Abstract: Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first change of a first sensed signal of the patient to movement by the patient and a second change of a second sensed signal of the patient to the movement by the patient. Based on the first change and the second change, the medical system selects one of the first sensed signal and the second sensed signal of the patient for controlling the electrical stimulation therapy. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.

Abstract: An example system includes a first lead configured to be positioned in or beside a left internal jugular vein (IJV) of a patient to deliver a first stimulation signal to a first vagus nerve, the first lead including one or more first segmented electrodes positioned on a distal portion of the first lead and a first anchoring mechanism; a second lead configured to be positioned in or beside a right IJV of the patient to deliver a second stimulation signal to a second vagus nerve, the second lead including one or more second segmented electrodes positioned on a distal portion of the second lead and a second anchoring mechanism; and circuitry configured to deliver electrical energy to the first lead to deliver the first stimulation signal and the second lead to deliver the second stimulation signal to provide bilateral stimulation to the first vagus nerve and the second vagus nerve.

Abstract: An example system includes a collar; a first stimulating electrode array positioned on the collar and configured to delivery stimulation therapy to a patient; a second stimulating electrode array being positioned on the collar and configured to deliver stimulation therapy to the patient; a sensor array being positioned on the collar and configured to detect one or more features indicative of laryngeal muscle activity of the patient; and a controller configured to control stimulation therapy to be delivered via the first stimulating electrode array and the second stimulating electrode array.

Abstract: In some examples, an endovascular device includes an elongated body configured to be introduced in a blood vessel of a patient and a plurality of electrodes disposed along the elongated body. The plurality of electrodes includes a first group of electrodes and a second group of electrodes. The endovascular device further includes a plurality of conductors including a first conductor electrically coupled to each electrode of the first group of electrodes and a second conductor electrically coupled to each electrode of the second group of electrodes. Each electrode of the first group of electrodes faces a first direction and each electrode of the second group of electrodes faces a second direction different from the first direction. The plurality of electrodes is configured to deliver electrical stimulation to tissue of a brain of the patient or sense a patient parameter from a location within the blood vessel.

Abstract: In some examples, an endovascular medical device includes an elongated body configured to be introduced in a cranial blood vessel of a patient and an expandable element on the elongated body. The expandable element includes a plurality of loops, wherein each loop includes one or more electrodes. The expandable element is configured to expand radially outwards from a relatively low-profile delivery configuration to a deployed configuration to position the one or more electrodes to deliver electrical stimulation to tissue of a brain of a patient or sense a patient parameter from a location within the cranial blood vessel.

Abstract: Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first change of a first sensed signal of the patient to movement by the patient and a second change of a second sensed signal of the patient to the movement by the patient. Based on the first change and the second change, the medical system selects one of the first sensed signal and the second sensed signal of the patient for controlling the electrical stimulation therapy. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.

Abstract: Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be re-configured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.

Abstract: Techniques, systems, and devices are disclosed for delivering stimulation therapy to a patient. In one example, a medical device determines a first set of stimulation parameters that define entrainment stimulation pulses configured to entrain electrical activity in a patient. The medical device may control a stimulation generator to generate the entrainment stimulation pulses according to the first set of stimulation parameters. The medical device may further determine a second set of stimulation parameters that define at least one desynchronization stimulation pulse configured to disrupt at least a portion of the electrical activity entrained by the entrainment stimulation pulses. The medical device may subsequently control the stimulation generator to generate the desynchronization stimulation pulse(s) according to the second set of stimulation parameters.

Abstract: A system for closed-loop therapy includes memory configured to store a first set of one or more parameters for a first set of therapeutic electrical stimulation signals. The system includes processing circuitry configured to determine one or more local field potential (LFP) measurements of an LFP that is intrinsically generated, cause stimulation generation circuitry to deliver one or more electrical stimulation signals, determine one or more evoked resonant neural activity (ERNA) signals that are evoked by delivery of respective ones of the electrical stimulation signals, determine a second set of one or more parameters for a second set of therapeutic electrical stimulation signals based on the one or more evoked signals and the one or more LFP measurements, and cause the stimulation generation circuitry to deliver the second set of the one or more therapeutic electrical stimulation signals.

Abstract: Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be reconfigured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.

Abstract: Techniques are disclosed for defining a homeostatic window for controlling delivery of electrical stimulation therapy to a patient. In one example, a method includes generating and delivering electrical stimulation therapy to tissue of a patient via electrodes. Further, the method includes adjusting a level of a parameter of the electrical stimulation therapy such that a signal of the patient is not less than a lower bound and not greater than an upper bound. The lower bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce one or more symptoms of a disease while the patient was receiving medication for reduction of the one or more symptoms. Further, the upper bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce the one or more symptoms when the patient was not receiving the medication.

Abstract: A system for providing therapy to a patient includes stimulation generation circuitry, sensing circuitry, and processing circuitry. The processing circuitry is configured to cause storage of a first voltage at a first terminal at a first calibration capacitor and storage of a second voltage at a second terminal at a second calibration capacitor. The processing circuitry is configured to switch out a first calibration switch to prevent the first voltage stored at the first calibration capacitor from changing and switch out a second calibration switch to prevent the second voltage stored at the second calibration capacitor from changing and determine, with the sensing circuitry, a sensing signal based on the first voltage offset by a first calibration voltage stored by the first capacitor and based on the second voltage offset by a second calibration voltage stored by the second capacitor.

Abstract: Devices, systems, and techniques are described for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

Abstract: Techniques are disclosed for defining a homeostatic window for controlling delivery of electrical stimulation therapy to a patient. In one example, a method includes generating and delivering electrical stimulation therapy to tissue of a patient via electrodes. Further, the method includes adjusting a level of a parameter of the electrical stimulation therapy such that a signal of the patient is not less than a lower bound and not greater than an upper bound. The lower bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce one or more symptoms of a disease while the patient was receiving medication for reduction of the one or more symptoms. Further, the upper bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce the one or more symptoms when the patient was not receiving the medication.

Abstract: A system includes memory and processing circuitry coupled to the memory and configured to determine a plurality of local field potential (LFP) measurements of an LFP, wherein the LFP is intrinsically generated by a signal source within a brain of a patient, determine one or more electrodes for delivering a therapeutic electrical stimulation signal based on the LFP measurements, control stimulation generation circuitry to deliver a plurality of electrical stimulation signals via the determined one or more electrodes, wherein the plurality of electrical stimulation signals each comprise at least one different therapy parameter, for respective ones of the plurality of electrical stimulation signals, determine respective evoked signals, wherein the respective evoked signals are evoked by delivery of the respective plurality of electrical stimulation signals, and determine at least one parameter for the therapeutic electrical stimulation signal based on the respective evoked signals.

Abstract: A system provides a burr hole cap assembly configured to secure a position of a lead implanted through a burr hole in a cranium of a patient. One or more electrodes are coupled to one or more components of the burr hole cap assembly. The one or more electrode is disposed within the burr hole cap assembly for sensing signals within a brain of the patient or stimulating a portion of the brain of the patient.

Abstract: A medical device may receive sensor data from sensing sources, and determine confidence levels for sensor data received from each of the plurality of sensing sources. Each of the confidence levels of the sensor data from each of the sensing sources is a measure of accuracy of the sensor data received from respective sensing sources. The medical device may also determine one or more therapy parameter values based on the determined confidence levels, and cause delivery of therapy based on the determined one or more therapy parameter values.

Abstract: Devices, systems, and techniques are described for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

Abstract: An example system includes stimulation generation circuitry configured to deliver electrical stimulation to a patient; sensing circuitry configured to sense one or more biomarker signals; and processing circuitry configured to: cause delivery of electrical stimulation with the patient in a first patient state; receive a first instance of a biomarker signal in presence of the electrical stimulation with the patient in the first patient state; cause delivery of electrical stimulation with the patient in a second patient state; receive a second instance of the biomarker signal in presence of the electrical stimulation with the patient in the second patient state; determine whether a difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies a threshold; select a therapy mode based on whether the difference satisfies the threshold; and cause delivery of electrical stimulation in accordance with the selected therapy mode.

Abstract: An implantable medical device (IMD) is described capable of determining whether a patient is susceptible to freezing of gait events during ambulatory movement without the patient demonstrating an episode of freezing of gait. In one example, the IMD senses, via one or more electrodes, a bioelectrical signal of a brain of the patient while the patient performs movement associated with freezing of gait. The IMD determines, based on the bioelectrical signal, whether the patient is susceptible to freezing of gait while the patient is not experiencing an episode of freezing of gait. Further, upon detecting the movement associated with freezing of gait, the IMD delivers electrical stimulation therapy to the patient configured to suppress freezing of gait.