Abstract: A characteristic of a washout period following the delivery of therapy to a patient according to a therapy program may be determined based on a physiological parameter of the patient. A washout period includes the period of time during which a carryover effect from the therapy dissipates. The washout period characteristic may include, for example, a duration of the washout period, an amplitude or a trend in a physiological signal during the washout period or a power level or a ratio of power levels in frequency bands of the physiological signal. In some embodiments, washout period characteristics associated with a plurality of therapy programs may be used to compare the programs. In other embodiments, a washout period characteristic may be used to determine a mood state of the patient and, in some cases, modify a therapy program. Monitoring a washout period may also be useful for timing therapy program trials.

Abstract: A characteristic of a stimulation period, which occurs during the delivery of stimulation therapy to a patient according to a therapy program, may be determined based on a physiological parameter of the patient. The stimulation period characteristic may include, for example, an amplitude or a trend in a physiological signal during the stimulation period or a power level or a ratio of power levels in frequency bands of the physiological signal. In some embodiments, stimulation period characteristics associated with a plurality of therapy programs may be used to compare the programs. In other embodiments, a stimulation period characteristic may be used to determine a mood state of the patient and, in some cases, modify a therapy program.

Abstract: A therapy system for managing a psychiatric disorder of the patient may be controlled based on a patient mood state. Therapy may be delivered to a patient according to a therapy program, and a physiological parameter of the patient may be monitored during or after therapy delivery. The patient mood state may be determined based on the monitored physiological parameter, and the therapy delivery may be controlled based on the determined mood state. In some embodiments, the therapy delivery is stopped prior to determining the patient mood state and the therapy delivery is restarted upon detecting a negative mood state. In other embodiments, therapy delivery is delivered until a positive mood state is detected, at which point the therapy delivery may be stopped.

Abstract: A characteristic of a washout period following the delivery of therapy to a patient according to a therapy program may be determined based on a physiological parameter of the patient. A washout period includes the period of time during which a carryover effect from the therapy delivery dissipates. Monitoring a washout period may be useful for timing the delivery of therapy according to different therapy programs during a therapy evaluation period. For example, at least one physiological signal of the patient may be monitored to automatically determine when a washout period has ended, e.g., when stimulation and carryover effects of therapy delivery according to a first therapy program have substantially dissipated, in order to determine when therapy delivery according to a second therapy program can be initiated.

Abstract: Techniques capable of selectively affecting and adjusting a volume of neural tissue in the brain, parenchyma of the spinal cord, or a peripheral nerve are disclosed. A lumen having at least one opening at its distal end that is capable of directing a lead outwardly along a predetermined trajectory is preferred. The lumen is capable of accepting a plurality of leads that can project outward in different directions from the distal end of the lumen. The leads have one or more electrodes at its ends and are thereby configured by the lumen in accordance with a predetermined two- or three-dimensional geometry. Anode/cathode relationships may be established between the electrodes by the operator to stimulate the neural tissue surrounding these electrodes. The operator may also adjust the stimulation to selectively stimulate the desired portion of the brain, spinal cord, peripheral nerve. Sensor feedback may be implemented to adjust the treatment therapy.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Abstract: Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination.

Abstract: Apparatuses and methods selectively blank a neurological channel of a medical device system in the treatment of a nervous system disorder. A selected signal of a selected channel may be blanked if it is determined that the selected signal may be affected by an artifact when the medical device system delivers a treatment therapy. The selected signal may be blanked by hardware, in which the selected electrode is disconnected from the selected channel (which may include an selected amplifier) and is connected to a fixed voltage in order to avoid saturation of the selected amplifier. The selected channel may be blanked by software, in which a signal processor is instructed not to process neurological data on the selected channel for a determined time duration. Embodiments may combine hardware and software blanking for the selected signal.

Abstract: Apparatus and techniques to address the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as_electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Abstract: Apparatus and techniques to address the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as_electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Abstract: Apparatus and techniques to address the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment therapy, such as electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Abstract: Apparatus and method support a neurological event screening for a medical device. The medical device assists a user in determining a configuration of the medical device for delivering an effective treatment for a nervous system disorder. The medical device detects a neurological event, such as a seizure, and reports a neurological event focus location and a neurological event spread to the user. The user may use the information to provide a configuration of a therapeutic delivery unit and associated therapy parameters. Therapeutic treatment is delivered to the patient, and the medical device is provided an indication of the patient's acceptance to the treatment. The user may modify the configuration and therapy parameters in order to achieve efficacy and acceptance. Depending upon the patient's acceptance, therapy is applied in either an open loop mode or a closed loop mode. The medical device determines whether the treatment is successful in accordance with a criterion.

Abstract: Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination.

Abstract: Apparatuses and methods support multi-modal operation of a medical device system for a nervous system disorder. The medical device system comprises an implanted component and an external component and supports a first feature and a second feature that are associated with the treatment therapy. The medical device system supports both features when the implanted component and the external component are coupled. If the external component is decoupled, the implanted component continues to support the first feature. Moreover, the embodiment may support a plurality of features during a treatment interval. Another aspect of the invention allows for modularly expanding a medical device system in order to add a feature that enhances existing functionality or that provides additional functionality. In an embodiment, a module that is associated with an external component of the medical device system supports the added feature.

Abstract: Apparatus and method facilitates communications between an implanted component and an external component of a medical device system through a relaying module. The medical device system provides treatment to a patient for a nervous system disorder. The relaying module (which may be worn by the patient) provides telemetry channels between the implanted component and the relaying module and between the telemetry module and the external component. With an implantable configuration the implanted component comprises a monitoring element, a treatment therapy unit, an interfacing unit, and a processing unit, and the external component comprises a programmer. With a hybrid configuration the implanted component comprises a monitoring element, a treatment delivery unit, and an interfacing unit, and the external component comprises a processing unit.

Abstract: Apparatuses and methods selectively blank a neurological channel of a medical device system in the treatment of a nervous system disorder. A selected signal of a selected channel may be blanked if it is determined that the selected signal may be affected by an artifact when the medical device system delivers a treatment therapy. The selected signal may be blanked by hardware, in which the selected electrode is disconnected from the selected channel (which may include an selected amplifier) and is connected to a fixed voltage in order to avoid saturation of the selected amplifier. The selected channel may be blanked by software, in which a signal processor is instructed not to process neurological data on the selected channel for a determined time duration. Embodiments may combine hardware and software blanking for the selected signal.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.