Neuropace RNS System - Modifying Detection and Responsive Therapy Settings

Clinical Use of the RNS
®
System 32
RNS
®
System User Manual
Modifying Detection and Responsive Therapy Settings
Once the neurostimulator is programmed to provide responsive stimulation, the patient should be
seen at approximately 3 month intervals to determine whether detection and/or responsive therapy
settings should be modified. At each patient visit, the physician reviews ECoGs that are stored on the
PDMS or programmer.
The physician decides whether the detection settings should be modified based on the ECoG review.
Detection settings should promptly detect ECoG activity and not detect on baseline activity. In
addition to the line length detector, the neurostimulator has bandpass and area detectors (described
in the section titled Setting up Detection). If the physician wishes to change which ECoG patterns
are detected, the detectors may be adjusted or a different detection tool may be selected. For
example, if the physician wishes to detect smaller changes in the ECoG amplitude, the line length
detector can be programmed to be more sensitive. If the physician wishes to detect specific ECoG
frequencies, the bandpass detector could be used. Different detection settings can be simulated on
the ECoG segments that have been stored on the PDMS or programmer. This allows the physician to
see how the modified detection settings perform, before deciding to program these settings into the
neurostimulator.
Instructions for modifying detection settings are provided in the section titled Setting up Detection.
The physician may choose to modify stimulation to improve the patient’s clinical response. Although
modifications can be made to the stimulation frequency, burst duration or pulse width, it is
recommended that initial modifications be to increase the current amplitude by 0.5 mA increments,
with each stimulation setting tested using the therapy testing function
to ensure that it is
well tolerated
by the patient and there are no undesired changes in the ECoG such as afterdischarges.
Instructions for modifying responsive therapy settings are provided in the section titled Setting up
Responsive Therapy.