Abstract: Systems, devices, and techniques for analyzing evoked compound action potentials (ECAP)signals to evaluate and select an electrode combination. A method includes controlling, by processing circuitry, deliver of a plurality of stimulation pulses via at least one stimulation electrode combination, receiving, by the processing circuitry, evoked compound action potential (ECAP) signal information representing different ECAP signals evoked from respective stimulation pulses of the plurality of stimulation pulses and obtained from respective different sensing electrode combinations, selecting by the processing circuitry and based on the ECAP signal information, one electrode combination from the different sensing electrode combinations.

Abstract: An example system includes electrical stimulation circuitry configured to generate electrical stimulation, electrodes configured to deliver the electrical stimulation to a patient, and processing circuitry configured to determine, for a patient, a first cycling of electric stimulation doses. The processing circuitry is also configured to deliver the electric stimulation doses according the determined first cycling, receive patient feedback representing a response of the patient to the electric stimulation doses delivered according to the first cycling, determine, based on the patient feedback, a second cycling of the electric stimulation doses, and deliver the electric stimulation doses to the patient according the determined second cycling. Delivering the electric stimulation doses for the patient according to the determined second cycling consumes less power of the implanted device than delivering the electric stimulation doses for the patient according to the determined first cycling.

Abstract: Systems, devices, and techniques are described for analyzing evoked compound action potential (ECAP) signals to determine an estimated neural threshold of a patient. In one example, a method includes controlling, by processing circuitry, delivery of a plurality of stimulation pulses to a patient, wherein each stimulation pulse of the plurality of stimulation pulses is at least partially defined by a different respective value of a stimulation parameter; receiving, by the processing circuitry, ECAP signal information, wherein the ECAP signal information comprises ECAP signals sensed by sensing circuitry and elicited by the plurality of stimulation pulses; determining, by the processing circuitry and based on the ECAP signal information, ECAP characteristic values for each of the ECAP signals elicited by the plurality' of stimulation pulses; and determining, by the processing circuitry and based on the ECAP characteristic values, an estimated neural threshold of the patient.

Abstract: A system is provided for informing a therapeutic procedure. In some embodiments, the system may be configured to determine specific states associated with a sleep-wake cycle of a patient. Additionally, the system may be configured to measure one or more signals with cardiac activity of the patient upon detecting the specific states of the sleep-wake cycle of the patient. Subsequently, the system may be configured to determine one or more parameters for applying an electrical signal to an anatomical element of the patient based on the one or more signals with cardiac activity. In some embodiments, the system may be configured to establish a longitudinal trend of cardiac metrics for the patient based on a plurality of signals with cardiac activity for the patient measured during the specific states of the sleep-wake cycle across a plurality of days.

Abstract: Systems and methods for generating and/or applying an adjustment for one or more parameters of a neuromodulation therapy of a user are provided. One or more physiological-based inputs of the user may be received and a therapy response score may be determined based on the one or more physiological-based inputs. At least one adjustment for one or more parameters of the neuromodulation therapy may be generated based on the therapy response score.

Abstract: A system is provided for identifying and reducing noise in a therapeutic procedure. For example, the system may be configured to measure one or more signals with cardiac activity. The system may be configured to then identify one or more sources of noise that are distorting the one or more signals with cardiac activity and may reduce the one or more sources of noise from the one or more signals with cardiac activity. Subsequently, the system may be configured to determine one or more aggregate cardiac-derived metrics and/or save processed cardiac data based on the one or more signals with cardiac activity with the one or more sources of noise reduced. Additionally, the system may be configured to determine one or more parameters for applying an electrical signal to an anatomical element of a patient based on the one or more aggregate cardiac-derived metrics and/or saved processed cardiac data.

Abstract: A system for selecting a sensitivity level for adjusting an intensity setting for therapy provided to a patient includes one or more processors and one or more processors coupled to the memory. The one or more processors are configured to receive an indication of an input to adjust an intensity setting related to the therapy provided to the patient and determine a sensitivity level for adjustment of the intensity setting based on an efficacy of the therapy provided to the patient. The one or more processors are further configured to determine an updated intensity level for the intensity setting based on the sensitivity level and the input to adjust the intensity setting and output an instruction to cause a medical device to provide the therapy at the updated intensity level.

Abstract: An illustrative system includes a cochlear implant, a lead configured to be inserted into a cochlea of a patient by way of an insertion procedure, a plurality of electrodes disposed on the lead and including an intracochlear electrode and an extracochlear electrode, a probe coupled to the extracochlear electrode, and a processor communicatively coupled with the probe and the cochlear implant. During the insertion procedure, the processor directs the cochlear implant to short the intracochlear and extracochlear electrodes, then detects, by way of the probe and the shorted intracochlear and extracochlear electrodes, evoked responses measured at the intracochlear electrode. The evoked responses include a first evoked response measured at a first insertion depth and a second evoked response measured at a second insertion depth. The processor generates, based on the first and second evoked responses, a notification indicating that cochlear trauma has likely occurred at the second insertion depth.

Abstract: In some examples, the disclosure relates to system, devices, and techniques for delivering electrical stimulation therapy to treat patient disorders. In some example, the disclosure is directed to a method including controlling, using processing circuitry, the delivery of an electrical stimulation therapy to a patient via a medical device, wherein the electrical stimulation therapy includes a plurality of bi-phasic pulses, each pulse of the di¬phasic pulses including a first phase followed by a second phase, and wherein the plurality 7 of bi-phasic pulses are configured to substantially block transmission of neural activity? along nerve fibers.

Abstract: Devices, systems, and techniques are configured for independently modulating two or more concurrent signals of electrical stimulation therapy. In one example, a system includes stimulation generation circuitry and processing circuitry configured to control the stimulation generation circuitry to deliver first electrical stimulation to a patient via a first electrode combination, wherein the first electrical stimulation is defined by at least a first set of stimulation parameters selected that the first electrical stimulation exceeds a first perception threshold, and control the stimulation generation circuitry to deliver second electrical stimulation, concurrent with the first electrical stimulation, to the patient via a second electrode combination. The second electrical stimulation may be defined by at least a second set of stimulation parameters selected that the second electrical stimulation is below a second perception threshold.

Abstract: A system includes memory, and processing circuitry coupled to the memory, the processing circuitry configured to: determine at least one of: a cross-electrical signal measurement at a first electrode on a first lead implanted within a tongue of the patient based on a stimulation signal between a second electrode on the first lead or a second lead implanted within the tongue of the patient and a third electrode, or a strain measurement of at least one of the first lead or the second lead. The processing circuitry is configured to determine movement of the tongue based on at least one of the cross-electrical signal measurement or the strain measurement, and generate information indicative of the movement of the tongue.

Abstract: An illustrative proximity detection system directs a first electrode of an electrode lead to apply a first pulse and directs a second electrode of the electrode lead to apply a second pulse concurrently with the first pulse so as to form a dipole that generates a field. The first and second electrodes are each configured as stimulating electrodes that apply stimulation to the cochlear tissue when the electrode lead is located at a resting position subsequent to a surgical insertion of the electrode lead into a cochlea of a patient. After the pulses are applied, and based on an energy magnitude of the field that is detected to reflect from cochlear tissue located within the field, the proximity detection system determines a proximity of the electrode lead to the cochlear tissue. Corresponding systems and methods are also disclosed.

Abstract: Systems and methods for generating and/or applying an adjustment for one or more parameters of a neuromodulation therapy of a user are provided. One or more physiological-based inputs of the user may be received and a therapy response score may be determined based on the one or more physiological-based inputs. At least one adjustment for one or more parameters of the neuromodulation therapy may be generated based on the therapy response score.

Abstract: A system is provided for informing a therapeutic procedure. In some embodiments, the system may be configured to determine specific states associated with a sleep-wake cycle of a patient. Additionally, the system may be configured to measure one or more signals with cardiac activity of the patient upon detecting the specific states of the sleep-wake cycle of the patient. Subsequently, the system may be configured to determine one or more parameters for applying an electrical signal to an anatomical element of the patient based on the one or more signals with cardiac activity. In some embodiments, the system may be configured to establish a longitudinal trend of cardiac metrics for the patient based on a plurality of signals with cardiac activity for the patient measured during the specific states of the sleep-wake cycle across a plurality of days.

Abstract: A system is provided for identifying and reducing noise in a therapeutic procedure. For example, the system may be configured to measure one or more signals with cardiac activity. The system may be configured to then identify one or more sources of noise that are distorting the one or more signals with cardiac activity and may reduce the one or more sources of noise from the one or more signals with cardiac activity. Subsequently, the system may be configured to determine one or more aggregate cardiac-derived metrics and/or save processed cardiac data based on the one or more signals with cardiac activity with the one or more sources of noise reduced. Additionally, the system may be configured to determine one or more parameters for applying an electrical signal to an anatomical element of a patient based on the one or more aggregate cardiac-derived metrics and/or saved processed cardiac data.

Abstract: A system may be configured to sense local field potentials (LFPs) from electrodes placed in epidural space near the spine of a patient. The system may be configured to analyze the sensed LFPs and determine a change in a state of the patient, such as a physiological state of the patient. The system may use such analysis to update and/or suggest parameters for delivery of electrical stimulation therapy. The system may further be configured to analyze LFPs in a frequency domain by applying a wavelet transform or other transform to sensed LFPs.

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: An exemplary diagnostic system may be configured to direct an acoustic stimulation generator to apply acoustic stimulation to a recipient of a cochlear implant during an insertion procedure in which an electrode lead coupled to the cochlear implant is supposed to be inserted into a cochlea of the recipient, direct the cochlear implant to use an electrode on the electrode lead to record an evoked response signal that occurs within the recipient in response to the acoustic stimulation, detect an anomaly in the evoked response signal, and determine, based on the anomaly, that the electrode lead is being inserted into a vestibular canal instead of into the cochlea.

Abstract: A system for selecting a sensitivity level for adjusting an intensity setting for therapy provided to a patient includes one or more processors and one or more processors coupled to the memory. The one or more processors are configured to receive an indication of an input to adjust an intensity setting related to the therapy provided to the patient and determine a sensitivity level for adjustment of the intensity setting based on an efficacy of the therapy provided to the patient. The one or more processors are further configured to determine an updated intensity level for the intensity setting based on the sensitivity level and the input to adjust the intensity setting and output an instruction to cause a medical device to provide the therapy at the updated intensity level.

Abstract: Methods, systems, and devices are configured delivering one or more sequences of different pulse trains to a patient. For example, a system includes processing circuitry configured to control stimulation circuitry to deliver a sequence of a plurality of trains of electrical stimulation pulses, wherein each train of the plurality of trains of electrical stimulation pulses comprises respective pulses at least partially defined by a unique parameter variation pattern of a plurality of parameter variation patterns, and control the stimulation circuitry to repeatedly deliver the sequence of the plurality of trains of electrical stimulation pulses.