Abstract: The present invention provides methods, systems and apparatuses for effecting excitation or inhibition of small sensory nerve fibers, such as C-afferent fibers, by electrical stimulation of nerves innervating the pancreas in diabetic subjects. In an aspect the methods are directed to effecting insulin production and for the treatment of diabetes. This invention includes a closed or open loop feedback control system in which biomarker levels are monitored in order to direct electrical stimulation. An implantable or external neural stimulation device is also provided.

Abstract: Methods and devices for monitoring and/or treating patients comprise a switch to automatically start-up the device when the device contacts tissue. By automatically starting up the device, the device may be installed without the clinician and/or user turning on the device, such that the device can be easy to use. In many embodiments, the device comprises startup circuitry with very low current and/or power consumption, for example less than 100 pA. The startup circuitry can detect tissue contact and turn on circuitry that is used to monitor or treat the patient.

Abstract: An implantable neurostimulator-implemented method for managing tachyarrhythmias upon a patient's awakening from sleep through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers comprising the cervical vagus nerve of a patient. Operating modes of the pulse generator are stored. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent initiation of or disrupt tachyarrhythmia upon the patient's awakening from a sleep state through at least one of continuously-cycling, intermittent and periodic ON-OFF cycles of electrical pulses. Other operating modes, including a maintenance dose and a restorative dose are defined.

Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: Apparatus and methods for detecting lead migration through the use of measured artifactual data about the tissue in the vicinity of the lead.

Abstract: Embodiments of the invention include a temporarily or permanently implantable medical device with an elongate electrical line, and a method of producing the implantable medical device. The elongate electrical line includes a first electrical component and a second component, wherein the first electrical component or part of the first electrical component includes a functional conductor. The second component includes at least one metal layer and at least one flexible plastic layer. The first electrical component is electrically connected in series to the at least one metal layer of the second component.

Abstract: A device for vestibular substitution includes a mouthpiece fitting entirely within a person's mouth in a shape that conforms to the palate. The mouthpiece encases a circuit board containing an electronic system that can deliver electrical pulses to electrical stimulators touching the palate based on head movement. The electronic system includes a motion sensor, a control unit; a stimulation circuit; and a battery. The control unit is preferably a microcontroller with a digital Input/Output capability, a Serial Peripheral Interface/Inter-Integrated Circuit protocol, a timer, and an oscillator for sensor interfacing and timing control. The microcontroller enables processing data from the accelerometer to indicate head movement, and controlling each embedded electrical stimulator to deliver electrical pulses with adjustable waveform parameters. The device may also include a wireless transceiver for remote control of the device from outside the person's mouth.

Abstract: Active rejection techniques are used to cancel MRI gradient signals in an implantable medical device. An active component placed in an input channel of the implantable medical device actively rejects MRI gradient signals received on the input channel. A sensing circuit that senses an external MRI gradient signal generates a control signal that controls the active component. For example, the control signal may be the inverse of the external MRI gradient signal. An active component that receives an input signal including a desired signal component (e.g., a cardiac signal) and an undesired MRI gradient signal component may thus use this control signal to reject the undesired MRI gradient signal component.

Abstract: A method includes coupling electrodes to a patient's head and identifying whether any of the electrodes form a functional set, such that a desired therapeutic effect is achieved when the two or more electrodes deliver a total amount of current to the patient regardless of what portion of the total amount of current each respective electrode carries. One or more constant current sources are provided, each having a supply and return terminal, which supply and return equal amounts of current at any given time. The constant current source(s) are coupled to the electrodes in such a manner that each supply terminal and each return terminal is coupled to no more than the electrodes of a single one of the functional sets, if any, or to a single one of the electrodes not included in one of the functional sets.

Abstract: An implantable electronic therapy device, having a therapy unit, a heart rate capturing unit, a contractility determination unit, and an evaluation and control unit. The therapy unit delivers an antitachycardiac therapy. The heart rate capturing unit determines a ventricular heart rate from an input signal, and the contractility determination unit generates from an input signal, a contraction signal reflecting a contractility of a ventricle. The evaluation and control unit is connected to the therapy unit, the heart rate capturing unit, and the contractility determination unit actuates the therapy unit to administer an antitachycardiac therapy when the heart rate capturing unit detects an increase in the heart rate above a specified threshold value and the contractility determination unit supplies a contraction signal which is not physiologically adequate for the increase in the heart rate.

Abstract: A device and method for carrying out a dialysis of a patient and a stimulation of said patient at the same time either during dialysis sessions, or between dialysis sessions or both.

Abstract: The invention relates to a device for applying a transcutaneous electrical stimulation stimulus to the surface of a section of the human ear, which comprises a retaining element which is mountable on or in the ear and a number of electrodes which are arranged on or in an electrode carrier, wherein the device comprises a control apparatus which controls or regulates the generation of a potential difference between the electrodes. In order to permit an improved and safer transcutaneous stimulation the invention proposes that at least three electrodes are arranged on or in the electrode carrier, wherein the at least three electrodes are located in one plane, wherein the position of at least one of the at least three electrodes is adjustable on the electrode carrier and wherein the at least one electrode of which the position is adjustable is mounted such as to be displaceable in a translational manner in the plane. Furthermore, the invention relates a method for the operation of such a device.

Abstract: Devices and methods compensate for perturbations in a stimulation signal caused by external conditions such as a magnetic field of an MRI machine so that stimulation therapy may continue in the presence of the external condition. Compensation for the perturbations during a stimulation pulse of a stimulation phase may be provided by using feedback within a stimulation current source. Perturbations during a recharge phase may be addressed by utilizing an active recharge at least when the external condition is present. Furthermore, compensation for perturbations during a recharge pulse of the active recharge phase may be provided by using feedback within a recharge current source. Passive recharge may be used instead of active recharge when the external condition is not present to preserve battery life of the stimulation device. The stimulation device may include a sensor to detect the external condition so that an appropriate mode of recharge may be chosen.

Abstract: An article for transcutaneously applying electrical stimulation to sensory receptors. The article is a support to which an electrode pair, a positive and corresponding negative electrode, is attached. Leads are electrically attached to each of the positive and negative electrodes, wherein each lead has an insulated coating. A controller is electrically attached to the leads for delivering monophasic or biphasic electrical stimulation at a single frequency. A power supply is electrically connected to the controller, and may be attached to the support. The article may be a sock, a glove, a harness or an insole.

Abstract: One embodiment relates to a medical device including a sensor to provide signals indicative of a detected posture state of a patient. A memory stores one or more defined vectors, each defined vector being associated with a tolerance describing a relationship with the defined vector. A processor determines a respective similarity between the detected vector and each of one or more of the defined vectors and classifies a posture state of the patient based on whether any similarity has a relationship to the respective defined vector that is described by the associated tolerance. In one embodiment, the similarity is determined without regard to a coordinate system of the patient. Another embodiment relates to determining the similarity based on at least one of an inner product, a length of the defined posture vector and a length of the detected vector.

Abstract: A method for establishing a connection between a first electronic computing device and a second electronic computing device includes moving the second electronic computing device so that it is proximal to the first electronic computing device. When the first electronic computing device detects the proximity of the first electronic computing device relative to the second electronic computing device, a radio on the first electronic device is set to a connectable and discoverable state. A wireless connection is automatically established between the first electronic computing device and the second electronic computing device. Data is transmitted between the first electronic computing device and the second electronic computing device.

Abstract: Methods and apparatuses are disclosed for potentiating a favorable brain state that is associated with relief in symptoms of a brain condition. Techniques include monitoring one or more brain signals and detecting an episode of a favorable brain state based on the one or more brain signals, the favorable brain state associated with a decrease in one or more symptoms of a brain condition of the patient. Then, in response to the detection of the favorable brain state episode, electrical stimulation that potentiates the favorable brain state is delivered to the brain of the patient, the electrical stimulation delivered within a window of time opened for detection of each favorable brain state episode.

Abstract: An implantable nerve stimulation device has a sensor system, a data processor in communication with the sensor system, and a nerve stimulation system in communication with the data processor and constructed to provide electrical stimulation to at least one branch of at least one vestibulocochlear nerve. The nerve stimulation system includes an electrode array that has a first plurality of electrodes structured to be surgically implanted in electrical communication with a superior branch of the vestibular nerve, a second plurality of electrodes structured to be surgically implanted in electrical communication with a horizontal branch of the vestibular nerve, a third plurality of electrodes structured to be surgically implanted in electrical communication with a posterior branch of the vestibular nerve, and a common crus reference electrode structured to be surgically implanted into a common crus of the vestibular labyrinth.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element to deliver therapy to a sympathetic cardiac nerve fiber. At least one of the therapeutic elements is disposed in the vasculature superior to the heart. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: An ambulatory medical device capable of delivering therapy to a patient is provided. The ambulatory medical device comprises at least one controller operatively connected to at least one sensor configured to detect a health disorder of the patient, at least one treatment element configured to deliver therapy to the patient, and at least one response mechanism configured to be actuated by the patient, the at least one response mechanism having one of a first state and a second state. The at least one controller being configured to delay delivery of the therapy to patient for a first predetermined period of time responsive to detection of the health disorder and the at least one response mechanism having the first state, and to deliver the therapy to the patient in response to continued detection of the health disorder, the at least one response mechanism remaining in the first state.

Abstract: Apparatus for transcutaneous electrical nerve stimulation in humans, comprising a housing; stimulation means mounted within the housing for electrically stimulating nerves; an electrode array releasably mounted to the housing, connectable to the stimulation means, and comprising electrodes for electrical stimulation of nerves; control means mounted to the housing and electrically connected to the stimulation means for controlling the stimulation means; monitoring means mounted to the housing and electrically connected to the stimulation means for monitoring the stimulation means; user interface means mounted to the housing and electrically connected to the control means for controlling the stimulation means; display means mounted to the housing and electrically connected to the control means and the monitoring means for displaying the status of the stimulations means; and a strap attached to the housing and configured to hold the housing, stimulation means and electrode array at a specific anatomical location

Abstract: A method comprises applying a first open-loop electrical signal to a neural structure at a first rate. The method also comprises applying a closed-loop electrical signal to the neural structure in response to an event detection, thus causing an overall rate at which electrical stimulation is applied to the neural structure to exceed the first rate. The method further comprises applying a second open-loop electrical signal to a neural structure at a second rate that is lower than the first rate, thus causing the overall rate to be reduced to the first rate.

Abstract: According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. Other embodiments are provided herein.

Abstract: A method of stimulating a portion of a spinal cord of a patient includes identifying an arrangement of electrodes including a relative placement of each electrode within the arrangement: identifying a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord: determining by calculation, for a selection of at least one cathode from the electrodes, at least two anode guard electrodes from the electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level; and stimulating the portion of the spinal cord of the patient at the vertebral level using the at least one cathode and the at least two anode guard electrodes.

Abstract: In an embodiment, a system includes a sensor device operable to detect a property of a mammal without a direct physical contact with the mammal. The system also includes a patient assessment device operable to evaluate the detected property of the mammal for an indicator of a disease. The system further includes a patient information device including a computer-readable medium, and configured to maintain and to provide access to information corresponding to the indication of the disease. The system further includes a transmitter device operable to broadcast a signal indicative of the disease.

Abstract: Provided is an electrical system including an intelligent learning terminal to analyze biometric information associated with a user and calculate an intensity of electrical stimulation for the user based on a result of the analyzing, and at least one wireless electrical stimulator to provide electrical stimulation to the user based on the calculated intensity of electrical stimulation, wherein the intelligent learning terminal is connected to the at least one wireless electrical stimulator based on wired or wireless communication.

Abstract: The invention relates to an apparatus for stimulating neurons having a pathological synchronous and oscillatory neural activity, the apparatus including a stimulation unit having a plurality of stimulation contacts to stimulate neurons in a patients brain and/or spinal cord with electric stimuli, a measurement unit for recording test signals that represent a neural activity of the stimulated neurons, and a control and analysis unit. Furthermore, the stimulation contacts of the stimulation unit apply stimuli, and the control and analysis unit selects the stimulation contacts, the stimuli of which cause the phase of the pathological synchronous and oscillatory neural activity of the stimulated neurons to be reset. The selected stimulation contacts then apply phase-resetting stimuli with a time delay, and the control and analysis unit verifies whether the pathological synchronous and oscillatory neural activity of the stimulated neurons is suppressed by said time-delayed stimuli.

Abstract: Apparatus for applying a treatment (216) to at least one tissue of a subject is described, the apparatus comprising a transmitting unit (210) configured to transmit a wireless power signal (214), a first implant (202a), and a second implant (202b), each of the implants being configured to receive the power signal and to apply the treatment asynchronously to each other, in response to the power signal. Other embodiments are also described.

Abstract: An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy.

Abstract: A method of performing an intracardiac procedure using controlled intermittent diastolic arrest (CIDA) to expand the chambers of the heart to a volume between about 75 to 200% of their normal end-diastolic volume. In one embodiment, CIDA is conducted so that cardiac arrest with cardiac distention is achieved in about 5 to 15 seconds and diastolic arrest is maintained for a time between about 5 and 90 seconds. Intracardiac procedures that are facilitated with CIDA include heart valve repair or replacement. The method involves the use of CIDA and wherein the procedure is performed in or on the heart with the use of a catheter or catheter-delivered device, therapy, or agent. In one aspect, the heart is accessed during CIDA via a left ventricular apical access port or device. In one aspect CIDA is conducted via stimulation of the vagal nerve alone or in combination with one or more of an acetylcholinesterase inhibitor, a ?-adrenergic receptor blocker, and/or a calcium channel blocker.

Abstract: A method of identifying a location for applying a stimulation therapy to treat a patient includes stimulating a first body region of the patient transcutaneously via a stimulus generator. The body region contains a first portion of a nerve that has an elongate shape. In response to the stimulating, action potentials received from a second portion of the nerve are monitored over a period of time. The second portion of the nerve is in a second body region of the patient that is located remotely from the first body region. Based on the monitoring, an optimized location of the second portion of the nerve is determined for applying the stimulation therapy to treat the first body region.

Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: A method of providing stimulation therapy to a patient includes performing first and second calibration processes in first and second patient posture states, respectively. The first and second calibration processes respectively associates a sensation experienced by a patient, in the respective patient posture states, with first and second amounts of an evoked potential, respectively, and also with first and second values of a stimulation parameter to achieve the first and second amounts of evoked potential, respectively. Thereafter, a current patient posture state is detected. If the current patient posture state is detected as the first patient posture state, stimulation therapy is applied to the patient using the first value of the stimulation parameter as an initial value. If the current patient posture state is detected as the second patient posture state, stimulation therapy is applied to the patient using the second value of the stimulation parameter as the initial value.

Abstract: A method of establishing a stimulation treatment protocol includes delivering electrical stimulation to a nerve site of the patient. The electrical stimulation is delivered using a stimulation configuration with respect to one or more of the following: activation of a subset of a plurality of electrodes on a lead, electrode polarity for the activated electrodes, stimulation pulse width, and stimulation pulse amplitude. An action potential evoked from the nerve site in response to the electrical stimulation is measured. The action potential includes a sensory fiber contribution and a motor fiber contribution. Both the sensory fiber contribution and the motor fiber contribution are measured. The delivering and the measuring are repeated for a plurality of cycles. Each cycle is performed using a different stimulation configuration.

Abstract: A medical system configured for performing a medical function in a patient comprises a medical lead configured for being implanted adjacent a tissue region of the patient, and an electrode configured for being implanted adjacent the tissue region. The medical system further comprises analog output circuitry configured for delivering one or more electrical signals having a plurality of different sinusoidal frequency components to the tissue region via the electrode, monitoring circuitry configured for measuring a plurality of different frequency-dependent or other basis function electrical parameter values in response to the delivery of the one or more electrical signals to the tissue region, and at least one controller/processor configured for analyzing the different electrical parameter values, and performing a function based on the different analyzed electrical parameter values.

Abstract: Disclosed herein are neural probes comprising an L1 polypeptide functional fragment thereof on the exterior surface of the probe, devices including such electrodes, and methods of their use. The disclosed embodiments are useful, for example, for in methods of recording and/or stimulating neural signals in a subject.

Abstract: Apparatus (20) is provided, including a bifurcation stent (50) comprising one or more electrodes (32), the stent (50) configured to be placed in a primary passage (52) and a secondary passage (54) of a blood vessel (30), and a control unit (34), configured to drive the electrodes (32) to apply a signal to a wall (36) of the blood vessel (30), and to configure the signal to increase nitric oxide (NO) secretion by the wall (36). Other embodiments are also described.

Abstract: A neuromimetic device includes a feedforward pathway and a feedback pathway. The device operates in parallel with a suspect neural region, coupled between regions afferent and efferent to the suspect region. The device can be trained to mimic the suspect region while the region is still considered functional; and then replace the region once the region is considered dysfunctional. The device may be particularly useful in treating neuromotor issues such as Parkinson's disease.

Abstract: Systems of and methods for stimulation of neurological tissue that may generate stimulation trains with temporal patterns of stimulation is shown and disclosed herein. The temporal patterns of stimulation may include intervals between electrical pulses (the inter-pulse intervals) that change or vary over time. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention may provide a lower average frequency.

Abstract: The present invention relates to an electronic circuit arrangement (10) comprising: a substrate (12) having a first surface (12a) and a second surface (12b), an electronic circuit, an electrical connection part (16) for providing an electrical connection to the electronic circuit and being arranged on the first surface (12a), and at least one electrical wire (18). The electrical wire (18) comprises at least one conductive core (20) and an isolation (22) surrounding the conductive core (20). An end portion (18a) of the electrical wire (18) is an isolation-free portion for allowing access to the conductive core (20), wherein the end portion (18a) of the electrical wire (18) is connected to the electrical connection part (16). At least one through-hole (24) extending from the first surface (12a) to the second surface (12b) is provided in the substrate (12), wherein the electrical wire (18) is arranged through the through-hole (24).

Abstract: Methods for caring for a patient are disclosed. In some embodiments, the methods include measuring a first autonomic nervous system condition of the patient, calculating a first autonomic dysfunction based on the measured first autonomic nervous system condition, and calculating a first sympathovagal balance based on the first measured autonomic nervous system condition. The method also includes treating the patient, measuring a second autonomic nervous system condition of the patient, calculating a second sympathovagal balance based on the second measured autonomic nervous system condition, and comparing the second sympathovagal balance with the first sympathovagal balance. The method also includes calculating a second autonomic dysfunction based on the measured second autonomic nervous system condition, and comparing the second autonomic dysfunction with the first autonomic dysfunction.

Abstract: A device for diagnosing a wound in a patient, the device comprising: at least two electrodes configured to be placed on the skin of the patient, wherein the at least two electrodes are placed in the vicinity of the wound; and at least one signal processor operatively coupled with the at least two electrodes, wherein the at least one signal processor is configured to: i) detect and record an endogenous alternating electrical signal in an area of the wound, ii) transform said endogenous alternating electrical signal into a voltage versus frequency spectrum using a Fast Fourier Transform (FFT) algorithm, and iii) diagnose the wound as a chronic wound if the voltage for a frequency between 65-200 Hz of the frequency spectrum is below 10?7.3±10% volts and as an acute wound if the voltage for a frequency between 65-200 Hz of the frequency spectrum is above 10?7.3±10% volts.

Abstract: A method for heart treatment includes analyzing the cardiac rhythm. The method further includes utilizing a generator to produce discharges (Si) of N pulses (I) of VNS stimulation in succession. The discharge may be synchronized to a detected R ventricular depolarization wave of each cardiac cycle. The method further includes controlling a stochastic modulation of the discharges control of the delivery of each VNS pulse of each discharge by selective inhibition or not of the generation of these VNS pulses. The number of pulses of each discharge thus randomly varies, and thus varies the VNS stimulation energy of this discharge, which is artificially induced, cycle-to-cycle variability in the RR interval. This stochastic therapy is applied if the spontaneous heart rate variability falls below a minimum level.

Abstract: A neuromodulation system includes modulation output circuitry and control circuitry. The modulation output circuitry may be configured to deliver therapeutic electrical energy including therapeutic sub-threshold electrical energy and therapeutic a super-threshold electrical energy. The sub-threshold electrical energy is below a patient-perception threshold and the super-threshold electrical energy is above the patient-perception threshold. The patient-perception threshold is a boundary below which a patient does not sense delivery of the electrical energy and above which the patient does sense delivery of the electrical energy. The control circuitry is configured to control the modulation output circuitry to deliver the therapeutic electrical energy using alternating cycles of the sub-threshold electrical energy below the patient-perception threshold and the super-threshold electrical energy above the patient-perception-threshold.

Abstract: A vestibular prosthesis system is described which includes an external movement sensor that is attachable a patient's head for generating an external movement signal. A fail-safe sensor is configured to detect movement of the one or more external movement sensors relative to the head and generate a corresponding relative motion signal. And an implant processor also is implantable under the skin and in communication with the fail-safe sensor and the external transmitter for generating an implant stimulation signal based on the external movement signal and/or the relative motion signal to electrically stimulate target neural tissue for vestibular sensation by the patient.

Abstract: Nanosecond pulsed electric field (nsPEF) treatments of a tumor are used to cause the tumor to express calreticulin and stimulate an immune response against the tumor and other tumors in a subject. An immune response biomarker can be measured, and further nsPEF treatments can be performed if needed to stimulate or further stimulate the immune response. Cancers that have metastasized may be treated. The treatment can be combined with CD47-blocking antibodies, doxorubicin, CTLA-4-blocking antibodies, and/or PD-1-blocking antibodies. Electrical characteristics of nsPEF treatments can be based on the size, type, and/or strength of tumors and/or a quantity of tumors in the subject.

Abstract: The present invention provides methods, systems and apparatuses for effecting excitation or inhibition of small sensory nerve fibers, such as C-afferent fibers, by electrical stimulation of nerves innervating the pancreas in diabetic subjects. In an aspect the methods are directed to effecting insulin production and for the treatment of diabetes. This invention includes a closed or open loop feedback control system in which biomarker levels are monitored in order to direct electrical stimulation. An implantable or external neural stimulation device is also provided.

Abstract: Provided herein are a device and method for attenuating posttraumatic stress syndrome, menopause symptoms, dysautonomia and pain by interfering with sympathetic chain signaling, particularly by blocking stellate ganglion conduction.

Abstract: A method and associated stimulation device for ensuring firing of an action potential in an intended physiological target activated by a stimulus pulse generated by an electrode of a non-invasive surface based stimulation device irrespective of skin-to-electrode impedance by: (i) increasing internal impedance of the stimulation device so as to widen a Chronaxie time period thereby ensuring firing of the action potential of the intended physiological target irrespective of the skin-to-electrode impedance; and/or (ii) generating a stimulation waveform that optimizes a non-zero average current (e.g., non-zero slope of the envelope of the stimulation waveform) during preferably substantially the entire current decay of the stimulus pulse.

Abstract: An implantable apparatus can comprise an electrical test energy delivery circuit configured to provide an electrical test signal to a cervical location in a patient body. A detector circuit can use the electrical test signal to detect cervical impedance and generate a cervical impedance signal representing fluctuations in the detected cervical impedance. The implantable apparatus can comprise a therapy delivery circuit, such as configured to provide electrical neural modulation therapy using a neural modulation timing parameter, and a processor circuit that can be coupled to the electrical test energy delivery circuit, the detector circuit, and the therapy delivery circuit.