Abstract: A wearable ambulatory data recorder that senses physiological parameters of a patient, and stores physiological parameter data for later retrieval, as well as techniques for using such a wearable ambulatory data recorder, are described. The data recorder includes one or more sensors located on or within a housing. The data recorder may include an adhesive layer for attachment to a patient. In some embodiments, the housing may be within a patch, e.g., bandage, which includes the adhesive layer. The housing may be waterproof. Features of the data recorder such as size, waterproofness, and inclusion of an adhesive may allow the data recorder to be unobtrusively worn by a patient during a variety of daily activities. The data recorder may be for single use and thereafter disposable.

Abstract: Implantable medical devices switch from a constant current mode of operation to a constant voltage mode of operation. The switching may be based on the device determining that tissue impedance stability has occurred. The determination may be a measurement of output voltage stability of the constant current source or based on other factors such as an amount of time that has elapsed. The switching may be as the result of an externally generated request such as by a clinician via an external device. The implantable medical device may begin constant voltage mode by utilizing stimulation parameters based on those initially programmed for constant current mode and based upon a measurement of voltage amplitude being output by the constant current source prior to the switch.

Abstract: The invention is directed to techniques and systems in which external brain monitoring is used to facilitate implantation and configuration of an implantable medical device. The techniques may create an open loop or closed loop system in which brain signals quantify the efficacy of electrical logical stimulation (or drug therapy via an implantable drug pump) at locations outside of the brain. The techniques may be used to improve placement of leads and electrodes during an implantation procedure, and/or to select or adjust stimulation parameters either during the implantation procedure or possibly following implantation of an implantable medical device. The described techniques have applications for the alleviation of pain, but may find other applications where EEG signals can quantify the efficacy of treatment via an implantable medical device.

Abstract: Delivery of electrical stimulation to the substantia nigra and the subthalamic nucleus of a brain of a patient are independently controlled in order to treat sleep and movement disorders. Electrical stimulation of the subthalamic nucleus may be effective in treating symptoms associated with a movement disorder, and electrical stimulation of the substantia nigra may be effective in treating symptoms associated with a sleep disorder. During a sleep state of the patient, a sleep stage of the patient may be determined, and an electrical stimulation device may be controlled based on the determined sleep stage. Electrical stimulation of the substantia nigra and subthalamic nucleus may be delivered at substantially the same time or at different times.

Abstract: Techniques for configuring electrical stimulation therapy utilizing one or more stimulation intensity values are described. In one example, a method includes receiving a stimulation intensity value that corresponds to an equal intensity function; determining a pulse width value and a pulse amplitude value based on the equal intensity function; and controlling delivery of electrical stimulation pulses with the determined pulse width value and amplitude value to a patient. A stimulation intensity value may correspond to a plurality of paired pulse width and amplitude values having substantially the same intensity. For example, the plurality of paired pulse width and amplitude values may activate a substantially equal volume of tissue when a stimulation pulse with the paired values is delivered.

Abstract: A set of therapy parameter values is selected based on a patient state, where the patient state comprises a speech state or a mixed patient state including the speech state and at least one of a movement state or a sleep state. In this way, therapy delivery is tailored to the patient state, which may include one or more patient symptoms specific to the patient state. In some examples, a medical device determines whether the patient is in the speech state or a mixed patient state including the speech state based on a signal generated by a voice activity sensor. The voice activity sensor detects the use of the patient's voice, and may include a microphone, a vibration detector or an accelerometer.

Abstract: Therapy delivery to a patient may be controlled based on a determined sleep stage of the patient. In examples, the sleep stage may be determined based on a frequency characteristic of a biosignal indicative of brain activity of the patient. A frequency characteristic may include, for example, a power level within one or more frequency bands of the biosignal, a ratio of the power level in two or more frequency bands, or a pattern in the power level of one or more frequency bands over time. A therapy program may be selected or modified based on the sleep stage determination. Therapy may be delivered during the sleep stage according to the selected or modified therapy program. In some examples, therapy delivery may be controlled after making separate determinations of a sleep stage based on the biosignal and another physiological parameter, and confirming that the sleep stage determinations are consistent.

Abstract: The invention is directed to techniques and systems in which external brain monitoring is used to facilitate implantation and configuration of an implantable medical device. The techniques may create an open loop or closed loop system in which brain signals quantify the efficacy of electrical logical stimulation (or drug therapy via an implantable drug pump) at locations outside of the brain. The techniques may be used to improve placement of leads and electrodes during an implantation procedure, and/or to select or adjust stimulation parameters either during the implantation procedure or possibly following implantation of an implantable medical device. The described techniques have applications for the alleviation of pain, but may find other applications where EEG signals can quantify the efficacy of treatment via an implantable medical device.

Abstract: A therapy program is selected based on a patient state, where the patient state comprises at least one of a movement state, sleep state or speech state. In this way, therapy delivery is tailored to the patient state, which may include specific patient symptoms. The therapy program is selected from a plurality of stored therapy programs that comprise therapy programs associated with a respective one at least two of the movement, sleep, and speech states. Techniques for determining a patient state include receiving volitional patient input or detecting biosignals generated within the patient's brain. The biosignals are nonsymptomatic and may be incidental to the movement, sleep, and speech states or generated in response to volitional patient input.

Abstract: A movement state of a patient is detected based on brain signals, such as an electroencephalogram (EEG) signal. In some examples, a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient indicative of prospective movement of the patient may be sensed in order to detect the movement state. The movement state may include the brain state that indicates the patient is intending on initiating movement, initiating movement, attempting to initiate movement or is actually moving. In some examples, upon detecting the movement state, a movement disorder therapy is delivered to the patient. In some examples, the therapy delivery is deactivated upon detecting the patient is no longer in a movement state or that the patient has successfully initiated movement. In addition, in some examples, the movement state detected based on the brain signals may be confirmed based on a signal from a motion sensor.

Abstract: A patient controls the delivery of therapy through volitional inputs that are detected by a biosignal within the brain. The volitional patient input may be directed towards performing a specific physical or mental activity, such as moving a muscle or performing a mathematical calculation. In one embodiment, a biosignal detection module monitors an electroencephalogram (EEG) signal from within the brain of the patient and determines whether the EEG signal includes the biosignal. In one embodiment, the biosignal detection module analyzes one or more frequency components of the EEG signal. In this manner, the patient may adjust therapy delivery by providing a volitional input that is detected by brain signals, wherein the volitional input may not require the interaction with another device, thereby eliminating the need for an external programmer to adjust therapy delivery. Example therapies include electrical stimulation, drug delivery, and delivery of sensory cues.

Abstract: A method and apparatus can be used to guide or navigate an instrument relative to a body. Various types of information can be used to assist in the navigation, such as MRI data, diffusion tensor image data, and the like. The information can assist in identifying the portions of the body.

Abstract: A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.