Methods for determining neurostimulation electrode configurations based on neural localization

摘要

Methods and systems for obtaining and analyzing electromyography responses of electrodes of an implanted neurostimulation lead for use neurostimulation programming are provided herein. System setups for neural localization and/or programming include a clinician programmer coupleable with a temporary or permanent lead implantable in a patient and at least one pair of EMG sensing electrodes minimally invasively positioned on a skin surface or within the patient. The clinician programmer is configured to determine a plurality of recommended electrode configurations based on thresholds and EMG responses of the plurality of electrodes and rank the electrode configuration according to pre-determined criteria. The clinician programmer further includes graphical user interface on which the plurality of recommended electrode configurations are displayed for modification and/or selection by a clinician in programming an IPG or EPG coupled with the lead to apply a neurostimulation treatment according to the selected electrode configuration.

主权项

1. A method of programming a neurostimulation device for treatment of bladder and/or bowel related dysfunction, the neurostimulation device having an implanted neurostimulation lead with a plurality of electrodes that is operatively coupled with a clinician programming device, the method comprising:
determining, with the clinician programming device, a plurality of recommended electrode configurations for a plurality of electrodes; of the implanted neurostimulation lead by:
obtaining a stimulation threshold for each of the plurality of electrodes with the clinician programming device, wherein the stimulation threshold is based, at least in part, on an electromyography (EMG) recording of at least one neuromuscular response during stimulation of each electrode of the plurality of electrodes;identifying cathode configurations of the plurality of recommended electrode configurations based at least in part on the stimulation thresholds,identifying anode configurations of the plurality of recommended electrode configurations for a mode of operation, the mode being bipolar or monopolar operation, wherein identifying anode configurations is based on the cathode configurations if the mode of operation is bipolar and identifying anode configurations comprises assigning a housing of an implantable pulse generator as the anode if the mode of operation is monopolar, andoutputting the plurality of recommended electrode configurations, which include the identified cathode and anode configurations, to a user on a graphical user interface display of the clinician programming device for selection by the user; and determining one or more neurostimulation programs for one or more electrode configurations of the plurality of recommended electrode configurations with the clinician programming device for treatment of bladder and/or bowel related dysfunction.