Abstract: A neurostimulation system includes a programming control circuit and a user interface. The programming control circuit may be configured to generate a plurality of stimulation parameters controlling delivery of neurostimulation pulses according to one or more neurostimulation programs each specifying a pattern of the neurostimulation pulses. The user interface includes a display screen, a user input device, and a neurostimulation program circuit. The neurostimulation program circuit may be configured to allow for construction of one or more pulse trains (PTs) and one or more train groupings (TGs) of the one or more neurostimulation programs, and to allow for scheduling of delivery of the one or more neurostimulation programs, using the display screen and the user input device. Each PT includes one or more pulse blocks each including a plurality of pulses of the neurostimulation pulses. Each TG includes one or more PTs.

Abstract: Passive tissue biasing circuitry in an Implantable Pulse Generator (IPG) is disclosed to facilitate the sensing of neural responses by holding the voltage of the tissue to a common mode voltage (Vcm). The IPG's conductive case electrode, or any other electrode, is passively biased to Vcm using a capacitor, as opposed to actively driving such electrode to a prescribed voltage using a voltage source. Once Vcm is established, voltages accompanying the production of stimulation pulses will be referenced to Vcm, which eases neural response sensing. An amplifier can be used to set a virtual reference voltage and to limit the amount of current that flows to the case during the production of Vcm. Circuitry can be used to monitor the virtual reference voltage to enable sensing neural responses, and to set a compliance voltage for the current generation circuitry.

Abstract: The disclosed techniques allow for externalizing errors from an implantable medical device using the device's charging coil, for receipt at an external charger or other external device. Transmission of errors in this manner is particularly useful when telemetry of error codes through a traditional telemetry coil in the implant is not possible, for example, because the error experienced is so fundamental as to preclude use of such traditional means. By externalizing the error via the charging coil, and though the use of robust error modulation circuitry in the implant designed to be generally insensitive to fundamental errors, the external charger can be consulted to understand the failure mode involved, and to take appropriate action.

Abstract: A computer implemented system and method facilitates a cycle of generation, sharing, and refinement of volumes related to stimulation of anatomical tissue, such as brain or spinal cord stimulation. Such volumes can include target stimulation volumes, side effect volumes, and volumes of estimated activation. A computer system and method also facilitates analysis of groups of volumes, including analysis of differences and/or commonalities between different groups of volumes.

Abstract: This document discusses, among other things, systems and methods to provide a paresthesia therapy to a patient using an implantable neuromodulation system, wherein providing the paresthesia therapy may include delivering to the patient an electrical waveform having a duration and a distribution of frequencies in the range of 0.001 kHz to 20 kHz, wherein the distribution of frequencies includes a first frequency group of one or more frequencies and a second frequency group of one or more frequencies, and wherein the patient continuously experiences paresthesia throughout the duration of the electrical waveform.

Abstract: An implantable pulse generator (IPG) is disclosed having a plurality of electrode nodes, each electrode node configured to be coupled to an electrode to provide stimulation pulses to a patient's tissue. The IPG includes a digital-to-analog converter configured to amplify a reference current to a first current specified by first control signals; a first resistance configured to receive the first current, wherein a voltage across the first resistance is held to a reference voltage at a first node; a plurality of branches each comprising a second resistance and configured to produce a branch current, wherein a voltage across each second resistance is held to the reference voltage at second nodes; and a switch matrix configurable to selectively couple any branch current to any of the electrode nodes via the second nodes.

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 can facilitate visualizing cathodic and anodic stimulation separately via displaying and modifying graphical representations of anodic and cathodic volumes of activation. Alternately, the methods and systems may separately visualize stimulation of different neural elements, such as nerve fibers and neural cells. These methods and systems can further facilitate programming an electrical stimulation system for stimulating patient tissue.

Abstract: An example of a system for programming neurostimulation according to a stimulation configuration may include stimulation configuration circuitry, volume definition circuitry, stimulation effect circuitry, and recording circuitry. The stimulation configuration circuitry may be configured to determine the stimulation configuration. The volume definition circuitry may be configured to determine stimulation field model(s) (SFM(s)) each representing a volume of tissue activated by the neurostimulation. The stimulation effect circuitry may be configured to determine a stimulation effect type for each tagging point specified for the SFM(s) and to tag the SFM(s) at each tagging point with the stimulation effect type determined for that tagging point. The stimulation effect type for each tagging point is a type of stimulation resulting from the neurostimulation as measured at that tagging point.

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: Techniques are described for providing a therapeutic pseudo-constant DC current in an implantable stimulator using pulses whose positive and negative phases are not charge balanced. Such charge imbalanced pulses act to charge any capacitance in the current path between selected electrode nodes, such as the DC-blocking capacitors and/or any inherent capacitance such as those present at the electrode/tissue interface. These charged capacitances act during quiet periods between the pulses to induce a pseudo-constant DC current. Beneficially, these DC currents can be small enough to stay within charge density limits and hence not corrode the electrode or cause tissue damage, and further can be controlled to stay within such limits or for other reasons. Graphical user interface (GUI) aspects for generating the charge imbalanced pulses and for determining and/or controlling the pseudo-constant DC current are also provided.

Abstract: This document discusses, among other things, systems and methods for managing pain in a subject. A system may include one or more sensors configured to sense from the subject information corresponding to emotional reaction to pain, such as emotional expression. The emotional expression includes facial or vocal expression. A pain analyzer circuit may generate a pain score using signal metrics of facial or vocal expression extracted from the sensed information. The pain score may be output to a user or a process. The system may additionally include a neurostimulator that can adaptively control the delivery of pain therapy by automatically adjusting stimulation parameters based on the pain score.

Abstract: The types of electrode leads that are connected to an implantable medical device are determined based on electrical parameters that are measured at the electrodes that are positioned on the leads. The different types of known electrode leads have different physical electrode arrangements that impact the measured electrical parameters. Properties in the measured electrical parameters that are indicative of the physical arrangements of electrodes of known types of electrode leads are utilized to determine the types of leads that are connected to the implantable medical device.

Abstract: A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

Abstract: An advertising algorithm is disclosed which operates in an Implantable Medical Device (IMD) to adjust an interval at which the IMD will transmit advertising data packets to an external device able to connect with the IMD. When a communication session between the IMD and an external device is terminated, the advertising algorithm will issue advertising data packets at a higher rate for a set duration. This will allow the external device to connect more quickly with the IMD in a next communication session. After the set duration, when it may be assumed that the external device is less likely to connect with the IMD, the algorithm reduces that rate at which advertising data packets are issued, which saves power in the IMD.

Abstract: An example of a system for delivering neurostimulation energy may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters according to a neurostimulation program including a pattern of interferential stimulation configured to effect asynchronous and/or non-regular activation of nerve fibers by simultaneously delivering a first stimulation current having a first waveform with a first frequency using a first electrode configuration and a second stimulation current having a second waveform with a second frequency using a second electrode configuration.

Abstract: Improved stimulation circuitry for controlling the stimulation delivered by an implantable stimulator is disclosed. The stimulation circuitry includes memory circuitry that stores pulse programs that define pulse shapes, steering programs that define electrode configurations, and aggregate programs that link a selected pulse program with a selected steering program. The aggregate programs also include an amplitude modulation factor that modulates the amplitude defined by the pulse program. The inclusion of an amplitude modulation factor in the aggregate program allows complex amplitude-modulated waveforms to be produced. Pulse definition circuits in the stimulation circuitry execute aggregate programs to generate stimulation waveforms, which stimulation waveforms can be generated simultaneously by the different pulse definition circuits.

Abstract: An example of a system may include a processor, and a memory device comprising instructions, which when executed by the processor, cause the processor to access at least one of patient input, clinician input, or automatic input, use the patient input, clinician input, or automatic input in a search method, the search method designed to evaluate a plurality of candidate neuromodulation parameter sets to identify an optimal neuromodulation parameter set, and program a neuromodulator using the optimal neuromodulation parameter set to stimulate a patient.

Abstract: An optical stimulation system includes a light source; an optical lead coupled, or coupleable, to the light source; at least one of a calibration table or a calibration formula, generated by a calibration procedure specifically using the light source and the optical lead of the optical stimulation system; and a control unit coupled, or coupleable, to the light source. The control module includes a memory to store the at least one of the calibration table or the calibration formula, and a processor coupled to the memory and configured for receiving a target light output level, using the at least one of the calibration table or the calibration formula to determine at least one operational parameter for generating the target light output level, and directing the light source, using the at least one operational parameter, to generate light at the target light output level.

Abstract: A virtual or augmented reality system is disclosed which is capable of both (i) evaluating prospective implantable neurostimulator patient candidates, and (ii) determining optimal stimulation settings for already-implanted neurostimulation patients. Physiological sensors are included with the system to provide objective measurements relevant to a patient's symptoms, such as pain in a Spinal Cord Stimulation (SCS) system. Such objective measurements are determined during the presentation of various virtual or augmented environments, and can be useful to determining which patients are suitable candidates to consider for implantation. Stimulation settings for already-implanted patients may be adjusted while presenting a virtual or augmented environment to the patient, with objective measurements being determined for each stimulation setting. Such objective measurements can then be used to determine optimal stimulation settings for the patient.