# US 8,788,059 B2 · Short duration pre-pulsing to reduce stimulation-evoked side effects

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- Number: US 8,788,059 B2
- Document ID: US8788059B2
- Status: Granted
- Kind: B2
- Application number: 13/651,077
- Filed: 2012-10-12
- Published: 2013-04-18
- Granted: 2014-07-22
- Earliest claimed: 2007-05-23
- Assignees: Boston Scientific Neuromodulation Corporation
- Applicants: Boston Scientific Neuromodulation Corporation
- Inventors: Michael A. Moffitt; David K. L. Peterson
- Web page: https://patentgrep.com/patent/US8788059B2

## CPC

- A61N 1/36128: {Control systems}
- A61N 1/0553: {Paddle shaped electrodes, e.g. for laminotomy}
- A61N 1/36164: {Sub-threshold or non-excitatory signals (non-excitatory signals to the heart A61N1/3628)}
- A61N 1/36167: {Timing, e.g. stimulation onset}
- A61N 1/36017: {with leads or electrodes penetrating the skin}
- A61N 1/36071: {Pain}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

A method and neurostimulation system of providing therapy to a patient is provided. At least one electrode is place in contact with tissue of a patient. A sub-threshold, hyperpolarizing, conditioning pre-pulse (e.g., an anodic pulse) is conveyed from the electrode(s) to render a first region of the tissue (e.g., dorsal root fibers) less excitable to stimulation, and a depolarizing stimulation pulse (e.g., a cathodic pulse) is conveyed from the electrode(s) to stimulate a second different region of the tissue (e.g., dorsal column fibers). The conditioning pre-pulse has a relatively short duration (e.g., less than 200 μs).

## Claims

### Claim 1

A neurostimulation system, comprising:
a plurality of electrical contacts configured for being in electrical communication with a plurality of electrodes placed adjacent a region of tissue;
analog output circuitry configured for outputting electrical pulses to the plurality of electrical contacts in accordance with a pulse pattern; and
control circuitry configured for defining the pulse pattern, such that the electrical pulses comprise a sub-threshold, conditioning, pre-pulse outputted to a first one of the electrical contacts, a stimulation pulse outputted to a second different one of the electrical contacts, and a sub-threshold, conditioning, post-pulse outputted to the first one of the electrical contacts, wherein a duration between the sub-threshold, conditioning pre-pulse and the stimulation pulse is such that the region of tissue is rendered less excitable to the stimulation pulse, and the duration between the sub-threshold, conditioning post-pulse and the stimulation pulse is such that the region of tissue is further rendered less excitable to the stimulation pulse.

### Claim 2 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse and the sub-threshold, conditioning post-pulse are both anodic, and the stimulation pulse is cathodic.

### Claim 3 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse has a duration equal to or less than 150 μs.

### Claim 4 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse has a duration equal to or less than 75 μs.

### Claim 5 (depends on 1)

The neurostimulation system of claim 1, wherein the stimulation pulse has a duration less than 200 μs.

### Claim 6 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse has a duration equal to or less than 200 μs.

### Claim 7 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse and the stimulation pulse have a delay therebetween less than 100 μs.

### Claim 8 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse and the stimulation pulse have a delay therebetween less than 30 μs.

### Claim 9 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning pre-pulse and the stimulation pulse has no delay therebetween.

### Claim 10 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning post-pulse and the stimulation pulse have a delay therebetween within 50 μs.

### Claim 11 (depends on 1)

The neurostimulation system of claim 1, wherein the sub-threshold, conditioning post-pulse overlaps the stimulation pulse in time.

### Claim 12 (depends on 1)

The neurostimulation system of claim 1, further comprising one or more stimulation leads carrying the plurality of electrodes in electrical communication with the plurality of electrical contacts.

### Claim 13 (depends on 12)

The neurostimulation system of claim 12, wherein the one or more stimulation leads comprises one or more spinal cord stimulation leads.

### Claim 14 (depends on 1)

The neurostimulation system of claim 1, further comprising memory configured for storing a set of stimulation parameters, wherein the control circuitry is configured for defining the pattern in accordance with the stimulation parameter set.

### Claim 15 (depends on 1)

The neurostimulation system of claim 1, further comprising a case, wherein the plurality of electrical contacts, analog output circuitry, and control circuitry are contained in the case to form an implantable neurostimulator.