Abstract: Methods and systems for planning configurations of a neuromodulation system having a lead with a plurality of electrodes. Configurations are planned using an optimizer that analyzes potential fractionalizations after removing unavailable electrodes from analysis and adjusting a candidate fractionalization to account for the removed electrodes. The unavailable electrodes may be identified by a physician or by analysis of impedances of the electrodes.

Abstract: An implantable stimulator device is disclosed for executing a stimulation program comprising a plurality of sub-programs, wherein the sub-programs are configured to be automatically sequentially executed by stimulation circuitry in the device. Control circuitry periodically stores log data to indicate where each sub-program is in its execution. If the device experiences an interruption that prevents the stimulation circuitry from executing the stimulation program, and upon receiving an indication that the stimulation circuitry can continue execution of the stimulation program, the control circuitry is configured to query the log data to determine a sub-program during which the interruption occurred, and using the log data, cause the stimulation circuitry to continue execution of the stimulation circuitry either at the beginning of the sub-program, or at a point during the sub-program when the interruption occurred.

Abstract: An example of a system for delivering neurostimulation energy to a patient using a plurality of electrodes may include a stimulation circuit and a sensing circuit. The stimulation circuit may be configured to deliver the neurostimulation energy using stimulation electrodes selected from the plurality of electrodes and to control the delivery of the neurostimulation energy. The sensing circuit may be configured to receive one or more neural signals from sensing electrodes selected from the plurality of electrodes and may include a signal processing circuit. The signal processing circuit may include a detection circuit and an analysis circuit. The detection circuit may be configured to detect one or more attributes of neural responses from the received one or more neural signals. The analysis circuit may be configured to analyze the detected one or more attributes of the neural responses for one or more indications of a neurodegenerative disease.

Abstract: Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: A neuromodulation targeting system includes a GUI that facilitates selection of one or more neuromodulation target regions. The GUI provides an interactive display representing anatomy of a patient with user-selectable portions corresponding to a plurality of predefined anatomical regions associated with distinct localized clinical effects of neuromodulation. The system further includes a targeting selector engine that is responsive to user selection of a first portion of the interactive display by configuring delivery of neuromodulation therapy to a first target region to produce a first localized clinical effect in the patient at a location corresponding to the first portion of the display, upon administration of the neuromodulation therapy to the patient.

Abstract: The problem of a potentially high amount of supra-threshold charge passing through the patient's tissue at the end of an Implantable Pulse Generator (IPG) program is addressed by circuitry that periodically dissipates only small amount of the charge stored on capacitances (e.g., DC-blocking capacitors) during a pulsed post-program recovery period. This occurs by periodically activating control signals to turn on passive recovery switches to form a series of discharge pulses each dissipating a sub-threshold amount of charge. Such periodic pulsed dissipation may extend the duration of post-program recovery, but is not likely to be noticeable by the patient when the programming in the IPG changes from a first to a second program. Periodic pulsed dissipation of charge may also be used during a program, such as between stimulation pulses.

Abstract: Systems and methods are disclosed to permit a patient to use his external controller to move the location of stimulation in an implantable stimulator system. The external controller can be programmed with a steering algorithm, which prompts the patient to enter certain data regarding their symptoms (e.g., pain), such as pain scores and stimulation coverage. Such data is preferably entered for a plurality of different regions of the patient's body. The algorithm can compute for each body regions a targeting precision value (TP), and from these values determine a steering vector D that suggests a direction and/or a magnitude that stimulation can be moved in the electrode array to more precisely target the patient's pain. The patient may then move the location of the stimulation in accordance with the steering vector using their external controller. The algorithm can be repeated if necessary to again move the stimulation.

Abstract: A system for regulating data downloads from an implantable pulse generator (IPG) includes an IPG configured to download data, receive signals, and provide electrical stimulation, and an external device configured to initiate a data download from the IPG and to direct the IPG to download the data for a first time period. The IPG and/or external device is configured to stop the data download after the first time period has expired and to wait a first time interval during which no data is downloaded and the IPG is available to receive signals from any external control devices. The IPG and/or external device is configured to initiate an additional data download from the IPG to the external device for a second time period after the first time interval has expired, and to repeat the steps until all data has been downloaded from the IPG to the external device.

Abstract: A connector stack includes a plurality of conductive rings and a plurality of insulator rings. The plurality of insulator rings separating the conductive rings from each other. The plurality of conductive rings and the plurality of insulator rings form the connector stack, and define a lumen therethrough. The plurality of conductive rings and the plurality of insulator rings are brazed together such that the connector stack is a hermetically sealed stack. The conductive rings have one or more of a counterbore design, a conical design, or a D-flat profile. The insulator rings may be disk shaped or may have a shape similar to the conductive rings.

Abstract: Methods and systems for modulating the neuroimmune response while monitoring biomarkers that may directly or indirectly correlate with neuroimmune function. A neuromodulation therapy may be delivered, and a biomarker level determined. Some biomarker levels are determined from bodily fluid collected from the patient, and are compared to a predetermined threshold level. A therapeutic stimulation is delivered to a patient using one or more electrode leads, and/or optical fibers.

Abstract: Methods and systems for pre-populating clinical effects maps for use in determining therapy parameters for a patient having a neuromodulation system. Neuromodulation planning may be aided by generating a map comparing electrode position and amplitudes used as a tool to test therapies on a patient and determine position and amplitude combinations associated with side effects and clinical benefits. The map may be pre-populated with borders indicating likely combinations for generating side effects and/or clinical benefits. The pre-populated map may be generated using the patient's anatomical data and data stored in a database.

Abstract: Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: Methods, system, and computer-implementable algorithms are disclosed for determining time-varying pulses for a patient having an implantable stimulator device (ISD). At least one time-invariant tonic stimulation pulse parameter (e.g., amplitude, pulse width, or frequency) is modified by a modulation function to produce time-varying pulses (TVPs), and one or more measurements are taken to determine the effectiveness of the TVP. The measurements may be objective and taken from the patient, and/or subjective and determined based on feedback from the patient. In one example, objective measurements may comprise one or more features determined from an electrospinogram (ESG) signal detected by the ISD, which may include evoked compound action potentials The one or more measurements are used to determine a score for the TVP, which is useful in selecting a best TVP for use with the patient, or for adjusting the modulation function applied to the tonic stimulation parameters.

Abstract: This document discusses systems, devices, and methods for computer-assisted pain or paresthesia assessment and pain management in a subject. A system includes a programming aid device including a user interface, a transceiver circuit to receive information about pain management for the patient from one or more of a software-based virtual agent (SVA) or a human assistant other than the patient, and a controller circuit to initiate and manage information exchange session between the patient and one or more of the SVA or the human assistant, via the user interface, regarding pain or paresthesia sensation and pain management. Based on the information exchange, the controller determines a stimulation setting, and generate a therapy control signal to the neuromodulation device to initiate delivery of neuromodulation energy according to the determined stimulation setting.

Abstract: A system may be used with a first neuromodulator of a first neuromodulator type and a second neuromodulator of a second neuromodulator type where the first neuromodulator is programmed with a first set of modulation parameter settings. The system may comprise an input configured for receiving the first set of modulation parameter settings for the first neuromodulator type, a processor configured to execute a programmed set of instructions to determine a second set of modulation parameter settings for the second neuromodulator type based on the first set of modulation parameter settings for the first neuromodulator type, and an output configured present the second set of modulation parameter settings for entering into a neuromodulator programmer. The neuromodulator programmer may be configured to program the second neuromodulator with the second set of modulation parameters.

Abstract: Techniques for sensing neural responses such as Evoked Compound Action Potentials (ECAPs) in an implantable stimulator device are disclosed. A first therapeutic pulse phase is followed by a charge recovery phase that includes at least one high-impedance passive charge recovery duration. The ECAP is sensed during the high-impedance passive charge recovery duration. The time period of the passive charge recovery is lengthened and the high-impedance passive recharge duration entirely overlaps the ECAP (i.e., the neural response duration) at the sensing electrode.

Abstract: Methods and systems for addressing issues related to synchrony in neural tissue signals. A spectrum of neural signals in a patient may be measured while the patient is asymptomatic, and compared to signals during a symptomatic episode to determine whether neural signals should be enhanced or disrupted. Depending on the change to neural signals, either enhancing or disrupting neural therapy is generated and confirmed or adjusted.

Abstract: Systems and methods for configuring neurostimulation systems to identify optimal therapies for use in a patient. Positional data for a lead implanted in the patient and anatomical data are obtained. Non-linear response structures are identified in the patient, and therapy metrics are generated using non-linear functions of the quantity of volume segments in the non-linear response structures that would be activated by a given therapy configuration including a combination of current fractionalization and current amplitude.

Abstract: Methods and systems for analyzing and selecting therapy configurations for use in stimulating neural tissue. Probability shells relating to a likelihood that electrical stimulation issued to a given volume of neural tissue will cause a therapeutic outcome are integrated in a system for analyzing anatomical and other data, including lead position relative to neural anatomy. Metrics for analyzing therapy configurations can then be calculated, and the process of identifying likely beneficial therapy configurations is enhanced.

Abstract: Methods and systems for performing spinal cord stimulation in the cervical spine while sensing for an evoked response, such as an evoked synaptic action potential (ESAP) at a different location from the location of stimulation. A first lead may be positioned in the cervical spine for issuing therapy pulses, and sensing is performed at a thoracic or lumbar location, or a caudal cervical location relative to the location of stimulation. First and second leads may be used in a single system, or two separate systems, one for stimulation and another for sensing, may be used.