System and method to managing stimulation of select a-beta fiber components

Abstract

A computer implemented method and system is provided for managing neural stimulation therapy. The method comprises under control of one or more processors configured with program instructions. The method delivers a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest. A parameter defines the candidate stimulation waveforms is changed to vary the stimulation intensity. The method identifies a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect. The method further identifies a second candidate stimulation waveform that does not induce the select analgesic effect. The method sets a stimulation therapy based on the first and second candidate stimulation waveforms.

What is claimed is: 
     
         1 . A computer implemented method for managing neural stimulation therapy, comprising:
 under control of one or more processors configured with program instructions,   delivering a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest, wherein a parameter defining the candidate stimulation waveforms is changed to vary the stimulation intensity;   identifying a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect;   identifying a second candidate stimulation waveform that does not induce the select analgesic effect; and   setting a stimulation therapy based on the first and second candidate stimulation waveforms, wherein the second candidate stimulation waveform exhibits a stimulation intensity that blocks large and medium A-beta fibers that would otherwise induce paresthesia and analgesic effects, respectively.   
     
     
         2 . The method of  claim 1 , wherein the candidate stimulation waveform corresponds to a high frequency stimulation waveform or a burst stimulation waveform for spinal cord stimulation (SCS). 
     
     
         3 . The method of  claim 2 , further comprising delivering tonic SCS pulses during the stimulation therapy in combination with the high frequency stimulation waveform or burst stimulation waveform. 
     
     
         4 . The method of  claim 3 , further comprising utilizing current steering to direct the tonic SCS pulses to dermatomes of interest. 
     
     
         5 . The method of  claim 1 , wherein the stimulation therapy includes first and second stimulation modalities, the method further comprising delivering the first and second stimulation modalities from different first and second electrode combinations. 
     
     
         6 . The method of  claim 1 , further comprising:
 sensing evoked compound action potential (ECAP) signals;   applying a narrow band-pass filter to the ECAP signals to filter out stimulation artifacts from at least one of the first and second stimulation candidate waveforms;   performing a fast Fourier transform to the ECAP signals after the filtering operation; and   the identifying operations including analyzing the ECAP signals in a frequency domain.   
     
     
         7 . The method of  claim 6 , wherein the analyzing includes determining a parameter setting associated with the stimulation therapy that yields ECAP signals that fit select profiles. 
     
     
         8 . A computer implemented method for managing neural stimulation therapy, comprising:
 under control of one or more processors configured with program instructions,   delivering a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest, wherein a parameter defining the candidate stimulation waveforms is changed to vary the stimulation intensity;   identifying a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect;   identifying a second candidate stimulation waveform that does not induce the select analgesic effect; and   setting a stimulation therapy based on the first and second candidate stimulation waveforms, wherein the stimulation therapy blocks the large A-beta fibers having diameters of approximately 11.0-13.0 μm and activates medium A-beta fibers having diameters of approximately 6.0-11.0 μm.   
     
     
         9 . A system for managing neural stimulation therapy comprising:
 a lead having at least one stimulation electrode, the lead configured to be implanted at a target position proximate to nervous tissue of interest; and   an implantable pulse generator (IPG) coupled to the lead, the IPG configured to:   deliver a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest,   wherein a parameter defining the candidate stimulation waveforms is changed to vary the stimulation intensity;   identify a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect;   identify a second candidate stimulation waveform that does not induce the select analgesic effect; and   set a stimulation therapy based on the first and second candidate stimulation waveforms, wherein the first candidate stimulation waveform exhibits a stimulation intensity that blocks large diameter A-beta fibers that would otherwise induce a paresthesia effect.   
     
     
         10 . The system of  claim 9 , wherein the second candidate stimulation waveform exhibits a stimulation intensity that blocks large and medium diameter A-beta fibers that would otherwise induce paresthesia and analgesic effects, respectively. 
     
     
         11 . The system of  claim 9 , wherein the stimulation therapy blocks the large A-beta fibers having diameters of approximately 11.0-13.0 μm and activates medium A-beta fibers having diameters of approximately 6.0-11.0 μm. 
     
     
         12 . The system of  claim 9 , wherein at least one of the first and second candidate stimulation waveforms correspond to a high frequency stimulation waveform or a burst stimulation waveform for spinal cord stimulation (SCS). 
     
     
         13 . The system of  claim 12 , wherein the IPG further delivers, as the stimulation therapy, tonic SCS pulses in combination with the at least one of the first and second candidate stimulation waveforms from the at least one stimulation electrode or from a different stimulation electrode. 
     
     
         14 . The system of  claim 13 , wherein the stimulation therapy represents a series of pulse bursts separated by quiescent periods, and the tonic SCS pulses are delivered during the quiescent periods. 
     
     
         15 . The system of  claim 9 , wherein the IPG further senses sensory evoked compound action potential (ECAP) signals from the nervous tissue of interest, and analyzing the ECAP signals for ECAP activity data to identify first and second components, the first component indicative of ECAP activity of large diameter A-beta fibers, the second component indicative of ECAP activity of medium diameter A-beta fibers, the setting operation based on the first and second components of the activity data. 
     
     
         16 . The system of  claim 15 , wherein the IPG determines a parameter setting associated with the stimulation therapy that yields ECAP activity data for which the first and second components fit within a select profile.