Abstract: Systems and methods for coordinated delivery of a therapeutic agent and low (less than about 20 Hz) and high (greater than about 50 Hz) frequency stimulation therapy are described. The systems include a control unit for coordinating therapy delivery between an infusion device and a pulse generator, such that a therapeutic agent is administered at a predetermined time relative to application of either low frequency or high frequency stimulation. For example, the control unit may instruct the infusion device to deliver therapeutic agent at a predetermined time prior to delivery of low frequency stimulation. Systems that include more than one infusion device or an infusion pump capable of delivering more than one therapeutic agent are also described.

Abstract: Devices, systems and methods for delivering one or more drugs to the cerebrospinal fluid periodically replace continuous infusion of the a solution with intermittent bolus infusion of the solution to reduce the local concentration of a drug over time at a vertebral level in the patient's spinal canal relative to the drug infused continuously through the infusion section of a catheter intrathecally into a patient's spinal canal at the vertebral level. Such periodic replacement of continuous infusion with intermittent bolus infusion assists in prevention formation of an inflammatory mass at the vertebral level.

Abstract: Devices, systems and methods for delivering one or more drugs to one or more internal body locations (such as the cerebrospinal fluid) are disclosed. In various aspects, the systems and methods may involve catheters having infusion sections with permeable membranes that develop significant back pressure to enhance uniform delivery of the drug over an infusion section; catheters that have two or more infusion sections spaced apart along the length of the same catheter, catheters that include two or more infusion sections serviced by independent lumens (such that, e.g., different drug solutions can be delivered to the different infusion sections); implantable drug delivery systems with pumps and multiple reservoirs from which drugs can be delivered; systems that are capable of delivering drug solutions with selected densities; etc.

Abstract: Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.

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: Devices, systems and methods for delivering one or more drugs to one or more internal body locations (such as the cerebrospinal fluid) are disclosed. In various aspects, the systems and methods may involve catheters having infusion sections with permeable membranes that develop significant back pressure to enhance uniform delivery of the drug over an infusion section; catheters that have two or more infusion sections spaced apart along the length of the same catheter, catheters that include two or more infusion sections serviced by independent lumens (such that, e.g., different drug solutions can be delivered to the different infusion sections); implantable drug delivery systems with pumps and multiple reservoirs from which drugs can be delivered; systems that are capable of delivering drug solutions with selected densities; etc. Methods for treating diseases, including pain and spasticity are also discussed, as well as methods for screening patients and optimizing therapies.

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: Devices, systems and methods for delivering one or more drugs to one or more internal body locations (such as the cerebrospinal fluid) are disclosed. In various aspects, the systems and methods may involve catheters having infusion sections with permeable membranes and one or more valves that control flow to the infusion sections.

Abstract: A miniature drug delivery pump utilizes a shape memory Ni—Ti alloy. A flow restrictor is provided and the pump is refillable.

Abstract: In an implantable medical device having individual modules, a coupling module couples the modules to one another. The coupling module supports electrical and/or mechanical coupling of the modules. The coupling module may assume a variety of shapes or configurations. The various embodiments of the coupling module may offer the modules varying degrees of freedom of movement relative to one another.

Abstract: Enhanced therapies for treating pain are described. The therapies include subcutaneous stimulation of tissue in proximity to a source of pain at low frequencies (less than about 20 Hz) and high frequencies (greater than about 50 Hz). The therapies further include administering a pain treating agent at a predetermined time relative to application of the high or low frequency stimulation. Delivery of the pain treating agent via an implantable infusion system is described. Coordination of output of an infusion device and a pulse generator to provide coordinated therapy is also discussed.

Abstract: In an implantable medical device having individual modules, a coupling module couples the modules to one another. The coupling module supports electrical and/or mechanical coupling of the modules. The coupling module may assume a variety of shapes or configurations. The various embodiments of the coupling module may offer the modules varying degrees of freedom of movement relative to one another.

Abstract: Enhanced therapies for treating pain are described. The therapies include subcutaneous stimulation of tissue in proximity to a source of pain at low frequencies (less than about 20 Hz) and high frequencies (greater than about 50 Hz). The subcutaneous stimulation may be applied in proximity to a structure in the back, such as discs, facet joints, nerve roots or ganglions, sympathetic chain, ligaments, muscles, and the like. Subcutaneous stimulation at high and low frequencies applied in combination with epidural stimulation is also described.

Abstract: In various aspects, systems and methods involve catheters having infusion sections with permeable membranes that develop significant back pressure to enhance uniform delivery of the drug over an infusion section; catheters that have two or more infusion sections spaced apart along the length of the same catheter, catheters that include two or more infusion sections serviced by independent lumens (such that, e.g., different drug solutions can be delivered to the different infusion sections); implantable drug delivery systems with pumps and multiple reservoirs from which drugs can be delivered; systems that are capable of delivering drug solutions with selected densities; etc. Methods for delivering a drug to a brain through a spinal canal include delivering hypobaric solutions containing the drug.

Abstract: Peripheral nerve field stimulation (PNFS) may be controlled based on detected physiological effects of the PNFS, which may be an efferent response to the PNFS. In some examples, a closed-loop therapy system may include a sensing module that senses a physiological parameter of the patient, which may be indicative of the patient's response to the PNFS. Based on a signal generated by the sensing module, the PNFS may be activated, deactivated or modified. Example physiological parameters of the patient include heart rate, respiratory rate, electrodermal activity, muscle activity, blood flow rate, sweat gland activity, pilomotor reflex, or thermal activity of the patient's body. In some examples, a patient pain state may be detected based on a signal generated by the sensing module, and therapy may be controlled based on the detection of the pain state.

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: An in-vitro model apparatus of a human spine and methods for detecting and analyzing substance distribution patterns therein. In one embodiment, the model apparatus includes a column body defining a passageway that substantially mimics the size, shape, and structure of an adult human spinal canal. Also included is a cord structure that may be located and anchored within the passageway. The cord structure substantially mimics the size, shape, and structure of an adult human spinal cord. For example, the cord structure may include connecting elements that resemble nerve roots, dentate ligaments, and the septum posticum of a human spine. The passageway of the model apparatus may be filled with a first fluid that simulates cerebro-spinal fluid (CSF), and a second fluid containing a drug (or simulated drug) may be introduced into the passageway, after which the drug's distribution within the passageway may be analyzed.

Abstract: A method and apparatus for optimizing a computer assisted procedure is provided. A method and apparatus for performing a procedure is also provided. Data can be accessed and processed to optimize and perform a procedure. The data can be augmented or supplemented with patient specific data.

Abstract: A medical device known as an implantable infusion device is configured for implanting in humans to deliver a therapeutic substance such as pharmaceutical compositions, genetic materials, and biologics to treat a variety of medical conditions such as pain, spasticity, cancer, and many other conditions. The infusion device incorporates a motor coil connector and mechanical sealing system between the clean motor compartment and the potentially corrosive pump compartment that provides a reliable electrical connection between the motor coil and the motor drive electronics. The motor coil connector provides for bonding of a very small diameter coil wire to one end of the connector and a highly corrosion resistant connection at the other end of the connector. Additionally, the motor coil connector and mechanical sealing system provides a seal against harmful corrosion materials that could emanate from the pump compartment and reach the motor compartment and cause malfunction of the motor.

Abstract: An implantable drug delivery device having a drug releaser that releases a drug from a capsule in the catheter. The drug delivery device includes a reservoir configured to store a drug capsule, a catheter, a pump configured to move the drug capsules into the catheter, and a drug releaser. The drug releaser is connected to the catheter for freeing at least a portion of the drug from one or more of the drug capsules while in the catheter.