantable pulse generator system
US7778703B2 (en) 2001-08-31 2010-08-17 Bio Control Medical (B.C.M.) Ltd. Selective nerve fiber stimulation for treating heart conditions
US8571653B2 (en) 2001-08-31 2013-10-29 Bio Control Medical (B.C.M.) Ltd. Nerve stimulation techniques
US7778711B2 (en) 2001-08-31 2010-08-17 Bio Control Medical (B.C.M.) Ltd. Reduction of heart rate variability by parasympathetic stimulation
IL145700A0 (en) 2001-09-30 2002-06-30 Younis Imad Electrode system for neural applications
DE10151020A1 (de) 2001-10-16 2003-04-30 Infineon Technologies Ag Schaltkreis-Anordnung, Sensor-Array und Biosensor-Array
US7493157B2 (en) 2001-10-24 2009-02-17 Gozani Shai N Devices and methods for the non-invasive detection of spontaneous myoelectrical activity
US7286876B2 (en) 2001-10-26 2007-10-23 Cardiac Pacemakers, Inc. Template-based capture verification for multi-site pacing
US7286878B2 (en) 2001-11-09 2007-10-23 Medtronic, Inc. Multiplexed electrode array extension
US6993384B2 (en) 2001-12-04 2006-01-31 Advanced Bionics Corporation Apparatus and method for determining the relative position and orientation of neurostimulation leads
US20030144708A1 (en) * 2002-01-29 2003-07-31 Starkebaum Warren L. Methods and apparatus for retarding stomach emptying for treatment of eating disorders
US7881805B2 (en) 2002-02-04 2011-02-01 Boston Scientific Neuromodulation Corporation Method for optimizing search for spinal cord stimulation parameter settings
US7317948B1 (en) 2002-02-12 2008-01-08 Boston Scientific Scimed, Inc. Neural stimulation system providing auto adjustment of stimulus output as a function of sensed impedance
US20030153959A1 (en) 2002-02-12 2003-08-14 Thacker James R. Neural stimulation system providing auto adjustment of stimulus output as a function of sensed coupling efficiency
US6931281B2 (en) 2002-04-12 2005-08-16 Pacesetter, Inc. Method and apparatus for monitoring myocardial conduction velocity for diagnostics of therapy optimization
WO2003103484A2 (en) 2002-06-05 2003-12-18 Nervetrack Ltd. Method and apparatus for measuring nerve signals in nerve fibers
US7203548B2 (en) 2002-06-20 2007-04-10 Advanced Bionics Corporation Cavernous nerve stimulation via unidirectional propagation of action potentials
US20060009820A1 (en) 2002-07-17 2006-01-12 John Royle Apparatus for the application of electrical pulses to the human body
AU2002951218A0 (en) 2002-09-04 2002-09-19 Cochlear Limited Method and apparatus for measurement of evoked neural response
US7328068B2 (en) 2003-03-31 2008-02-05 Medtronic, Inc. Method, system and device for treating disorders of the pelvic floor by means of electrical stimulation of the pudendal and associated nerves, and the optional delivery of drugs in association therewith
US7415307B2 (en) 2002-10-31 2008-08-19 Medtronic, Inc. Ischemia detection based on cardiac conduction time
AU2003286842A1 (en) 2002-11-01 2004-06-07 George Mason Intellectual Properties, Inc. Methods and devices for determining brain state
US20040122482A1 (en) 2002-12-20 2004-06-24 James Tung Nerve proximity method and device
US7171261B1 (en) 2002-12-20 2007-01-30 Advanced Bionics Corporation Forward masking method for estimating neural response
CA2519771C (en) 2003-04-02 2011-11-29 Neurostream Technologies Inc. Implantable nerve signal sensing and stimulation device for treating foot drop and other neurological disorders
DE10318071A1 (de) 2003-04-17 2004-11-25 Forschungszentrum Jülich GmbH Vorrichtung zur Desynchronisation von neuronaler Hirnaktivität
US20040254494A1 (en) 2003-06-11 2004-12-16 Spokoyny Eleonora S. Method and appartaus for use in nerve conduction studies
US7582062B2 (en) 2003-09-12 2009-09-01 Medical Research Council Methods of neural centre location and electrode placement in the central nervous system
US7930037B2 (en) 2003-09-30 2011-04-19 Medtronic, Inc. Field steerable electrical stimulation paddle, lead system, and medical device incorporating the same
US8489196B2 (en) 2003-10-03 2013-07-16 Medtronic, Inc. System, apparatus and method for interacting with a targeted tissue of a patient
US7236834B2 (en) 2003-12-19 2007-06-26 Medtronic, Inc. Electrical lead body including an in-line hermetic electronic package and implantable medical device using the same
US7412287B2 (en) 2003-12-22 2008-08-12 Cardiac Pacemakers, Inc. Automatic sensing vector selection for morphology-based capture verification
US7295881B2 (en) 2003-12-29 2007-11-13 Biocontrol Medical Ltd. Nerve-branch-specific action-potential activation, inhibition, and monitoring
US7177693B2 (en) * 2004-01-07 2007-02-13 Medtronic, Inc. Gastric stimulation for altered perception to treat obesity
ATE429949T1 (de) * 2004-02-05 2009-05-15 Motorika Ltd Neuromuskuläre stimulation
US20060020291A1 (en) 2004-03-09 2006-01-26 Gozani Shai N Apparatus and method for performing nerve conduction studies with multiple neuromuscular electrodes
US20050203600A1 (en) 2004-03-12 2005-09-15 Scimed Life Systems, Inc. Collapsible/expandable tubular electrode leads
GB0409806D0 (en) 2004-04-30 2004-06-09 Univ Brunel Nerve blocking method and system
US8224459B1 (en) 2004-04-30 2012-07-17 Boston Scientific Neuromodulation Corporation Insertion tool for paddle-style electrode
US7369900B2 (en) 2004-05-08 2008-05-06 Bojan Zdravkovic Neural bridge devices and methods for restoring and modulating neural activity
US8078284B2 (en) 2004-05-25 2011-12-13 Second Sight Medical Products, Inc. Retinal prosthesis with a new configuration
US7993906B2 (en) 2004-05-28 2011-08-09 The Board Of Trustees Of The Leland Stanford Junior University Closed-loop electrical stimulation system for cell cultures
WO2005122887A2 (en) 2004-06-15 2005-12-29 Cochlear Americas Automatic determination of the threshold of an evoked neural response
US8239029B2 (en) 2004-10-21 2012-08-07 Advanced Neuromodulation Systems, Inc. Stimulation of the amygdalohippocampal complex to treat neurological conditions
US8332047B2 (en) 2004-11-18 2012-12-11 Cardiac Pacemakers, Inc. System and method for closed-loop neural stimulation
US10537741B2 (en) 2004-12-03 2020-01-21 Boston Scientific Neuromodulation Corporation System and method for choosing electrodes in an implanted stimulator device
US8103352B2 (en) 2004-12-03 2012-01-24 Second Sight Medical Products, Inc. Mimicking neural coding in retinal ganglion cells with short pulse electrical stimulation
US20110307030A1 (en) 2005-03-24 2011-12-15 Michael Sasha John Methods for Evaluating and Selecting Electrode Sites of a Brain Network to Treat Brain Disorders
US7702502B2 (en) 2005-02-23 2010-04-20 Digital Intelligence, L.L.C. Apparatus for signal decomposition, analysis and reconstruction
EP1895890B1 (en) * 2005-03-03 2013-05-22 Ull Meter A/S Evaluation of sympathetic tone
US20070185409A1 (en) 2005-04-20 2007-08-09 Jianping Wu Method and system for determining an operable stimulus intensity for nerve conduction testing
US20060264752A1 (en) 2005-04-27 2006-11-23 The Regents Of The University Of California Electroporation controlled with real time imaging
US20060247717A1 (en) * 2005-04-28 2006-11-02 Medtronic, Inc. Electrical stimulation of the gastrointestinal tract to regulate motility
US7818052B2 (en) 2005-06-01 2010-10-19 Advanced Bionics, Llc Methods and systems for automatically identifying whether a neural recording signal includes a neural response signal
US7856273B2 (en) * 2005-07-28 2010-12-21 Cyberonics, Inc. Autonomic nerve stimulation to treat a gastrointestinal disorder
US7450992B1 (en) 2005-08-18 2008-11-11 Advanced Neuromodulation Systems, Inc. Method for controlling or regulating therapeutic nerve stimulation using electrical feedback
US8639329B2 (en) 2005-08-30 2014-01-28 Georgia Tech Research Corporation Circuits and methods for artifact elimination
US20070073354A1 (en) 2005-09-26 2007-03-29 Knudson Mark B Neural blocking therapy
US9168383B2 (en) 2005-10-14 2015-10-27 Pacesetter, Inc. Leadless cardiac pacemaker with conducted communication
US7616990B2 (en) 2005-10-24 2009-11-10 Cardiac Pacemakers, Inc. Implantable and rechargeable neural stimulator
US7957796B2 (en) 2005-10-28 2011-06-07 Cyberonics, Inc. Using physiological sensor data with an implantable medical device
US7555344B2 (en) * 2005-10-28 2009-06-30 Cyberonics, Inc. Selective neurostimulation for treating epilepsy
US7853322B2 (en) 2005-12-02 2010-12-14 Medtronic, Inc. Closed-loop therapy adjustment
US20070287931A1 (en) 2006-02-14 2007-12-13 Dilorenzo Daniel J Methods and systems for administering an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders
US7894905B2 (en) 2006-03-13 2011-02-22 Neuropace, Inc. Implantable system enabling responsive therapy for pain
US8190251B2 (en) 2006-03-24 2012-05-29 Medtronic, Inc. Method and apparatus for the treatment of movement disorders
US7835804B2 (en) 2006-04-18 2010-11-16 Advanced Bionics, Llc Removing artifact in evoked compound action potential recordings in neural stimulators
DE102006018851A1 (de) 2006-04-22 2007-10-25 Biotronik Crm Patent Ag Aktives medizinisches Geräteimplantat mit mindestens zwei diagnostischen und/oder therapeutischen Funktionen
US7792584B2 (en) 2006-04-25 2010-09-07 Medtronic, Inc. System and method for characterization of atrial wall using digital signal processing
US8099172B2 (en) 2006-04-28 2012-01-17 Advanced Neuromodulation Systems, Inc. Spinal cord stimulation paddle lead and method of making the same
US7515968B2 (en) 2006-04-28 2009-04-07 Medtronic, Inc. Assembly method for spinal cord stimulation lead
US20070255154A1 (en) * 2006-04-28 2007-11-01 Medtronic, Inc. Activity level feedback for managing obesity
US9084901B2 (en) 2006-04-28 2015-07-21 Medtronic, Inc. Cranial implant
US20080051647A1 (en) 2006-05-11 2008-02-28 Changwang Wu Non-invasive acquisition of large nerve action potentials (NAPs) with closely spaced surface electrodes and reduced stimulus artifacts
US20070282217A1 (en) 2006-06-01 2007-12-06 Mcginnis William J Methods & systems for intraoperatively monitoring nerve & muscle frequency latency and amplitude
WO2008004204A1 (en) 2006-07-06 2008-01-10 University Of Limerick An electrical stimulation device for nerves or muscles
US7848797B2 (en) * 2006-08-17 2010-12-07 Neurometrix, Inc. Motor unit number estimation (MUNE) for the assessment of neuromuscular function
US8532741B2 (en) 2006-09-08 2013-09-10 Medtronic, Inc. Method and apparatus to optimize electrode placement for neurological stimulation
US9162051B2 (en) 2006-09-21 2015-10-20 Neuropace, Inc. Treatment of language, behavior and social disorders
US8588927B2 (en) 2006-10-06 2013-11-19 Neurostream Technologies General Partnership Implantable pulse generator
US7881803B2 (en) 2006-10-18 2011-02-01 Boston Scientific Neuromodulation Corporation Multi-electrode implantable stimulator device with a single current path decoupling capacitor
US8280514B2 (en) 2006-10-31 2012-10-02 Advanced Neuromodulation Systems, Inc. Identifying areas of the brain by examining the neuronal signals
US8160719B2 (en) 2006-12-19 2012-04-17 Greatbatch Ltd. Braided electrical lead
US8057390B2 (en) 2007-01-26 2011-11-15 The Regents Of The University Of Michigan High-resolution mapping of bio-electric fields
US8224453B2 (en) 2007-03-15 2012-07-17 Advanced Neuromodulation Systems, Inc. Spinal cord stimulation to treat pain
US8406877B2 (en) 2007-03-19 2013-03-26 Cardiac Pacemakers, Inc. Selective nerve stimulation with optionally closed-loop capabilities
US8083685B2 (en) 2007-05-08 2011-12-27 Propep, Llc System and method for laparoscopic nerve detection
US9042978B2 (en) 2007-05-11 2015-05-26 Neurometrix, Inc. Method and apparatus for quantitative nerve localization
US7742810B2 (en) 2007-05-23 2010-06-22 Boston Scientific Neuromodulation Corporation Short duration pre-pulsing to reduce stimulation-evoked side-effects
US7634315B2 (en) 2007-05-31 2009-12-15 Pacesetter, Inc. Techniques to monitor and trend nerve damage and recovery
KR100897528B1 (ko) 2007-06-22 2009-05-15 주식회사 사이버메드 디비에스 전극의 위치 판단 방법
US8649858B2 (en) 2007-06-25 2014-02-11 Boston Scientific Neuromodulation Corporation Architectures for an implantable medical device system
US8417342B1 (en) * 2007-07-03 2013-04-09 University Of Mississippi Medical Center Gastrointestinal electrical stimulation device and method for treating gastrointestinal disorders
US8880180B2 (en) 2007-07-13 2014-11-04 Cochlear Limited Assessing neural survival
US8063770B2 (en) 2007-08-01 2011-11-22 Peter Costantino System and method for facial nerve monitoring
WO2009026625A1 (en) 2007-08-29 2009-03-05 Cochlear Limited Method and device for intracochlea impedance measurement
US8515547B2 (en) 2007-08-31 2013-08-20 Cardiac Pacemakers, Inc. Wireless patient communicator for use in a life critical network
EP2200692B1 (en) 2007-09-26 2016-11-09 Medtronic, Inc. Frequency selective monitoring of physiological signals
US9248274B2 (en) 2007-10-10 2016-02-02 Sorin Crm Sas Neurostimulator and method for regulating same
DE102007051847B4 (de) 2007-10-30 2014-07-17 Forschungszentrum Jülich GmbH Vorrichtung zur Stimulation von Neuronen mit einer krankhaft synchronen und oszillatorischen neuronalen Aktivität
WO2009064858A1 (en) 2007-11-14 2009-05-22 Med-El Elektromedizinische Geraete Gmbh Cochlear implant stimulation artifacts
US8195287B2 (en) * 2007-12-05 2012-06-05 The Invention Science Fund I, Llc Method for electrical modulation of neural conduction
US20090157155A1 (en) 2007-12-18 2009-06-18 Advanced Bionics Corporation Graphical display of environmental measurements for implantable therapies
GB0800797D0 (en) 2008-01-16 2008-02-27 Cambridge Entpr Ltd Neural interface
WO2009119236A1 (ja) 2008-03-26 2009-10-01 テルモ株式会社 治療装置
GR1006568B (el) 2008-04-22 2009-10-13 Αλεξανδρος Μπερης Μεθοδος και συστημα για την καταγραφη και υποβοηθηση της αναγεννησης περιφερικου νευρου
US9492655B2 (en) 2008-04-25 2016-11-15 Boston Scientific Neuromodulation Corporation Stimulation system with percutaneously deliverable paddle lead and methods of making and using
WO2009134478A1 (en) 2008-04-29 2009-11-05 Medtronic, Inc. Therapy program modification
US20090287277A1 (en) 2008-05-19 2009-11-19 Otologics, Llc Implantable neurostimulation electrode interface
WO2009146427A1 (en) 2008-05-29 2009-12-03 Neurometrix, Inc. Method and apparatus for quantitative nerve localization
US20090306491A1 (en) 2008-05-30 2009-12-10 Marcus Haggers Implantable neural prosthetic device and methods of use
US9592387B2 (en) 2008-07-11 2017-03-14 Medtronic, Inc. Patient-defined posture states for posture responsive therapy
US8315710B2 (en) 2008-07-11 2012-11-20 Medtronic, Inc. Associating therapy adjustments with patient posture states
WO2010013170A1 (en) 2008-07-29 2010-02-04 Koninklijke Philips Electronics N.V. System and method for communicating information between implantable devices
US7941713B2 (en) 2008-08-27 2011-05-10 Taiwan Semiconductor Manufacturing Company, Ltd. Programmable self-test for random access memories
WO2010033368A1 (en) 2008-09-17 2010-03-25 National Ict Australia Limited (Nicta) Knitted electrode assembly and integrated connector for an active implantable medical device
US9044155B2 (en) 2008-09-17 2015-06-02 Med-El Elektromedizinische Geraete Gmbh Stimulus artifact removal for neuronal recordings
US8428733B2 (en) 2008-10-16 2013-04-23 Medtronic, Inc. Stimulation electrode selection
EP2351467A1 (en) 2008-10-27 2011-08-03 Philips Intellectual Property & Standards GmbH Method of driving a short-arc discharge lamp
US9987493B2 (en) 2008-10-28 2018-06-05 Medtronic, Inc. Medical devices and methods for delivery of current-based electrical stimulation therapy
US8301263B2 (en) 2008-10-31 2012-10-30 Medtronic, Inc. Therapy module crosstalk mitigation
US20100114237A1 (en) 2008-10-31 2010-05-06 Medtronic, Inc. Mood circuit monitoring to control therapy delivery
US8560060B2 (en) 2008-10-31 2013-10-15 Medtronic, Inc. Isolation of sensing and stimulation circuitry
US8255057B2 (en) 2009-01-29 2012-08-28 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
JP2012508624A (ja) 2008-11-13 2012-04-12 プロテウス バイオメディカル インコーポレイテッド 多重化複数電極神経刺激装置
US8504160B2 (en) 2008-11-14 2013-08-06 Boston Scientific Neuromodulation Corporation System and method for modulating action potential propagation during spinal cord stimulation
US9463321B2 (en) 2008-11-14 2016-10-11 Boston Scientific Neuromodulation Corporation System and method for adjusting automatic pulse parameters to selectively activate nerve fibers
WO2010065146A1 (en) 2008-12-05 2010-06-10 Ndi Medical, Llc Systems and methods to place one or more leads in tissue to electrically stimulate nerves of passage to treat pain
US9084551B2 (en) 2008-12-08 2015-07-21 Medtronic Xomed, Inc. Method and system for monitoring a nerve
US20100179626A1 (en) 2009-01-09 2010-07-15 Medtronic, Inc. System and method for implanting a paddle lead
US20100222858A1 (en) 2009-02-27 2010-09-02 Meloy T Stuart Method and system for neurally augmenting sexual function during sexual activity
MX2011009165A (es) 2009-03-13 2011-09-26 Baxano Inc Dispositivo y metodos de localizacion neural flexibles.
US10286212B2 (en) 2009-03-20 2019-05-14 Electrocore, Inc. Nerve stimulation methods for averting imminent onset or episode of a disease
US10252074B2 (en) 2009-03-20 2019-04-09 ElectroCore, LLC Nerve stimulation methods for averting imminent onset or episode of a disease
US8504154B2 (en) 2009-03-30 2013-08-06 Medtronic, Inc. Physiological signal amplifier with voltage protection and fast signal recovery
AU2009344197A1 (en) 2009-04-08 2011-12-01 Saluda Medical Pty Limited Bonded hermetic feed through for an active implantable medical device
WO2010117382A1 (en) 2009-04-08 2010-10-14 National Ict Australia Limited (Nicta) Electronics package for an active implantable medical device
JP2012523268A (ja) 2009-04-08 2012-10-04 ナショナル・アイシーティ・オーストラリア・リミテッド 移植可能医療デバイスの縫いつけコンポーネント
DE202010018211U1 (de) 2009-04-22 2014-09-29 Nevro Corporation Selektive Hochfrequenzrückenmarksmodulation zur Schmerzhemmung mit weniger Nebenwirkung, sowie zugehörige Systeme
US8744588B2 (en) 2009-05-07 2014-06-03 Hani Midani Method and system for connecting an impaired nervous system to a muscle or a group of muscles based on template matching and intelligent end points
WO2010138915A1 (en) 2009-05-29 2010-12-02 University Of Washington Vestibular implant
US20100331926A1 (en) 2009-06-24 2010-12-30 Boston Scientific Neuromodulation Corporation Reversing recruitment order by anode intensification
US9566439B2 (en) 2009-07-20 2017-02-14 Saluda Medical Pty Limited Neuro-stimulation
US20110028859A1 (en) 2009-07-31 2011-02-03 Neuropace, Inc. Methods, Systems and Devices for Monitoring a Target in a Neural System and Facilitating or Controlling a Cell Therapy
US20110093042A1 (en) 2009-10-21 2011-04-21 Medtronic, Inc. Stimulation with utilization of case electrode
WO2011119251A2 (en) 2010-03-22 2011-09-29 Research Foundation Of The City University Of New York Charge-enhanced neural electric stimulation system
US8209224B2 (en) * 2009-10-29 2012-06-26 The Nielsen Company (Us), Llc Intracluster content management using neuro-response priming data
US11045221B2 (en) 2009-10-30 2021-06-29 Medtronic, Inc. Steerable percutaneous paddle stimulation lead
WO2011066478A1 (en) 2009-11-26 2011-06-03 National Ict Australia Limited (Nicta) Forming feedthroughs for hermetically sealed housings using two-material powder injection molding
US8886323B2 (en) 2010-02-05 2014-11-11 Medtronic, Inc. Electrical brain stimulation in gamma band
CA2792529C (en) * 2010-03-11 2018-06-05 Mainstay Medical, Inc. Modular stimulator for treatment of back pain, implantable rf ablation system and methods of use
EP3381366A1 (en) 2010-03-12 2018-10-03 Inspire Medical Systems, Inc. System for identifying a location for nerve stimulation
US9814885B2 (en) 2010-04-27 2017-11-14 Medtronic, Inc. Stimulation electrode selection
US8423134B2 (en) 2010-04-29 2013-04-16 Medtronic, Inc. Therapy using perturbation and effect of physiological systems
JP5464072B2 (ja) 2010-06-16 2014-04-09 ソニー株式会社 筋活動診断装置および方法、並びにプログラム
AU2013277009B2 (en) 2010-06-18 2016-01-07 Cardiac Pacemakers, Inc. Neurostimulation system with control using evoked responses
US9265431B2 (en) 2010-06-18 2016-02-23 Cardiac Pacemakers, Inc. Methods and apparatus for controlling neurostimulation using evoked physiologic events
EP3485808A1 (en) 2010-07-29 2019-05-22 MED-EL Elektromedizinische Geräte GmbH Electrically evoked brainstem response measurements via implant prosthesis
JP2013536044A (ja) 2010-08-23 2013-09-19 ラファエル デベロップメント コーポレイション リミテッド 除細動パルス送達と呼吸周期との同期
WO2012027791A1 (en) 2010-08-31 2012-03-08 National Ict Australia Ltd Distributed implant systems
US9420960B2 (en) 2010-10-21 2016-08-23 Medtronic, Inc. Stereo data representation of biomedical signals along a lead
EP2443995A3 (en) 2010-10-21 2013-02-27 Syncrophi Systems Ltd. An ECG apparatus with lead-off detection
US9155503B2 (en) 2010-10-27 2015-10-13 Cadwell Labs Apparatus, system, and method for mapping the location of a nerve
WO2012056882A1 (ja) 2010-10-27 2012-05-03 株式会社村田製作所 検出回路
US8788047B2 (en) 2010-11-11 2014-07-22 Spr Therapeutics, Llc Systems and methods for the treatment of pain through neural fiber stimulation
KR101198515B1 (ko) 2010-12-15 2012-11-06 에스케이하이닉스 주식회사 반도체 메모리 소자의 동작 방법
KR101241943B1 (ko) 2011-03-29 2013-03-11 한국과학기술연구원 손상된 신경의 기능을 복구하기 위한 인공신경 네트워킹 시스템 및 방법
US9789307B2 (en) 2011-04-29 2017-10-17 Medtronic, Inc. Dual prophylactic and abortive electrical stimulation
US10448889B2 (en) 2011-04-29 2019-10-22 Medtronic, Inc. Determining nerve location relative to electrodes
US9872990B2 (en) 2011-05-13 2018-01-23 Saluda Medical Pty Limited Method and apparatus for application of a neural stimulus
CA2835486C (en) 2011-05-13 2022-07-19 Saluda Medical Pty Limited Method and apparatus for measurement of neural response - a
WO2012155189A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for estimating neural recruitment - f
WO2012155185A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for measurement of neural response
WO2012155184A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for measurement of neural response - c
WO2012155187A1 (en) 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for application of a neural stimulus - i
US20130172774A1 (en) 2011-07-01 2013-07-04 Neuropace, Inc. Systems and Methods for Assessing the Effectiveness of a Therapy Including a Drug Regimen Using an Implantable Medical Device
US9517020B2 (en) 2011-08-04 2016-12-13 Ramot At Tel Aviv University Ltd. IL-1 receptor antagonist-coated electrode and uses thereof
US9888861B2 (en) 2011-08-25 2018-02-13 Medtronic, Inc. Method and apparatus for detecting a biomarker in the presence of electrical stimulation
US8483836B2 (en) 2011-09-07 2013-07-09 Greatbatch Ltd. Automated search to identify a location for electrical stimulation to treat a patient
US10335547B2 (en) 2011-10-24 2019-07-02 Purdue Research Foundation Method and apparatus for closed-loop control of nerve activation
US20140288577A1 (en) 2011-11-24 2014-09-25 Saluda Medical Pty Limited Electrode Assembly for an Active Implantable Medical Device
WO2013116161A1 (en) 2012-01-30 2013-08-08 The Regents Of The University Of California System and methods for closed-loop cochlear implant
FR2988996B1 (fr) 2012-04-06 2015-01-23 Uromems Methode et dispositif de controle d'un dispositif implantable
US8972018B2 (en) * 2012-03-20 2015-03-03 Articulate Labs, Inc. Adaptive muscle stimulation technique
AU2013252839B2 (en) 2012-04-27 2015-09-17 Boston Scientific Neuromodulation Corporation Timing channel circuitry for creating pulses in an implantable stimulator device
US9603538B2 (en) 2012-06-15 2017-03-28 Case Western Reserve University Implantable cuff and method for functional electrical stimulation and monitoring
KR102234778B1 (ko) 2012-06-21 2021-03-31 뉴로나노 아베 의료용 미소 전극
TWI498101B (zh) 2012-08-30 2015-09-01 Univ Nat Chiao Tung 神經纖維分佈之分析方法及標準化誘發復合動作電位之量測方法
DE102012218057A1 (de) 2012-10-02 2014-04-03 Forschungszentrum Jülich GmbH Vorrichtung und verfahren zur untersuchung einer krankhaften interaktion zwischen verschiedenen hirnarealen
EP2908904B1 (en) 2012-11-06 2020-09-23 Saluda Medical Pty Limited System for controlling electrical conditions of tissue
US20150282725A1 (en) 2012-11-06 2015-10-08 Saluda Medical Pty Ltd Method and System for Controlling Electrical Conditions of Tissue II
US9533148B2 (en) 2013-02-22 2017-01-03 Boston Scientific Neuromodulation Corporation Neurostimulation system and method for automatically adjusting stimulation and reducing energy requirements using evoked action potential
US20140276925A1 (en) 2013-03-12 2014-09-18 Spinal Modulation, Inc. Methods and systems for use in guiding implantation of a neuromodulation lead
US10105091B2 (en) 2013-03-12 2018-10-23 The Cleveland Clinic Foundation Methods of using nerve evoked potentials to monitor a surgical procedure
US9446235B2 (en) 2013-03-14 2016-09-20 Medtronic, Inc. Low frequency electrical stimulation therapy for pelvic floor disorders
US9610444B2 (en) 2013-03-15 2017-04-04 Pacesetter, Inc. Erythropoeitin production by electrical stimulation
US20140350634A1 (en) 2013-05-21 2014-11-27 Duke University Devices, systems and methods for deep brain stimulation parameters
US11083402B2 (en) 2013-06-04 2021-08-10 Medtronic, Inc. Patient state determination based on one or more spectral characteristics of a bioelectrical brain signal
US9545516B2 (en) 2013-07-19 2017-01-17 Med-El Elektromedizinische Geraete Gmbh Triphasic pulses to reduce undesirable side-effects in cochlear implants
JP6671021B2 (ja) 2013-11-22 2020-03-25 サルーダ・メディカル・ピーティーワイ・リミテッド 神経測定において神経反応を検出するための方法およびデバイス
WO2015109239A1 (en) 2014-01-17 2015-07-23 Medtronic, Inc. Movement disorder symptom control
EP3122247A4 (en) 2014-03-28 2017-11-08 Saluda Medical Pty Ltd Assessing neural state from action potentials
ES2801348T3 (es) 2014-05-05 2021-01-11 Saluda Medical Pty Ltd Medición neurológica mejorada
US9302112B2 (en) 2014-06-13 2016-04-05 Pacesetter, Inc. Method and system for non-linear feedback control of spinal cord stimulation
EP3838331B1 (en) 2014-07-25 2024-05-22 Saluda Medical Pty Limited Neural stimulation dosing
EP3197543B1 (en) 2014-09-23 2019-03-13 Boston Scientific Neuromodulation Corporation Systems for receiving user-provided selection of electrode lists
AU2015321740B2 (en) 2014-09-23 2018-03-01 Boston Scientific Neuromodulation Corporation System for calibrating dorsal horn stimulation
US10471268B2 (en) 2014-10-16 2019-11-12 Mainstay Medical Limited Systems and methods for monitoring muscle rehabilitation
US9597507B2 (en) 2014-10-31 2017-03-21 Medtronic, Inc. Paired stimulation pulses based on sensed compound action potential
US9610448B2 (en) * 2014-11-12 2017-04-04 Pacesetter, Inc. System and method to control a non-paresthesia stimulation based on sensory action potentials
AU2015349614B2 (en) 2014-11-17 2020-10-22 Saluda Medical Pty Ltd Method and device for detecting a neural response in neural measurements
EP4285985A3 (en) 2014-12-11 2024-01-17 Saluda Medical Pty Ltd Method and device for feedback control of neural stimulation
US20160166164A1 (en) 2014-12-11 2016-06-16 Saluda Medical Pty Limited Method and Apparatus for Detecting Neural Injury
WO2016090420A1 (en) 2014-12-11 2016-06-16 Saluda Medical Pty Ltd Implantable electrode positioning
US9387325B1 (en) * 2014-12-19 2016-07-12 Pacesetter, Inc. System and method to control dorsal root stimulation parameters based on frequency decomposition
WO2016115596A1 (en) 2015-01-19 2016-07-28 Saluda Medical Pty Ltd Method and device for neural implant communication
AU2016245335B2 (en) 2015-04-09 2020-11-19 Saluda Medical Pty Ltd Electrode to nerve distance estimation
EP3302692B1 (en) 2015-05-31 2024-07-24 Closed Loop Medical Pty Ltd Brain neurostimulator electrode fitting
JP2018516150A (ja) 2015-05-31 2018-06-21 サルーダ・メディカル・ピーティーワイ・リミテッド 脳神経活動の監視
CA2980482C (en) 2015-06-01 2023-09-26 Saluda Medical Pty Ltd Motor fibre neuromodulation
CA3019701A1 (en) 2016-04-05 2017-10-12 Saluda Medical Pty Ltd Improved feedback control of neuromodulation
EP3474747A4 (en) 2016-06-24 2020-01-22 Saluda Medical Pty Ltd NERVOUS STIMULATION FOR REDUCED ARTIFACT
JP7247211B2 (ja) 2018-03-23 2023-03-28 サルーダ・メディカル・ピーティーワイ・リミテッド 臨床データ管理システム
CN112334184A (zh) 2018-04-27 2021-02-05 萨鲁达医疗有限公司 混合神经的神经刺激

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012155188A1 (en) * 2011-05-13 2012-11-22 National Ict Australia Ltd Method and apparatus for controlling a neural stimulus - e
WO2015070281A1 (en) * 2013-11-15 2015-05-21 Saluda Medical Pty Ltd Monitoring brain neural potentials

Also Published As

Publication number Publication date
CN107613861A (zh) 2018-01-19
CA2980482A1 (en) 2016-12-08
AU2016269843A1 (en) 2017-09-14
US11006857B2 (en) 2021-05-18
EP3261533A1 (en) 2018-01-03
WO2016191815A1 (en) 2016-12-08
JP2018517445A (ja) 2018-07-05
JP7204325B2 (ja) 2023-01-16
US20180132760A1 (en) 2018-05-17
AU2016269843B2 (en) 2021-03-04
EP3261533A4 (en) 2018-10-31
CA2980482C (en) 2023-09-26

Similar Documents

Publication Publication Date Title
CN107613861B (zh) 运动纤维神经调节
US11439828B2 (en) Method and apparatus for application of a neural stimulus
US11938320B2 (en) Electrode to nerve distance estimation
CN109219467B (zh) 神经调节的经改进反馈控制
AU2022202211A1 (en) Method and apparatus for application of a neural stimulus
EP3765145A1 (en) Neural stimulation with decomposition of evoked compound action potentials
US11938315B2 (en) Methods and systems for discrete measurement of electrical characteristics
US20160158550A1 (en) System and method for coupling burst and tonic stimulation
EP3946561B1 (en) System for selecting neuromodulation parameters using electrospinogram
JP2024508685A (ja) 刺激内リクルートメント制御
WO2022271777A1 (en) Systems and method for modulating the spinal cord based on spinal field potentials

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
SE01 Entry into force of request for substantive examination
SE01 Entry into force of request for substantive examination
TA01 Transfer of patent application right
TA01 Transfer of patent application right

Effective date of registration: 20210917

Address after: New South Wales Australia

Applicant after: Closed loop medical Pte. Ltd.

Address before: New South Wales Australia

Applicant before: Saluda Medical Pty Ltd.

GR01 Patent grant
GR01 Patent grant