Abstract: An example of a system for modulating neuroinflammation at a tissue site in a patient includes a neuromodulation output circuit, a memory, and a control circuit. The neuromodulation output circuit may be configured to deliver the neuromodulation. The memory may be configured to store a neuromodulation parameter set selected to modulate neural activity at the tissue site and a sensed biomarker parameter. The biomarker parameter may include a measure of a biomarker or a measure of a derivative of the biomarker. The biomarker may be indicative of the neuroinflammation at the tissue site. The control circuit may be configured to control the delivery of the neuromodulation using the neuromodulation parameter set and adjust one or more parameters of the neuromodulation parameter set using the biomarker parameter.

Abstract: Methods for determining stimulation for a patient having a stimulator device are disclosed. A model is received at an external system indicative of a range or volume of preferred stimulation parameters, which model is preferably specific to and determined for the patient. The external system receives a plurality of pieces of fitting information for the patient, including information indicative of a symptom of the patient, information indicative of stimulation provided by the stimulator device during a fitting procedure, and/or phenotype information for the patient. The external system determines one or more sets of stimulation parameters for the patient using the pieces of fitting information. In one example, training data is applied to the pieces of fitting information to select the one or more sets of stimulation parameters from the range or volume of preferred stimulation parameters in the model.

Abstract: An electrical stimulation system includes at least one electrical stimulation lead, each of the at least one electrical stimulation lead including a plurality of stimulation electrodes; and a processor coupled to the lead and configured to perform actions, including: directing delivery of at least one electrical pulse through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient; and directing discrete or intermittent measurement of an electrical characteristic of the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead during, and after, delivery of the at least one electrical pulse to the tissue of the patient.

Abstract: Methods and systems for providing neuromodulation to a patient are disclosed. The disclosed methods and systems use sensed neural responses to construct and optimize models of the neural elements recruited during the neuromodulation. The models are used to estimate neural recruitment associated with a therapeutic effect and/or with side-effects to stimulation. The models can be used to adjust neuromodulation in a closed-loop fashion.

Abstract: A method for photobiomodulation of tissue includes emitting light from a lead implanted in the tissue using an implanted light source according to a first delivery program; repeatedly estimating an amount, speed, or time of a temperature or temperature change of, or amount of heat generated by, the implanted light source or repeatedly estimating an amount, speed, or time of a temperature or temperature change of tissue receiving the emitted light; and when the estimate exceeds a first threshold value and the light is emitted according to the first delivery program, emitting light from the implanted lead using the implanted light source according to a second delivery program, wherein the second delivery program results in lower heat generation by the implanted light source over a period of time than the first delivery program.

Abstract: An example of a system may include electrodes on at least one lead configured to be operationally positioned for use in modulating a volume of neural tissue, where the neural tissue has an activation function. The system may further include a neural modulation generator configured to deliver energy using at least some electrodes to generate a modulation field within the volume of neural tissue. The neural modulation generator may be configured to use a programmed modulation parameter set to generate the modulation field. The programmed modulation parameter set having values selected to control energy delivery using the at least some electrodes to achieve an objective function specific to the activation function of the volume of neural tissue to promote uniformity of a response to the modulation field in the volume of neural tissue along a span of the at least one lead.

Abstract: A system for use with a neurostimulator coupled to one or more electrodes implanted adjacent neural tissue of a patient. The system comprises a user input device configured for allowing a user to select different nerve fiber diameters and to select a set of stimulation parameters. The system further comprises processing circuitry configured estimating regions of activation within the neural tissue of the patient based on the selected nerve fiber diameters and the selected stimulation parameter set. The system further comprises a display device configured for displaying the estimated regions of tissue activation. The user input device may further be configured for allowing the user to select different tissue regions of therapy, in which case, the display device may display the different tissue region on a human body map, and different indicia associating the displayed tissue regions for therapy to displayed estimated regions of tissue activation.

Abstract: A neuromodulation customization system includes a field definition user interface, a neuromodulation signaling engine, and a supervisor engine. The field definition user interface is to facilitate entry of a customized electrotherapy field definition, with the field definition user interface including a set of input controls for defining field shape, field intensity, and field steering parameters of the customized electrotherapy field. The neuromodulation signaling engine is to produce commands for neuromodulation output circuitry to control generation of a customized electrotherapy field via a set of electrodes based on the customized electrotherapy field definition. The supervisor engine is to assess compliance of the customized electrotherapy field to be generated with applicable predefined criteria, and to modify generation of the customized electrotherapy field in response to an assessed non-compliance with the criteria.

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 a patient metric of a subject; use the patient metric as an input to a machine learning algorithm, the machine learning algorithm to search a plurality of neuromodulation parameter sets and to identify a candidate neuromodulation parameter set of the plurality of neuromodulation parameter sets, the candidate neuromodulation parameter set designed to produce a non-regular waveform that varies over a time domain and a space domain; and program a neuromodulator using the candidate neuromodulation parameter set to stimulate the subject.

Abstract: An Implantable Pulse Generator (IPG) is disclosed that is capable of sensing a degree to which recruited neurons in a patient's tissue are firing synchronously, and of modifying a stimulation program to promote desynchronicity and to reduce paresthesia. An evoked compound action potential (ECAP) of the recruited neurons is sensed as a measure of synchronicity by at least one non-active electrode. An ECAP algorithm operable in the IPG assesses the shape of the ECAP and determines one or more ECAP shape parameters that indicate whether the recruited neurons are firing synchronously or desynchronously. If the shape parameters indicate significant synchronicity, the ECAP algorithm can adjust the stimulation program to promote desynchronous firing.

Abstract: An example of a system may include an electrode arrangement and a neuromodulation device configured to use electrodes in the electrode arrangement to generate a neuromodulation field. The neuromodulation device may include a neuromodulation generator, a neuromodulation control circuit and a storage. The storage may include a stochastically-modulated neuromodulation parameter set and the stochastically-modulated neuromodulation parameter set may include at least one stochastically-modulated parameter. The controller may be configured to control the neuromodulation generator using the stochastically-modulation parameter set to generate the neuromodulation field.

Abstract: A method for determining an intensity index for electrical stimulation includes receiving stimulation information; determining a stimulation field from the stimulation information; determining at least one stimulation field function using the stimulation field; and analyzing the determined at least one stimulation field function to determine the intensity index. The intensity index corresponds to a stimulation target and indexes at least one dosing reference for electrical stimulation for that stimulation target.

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 a patient metric of a subject; use the patient metric as an input to a machine learning algorithm, the machine learning algorithm to search a plurality of neuromodulation parameter sets and to identify a candidate neuromodulation parameter set of the plurality of neuromodulation parameter sets, the candidate neuromodulation parameter set designed to produce a non-regular waveform that varies over a time domain and a space domain; and program a neuromodulator using the candidate neuromodulation parameter set to stimulate the subject.

Abstract: A system may include a neuromodulator and a processing system. The neuromodulator may be configured to be programmed with a set of more than one program to deliver neuromodulation. The processing system may be configured to: receive sensed data indicative of activity, motion and/or posture of a patient; analyze the activity, motion and/or posture of the patient; and perform a process, based on the analyzed activity, motion and/or posture, for switching from one program in the set of more than one program to another program from the set of more than one program. The process may include automatically implementing the other program from the set of more than one program or suggesting to switch to the other program from the set of more than one program.

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 Implantable Pulse Generator (IPG) is disclosed that is capable of sensing a degree to which recruited neurons in a patient's tissue are firing synchronously, and of modifying a stimulation program to promote desynchronicity and to reduce paresthesia. An evoked compound action potential (ECAP) of the recruited neurons is sensed as a measure of synchronicity by at least one non-active electrode. An ECAP algorithm operable in the IPG assesses the shape of the ECAP and determines one or more ECAP shape parameters that indicate whether the recruited neurons are firing synchronously or desynchronously. If the shape parameters indicate significant synchronicity, the ECAP algorithm can adjust the stimulation program to promote desynchronous firing.

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 electrical stimulation system includes at least one electrical stimulation lead, each of the at least one electrical stimulation lead including a plurality of stimulation electrodes; and a processor coupled to the lead and configured to perform actions, including: directing delivery of at least one electrical pulse through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient; and directing discrete or intermittent measurement of an electrical characteristic of the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead during, and after, delivery of the at least one electrical pulse to the tissue of the patient.

Abstract: An electrical stimulation system includes at least one electrical stimulation lead, each of the at least one electrical stimulation lead including a plurality of stimulation electrodes; and a processor coupled to the lead and configured to perform actions, including: directing delivery of at least one electrical pulse through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient; and directing discrete or intermittent measurement of an electrical characteristic of the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead during, and after, delivery of the at least one electrical pulse to the tissue of the patient.

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.