Abstract: A system may include a stimulus circuit configured to provide electrostimulation to a neural target of a patient via electrodes on a lead, a sensing circuit configured to sense evoked response (ER) signals produced by the electrostimulation, a user interface, and a controller operably connected to the stimulus circuit, the sensing circuit, and the user interface. The controller is configured to initiate delivery of the electrostimulation to the electrodes, identify ER signal features of the sensed ER signals, compute a longitudinal distribution of the ER signal features for a longitudinal direction of the lead, compute a rotational distribution that is a is a periodic distribution of the ER signal features for an angular direction of the lead, and display peak regions of the longitudinal distribution and the rotational distribution as a hotspot view of the sensed ER signals on the user interface.

Abstract: An example method of operating a neuromodulation device to modify or achieve a desired arousal state in a patient may include determining the patient's desired arousal state, detecting one or more signals that are related to the desired arousal state, where the one or more signals are sensed from the patient or provided by an external source. The method also includes determining, via a controller circuit, a therapy parameter setting for the neuromodulation device based on the one or more signals, and generating, via the controller circuit, a control signal in the neuromodulation device to initiate or adjust an arousal state therapy program in accordance with the therapy parameter setting.

Abstract: Implantable medical devices (IMD) such as those used in Deep Brain Stimulation application are commonly replaced when the device's useful life expires. At the time of replacement, the electrodes that were connected to the initial IMD are typically reused with the replacement IMD. It is desirable for the replacement IMD to utilize the stimulation parameters that were being utilized to provide stimulation in the initial IMD, but it is important that the electrodes be connected to the replacement IMD in a similar manner as they were connected to the initial IMD if stimulation parameters are reused. A connected electrode profile that includes measurements of electrical parameters associated with the electrodes can be generated in the initial IMD and the replacement IMD, and the profiles can be compared to determine whether the electrodes are connected in a similar manner in the replacement IMD as they were in the initial IMD.

Abstract: Systems and methods for selective sensing of evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes selected from and less than an entirety of the electrodes on the lead. The selected electrodes can be distinct from the stimulating electrode, or within a specific proximity to the stimulating electrode. Based on a comparison of the sensed ERs to acceptance criteria, the controller circuit can provide a recommendation to reposition the lead or to adjust the stimulation setting.

Abstract: Systems and methods for selective sensing of evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes selected from and less than an entirety of the electrodes on the lead. The selected electrodes can be distinct from the stimulating electrode, or within a specific proximity to the stimulating electrode. The controller circuit can use a comparison of the sensed ERs to acceptance criterion to aid in lead placement and stimulation programming.

Abstract: Systems and methods for modelling a spatial distribution of evoked responses (ERs) to electrostimulation and using the model to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes positioned at respective sensing locations and selected from the electrodes on the at least one lead, generate a model representing a spatial distribution of ER features of the sensed ERs, and based on a comparison of the model to acceptance criteria, provide a recommendation to reposition the lead or to adjust the stimulation setting.

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: This document discusses a computer-implemented method of operating a neurostimulation device to deliver electrical neurostimulation when connected to an implantable stimulation lead. The method includes delivering neurostimulation to a subject using the neurostimulation device; recording electrical signals sensed using the implantable stimulation lead; extracting one or more features from the recorded electrical signals; detecting clustering of the one or more extracted features of the recorded electrical signals; and identifying, by the neurostimulation device, an evoked response signal of interest from among the recorded electrical signals using the detected clustering of the one or more extracted features of the recorded electrical signals.

Abstract: Methods and systems for using sensed evoked neural responses for informing aspects of neurostimulation therapy are disclosed. Electrical signals may be recorded during the provision of electrical stimulation to a patient's neural tissue. The electrical signals may be processed and analyzed using one or more classification criteria to determine if the electrical signals contain a neural response of interest. Examples of such neural responses include evoked neural responses that are oscillatory and/or resonant in nature. If the electrical signals include such responses of interest, one or more features may be extracted from the signals and used as biomarkers for informing aspects of neurostimulation therapy, such as directing lead placement, optimizing stimulation parameters, closed-loop feedback control of stimulation, and the like. Various methods and systems described herein are particularly relevant in the context of multi-site stimulation paradigms, such as coordinated reset neuromodulation.

Abstract: A system may include an electrostimulator configured to provide electrostimulation to a neural target patient via electrodes on a lead, a sensing circuit configured to sense, at a plurality of sensing locations, evoked responses (ERs) to the electrostimulation, a user interface, and a controller operably connected to the electrostimulator, the sensing circuit and the user interface. The controller may be configured to deliver the electrostimulation in accordance with a stimulation setting, determine the sensed ERs to the electrostimulation delivered in accordance with a sensing setting and the stimulation setting, determine acceptance criteria using user input received via the user interface, compare the sensed ERs to the acceptance criteria to provide a comparison result, and display on the user interface an indicator of the comparison result.

Abstract: A method for adapting stimulation by a stimulation system to a change in a symptom, therapeutic effect, or side effect includes detecting a change in a symptom of a disease or disorder or in a therapeutic effect or a side effect of stimulation by the stimulation system; in response to the detecting, determining, by the stimulation system, a modification of one or more stimulation parameter values to adapt to the change in the symptom, the therapeutic effect, or the side effect; and at least one of the following: 1) suggesting to the patient or to a clinician adoption of the modification and, upon receiving affirmation from the patient or the clinician, stimulating the patient according to the modification of the one or more stimulation parameter values, or 2) automatically stimulating the patient according to the modification of the one or more stimulation parameter values.

Abstract: This document discusses a computer-implemented method of operating a neurostimulation device to deliver electrical neurostimulation when connected to an implantable stimulation lead. The method includes delivering neurostimulation to a subject that produces evoked potential signals, sensing the evoked potential signals resulting from the neurostimulation, detecting changes in the sensed evoked potential signals in response to a change in at least one of the number of repeated presentations of the neurostimulation or a change in a parameter of the first neurostimulation, and producing an indication of proximity of the stimulation lead to a preferred lead location according to the detected changes in the evoked potential signals.

Abstract: Methods and systems for using sensed evoked neural responses for informing aspects of neurostimulation therapy are disclosed. Electrical signals may be recorded during the provision of electrical stimulation to a patient's neural tissue. The electrical signals may be processed and analyzed using one or more classification criteria to determine if the electrical signals contain a neural response of interest. Examples of such neural responses include evoked neural responses that are oscillatory and/or resonant in nature. If the electrical signals include such responses of interest, one or more features may be extracted from the signals and used as biomarkers for informing aspects of neurostimulation therapy, such as directing lead placement, optimizing stimulation parameters, closed-loop feedback control of stimulation, and the like. Various methods and systems described herein are particularly relevant in the context of multi-site stimulation paradigms, such as coordinated reset neuromodulation.

Abstract: Methods and systems for planning a trajectory for implanting electrical stimulation leads in a patient's brain are described. The methods and systems rank candidate trajectories based on their expected therapeutic efficacies, as well as other criteria. Optimized stimulation parameters are determined for each of the candidate trajectories and therapeutic efficacies using the optimized parameters are predicted.

Abstract: An example a neurostimulation system may include one or more sensors configured to sense a measure of tissue heating caused by neurostimulation, a stimulation output circuit configured to deliver the neurostimulation, and a stimulation control circuit configured to control the delivery of the neurostimulation using stimulation parameters. The stimulation control circuit may include temperature sensing circuitry and stimulation parameter circuitry. The temperature sensing circuitry may be configured to receive the measure of tissue heating and to determine a temperature parameter representing a temperature or a temperature change using the received measure of tissue heating.

Abstract: Incorrect connection or mapping of leads' proximal terminals to the ports of an Implantable Stimulator Device (ISD), such as an implantable pulse generator or an external trial stimulator, is a concern, and this disclosure is directed to use of measurement and identification algorithms to either determine that leads are properly connected to their assigned ISD ports, or to determine which leads are connected to the ports even if the leads are not preassigned to the ports. Particular focus is given in the disclosed technique to assessing leads that comprise larger number of electrodes than are supported at each port, and thus have more than one proximal terminal that connect to more than one port of the ISD.

Abstract: An example of a system for delivering neurostimulation from a stimulation device may include a programming control circuit and a programming control circuit. The programming control circuit may be configured to generate information for programming the stimulation device to deliver the neurostimulation according to a pattern of neurostimulation pulses. The stimulation programming circuit may be configured to: receive goal option(s) selected from a plurality of goal options each including at least one goal for deep brain stimulation; select programmability option(s) associated with the received goal option(s) from a plurality of programmability options each allowing one or more aspects of the pattern of neurostimulation pulses and/or its delivery to be programmable; receive programming information required by the selected programmability option(s); and determine the pattern of neurostimulation pulses for the selected goal option(s) using the received programming information.

Abstract: Methods and systems for planning a trajectory for implanting electrical stimulation leads in a patient's brain are described. The methods and systems rank candidate trajectories based on their expected therapeutic efficacies, as well as other criteria. Optimized stimulation parameters are determined for each of the candidate trajectories and therapeutic efficacies using the optimized parameters are predicted.

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: A computer implemented system and method provides a volume of activation (VOA) estimation model that receives as input two or more electric field values of a same or different data type at respective two or more positions of a neural element and determines based on such input an activation status of the neural element. A computer implemented system and method provides a machine learning system that automatically generates a computationally inexpensive VOA estimation model based on output of a computationally expensive system.