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1. 发明授权

US09289607B2 Urgency therapy with neuromodulation and C-afferent nerve desensitization 有权
标题翻译：紧急治疗与神经调节和C传入神经脱敏
公开(公告)号：US09289607B2
公开(公告)日：2016-03-22
申请号：US13817486
申请日：2011-08-16
申请人： Xin Su , Gregory F. Molnar , Dwight E. Nelson
发明人： Xin Su , Gregory F. Molnar , Dwight E. Nelson
IPC分类号： A61N1/02 , A61N1/36 , A61M5/142 , A61M5/172 , G06F19/00 , A61K31/165
CPC分类号： A61N1/36007 , A61K31/165 , A61M5/14276 , A61M5/1723 , A61M2205/054 , A61M2210/1085 , A61N1/36057 , A61N1/3606 , A61N1/36071 , A61N1/36171 , G06F19/00 , G06F19/3468 , G06F19/3481
摘要： Systems (10), devices (16), and methods may be used for treating bladder dysfunction, such as urgency and pelvic pain. In one example, a method includes administering a pharmacological agent to a patient (14) in a dosage sufficient to desensitize a C-afferent nerve fiber of the patient. Additionally, the method includes delivering stimulation to activate a nerve fiber proximate to the C-afferent nerve fiber via an electrode (19A, 19B, 21A, 21B, 29A-29D) electrically coupled to an implantable medical device (16). In some examples, the nerve fiber may be different than the C-afferent nerve fiber, the stimulation of the nerve fiber may elicit an inhibitory physiological response related to voiding in the patient, and/or the stimulation substantially may not activate the C-afferent nerve fiber after desensitization of the nerve fiber via the administration of the pharmacological agent.
摘要翻译：系统（10），装置（16）和方法可用于治疗膀胱功能障碍，如紧急和盆腔疼痛。在一个实例中，一种方法包括以足以使患者的C型传入神经纤维脱敏的剂量向患者（14）施用药理学试剂。另外，该方法包括递送刺激以通过电耦合到可植入医疗装置（16）的电极（19A，19B，21A，21B，29A-29D）激活靠近C型传入神经纤维的神经纤维。在一些实例中，神经纤维可能与C传入神经纤维不同，神经纤维的刺激可能引起与患者排尿有关的抑制性生理反应，和/或刺激基本上不能激活C传入神经纤维通过施用药理学神经纤维脱敏后。

2. 发明申请

US20120130444A1 INCONTINENCE THERAPY 有权
标题翻译：不良治疗
公开(公告)号：US20120130444A1
公开(公告)日：2012-05-24
申请号：US13265702
申请日：2010-04-09
申请人： Xuan K. Wei , Eric H. Bonde , Keith A. Miesel , Mark S. Lent , Gregory F. Molnar
发明人： Xuan K. Wei , Eric H. Bonde , Keith A. Miesel , Mark S. Lent , Gregory F. Molnar
IPC分类号： A61N1/36
CPC分类号： A61N1/36007 , A61N1/0514 , A61N1/0551 , A61N1/36128 , A61N1/36135 , A61N1/37235 , A61N1/37252
摘要： Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.
摘要翻译：用于管理尿失禁或大便失禁的技术包括递送第一类型的治疗以产生第一生理反应，并且在检测到触发事件时，递送第二类型的治疗以产生第二生理反应。第一种类型的治疗可以基本上定期地递送，而第二种类型的治疗根据需要被递送以提供额外的治疗效果。用于激活第二类治疗的递送的触发事件可以包括来自传感器的输入，其指示膀胱状况，患者活动水平或患者姿势或患者输入。在一些例子中，治疗是刺激疗法。

3. 发明授权

US08185207B2 Medical device configuration based on sensed brain signals 有权
标题翻译：基于感觉到的大脑信号的医疗设备配置
公开(公告)号：US08185207B2
公开(公告)日：2012-05-22
申请号：US13167754
申请日：2011-06-24
申请人： Gabriela C. Molnar , Gregory F. Molnar
发明人： Gabriela C. Molnar , Gregory F. Molnar
IPC分类号： A61N1/00
CPC分类号： A61N1/36071 , A61B5/048 , A61B5/7257
摘要： The invention is directed to techniques and systems in which external brain monitoring is used to facilitate implantation and configuration of an implantable medical device. The techniques may create an open loop or closed loop system in which brain signals quantify the efficacy of electrical logical stimulation (or drug therapy via an implantable drug pump) at locations outside of the brain. The techniques may be used to improve placement of leads and electrodes during an implantation procedure, and/or to select or adjust stimulation parameters either during the implantation procedure or possibly following implantation of an implantable medical device. The described techniques have applications for the alleviation of pain, but may find other applications where EEG signals can quantify the efficacy of treatment via an implantable medical device.
摘要翻译：本发明涉及使用外部脑部监测来促进可植入医疗装置的植入和构造的技术和系统。这些技术可以产生开环或闭环系统，其中脑信号定量在脑外部位置的电逻辑刺激（或通过可植入药物泵的药物治疗）的功效。这些技术可以用于在植入过程期间改善引线和电极的放置，和/或在植入过程期间或可能在植入可植入医疗器械之后选择或调整刺激参数。所描述的技术具有减轻疼痛的应用，但是可以找到其他应用，其中EEG信号可以通过可植入医疗装置量化治疗的功效。

4. 发明授权

US08135473B2 Collecting posture and activity information to evaluate therapy 有权
标题翻译：收集姿势和活动信息以评估治疗
公开(公告)号：US08135473B2
公开(公告)日：2012-03-13
申请号：US11691381
申请日：2007-03-26
申请人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
发明人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
IPC分类号： A61N1/36
CPC分类号： A61B5/103 , A61B5/0205 , A61B5/1116 , A61B5/4082 , A61B5/4094 , A61B5/6804 , A61B5/6825 , A61B5/686 , A61N1/0529 , A61N1/0531 , A61N1/0534 , A61N1/36071 , A61N1/36082 , A61N1/36585 , A61N1/37235 , G06F19/00
摘要： A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.
摘要翻译：医疗设备，程序员或其他计算设备可以确定一个或多个活动的值，并且在一些实施例中，确定由医疗设备用于递送治疗的每个治疗参数集的姿势度量。当参数组被使用时，基于由传感器产生的信号来确定参数集的度量值。除了治疗参数集之外，活动度量值可以与姿势类别相关联，并且可以指示根据治疗参数集合递送治疗产生的一个或多个姿势类别内的活动的持续时间和强度。用于治疗参数组的姿势度量可以指示当医疗装置使用治疗参数集时患者在各种姿势中花费的时间的分数。度量值可用于评估治疗参数组的功效。

5. 发明申请

US20090192556A1 SLEEP STAGE DETECTION 有权
标题翻译：睡眠阶段检测
公开(公告)号：US20090192556A1
公开(公告)日：2009-07-30
申请号：US12238105
申请日：2008-09-25
申请人： Jianping Wu , Gregory F. Molnar , Gabriela C. Miyazawa , Timothy J. Denison
发明人： Jianping Wu , Gregory F. Molnar , Gabriela C. Miyazawa , Timothy J. Denison
IPC分类号： A61N1/00 , A61B5/04
CPC分类号： A61B5/4812 , A61B5/0031 , A61B5/01 , A61B5/02055 , A61B5/024 , A61B5/04014 , A61B5/04015 , A61B5/0402 , A61B5/0478 , A61B5/048 , A61B5/1116 , A61B5/1118 , A61B5/4082 , A61B5/4839 , A61M5/1723 , A61M21/02 , A61M2005/1726 , A61M2021/0072 , A61M2205/3523 , A61M2205/3553 , A61M2205/3584 , A61M2205/3592 , A61M2205/50 , A61M2205/52 , A61M2230/005 , A61M2230/04 , A61M2230/08 , A61M2230/10 , A61M2230/205 , A61M2230/30 , A61M2230/42 , A61M2230/50 , A61M2230/60 , A61M2230/63 , A61M2230/65 , A61N1/36078 , A61N1/36139 , G06F19/3481 , G16H40/63
摘要： Therapy delivery to a patient may be controlled based on a determined sleep stage of the patient. In examples, the sleep stage may be determined based on a frequency characteristic of a biosignal indicative of brain activity of the patient. A frequency characteristic may include, for example, a power level within one or more frequency bands of the biosignal, a ratio of the power level in two or more frequency bands, or a pattern in the power level of one or more frequency bands over time. A therapy program may be selected or modified based on the sleep stage determination. Therapy may be delivered during the sleep stage according to the selected or modified therapy program. In some examples, therapy delivery may be controlled after making separate determinations of a sleep stage based on the biosignal and another physiological parameter, and confirming that the sleep stage determinations are consistent.
摘要翻译：可以基于患者的确定的睡眠阶段来控制对患者的治疗递送。在实施例中，睡眠阶段可以基于指示患者的大脑活动的生物信号的频率特性来确定。频率特性可以包括例如生物信号的一个或多个频带内的功率电平，两个或更多个频带中的功率电平的比率，或者一个或多个频带的功率电平中的模式随时间的变化。可以基于睡眠阶段确定来选择或修改治疗程序。根据所选择或修改的治疗方案，治疗可以在睡眠阶段期间递送。在一些实例中，可以在基于生物信号和另一生理参数进行睡眠阶段的单独测定以及确认睡眠阶段确定是一致的之后控制治疗递送。

6. 发明申请

US20070225674A1 Method and Apparatus for the Treatment of Movement Disorders 有权
标题翻译：用于治疗运动障碍的方法和装置
公开(公告)号：US20070225674A1
公开(公告)日：2007-09-27
申请号：US11565268
申请日：2006-11-30
申请人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
发明人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
IPC分类号： A61N1/00 , A61M31/00 , A61B5/00 , A61B5/04
CPC分类号： A61N1/36067 , A61B5/048 , A61B5/4082 , A61N1/36003
摘要： A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.
摘要翻译：用于治疗患有运动障碍的患者的方法，装置和系统，其具有确定指示疾病状态的一种或多种生物标志物的能力。在一些实施方案中，生物标志物可以用作闭环反馈信号以控制治疗的递送（例如电刺激或药物治疗），并且其也可以用作治疗有效性的指示。一个实施例使用放置在脑中的电极来测量EEG或局部场电位（LFP）信号，从该信号可以确定一个或多个生物标志物。

7. 发明授权

US08688221B2 Collecting posture and activity information to evaluate therapy 有权
标题翻译：收集姿势和活动信息以评估治疗
公开(公告)号：US08688221B2
公开(公告)日：2014-04-01
申请号：US13401348
申请日：2012-02-21
申请人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
发明人： Keith A. Miesel , Kenneth T. Heruth , Gregory F. Molnar
IPC分类号： A61N1/36
CPC分类号： A61B5/103 , A61B5/0205 , A61B5/1116 , A61B5/4082 , A61B5/4094 , A61B5/6804 , A61B5/6825 , A61B5/686 , A61N1/0529 , A61N1/0531 , A61N1/0534 , A61N1/36071 , A61N1/36082 , A61N1/36585 , A61N1/37235 , G06F19/00
摘要： A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.
摘要翻译：医疗设备，程序员或其他计算设备可以确定一个或多个活动的值，并且在一些实施例中，确定由医疗设备用于递送治疗的每个治疗参数集的姿势度量。当参数组被使用时，基于由传感器产生的信号来确定参数集的度量值。除了治疗参数集之外，活动度量值可以与姿势类别相关联，并且可以指示根据治疗参数集合递送治疗产生的一个或多个姿势类别内的活动的持续时间和强度。用于治疗参数组的姿势度量可以指示当医疗装置使用治疗参数集时患者在各种姿势中花费的时间的分数。度量值可用于评估治疗参数组的功效。

8. 发明授权

US08380314B2 Patient directed therapy control 有权
公开(公告)号：US08380314B2
公开(公告)日：2013-02-19
申请号：US11974931
申请日：2007-10-16
申请人： Eric J. Panken , Timothy J. Denison , Gregory F. Molnar
发明人： Eric J. Panken , Timothy J. Denison , Gregory F. Molnar
IPC分类号： A61N1/18
CPC分类号： A61N1/36139 , A61B5/048 , A61B5/4082 , A61B5/7475 , A61M5/14276 , A61M5/1723 , A61M2210/0693 , A61N1/36014 , A61N1/36017 , A61N1/36021 , A61N1/36025 , A61N1/3605 , A61N1/3606 , A61N1/36071 , A61N1/36082 , A61N1/37252 , G06F3/015
摘要： A patient controls the delivery of therapy through volitional inputs that are detected by a biosignal within the brain. The volitional patient input may be directed towards performing a specific physical or mental activity, such as moving a muscle or performing a mathematical calculation. In one embodiment, a biosignal detection module monitors an electroencephalogram (EEG) signal from within the brain of the patient and determines whether the EEG signal includes the biosignal. In one embodiment, the biosignal detection module analyzes one or more frequency components of the EEG signal. In this manner, the patient may adjust therapy delivery by providing a volitional input that is detected by brain signals, wherein the volitional input may not require the interaction with another device, thereby eliminating the need for an external programmer to adjust therapy delivery. Example therapies include electrical stimulation, drug delivery, and delivery of sensory cues.

9. 发明申请

US20110313261A1 WEARABLE AMBULATORY DATA RECORDER 有权
标题翻译：耐用的数据记录仪
公开(公告)号：US20110313261A1
公开(公告)日：2011-12-22
申请号：US13217011
申请日：2011-08-24
申请人： Duane Bourget , Keith A. Miesel , Gregory F. Molnar
发明人： Duane Bourget , Keith A. Miesel , Gregory F. Molnar
IPC分类号： A61B5/103 , A61B5/04 , A61B5/00
CPC分类号： A61N1/08 , A61B5/0002 , A61B5/0031 , A61B5/0402 , A61B5/0476 , A61B5/0488 , A61B5/08 , A61B5/1116 , A61B5/1118 , A61B5/112 , A61B5/145 , A61B5/4082 , A61B5/4809 , A61B5/4815 , A61B5/4839 , A61B5/6831 , A61B5/6833 , A61B2560/0223 , A61B2560/0412 , A61B2560/0431 , A61B2562/0219 , A61N1/36021 , A61N1/36071 , A61N1/3702 , G06F19/00 , G06F19/3456 , G06F19/3481 , G16H10/60 , G16H40/63
摘要： A wearable ambulatory data recorder that senses physiological parameters of a patient, and stores physiological parameter data for later retrieval, as well as techniques for using such a wearable ambulatory data recorder, are described. The data recorder includes one or more sensors located on or within a housing. The data recorder may include an adhesive layer for attachment to a patient. In some embodiments, the housing may be within a patch, e.g., bandage, which includes the adhesive layer. The housing may be waterproof. Features of the data recorder such as size, waterproofness, and inclusion of an adhesive may allow the data recorder to be unobtrusively worn by a patient during a variety of daily activities. The data recorder may be for single use and thereafter disposable.
摘要翻译：描述了感测患者的生理参数并存储用于稍后检索的生理参数数据的可穿戴式动态数据记录器以及用于使用这种可穿戴式可动态数据记录器的技术。数据记录器包括位于壳体上或壳体内的一个或多个传感器。数据记录器可以包括用于附接到患者的粘合剂层。在一些实施例中，壳体可以在包括粘合剂层的贴片（例如绷带）内。外壳可能是防水的。诸如尺寸，防水性和包含粘合剂的数据记录器的特征可允许数据记录器在各种日常活动期间被患者不佩服地佩戴。数据记录器可以是单次使用的，然后是一次性的。

10. 发明申请

US20110190851A1 STIMULATION MODE SWITCHING BASED ON TISSUE IMPEDANCE STABILITY 有权
标题翻译：基于组织阻力稳定性的刺激模式切换
公开(公告)号：US20110190851A1
公开(公告)日：2011-08-04
申请号：US12699668
申请日：2010-02-03
申请人： Kevin J. Kelly , Matthew J. Michaels , Gregory F. Molnar , Jonathan C. Werder
发明人： Kevin J. Kelly , Matthew J. Michaels , Gregory F. Molnar , Jonathan C. Werder
IPC分类号： A61N1/08 , A61N1/36
CPC分类号： A61B5/053 , A61N1/00 , A61N1/3614 , A61N1/36521 , A61N1/3702
摘要： Implantable medical devices switch from a constant current mode of operation to a constant voltage mode of operation. The switching may be based on the device determining that tissue impedance stability has occurred. The determination may be a measurement of output voltage stability of the constant current source or based on other factors such as an amount of time that has elapsed. The switching may be as the result of an externally generated request such as by a clinician via an external device. The implantable medical device may begin constant voltage mode by utilizing stimulation parameters based on those initially programmed for constant current mode and based upon a measurement of voltage amplitude being output by the constant current source prior to the switch.
摘要翻译：可植入医疗设备从恒定电流工作模式切换到恒压工作模式。切换可以基于确定发生了组织阻抗稳定性的设备。该确定可以是恒定电流源的输出电压稳定性的测量，或者基于其他因素，例如已经经过的时间量。切换可能是外部产生的请求的结果，例如由临床医生经由外部设备。可植入医疗装置可以通过利用基于最初为恒定电流模式编程的刺激参数并且基于在切换之前由恒定电流源输出的电压幅度的测量来开始恒定电压模式。

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