Systems and methods for determining spinal cord stimulation parameters based on patient feedback

Abstract

The present disclosure provides a grip sensor for quantifying pain experienced by a patient during spinal cord stimulation (SCS). The grip sensor includes an electronics enclosure, an annular outer shell substantially surrounding the electronics enclosure and sized to be held by the patient, a pressure sensor embedded in the outer shell and communicatively coupled to the electronics enclosure, the pressure sensor configured to measure a grip strength of the patient as SCS is applied to the patient, and a plurality of galvanic skin response sensors communicatively coupled to the electronics enclosure and configured to measure an electrical impedance of the skin of the patient as SCS is applied to the patient.

What is claimed is: 
     
         1 . A system for quantifying pain experienced by a patient during spinal cord stimulation (SCS). the system comprising:
 a grip sensor sized to be gripped by the patient and comprising at least one sensor configured to measure at least one value as different SCS configurations are applied to the patient;   a computing device communicatively coupled to the grip sensor and configured to calculate a pain level for each SCS configuration based on the at least one value measured by the at least one sensor; and   a display device communicatively coupled to the grip sensor and configured to display a plot including the calculated pain level for each SCS configuration.   
     
     
         2 . The system of  claim 1 , wherein the grip sensor comprises:
 an electronics enclosure;   an annular outer shell substantially surrounding the electronics enclosure and sized to be held by the patient;   a pressure sensor embedded in the outer shell and communicatively coupled to the electronics enclosure, the pressure sensor configured to measure a grip strength of the patient; and   a plurality of galvanic skin response sensors communicatively coupled to the electronics enclosure and configured to measure an electrical impedance of the skin of the patient.   
     
     
         3 . The system of  claim 2 , further comprising a thermometer configured to measure a skin temperature of the patient. 
     
     
         4 . The system of  claim 2 , wherein the electronics enclosure and the outer shell form a substantially cylindrical housing. 
     
     
         5 . The system of  claim 4 , further comprising;
 a first mechanical support member extending from a first end of the housing; and   a second mechanical support member extending from a second end of the housing.   
     
     
         6 . The system of  claim 2 , wherein the electronics enclosure is configured to:
 receive a first measurement from the pressure sensor;   receive a second measurement from the plurality of galvanic skin response sensors;   receive a third measurement from a thermometer; and   calculate the pain level based on the first, second, and third measurements.   
     
     
         7 . The system of  claim 2 , wherein the computing device is included within the electronics enclosure. 
     
     
         8 . The system of  claim 1 , wherein the display device is configured to display a plot that includes an electrode configuration display. 
     
     
         9 . A method for determining SCS therapy parameters for a patient, the method comprising:
 applying tonic stimulation at a fixed frequency;   varying at least one parameter of the applied tonic stimulation until paresthesia coverage of a target area of the patient is achieved; and   further manipulating the applied tonic stimulation to achieve one of burst stimulation and high-frequency stimulation that provides pain relief with reduced paresthesia.   
     
     
         10 . The method of  claim 9 , wherein further manipulating the applied tonic stimulation comprises:
 dividing each pulse of the applied tonic stimulation into a plurality of pulses to produce burst stimulation; and   adjusting an intra-burst frequency and an inter-burst frequency of the burst stimulation until pain relief with reduced paresthesia is achieved.   
     
     
         11 . The method of  claim 9 , wherein further manipulating the applied tonic stimulation comprises:
 adjusting the frequency of the tonic stimulation to a lower threshold frequency to produce high-frequency stimulation; and   increasing the frequency from the lower threshold frequency until pain relief with reduced paresthesia is achieved.  12 , The method of  claim 9 , wherein further manipulating the applied tonic stimulation comprises:   adjusting the frequency of the tonic stimulation to an upper threshold frequency to produce high-frequency stimulation; and   decreasing the frequency from the upper threshold frequency until a minimum frequency at which pain relief with reduced paresthesia is generated is reached.   
     
     
         13 . The method of  claim 9 , wherein varying at least one parameter comprises varying at least one of a contact configuration, an amplitude, a pulse width, and a frequency of the applied tonic stimulation. 
     
     
         14 . The method of  claim 9 , wherein applying tonic stimulation comprises applying tonic stimulation at approximately 50 Hz.