Implantable pulse generator having current steering means

Abstract

An implantable pulse generator includes a current steering capability that allows a clinician or patient to quickly determine a desired electrode stimulation pattern, including which electrodes of a group of electrodes within an electrode array should receive a stimulation current, including the amplitude, width and pulse repetition rate of such current. Movement of the selected group of electrodes is facilitated through the use of remotely generated directional signals, generated by a pointing device, such as a joystick. As movement of the selected group of electrodes occurs, current redistribution amongst the various electrode contacts takes place. The redistribution of stimulus amplitudes utilizes re-normalization of amplitudes so that the perceptual level remains fairly constant. This prevents the resulting paresthesia from falling below the perceptual threshold or above the comfort threshold.

1 - 17 . (canceled) 
     
     
         18 . A mapping system comprising:
 an input circuit to receive an output from a control device, the output reflecting manipulation of a directional controller of the control device by a user;   an electrode combination map that maps the output of the control device to a predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes;   a telemetry circuit; and   a processor to select one of the subset of electrode combinations based on the received output and the map, and provide the selected electrode combination to a stimulation device coupled to the set of electrodes via the telemetry circuit for application of electrical stimulation to the patient via the selected electrode combination.   
     
     
         19 . The system of  claim 18 , wherein the output of the control device comprises directional information that reflects a direction of a manipulation of the directional controller, and the processor selects the electrode combination such that a direction of movement of paresthesia resulting from application of electrical stimulation via the selected electrode combination reflects the direction of the manipulation of the directional controller. 
     
     
         20 . The system of  claim 18 , further comprising a plurality of electrode combination maps, each of the electrode combination maps mapping the output of the control device to a respective predetermined subset of electrode combinations available from one of a plurality of electrode set configurations, and wherein the processor receives information that describes a configuration of the set of electrodes coupled to the stimulation device, and selects the electrode combination map based on the configuration information. 
     
     
         21 . The system of  claim 18 , wherein the processor is configured to select a plurality of electrode combinations and provide the selected electrode combinations to the stimulation device in response to the user manipulating the directional controller to test the plurality of electrode combinations by application of electrical stimulation from the stimulation device to the patient via the plurality of electrode combinations. 
     
     
         22 . The system of  claim 21 , wherein the processor is further configured to identify one of the tested electrode combinations based on input received from the user via the control device, and store the identified electrode combination within the memory for reapplication by the stimulation device at a later time. 
     
     
         23 . The system of  claim 21 , wherein each of the predetermined subset of electrode combinations corresponds to a respective stimulation location. 
     
     
         24 . The system of  claim 23 , wherein each of the predetermined subset of electrode combinations corresponds to a respective paresthesia location. 
     
     
         25 . The system of  claim 23 , wherein the set of electrodes comprises a two dimensional array of electrodes, and the mapping of the subset of electrode combinations to the output of the control device in the electrode combination map enables the user to move the stimulation longitudinally and laterally. 
     
     
         26 . The system of  claim 18 , further comprising a computer readable storage medium comprising instructions that cause the processor to:
 receive an output from the control device that reflects manipulation of a the directional controller of the control device by a user;   select the one predetermined subset of electrode combinations based on the received output and the electrode combination map; and   provide the selected electrode combination to the stimulation device for application of the electrical stimulation to the patient via the selected electrode combination.   
     
     
         27 . The system of  claim 18 , further comprising a memory configured to store a plurality of electrode combination maps, each of the electrode combination maps mapping the output of the control device to a respective predetermined subset of electrode combinations available from one of a plurality of electrode set configurations, wherein the processor is configured to receive information that describes a configuration of the set of electrodes coupled to the stimulation device and select the electrode combination map based on the configuration information. 
     
     
         28 . A method of operating the system of  claim 18 , comprising:
 storing the electrode combination map;   receiving the output from the control device;   selecting the one predetermined subset of electrode combinations based on the received output and the electrode combination map; and   controlling the stimulation device to apply the electrical stimulation to the patient via the selected electrode combination.   
     
     
         29 . The method of  claim 28 , wherein the output of the control device comprises directional information that reflects a direction of a manipulation of the directional controller, and selecting the electrode combination comprises selecting the electrode combination such that a direction of movement of paresthesia resulting from application of electrical stimulation via the selected electrode combination reflects the direction of the manipulation of the directional controller. 
     
     
         30 . The method of  claim 28 , further comprising:
 storing a plurality of electrode combination maps, each of the electrode combination maps mapping the output of the control device to a respective predetermined subset of electrode combinations available from one of a plurality of electrode set configurations;   receiving information that describes a configuration of the set of electrodes coupled to the stimulation device; and   selecting the electrode combination map based on the configuration information.   
     
     
         31 . The method of  claim 28 , wherein the user manipulates the directional controller to test a plurality of electrode combinations by application of electrical stimulation from the stimulation device to the patient via the plurality of electrode combinations. 
     
     
         32 . The method of  claim 31 , further comprising: identifying one of the tested electrode combinations based on input received from the user via the control device; and storing the identified electrode combination for reapplication by the stimulation device at a later time. 
     
     
         33 . The method of  claim 28 , wherein the set of electrodes are implanted proximate to the spinal cord of the patient, and the electrical stimulation comprises spinal cord stimulation. 
     
     
         34 . The method of  claim 28 , wherein each of the predetermined subset of electrode combinations corresponds to a respective stimulation location. 
     
     
         35 . The method of  claim 34 , wherein each of the predetermined subset of electrode combinations corresponds to a respective paresthesia location. 
     
     
         36 . A mapping system comprising:
 an input circuit to receive an output from a control device, the output reflecting manipulation of a directional controller of the control device by a user;   an electrode combination map that maps the output of the control device to a predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes; and   a processor to select one of the subset of electrode combinations based on the received output and the map, and control a stimulation device coupled to the set of electrodes to apply electrical stimulation to the patient via the selected electrode combination.   
     
     
         37 . A method comprising:
 storing an electrode combination map that maps an output of a control device to a predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes;   receiving the output from the control device, wherein the output reflects manipulation of a directional controller of the control device by a user;   selecting one electrode combination of the predetermined subset of electrode combinations based on the received output and the electrode combination map; and   controlling a stimulation device coupled to the set of electrodes to apply electrical stimulation to the patient via the selected electrode combination.   
     
     
         38 . A mapping system comprising:
 an input circuit configured to receive an output from a control device, the output reflecting manipulation of a directional controller of the control device by a user;   an electrode combination map that maps the output of the control device to a predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes;   a telemetry circuit; and   a processor configured to select one electrode combination of the predetermined subset of electrode combinations based on the received output and the map, and provide the selected electrode combination to a stimulation device coupled to the set of electrodes via the telemetry circuit for application of electrical stimulation to the patient via the selected electrode combination.   
     
     
         39 . A computer readable storage medium comprising instructions that cause a programmable processor to:
 receive an output from the control device that reflects manipulation of a directional controller of the control device by a user;   select one electrode combination of a predetermined subset of electrode combinations based on the received output and an electrode combination map, wherein the electrode combination map maps the output of the control device to the predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes; and   provide the selected electrode combination to a stimulation device coupled to the set of electrodes for application of electrical stimulation to the patient via the selected electrode combination.   
     
     
         40 . A mapping system comprising:
 an input circuit configured to receive an output from a control device, the output reflecting manipulation of a directional controller of the control device by a user;   an electrode combination map that maps the output of the control device to a predetermined subset of electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes; and   a processor configured to select one of the subset of electrode combinations based on the received output and the map, and control a stimulation device coupled to the set of electrodes to apply electrical stimulation to the patient via the selected electrode combination.   
     
     
         41 . A mapping system comprising:
 an input circuit to receive a directional signal;   an electrode combination map that maps the directional signal to one or more electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes; and   a processor to select an electrode combination based on the directional signal and the map, and control a stimulation device coupled to the set of electrodes to apply electrical stimulation to the patient via the selected electrode combination.   
     
     
         42 . A method comprising:
 storing an electrode combination map that maps a directional signal to one or more electrode combinations available from a set of electrodes implanted within a patient, wherein the electrode combinations specify polarities of electrodes of the set of electrodes;   receiving the directional signal;   selecting one electrode combination based on the directional signal and the electrode combination map; and   controlling a stimulation device coupled to the set of electrodes to apply electrical stimulation to the patient via the selected electrode combination.