US 12,471,832 B2Granted

System and methods for improving diagnostic evoked potential studies for functional assessments of nerves and nerve pathways

AssigneeSidewayStrategies LLC

InventorsJonathan D. Block, Hieu T. Ball

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Abstract

Systems and methods for enhancing diagnostic evoked potential recordings of a nerve or nerve pathway of interest. A grid array of stimulating electrodes are placed on, over, or through skin in a location beneath which a nerve or nerve pathway is suspected to lie. A stimulator controls the grid array, where each electrode is independently controllable as active or inactive, as a cathode or anode, etc. A plurality of recording electrodes may record Somato-Sensory Evoked Potentials (SSEPs) and/or Transcranial Electrical Motor Evoked Potentials (TCeMEP) in response to activation of the stimulating electrodes. A processor controls stimulating the stimulating electrodes, and receives responses from the recording electrodes, in a general search mode and a focused search mode in order to use a minimum stimulation intensity at which a maximum response amplitude is detected to continually stimulate the nerve or the nerve pathway.

Claims20

Dependent claims

A system comprising:

a plurality of stimulating electrodes arranged in a grid array configured to be placed on, over, or through skin over an area of a nerve or nerve pathway;
a stimulator configured to control the grid array;
a plurality of recording electrodes;
and
one or more processors configured to:
execute a general search mode comprising:
instructing the stimulator to systematically test a plurality of stimulation schemes until a first evoked potential response is detected by the plurality of recording electrodes having a maximum response amplitude, wherein:
each of the plurality of stimulation schemes includes activating and assigning positions and polarity of one or more of the plurality of stimulating electrodes, and
instructing the stimulator to systematically test the plurality of stimulation schemes in the general search mode comprises instructing the stimulator to ramp stimulation intensity during testing each of the plurality of stimulation schemes until at least one of:
a maximum stimulation intensity value is reached, or the maximum response amplitude is detected;
execute a focused search mode after executing the general search mode, the focused search mode comprising:
utilizing information from the general search mode, instructing the stimulator to systematically test the plurality of stimulation schemes until a second evoked potential response is detected by the plurality of recording electrodes having the maximum response amplitude and a minimum stimulation intensity, wherein:
instructing the stimulator to systematically test the plurality of stimulation schemes in the focused search mode comprises instructing the stimulator to ramp stimulation intensity during testing each of the plurality of stimulation schemes until the maximum response amplitude is detected;
for each stimulation scheme of the plurality of stimulation schemes, recording a respective stimulation intensity for the stimulation scheme at which the maximum response amplitude is detected;
comparing the respective stimulation intensities of the plurality of stimulation schemes at which the maximum response amplitudes was detected;
and
selecting the minimum stimulation intensity at which the maximum response amplitude was detected;
and
use the minimum stimulation intensity at which the maximum response amplitude was detected to further stimulate the nerve or nerve pathway.

16 more elements

A computer-implemented method comprising:

by one or more processors executing program instructions:
communicating with a stimulator configured to control a grid array of a plurality of stimulating electrodes;
executing a general search mode comprising:
instructing the stimulator to systematically test a plurality of stimulation schemes until a first evoked potential response is detected by a plurality of recording electrodes having a maximum response amplitude, wherein:
each of the plurality of stimulation schemes includes activating and assigning positions and polarity of the plurality of stimulating electrodes, and
instructing the stimulator to systematically test the plurality of stimulation schemes in the general search mode comprises instructing the stimulator to ramp stimulation intensity during testing each of the plurality of stimulation schemes until at least one of:
a maximum stimulation intensity value is reached or the maximum response amplitude is detected;
executing a focused search mode after executing the general search mode, the focused search mode comprising:
utilizing information from the general search mode, instructing the stimulator to systematically test the plurality of stimulation schemes until a second evoked potential response is detected by the plurality of recording electrodes having the maximum response amplitude and a minimum stimulation intensity, wherein:
instructing the stimulator to systematically test the plurality of stimulation schemes in the focused search mode comprises instructing the stimulator to ramp stimulation intensity during testing each of the plurality of stimulation schemes until the maximum response amplitude is detected;
for each stimulation scheme of the plurality of stimulation schemes, recording a respective stimulation intensity for the stimulation scheme at which the maximum response amplitude is detected;
comparing the respective stimulation intensities of the plurality of stimulation schemes at which the maximum response amplitude was detected;
and
selecting the minimum stimulation intensity at which the maximum response amplitude was detected;
and
using the minimum stimulation intensity at which the maximum response amplitude was detected to further stimulate a nerve or nerve pathway.

13 more elements

Dependencies are inferred from the claim text.

Facts

Application: 17/649,860Filed 3 Feb 2022 · continuation
Priority: 14 Jul 2016
Published: US 2022/0400999 A122 Dec 2022
Granted: 18 Nov 2025
Term ends: Not estimatedThe source records don’t support an estimate.

Classification15 codes

A61B 5/388
Modalities, i.e. specific diagnostic methods: nerve conduction study, e.g. detecting action potential of peripheral nerves
A61B 5/383
Using evoked responses: somatosensory stimuli, e.g. electric stimulation
A61B 5/4047
Evaluating nerves condition: afferent nerves, i.e. nerves that relay impulses to the central nervous system
A61B 5/6814
Specially adapted to be attached to a specific body part: head

Family

Application62/362,523Us provisional application · filed 14 Jul 2016
PCT/US2017/042271Parent of this continuation · filed 14 Jul 2017
US 2022/0400999 A1Pre-grant publication · published 22 Dec 2022
Application16/317,221Parent of this continuation
US 11,272,871 B2Parent of this continuation
US 2019/0239763 A1Published application
US 12,471,832 B2This patent

From the US filing history. Foreign family members aren’t listed.