This application claims the benefit under 35 U.S.C. § i 19(e) of U.S. Provisional Patent Application Serial No. 61/829, 12. filed May 3 1 , 2013, which is incorporated herein by reference.

FIELD

The present invention is directed to the area o implantable electrical stimulation systems and methods of making and using the systems. The present invention is also directed to implantable electrica! stimulation leads having segmented eiecirodes, as well as methods of making and using Ihe leads and electrical stimulation systems.

Electrical stimulation can be useful for treating a variety of conditions. Deep brain stimulation can be useful for treating, for example. Parkinson's disease, dystonia, essential tremor, chronic pain, Huntington ^' s disease, levodopa-induced dyskinesias and rigidity, bradykinesia, epilepsy and seizures, eating disorders, and mood disorders.

Typically, a lead with a stimulating electrode at or near a tip of the lead provides the stimulation to target neurons in the brain. Magnetic resonance imaging ("Mill") or computerized tomography ("CT ^' d scans can provide a starting point for determining where the stimulating electrode should be positioned to provide the desired siimulus to the target neurons.

A ter the lead is implanted into a patient's brain, electrical stimulus current can be delivered through selected eiecirodes on the lead to stimulate target neurons in the brain. Typically, the electrodes are formed into rings disposed on a distal portion of the lead. The stimulus current projects from the rmg electrodes equally in every direction. Because of the ring shape of these electrodes, the stimulus current cannot be directed to one or more specific positions around the ring electrode (e.g.. on one or more sides, or points, around ihe lead ). Consequently, undirected stimulation may result in unwanted stimulation of neighboring neural tissue, potentially resulting in undesired side effects. EIEF ^ MARY

One embodiment is a method of making an electrical stimulation lead, T he method includes attaching, segmented electrodes io an interior of a ring in a

oireumreteirUally spaced-apart arrangement; attaching a conductor wire to each of the segmented electrodes; coupling the ring with the segmented electrodes to a lead body; and, alter coupling to the lead body , removing at least those portions of the ring between the segmented electrodes to separate the plurality of segmented electrodes from each other.

Another embodiment is a pre-eiectrode that includes a ring having an interior: and segmented electrodes attached to the interior of the ring in a circumferential ly spaced- apa;t arrangement.

Yet another embodiment is a method of making a pre -electrode. The method, includes placing a portion of tool in a ring where the portion of the tool defines channels for receiving segmented electrodes; individually inserting segmented electrodes into the channels of the tool and sliding the segmented electrodes into the ring; attaching the segmented electrodes to an interior of t he ring in a circumferentially spaced-apart arrangement defined by the tool: and removing the tool.

Non-limiting and non-exhaustive embodiments of the present invention are described with reference to the following drawings. In the drawings, like reference numerals refer to like parts throughout the various figures unless otherwise specified.

For a better understanding of the present invention, reference will be made to the following Detailed Description, which is io be read in association with the accompanying drawings, wherein:

FIG. 1 is a schematic side view of one embodiment of a device for brain stimulation, according to the invention;

FIG. 2 is a schematic diagram of mdia! cuirent steering along various electrode levels along the length of a lead, according to the invention;

FIG. 3A is a perspective view of an embodiment of a portion uf a lead having a plurality of segmented electrodes, according to the invention: FIG. 3B is a perspective view of a second embodiment of a portion of a lead having a plnniiity of segmented electrodes, according to the invention;

FKJ. 3C is a perspective view of a ihird embodimeni of a portion of a lead having a plurality of segmented electrodes, according to the invention;

FIG. 3D is a perspective view of a fourth embodiment of a portion of a lead having a plurality of segmented electrodes, according to the invention;

FIG. 3E is a perspective view of a fifth embodiment of a portion of a lead having a plurality of segmented electrodes, according to the invention;

FIG. 3F is a perspective view of a sixth mbodiment of a portio of a lead having a plurality of segmented electrodes, according to the invention;

FIG, 3G is a perspecti e view of a seventh embodiment of a portion of a lead having a plurality of segmented electrodes, according to die invention;

F IG. 4 is a perspective view of one embodiment of a ring with segmented electrodes attached to an interior thereof, according to the invention;

FKJ . 5 is a perspective view of one embodimeni of a segmented electrode, according to the invention;

FKJ. 6A IS a side view of one embodiment of tool tor placing the segmented electrodes within a ring, according to the invention;

FKj. 613 is a cross- sectional view of die tool of FKj. 6A along line 6B-6B.

according to the invention:

FIG 6C is a cross-sectional view of one embodiment of a ring with segmented electrodes and the tool of FIG, 6A disposed therein, according to the invention;

FIG, 7 A is a cross-sectional view of one embodiment of a pre-electrode including a ring and segmented elect rodes attached to an interior thereof, according to the invention; FIG, 7B is a cross-sectional view of the pre-electrode of FIG. 7 A with a portion of a lead body formed therein, according to die invention;

FIG. 7C is a cross-sectional view of one embodiment of a lead with segmented electrodes formed from the pre-elecirode of FIGS, 7 A and 7B. according to the invention;

FIG, 8 A is a cross-sectional view of one embodiment of a pre-electrode including a ring having an opening and segmented electrodes attached to an interior thereof, according to the invention;

FIG. 8B is a side view of the ring of FIG. 8A where die opening is a slit, according to the invention; and

FIG. &C is a side view of the ring of FIG. 8A where the opening is a set of holey through the ring, according to lite invention.

The present invention is directed to the area of implantable electrical stimulation s stem and methods of making and using the systems, lire present invention is also directed to implantable electrical stimulation leads having segmented electrodes, as well as methods of making and using tire leads and electrical stimulation systems.

A lead for deep brain stimulation may include stimulation electrodes, recording electrodes, or a combination of both. At least some of the stimulation electrodes, recording electrodes, or both axe provided in the form of segmented electrodes thai extend only partially around the circumference of the lead. These segmented electrodes can be provided in sets of electrodes,, with each set having electrodes radially distributed about the lead at a particular longitudinal position. For illustrative purposes, the leads are described herein relative to use for deep brain stimulation, but it will be understood that any of the leads can be used for applications other than deep brain stimulation, including spinal cord stimulation, peripheral nerve stimulation, or stimulation of other nerves and tissues.

Suitable implantable electrical stimulation systems include, but are not limited to. a least one lead with one or more electrodes disposed on a distal end of die lead and one or more terminals disposed on one or more proximal ends of the lead. Leads include, for example., percutaneous leads. Examples of electrical stimulation systems with leads are found m. for example, ILS. Patents Nos. 6,181.969; 6,516.227; 6,609.029; 6,609,032; 7741 ,892; 7,244,150; 7,450,997; 77Τ72,734;7;761 J 65; 7,783,359; 7,792,590; 7.809,446; 7,949,395; 7,974,706; 8,1757710; 8,224,450; 8,271 ,094; 8,295,944; 8,364,278; 8.391 ,985; and 8.688.235: and U.S. Patent Applications Publication Nos. 2007/0150036;

2009/0187222; 2009/0276021 ; 2010/0076535; 2010/0268208; 20 1/0005069;

201 1 /0004267; 201 1 /O078900; 201 1 /0] 30817: 20 170130818; 201 /0238129;

201 1/0313500; 2012/0016378; 2012/0046710: 2012/0071949; 2012/016591 1 ;

2012/0197375; 2012/0203316; 2012/0203320: 2012/0203321 ; 2012/0316615;

2013/0105071 ; and 2013/0197602, all of which are incorporated by reference. in at least some embodiments, a practitioner may determine the position of the target neurons using recording el ctrodc(s) and then position the stimulation electrode(s) accordingly. In some embodiments, the same electrodes can be used for both recording and stimulation. I some embodiments, separate leads can be used; one with recording electrodes which identify target neurons, and a second lead with stimulation electrodes that replaces the first a fter target neuron identification. In some embodiments, the same lead may include both recording electrodes and stimulation electrodes or electrodes may be used for both recording and stimulation.

Figure 1 illustrates one embodiment of a device 100 for brain stimulation. The de vice includes a lead 1 10. a plurality of electrodes 125 disposed at. least partially about a circumference of the lead 1 0, a plurality of terminals 135, a connector 132 tor connection of the electrodes to a control unit, and a stylet 140 for assisting in insertion and positioning of the lead in the patient's brain. The stylet 140 can be made of a rigid material. Examples of suitable materials for the stylet include, but are not limited to, tungsten, stainless steel, and plastic. The stylet 140 may have a handle 150 to assist insertion into the lead 1 10. as wel l as rotation of the stylet 140 and lead 1 10. The connector 132 fits o v er a proximal end of the lead 1 10, preferably after removal of the st le 140.

The control unit (not shown) is lypically an implantable pulse generator that can be implanted into a patient's body, for example, below the patient's clavicle area. The pulse generator can have eight stimulation channels which may be independently programmable TO control the magnitude of the current stimulus horn each channel. In some cases the pulse generator may have more or fewer than eight stimulation channels (e.g.. 4-, ' -·. 16-, 32--, or more stimulation channels). The control unit may have one, two, three, tour, or m re connector ports, for receiving the plurality of terminals 135 at the proximal end of the lead 1 10,

In one example of operation, access to the desired position in the brain can be accomplished by drilling a hole in the patient's skull or cranium with a cranial drill (commonly referred to as a burr), and coagulating and incising the dura mater, or brain covering. The d 1 .10 can be inserted into the cranium and brain tissue with the assistance of the stylet 140. T he lead 1 10 can he guided to the target location within the brain using, for example, a stereotactic frame and a microdrive motor system. In some embodiments, the microdrive motor system can be folly or partially automatic. The microdri e motor system may be configured to perform one or more the followin actions (alone or in combination): insert the lead 1 10, retrac die lead 1 10, or rotate the lead 1 10. In some embodiments, measurement devices coupled to the muscles or other tissues stimulated by the target neurons, or a unit responsive to the patient or clinician, can be coupled to the control unit or microdrive motor system. The measurement device, user, or clinician can indicate a response by the target muscles or other tissues to the stimulation or recording electrodei s) to further identify the target neurons and facilitate positioning of the stimulation electrode! s). For example, if the target neurons are directed to a muscle experiencing tremors, a measurement device can he used to observe the muscle and indicate changes in tremor frequency or amplitude in response to stimulation of neurons. Alternativel , the patient or clinician may observe the muscle and provide feedback. The lead ] 10 for deep brain stimulation can include stimulation electrodes, recording electrodes, or both, in at least some embodiments, the lead 1 10 is rotatable so that the stimulation electrodes can be aligned with the target neurons alter the neurons have been located using the recording electrodes.

Stimulation electrodes may be disposed on the circumference of the lead 1 10 to stimulate the target neurons. Stimulation electrodes may be ring-shaped so that current projects from each electrode equally in every direction from the position of the electrode

- a . along a length of the lead 1 10. Ring electrodes typically do noi enable stimulus current to be directed from only a limited angular range around of the lead- Segmented electrodes, however, can be used to direct stimulus current to a selected angular range around the lead. When segmented electrodes are used in conjunction with an implantable pulse generator that delivers constant current stimulus, current steering can be achieved to more precisely deli ver the stimulus to a position around an axis of the lead (i.e., radial positioning around the axis of the lead).

To achieve current steering, segmented electrodes can be utilized in addition to, or as an alternative to, ring electrodes, Though the following description discusses stimulation electrodes, it will be understood that all configurations of the stimulation electrodes discussed may be utilized in arranging recording electrodes as well.

The lead f 00 includes a lead body 1 10, one or more optional ring electrodes 120. and a plurality of sets of segmented electrodes 130, The lead body 1 10 can he formed of biocompatible, non-conducting material such as, lor example, a polymeric material. Suitable polymeric materials include, but are not limited to, silicone, polyuremane, polyurea, polyurethane-urea, polyethylene, or the like. Once implanted in the body, the lead 100 may be in contact with body tissue for extended periods of time. In at least some embodiments, the lead 100 has a cross-sectional diameter of no more than 1 ,5 mm and may be in the range of 0,5 to 1.5 mm. In at least some embodiments, the lead 100 has a length of at least 10 cm and (he length of the lead 100 may be in. the range of 10 to 70 cm.

T he electrodes may be made using a metal, alloy, conductive oxide, or any other suitable conductive biocompatible material- Examples of suitable materials include, but are not limited to. platinum, platinum iridium alloy, iridium, titanium, tungsten, palladium, palladium rhodium, or the like. Preferably, the electrodes are made of a materia! that is biocompatible and does not substantially corrode under expected operating conditions in the operating environment ids the expected duration of use.

Each of the electrodes can either be used or unused (OFF). When die electrode is used, the electrode can be used as an anode or cathode and cam- anodic or call sod to current, in some instances, an electrode might be an anode lor a period of time and a cathode lor a period of time. Stimulation electrodes in the form of ring electrodes 120 may be disposed on any part of the lead body i 10, usually near a distal end of the lead 100, in Figure 1 , the lead 100 includes two ring electrodes 120. Any number of ring electrodes 120 may he disposed along the length of the lead body 1 10 including, for example, one, two three, four, five, six, seven, eight, nine, ten. eleven, twelve, thirteen, fourteen, fifteen, sixteen or more ring electrodes 120. It will be understood that any number of ring electrodes ma be disposed along the length of the lead body 1 10. in some embodiments, the ring electrodes 120 are substantially cylindrical and wrap around the entire circumference of the lead body 110. In some embodiments, the outer diameters of the ring electrodes 120 are substantially equal to the outer diameter of the lead body 1 10. dire length of the ring electrodes 120 may vary according to the desired treatment and the location of the target neurons, in some embodiments the length of the ring electrodes 120 are less than or equal to the diameters of the ring electrodes 120, In other embodiments, the lengths of the ring electrodes 120 are greater than the diameters of the ring electrodes 1 0. T he distal-most ring electrode 120 may be a tip electrode (see, e.g., tip electrode 320a of Figure 3E) which covers most, or ail, of the distal tip of the lead.

Deep brain stimulation leads ma include one or more sets of segmented electrodes. Segmented electrodes may provide for superior current steering than ring electrodes because target structures in deep brain stimulation are not typically symmetric about the axis of the distal electrode array, instead, a target may be located on one side of a plane running through the axis of the lead. Through the use of a radially segmented electrode array ("RSEA"), current steering can be performed not only along a length of the lead but also around a circumference of the lead. This provides precise three - dimensional targeting and delivery of the current stimulus to neural target tissue, while potentially avoiding stimulation of other tissue. Examples of leads with segmented electrodes include U.S. Patent Application Publication Nos. 2010/0268298;

201 1/0005064; 201 1/0130803: 201 1/0130816; 201 1/0130817; 201 1/0130818; .

201 1 /0078900; 201 1/0238129; 2012/0016378; 2012/0046710; 2012/0071949;

2012/016591 1 ; 2012/197375; 2012/0203316; 2012/0203320; 2012/0203321 . all of which axe incorporated herein by reference.

In f igure 1 , the lead 100 is shown having a plurality of segmented electrodes ( 30, Any number of segmented electrodes 130 may be disposed on the lead body 1 10 including, for example, one, two three, four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen or more segmented electrodes 130. It will be understood that a number of segmented electrodes ] 30 may be disposed along the length of the lead body 1 10. A segmented electrode 1 0 typically extends only 75%, 67%, 60%, 50% _s 40%, 33%,, 25%, 20%, 17%, 15%, or less around die circumference of the lead.

The segmented electrodes 130 may be grouped into sets of segmented electrodes, where each set is disposed around a circumference of the lead 100 at a particular longitudinal portion of the lead 100. The lead 100 may have any number segmented electrodes 130 in a given set of segmented electrodes. The lead 100 may have one, two, three, four, five, six, seven, eight, or more segmented electrodes 130 in a given set. in ai least some embodiment, each set of segmented electrodes 130 of the lead 100 contains the same number of segmented electrodes 1 30. The segmented electrodes 1 0 disposed on the lead 100 may include a different number of electrodes than at least one other set of segmented electrodes 130 disposed on the lead 100.

The segmented eiecirodes 130 may vary in size and shape, !n some embodiments,, the segmented eiecirodes 1 0 are all of the same size, shape, diameter, width or area or any combination thereof. In some embodiments, the segmented electrodes 1 30 of each circumferential set (or even ail segmented electrodes disposed on the lead 100) may be identical in size and shape.

Bach set of segmented eleeirodes 130 may be disposed around the circumference of the lead body 1 10 to form a substantially cylindrical shape around the lead body 1 10. The spacing between individual electrodes of a given set of the segmented eleeirodes may be the same, or different Irom, the spacing between individual electrodes oi another set of segmented electrodes on die lead 100. In at least some embodiments, equal spaces, gaps or cutouts are disposed between each segmented electrode 1 0 around the circumference of the lead body { 10. In other embodiments, the spaces, gaps or cutouts between die segmented electrodes 130 may differ in size or shape, in other embodiments, the spaces, gaps, or cutouts between segmented electrodes 1 0 may be uniform tor a articula sei of the segmented electrodes 130, or for all sets of the segmented electrodes 130. The sets of segmented electrodes 130 may be positioned in irregular or regular intervals along a length the lead body 1 10.

Conductor wires that attach to the ring electrodes 120 or segmented electrodes 130 extend along the lead body 1 10. These conductor wires may extend through the material of the lead 100 or along one or more lumens defined by the lead 100, or both. The cond uctor wires are presented at a connector (via tenninals) for coupling of the electrodes 120, 130 to a control unit (not shown).

When the lead 00 includes both ring electrodes 120 and segmented electrodes 130, the ring electrodes 120 and the segmented electrodes 130 may be arranged in any suitable configuration. For example, when the lead 100 includes two sets of ring electrodes 120 and two sets of segmented electrodes 130, the ring electrodes 120 can flank the two sets of segmented electrodes 130 (see e.g. ,. Figure 1 ). Alternately, the two sets of ring electrodes 120 can be disposed proximal to the two sets of segmented electrodes 130 (see . Figure 3(3), or the two sets of ring electrodes 120 can be disposed distal to the two sets of segmented electrodes 130 (see e.g.. Figure 3D), One of the ring electrodes can he a tip electrode (see, tip electrode 320a of Figures 3E and 3G). It will be understood that other configurations are possible as well (e.g. , alternating ring and segmented electrodes, or the like).

By varying the location of the segmented electrodes 130, different coverage of the target neurons may be selected. For example, the electrode arrangement of Figure 3C may be useful if the physician anticipates that the neural target will be closer to a distal tip of the lead body 1 10, while the electrode arrangement of Figure 3D may be useful if the physician anticipates that the neural target will be closer to a proximal end of the lead body 1 10. Any combination of ring electrodes 120 and segmented electrodes J 30 may be disposed on the lead 1(50, For example, the lead may include a first ring electrode 120, two sets of segmented electrodes; each set formed of four segmented electrodes 130, and a .final ring electrode 120 at the end of the lead. Ibis configuration may simply be referred to as a ] -4-4-1 configuration (Figures 3 A and 3E). It. may be useful to refer to the electrodes with this shorthand notation. Thus, the embodiment of Figure 3C may be referred to as a 1-1 -4-4 configuration, wh le the embodiment of Figure 3 may be referred to as a 4-4-1 -1 configuration. The embodiments of Figures 3F and 3G c n be referred to as a 1 -3-3-1 configuration. Other electrode configurations include, for example, a 2-2-2-2 configuration, where four sets of segmented electrodes are disposed on the lead, and a 4-4 configuration, where two sets of segmented electrodes, each having tour segmented electrodes 130 are disposed on die lead, ^' The 1-3-3-1 electrode configuration of Figures 3F and 3G has two sets of segmented electrodes, each set containing du ee electrodes disposed around the circumference of die lead, flanked by two ring electrodes (Figure 3F) or a ring electrode and a tip electrode (Figure 3G), In some embodiments, the lead includes 16 electrodes. Possible configurations .for a 16-electrode lead include, but are not limited to 4-4-4-4; 8-8; 3-3-3-3-3-1. (and all rearrangements of this configuration); and 2-2-2-2-2-2-2-2.

Figure 2 is a schematic diagram to illustrate radial current steering along various electrode levels along the length of the lead 200. While conventional lead configurations with ring electrodes are only able to steer current along the length of the lead (the 2-axis), the segmented electrode configuration is capable of steering current in the v-axis, y-axis as well as the e-axis. Thus, the centroid of stimulation may be steered in any direction in the three-diniensional space surrounding the lead 200. in some embodiments, the radial distance, r, and the angle Θ around the circumference of die lead 200 may bo dictated by the percentage of anodic current (recognizing that stimulation predominantly occurs near the cathode, although strong anodes may cause stimulation as well ) introduced to each electrode. In at least some embodiments, the configuration of anodes and cathodes along the segmented electrodes al lows the centroid of si.imulad.on to be shifted to a variety of diffeient locations along the ad 200,

As can be appreciated from Figure 2. the centroid of stimulation can be shifted at each level along the length of the lead 200, The use of multiple sets of segmented electrodes at different levels along the length of the lead allows for three-dimensional current steering, in some embodiments, the sets of segmented electrodes are shifted collectively (i.e., the centroid of simulation is similar at each level along the length of the lead), in at least some other embodiments, each set of segmented electrodes is controlled independently. Each set of segmented electrodes may contain two, three _: lour, live, six, seven, eight or more segmented electrodes. It will be understood that different stimulation pt illes may be produced by varying the number of segmented electrodes at each level. F or example _. , when each set of segmented electrodes includes only two segmented electrodes, uniformly distributed gaps (inability to stimulate selectively) may be formed in the stimulation profile, in sotne embodiments, at least three segmented electrodes 230 in a set are utilized to allow for true 360'-' selectivity. As previously indicated, the foregoing configurations may also be used while utilizing recording electrodes. In some embodiments., measurement devices coupled to the muscles or other tissues stimulated by the target neurons or a unit responsive to the patient or clinician can be coupled to the control unit or microdrive motor system. The measurement device, user, or clinician can indicate a response by the target muscles or other tissues to the stimulation or recording electrodes to further identify the target neurons and facilitate positioning of the stimulation electrodes. For example, if the target neurons are directed to a. muscle experiencing tremors, a measurement device can be used to observe the muscle and indicate changes in tremor frequency or amplitude in response to .stimulation of neurons. Alternatively, the patient or clinician may observe the muscle and provide feedback.

The reliability and durability of the lead wil l depend heavily on the design and method of manufacture, fabrication techniqu s discussed below provide methods that can produce manufacturable and reliable leads.

Returning to Figure 1 , when the lead 100 includes a plurality of sets of segmented electrodes 130, it may be desirable to form the lead 1 0 such that corresponding electrodes of different sets of segmented electrodes 130 are radially aligned with one another along the length of the lead 100 (see e.g. , die segmented electrodes 130 shown in Figure 1 ). Radial alignment between corresponding electrodes of different sets of segmented electrodes 130 along the length of the lead 100 may reduce uncertainty as to the location or orientation between corresponding segmented electrodes of different sets of segmented, electrodes. Accordingly _; it may be beneficial to form, electrode arrays such that corresponding electrodes of different sets of segmented electrodes along the length of the lead 1 0 are radially aligned with one another and do not radially shift in relation to one another during manufacturing of the lead 100. In other embodiments, individual electrodes in the two sets of segmented electrodes 130 a e staggered (see. Figure 3B) relative to one another along the length or i .: the lead body ! 10. In some cases, the staggered positioning of corresponding eiectrodes of different sets of segmented eiectrodes along the length of the lead 100 may be designed for a specific plication.

Segmented electrodes can be used to tailor the stimulation region so that, instead of stimulating tissue around the circumference of the lead us would be achieved using a ring electrode, the stimulation region can be direetionally targeted. In some instances, it is desirable to target a parallelepiped (or slab) region 250 that contains the electrodes of the lead 200- as illustrated in Figure 2. One arrangement for directing a stimulation field into a parallelepiped region uses segmented electrodes disposed on opposite sides of a lead.

Figures 3A-3E illustrate leads 300 with segmented electrodes 330. optional ring electrodes 320 or tip electrodes 320a, and a lead body 10. The sets of segmented electrodes 330 include either two (Figure 3B) or four (Figures 3 A, 30, and 3D _, ) or any other number of segmented electrodes including, for example, three, five., six. or more.

Any other suitable arrangements of segmented electrodes can be used. As an example, arrangements in which segmented electrodes are arranged helically with respect to each other. One embodiment includes a double helix.

One challenge to making leads with segmented electrodes is the correct placement of the electrodes, and retention of the desired electrode placement, during the manufacturing process. In at least some embodiments, each set of segmented electrodes can be arranged by coupling the segmented electrodes of the set into a ring in a desired circumferential arrangement to form a pre-electrode. The pre -electrode can be disposed on the lead and a lead body formed around the segmented electrodes. After forming the lead body, the ring, or at least the port ions of the r ing between the segmented electrodes, can be removed to separate the segmented electrodes.

Figure 4 illustrates one embodiment of a pre-electrode 450 with three segmented electrodes 452 attached to an interior of a ring 454. Although the Figure illustrates three segmented electrodes, it will be understood that any other number of segmented electrodes may be provided within the ring including, but not limited to, two. three, four, five, six, or more segmented electrodes. In at least some embodiments, the segmented electrodes 452 are evenly or uniformly spaced-apart around the cucumJerence of the ring 454» although other arrangements of the electrodes, including those in which the spacing is not uniform or even, are also acceptable.

The ring can have any suitable thickness. In at l st some embodiments, the ring has a thickness no greater than 0.25 mm.

The electrodes 452 can be attached to the ring 454 in any sui table manner including, but not hmited to, welding, soldering, using an adhesive, or any combination thereof. The ring 454 can be made of any suitable material including, but not limited to, metal, ceramic, or plastic materials, or any combination thereof The ring 454 may be conductive or non-conductive- In at least some embodiments, the ring is made of a biocompatible material as part of the ring may be in the final lead or because processing of the ring may result in microscopic particles of the ring remaining i the lead even though the entire ring is intended to be removed.

The segmented electrodes can be formed in any suitable shape or size and can be formed of the materials described above. Figure 5 illustrates one example of a segmented electiode 552. in at least some embodiments, the segmented electrodes have a curved, shape. The curved shape preferably corresponds to the curvature of the lead, For example, the curved shape of the segmented electrodes can have an arc of at least 10, 1 , 20, 30, 40, 50, or 60 degrees. The arc of the segmented electrode may be no more than 175, 160, 1 50., 125, 1 15, 100, or 90 degrees. In some instance, the are of the segmented electrodes is in the range of 10 to 1 75 degrees or in the range of 30 to 120 degrees or in the range of 40 to 100 degrees. The illustrated embodiments include three electrodes 452 disposed in the ring 454, but it will be recognized thai an number of electrodes could be disposed within the ring including two, four, five. six. or more electrodes. Examples of other segmented electrodes that could be attached to the ring are presented in U.S.

Provisional Patent Applications Serial Nos. 61 /820.008, and 6.1/829,9.18, both filed May 31 , 2013, and incorporated herein by reference.

The segmented electrodes 552 optionally include one or more additional features to aid in holding the segmented electrode within the lead. One embodiment of a segmented electrode 552 displaying several optional features is provided in Figure S. The segmented electrode includes a stimulation surface 584 ihai. when the lead is formed and inserted into the patient, will be exposed fo patient tissue. The segmented electrode also includes an interior surface 586 opposing the stimulation suriace 584, The interior surface 566 vvill be in the interior the lead. On opiional feature that aids in anchoring the segmented electrode 552 within the lead is a corrugated, or otherwise rough or nonuniform, texture 588 of the interior surface 586, The non-uniform texture 588 of the interior suriace 586 increases the surface area that contacts the material of the lead body that i formed around the segmented electrode 552, as described below, and helps in retaining the segmented electrode within the lead. The corrugation of the texture 588 can have a triangular cross-section, as illustrated in Figure 5, or any other suitable shape including, but not limited, a square, rectangular, trapezoidal hemispherical, hexagonal or any other regular or irregular cross-section. Other examples of suitable non- uniform textures include, but are not limited to, a checkerboard arrangement that is similar to corrugation but with intersecting grooves, an arrangement with multiple cleat-like projections or dimples extending from the suriace 586, or a surface with a texture formed by knurling, grit blasting, or other methods of roughening of the surface, and the like.

Another optional feature of the segmented electrode 552 is one or more anchoring legs 590. The anchoring legs 5^0 are arranged so diat they project into the interior of the lead and into the material of the lead body that is formed around the segmented electrode. The anchoring legs can have an suitable size or shape and may optionally include one or more holes 592 in the legs. In at least some embodiments, material from the lead body may flow into the holes 592 during die molding process to provide additional anchoring. When the segmented electrode 552 includes more than one anchoring leg 590, the anchoring legs may be arranged around the segmented electrode in any suitable arrangement. For example, as illustrated in Figure 5. two anchoring legs 590 may extend from opposing sides towards each other. In other embodiments, the two anchoring legs may extend from only a portion of a particular side of the segmented electrode 552. For example, two anchoring legs may extend irom the .segmented electrode 552 with one leg extending near one end of a side of the electrode and the other leg extending near the other end of the opposing side of the electrode so thai the two legs are diagonally opposed. It wil l be understood that other arrangements can be used including, for example, arrangements in winch legs are directly opposed. Yet another optional feature of the segmented electrodes 452 is one or more radial channels 494 as illustrated in Figure 4. These radial channels 494 can be on the edges of the segmented electrode 452, as illustrated in Figure 4, or be openings through the body of the segmented electrode These radial channels 494 can facilita te retention of the segmented electrode in the lead body by interacting with the material ol ^' ihe lead body.

In at least some embodiments, the segmented electrodes 452 cm be arranged in the ring 450 using a tool. One embodiment of a suitable tool is the tool 670 illustrated in Figures 6A-6C, The tool 670 includes a handle 672. a centra! body 674, and projections 676 extending away from the central body 674, as illustrated m Figures 6A and 6B. The regions between the projections 676 form channels 678 that are sized to receive the electrodes 452 so thai they can be placed in the ring 454 in tire desired arrangement, as illustrated in Figure 6C. In at least some embodiments, the ring 454 can be slid onto the tool. One or more segmented electrodes 452 can then be placed in the channels 678 and slid into the ring 454, The 452 can then be attached to the ring 454 by, tor example, welding. Ore tool 670 can then be rotated nd the process repeated for an ther electrode, and so on.

After all of the electrodes 452 are attached to the ring 454. the tool 670 can be removed. Conductor wires 756 can then be coupled to each of the segmented electrodes 452, as illustrated in Figure ?A. The conductor wires can be attached using any suitable technique including, but not limited to, welding, soldering, crimping, staking, or the like.

The lead body 758 can then be formed around the segmented electrodes 452 and conductor wires 756, as illustrated in Figure 7B. The lead body can be formed using, for example, a polymeric material such as poiyureihane, silicone, or the like or any combination thereof. It will be understood that there may be more than one ring 454 with segmented electrodes 452 and that the lead body 758 may be simultaneously or sequentially formed around all of these segmented electrodes. For example, in at least some embodiments, one or more rings 454 with segmented electrodes 452 may be placed in a mold in a space-apart arrangement. The material of the lead body 758 can then be molded around all of the segmented electrodes 452 and through each of the rings 454 simultaneously. I he material ol the lead body 758 may also pass through the holes 592 (see Figure 5), If any, of the segmented electrodes 452 to facilitate retention of the segmented electrodes in contact with the lead body. It wil l be understood that ring electrodes, such as those illustrated in Figures 3A-3D may also be placed in the mold and the lead body molded through the ring electrodes.

Alter forming the lead body 758, at least a portion of the ring 454 that connects the segmented electrodes 452 together (and, at least in some embodiments, ail, or almost all, of the ring) i s removed, as illustrated in Figure 7(2 This removal separates the segmented electrodes 452 and also exposes the outer suriace of the segmented electrodes so that outer surface can be used for electrical stimulation of adjacent tissue when the lead is implanted. Any suitable process can be used for removing the ring 454, or portions of the ring, including, hut not limited to, grinding (such as, centerless grinding), ablation, etching, machining, and the like or any combination thereof In some embodiments, removal of the ring, or portions of the ring, may also include removal of outer portions of the segmented electrodes 452 or lead body 758 or both.

Figures 8A-8C illustrated other embodiments of a pre-electrode 850 with a ring 854 with electrodes 852 attached to the interior of the ring. In these embodiments, the ring 850 has at least one opening 862 through the ring. In Figure SB. the opening is a slit 862 thai can extend the entire axial length of the ring 854 or only a portion of (he axial length of the ring. In Figure 8C, the opening is one or more holes 862b formed through the ring 854, The opening 862 (such as slit 862a o hose 862b) may facilitate

manufacture as the material of the lead body may extend into the opening as the lead body is formed which may reduce rotational or axial slippage of the ring during subsequent processing (at least until the ring is removed) and, therefore, reduce the possibility of the placement of the segmented electrodes being altered during that processing.

The above specification, examples and data provide a description of the manutacture and use of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention also resides m the chums heremaiter appended.