Method and apparatus for determining tolerance thresholds for neurostimulation

Abstract

An example of a system for delivering neurostimulation using a stimulation device and controlling the delivery of the neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to program the stimulation device for delivering the neurostimulation according to a pattern of neurostimulation pulses defined by one or more stimulation waveforms. The stimulation control circuit may be configured to determine the pattern of neurostimulation pulses with the one or more stimulation waveforms constrained by one or more thresholds, and may include threshold circuitry that may be configured to receive one or more known values of the one or more thresholds and to determine needed values of the one or more thresholds by executing an algorithm allowing for prediction of the needed values of the one or more thresholds based on the one or more known values.

What is claimed is: 
     
         1 . A method for delivering neurostimulation to a patient using a stimulation device coupled to a plurality of electrodes, the method comprising:
 controlling the delivery of the neurostimulation from the stimulation device according to one or more stimulation waveforms defined by waveform parameters; and   determining the one or more stimulation waveforms using the processor, including:
 receiving a maximum value of a first parameter of the waveform parameters; 
 determining a maximum value of a second parameter of the waveform parameters using the received maximum value of the first parameter and a relationship allowing for prediction of needed values of the second parameter using one or more known values of the first parameter; and 
 determining the one or more stimulation waveforms using constraints including the maximum value of the first parameter and the maximum value of the second parameter. 
   
     
     
         2 . The method of  claim 1 , wherein controlling the delivery of the neurostimulation from the stimulation device according to the one or more stimulation waveforms comprises controlling the delivery of the neurostimulation from the stimulation device according a pattern of neurostimulation pulses including the one or more stimulation waveforms. 
     
     
         3 . The method of  claim 2 , wherein the pattern of neurostimulation pulses has multiple segments, receiving the maximum value of the first parameter comprises receiving the maximum value of the first parameter for each segment of the multiple segment, and determining the maximum value of the second parameter comprises determining the maximum value of the second parameter for the each segment. 
     
     
         4 . The method of  claim 3 , wherein receiving the maximum value of the first parameter comprises receiving a user-defined worst case for the each segment using a user interface, and the maximum value of the first parameter for the each segment is the value of the first parameter under the user-defined worst case for the each segment. 
     
     
         5 . The method of  claim 3 , further comprising identifying a worst case from the one or more stimulation waveforms for the each segment using the processor, wherein the maximum value of the first parameter is the value of the first parameter for the each segment under the worst case identified for the each segment. 
     
     
         6 . The method of  claim 2 , comprising controlling the delivery of the neurostimulation from the stimulation device according to the one or more stimulation waveforms and stimulation fields each defined by a set of active electrodes selected from the plurality of electrodes, and wherein receiving the maximum value of the first parameter comprises receiving the maximum value of the first parameter for each stimulation field of the stimulation fields, and determining the maximum value of the second parameter comprises determining the maximum value of the second parameter for the each stimulation field. 
     
     
         7 . The method of  claim 6 , wherein the first parameter is one of a pulse amplitude and a pulse width, the second parameter is the other of the pulse amplitude and the pulse width, and determining the maximum value of the second parameter using the received maximum value of the first parameter and the relationship comprises determining the maximum value of the second parameter using the received maximum value of the first parameter and a strength-duration curve. 
     
     
         8 . The method of  claim 7 , further comprising determining the strength-duration curve for each stimulation field of the stimulation fields using information including data collected from the patient. 
     
     
         9 . The method of  claim 2 , wherein receiving the maximum value of the first parameter comprises receiving a highest pulse amplitude. 
     
     
         10 . The method of  claim 2 , wherein receiving the maximum value of the first parameter comprises receiving a longest pulse width. 
     
     
         11 . The method of  claim 2 , wherein receiving the maximum value of the first parameter comprises receiving a highest pulse frequency. 
     
     
         12 . The method of  claim 2 , wherein receiving the maximum value of the first parameter comprises receiving a most efficiency waveform shape in producing a response in the patient. 
     
     
         13 . The method of  claim 2 , wherein receiving the maximum value of the first parameter comprises receiving a largest amount of pulse charge. 
     
     
         14 . A system for delivering neurostimulation to a patient using a stimulation device coupled to a plurality of electrodes, the system comprising:
 a programming control circuit configured to program the stimulation device for delivering the neurostimulation according to one or more stimulation waveforms; and   a stimulation control circuit configured to:
 receive a maximum value of a first parameter of waveform parameters defining the one or more stimulation waveforms; 
 determine a maximum value of a second parameter of the waveform parameters using the received maximum value of the first parameter and a relationship allowing for prediction of needed values of the second parameter using one or more known values of the first parameter; and 
 determine the one or more stimulation waveforms using constraints including the maximum value of the first parameter and the maximum value of the second parameter. 
   
     
     
         15 . The system of  claim 14 , wherein the stimulation control circuit is further configured to identify a worse case from the one or more stimulation waveforms, and the maximum value of the first parameter is the value of the first parameter under the identified worst case. 
     
     
         16 . The system of  claim 15 , wherein the programming control circuit is configured to program the stimulation device for delivering the neurostimulation according to pattern of neurostimulation pulses including the one or more stimulation waveforms and including multiple segments, and the stimulation control circuit is further configured to identify the worst case from each segment of the multiple segments. 
     
     
         17 . The system of  claim 14 , further comprising a user interface coupled to the stimulation control circuit, the user interface configured to receive a user-defined worst case in the one or more stimulation waveforms, and wherein the maximum value of the first parameter is the value of the first parameter under the user-defined worst case. 
     
     
         18 . The system of  claim 14 , wherein the programming control circuit is configured to program the stimulation device for delivering the neurostimulation according to pattern of neurostimulation pulses including the one or more stimulation waveforms, the first parameter is one of a pulse amplitude and a pulse width, the second parameter is the other of the pulse amplitude and the pulse width, and the stimulation control circuit is configured to determine the maximum value of the second parameter using the received maximum value of the first parameter and a strength-duration curve. 
     
     
         19 . The system of  claim 18 , wherein the programming control circuit is configured to program the stimulation device for delivering the neurostimulation according to the one or more stimulation waveforms and stimulation fields each defined by a set of active electrodes selected from the plurality of electrodes, and the stimulation control circuit is configured to receive the maximum value of the first parameter for each stimulation field of the stimulation fields and determine the maximum value of the second parameter for the each stimulation field. 
     
     
         20 . A non-transitory computer-readable storage medium including instructions, which when executed by a system, cause the system to perform a method for delivering neurostimulation to a patient using a stimulation device coupled to a plurality of electrodes, the method comprising:
 controlling the delivery of the neurostimulation from the stimulation device according to one or more stimulation waveforms defined by waveform parameters; and   determining the one or more stimulation waveforms using the processor, including:
 receiving a maximum value of a first parameter of the waveform parameters; 
 determining a maximum value of a second parameter of the waveform parameters using the received maximum value of the first parameter and a relationship allowing for prediction of needed values of the second parameter using one or more known values of the first parameter; and 
   
       determining the one or more stimulation waveforms using constraints including the maximum value of the first parameter and the maximum value of the second parameter.