Abstract: An example method includes: delivering one or more electrical stimulation pulses to one or more nerves of a patient via one or more inserted electrodes on a lead or formed on an evaluation needle and prior to implantation of an implantable medical device, the one or more nerves being associated with stimulation therapy; sensing an evoked signal generated by one or more signal sources in response to delivery of the one or more electrical stimulation pulses; determining, based at least in part on the evoked signal, a therapy response group of a plurality of therapy response groups for the patient, wherein the therapy response group indicates whether implantation of the implantable medical device is recommended; and outputting information indicative of the determined therapy response group.

Abstract: Devices, systems, and techniques are described that use electric field imaging (often referred to as the sensed stimulation artifact representative of a delivered stimulus) as an informative feedback signal to provide closed loop control of electrical stimulation therapy. In some examples, the electric field imaging may be used in combination with other feedback signals, such as ECAP do monitor and adjust the delivered electrical stimulation therapy.

Abstract: A leadless neurostimulation device having a header unit having at least one primary electrode that defines an external surface of the device, and a housing that includes a secondary electrode positioned on the same side of device as the primary electrode, a footer coupled to the housing opposite of the header unit, and a controller. The controller configured to operate in a closed-loop to transmit an electrical stimulation signal between the primary electrode to the secondary electrode to provide electrical stimulation therapy to a tibial nerve of a patient, measure a physiologic parameter in response to transmission of the electrical stimulation therapy, and adjust one or more parameters of the electrical stimulation signal based on the measured physiologic parameter.

Abstract: Closed loop control of electrical stimulation therapy by measuring a neuromuscular response to determine that the electrical stimulation therapy is adequately stimulating the target nerve. In some examples, a system using the techniques of this disclosure may measure a reflex response, e.g., using electromyography (EMG), which measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. In some examples, the techniques of this disclosure may measure an H-reflex, such as an evoked motor response that occurs caused by a first afferent stimulation, through a signal synapse, and an efferent alpha-motor neuron excitation.

Abstract: A sacral lead system including a sacral lead configured to for insertion within a sacral foramen of a patient. The sacral lead supports one or more electrodes which may be configured as one or more stimulation electrodes and/or one or more sensing electrodes. The sacral lead is configured to deliver a stimulation signal to a patient using at least one stimulation electrode and sense an evoked signal produced in response to the stimulation signal using at least one sensing electrode. The sacral lead system may be configured to position the at least one stimulation electrode and/or the at least one sensing electrode within, dorsal, or ventral to the sacral foramen. The sacral lead system may include stimulation circuitry configured to generate the stimulation signal and sensing circuitry configured to receive a signal indicative of the evoked signal.

Abstract: An example method includes delivering, via an electrical stimulation device, one or more electrical stimulation signals to a patient, sensing one or more stimulation-evoked signals that are evoked by stimulation of nerves or muscles of the patient due to the delivery of the one or more electrical stimulation signals, determining a quality of the one or more stimulation-evoked signals, and outputting, based on the quality of the one or more sensed stimulation-evoked signals being below a quality threshold, one or more instructions to improve the quality of one or more subsequent stimulation-evoked signals.

Abstract: An example method includes delivering one or more electrical stimulation signals to a patient, sensing a composite stimulation-evoked signal comprising a composite of signals generated by one or more signal sources in response to the one or more electrical stimulation signals, and controlling delivery of electrical stimulation therapy to the patient based on the composite stimulation-evoked signal.