Abstract: An example of a system may include electrodes on at least one lead configured to be operationally positioned for use in modulating neural tissue. The neural tissue may include at least one of dorsal horn tissue, dorsal root tissue or dorsal column tissue. The system may include an implantable device including a neural modulation device and a controller. The neural modulation device may be configured to use at least some of the electrodes to generate a modulation field to deliver sub-perception modulation to the neural tissue. The sub-perception modulation may have an intensity below a patient-perception threshold. The patient-perception threshold may be a boundary below which a patient does not sense generation of the modulation field. The controller may be configured to control the neural modulation device to generate the modulation field, and automatically adjust the modulation field in response to a patient input.

Abstract: Methods and systems for electrical stimulation can include obtaining a biosignal of the patient; altering at least one stimulation parameter of an electrical stimulation system in response to the biosignal; and delivering an electrical stimulation current to one or more selected electrodes of the electrical stimulation system using the at least one stimulation parameter. In some embodiments, a power spectrum is determined from the biosignal. In some embodiments, the biosignal is at least two different biosignals measured at the same or different locations on the patient and a coherence, correlation, or association between the two biosignal is determined.

Abstract: A system for a tissue stimulator coupled to an array of electrodes. The system comprises a user-controlled input device configured for generating control signals, and at least one processor configured for generating a plurality of stimulation parameter sets in response to the control signals that, when applied to the electrodes, will shift electrical current between electrodes to modify a region of tissue activation. The processor(s) is further configured for computing an estimate of the region of tissue activation, and for generating display signals capable of prompting a monitor to display an animated graphical representation of the computed estimate of the region of tissue activation.

Abstract: This document discusses, among other things, systems and methods for programming neuromodulation therapy to treat neurological or cardiovascular diseases. A system includes an input circuit that receives a modulation magnitude representing a level of stimulation intensity, a memory that stores a plurality of gain functions associated with a plurality of modulation parameters, and a electrostimulator that may generate and deliver an electrostimulation therapy. A controller may program the electrostimulator with the plurality of modulation parameters based on the received modulation magnitude and the plurality of gain functions, and control the electrostimulator to generate electrostimulation therapy according to the plurality of modulation parameters.

Abstract: A method and neurostimulation system of providing therapy to a patient is provided. A plurality of electrodes are placed in contact with tissue of a patient, a conditioning pulse is conveyed from the plurality of electrodes in one of a monopolar manner and a multipolar manner, and a stimulation pulse is conveyed from the plurality of electrodes in a different one of the monopolar manner and the multipolar manner. As one example, the sub-threshold conditioning pulse may be a depolarizing pulse conveyed from the plurality of electrodes to render a first region of the tissue less excitable to stimulation, and the stimulation pulse may be conveyed from the plurality of electrodes to stimulate a second different region of the tissue.

Abstract: An electrical stimulation system for use with a plurality of electrodes implanted within a tissue region comprises a neurostimulator configured for delivering electrical stimulation energy to the plurality of electrodes in accordance with a set of stimulation parameters, thereby injecting a charge into the tissue region, a control device configured for receiving user input to modify the set of stimulation parameters, and controller/processor circuitry configured for, in response to the user input computing a charge injection metric value as a function of a physical electrode parameter and an electrical source parameter for a first set of the electrodes, wherein the electrode set comprises at least two electrodes, comparing the computed charge injection metric value to a safety threshold value, and performing a corrective action based on the comparison.

Abstract: An electrical stimulation system includes a control module that provides electrical stimulation signals to an electrical stimulation lead coupled to the control module for stimulation of patient tissue. The system also includes a sensor to be disposed on or within the body of the patient and to measure a biosignal; and a processor to communicate with the sensor to receive the biosignal and to generate an adjustment to one or more of the stimulation parameters based on the biosignal. The adjustment can be configured and arranged to steer the electrical stimulation signals to stimulate a region of the patient tissue that is different, at least in part, from a region of the patient tissue stimulated prior to the adjustment. Alternatively or additionally, the biosignal is indicative of a particular patient activity and the adjustment is a pre-determined adjustment selected for the particular patient activity.

Abstract: A neurostimulation paddle lead, method of neurostimulation, and neurostimulation system are provided. The neurostimulation paddle lead carries a plurality of electrodes comprising at least four columns of electrodes having a spacing between two inner electrode columns less than a spacing between the inner electrode columns and adjacent outer electrode columns. The inner electrode columns may also be longitudinally offset from the outer electrode columns. The methods and neurostimulation systems steer current between the electrodes to modify a medial-lateral electrical field created adjacent spinal cord tissue.

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.

Abstract: A neurostimulation system for management of stimulation safety limits. The system determines a tissue charge injection metric at each electrode, compares the metric to the hard stop charge limit, and prevents the neurostimulator from delivering stimulation energy to the tissue region in accordance based on the comparison. The hard stop limit may be user-programmable or may be automatically modified in response to detection of electrode characteristics. The system may quantitatively notify a user of a value of the injected charge injected into the tissue. The electrodes may be organized into different sets, in which case, the system may directly control tissue charge independently at each of the electrode sets. If current steering is provided, the system may displace the electrical stimulation energy along the tissue region in one direction, while preventing the charge injection value at each of the electrodes from meeting or exceeding the hard stop charge limit.

Abstract: A method or system for facilitating the determining and setting of stimulation parameters for programming an electrical stimulation system using closed loop programming is provided. For example, pulse generator feedback logic is executed by a processor to interface with control instructions of an implantable pulse generator by incorporating one or more machine learning engines to automatically generate a proposed set of stimulation parameter values that each affect a stimulation aspect of the implantable pulse generator, receive one or more clinical responses and automatically generate a revised set of values taking into account the received clinical responses, and repeating the automated receiving of a clinical response and adjusting the stimulation parameter values taking the clinical response into account, until or unless a stop condition is reach or the a therapeutic response is indicated within a designated tolerance.

Abstract: A system for a neurostimulator coupled to electrodes, and a method of providing therapy to a patient using the electrodes implanted within the patient. A target multipole relative to the electrodes is defined. The target multipole is emulated by defining an initial electrical current distribution for the electrodes, such that a first set of active electrodes respectively has electrical current values of a first polarity. Each of the electrical current values of the first polarity is compared to a first threshold value, and at least one of the electrodes in the first active electrode set is zeroed-out based on the comparison. The electrical current value of each of the zeroed-out electrode(s) is redistributed to remaining ones of the electrodes to define a new electrical current distribution for the electrodes. Electrical current is conveyed to the electrodes in accordance with the new electrical current distribution, thereby providing the therapy.

Abstract: An external control device for use with a neurostimulation system having a plurality of electrodes capable of conveying an electrical stimulation field into tissue in which the electrodes are implanted is provided. The external control device comprises a user interface having one or more control elements, a processor configured for generating stimulation parameters designed to modify the electrical stimulation field relative to one or more neurostimulation lead carrying the electrodes. The external control device further comprises output circuitry configured for transmitting the stimulation parameters to the neurostimulation system.

Abstract: A neuromodulation targeting system includes a GUI that facilitates selection of one or more neuromodulation target regions. The GUI provides an interactive display representing anatomy of a patient with user-selectable portions corresponding to a plurality of predefined anatomical regions associated with distinct localized clinical effects of neuromodulation. The system further includes a targeting selector engine that is responsive to user selection of a first portion of the interactive display by configuring delivery of neuromodulation therapy to a first target region to produce a first localized clinical effect in the patient at a location corresponding to the first portion of the display, upon administration of the neuromodulation therapy to the patient.

Abstract: Methods and systems for electrical stimulation can include obtaining a biosignal of the patient; altering at least one stimulation parameter of an electrical stimulation system in response to the biosignal; and delivering an electrical stimulation current to one or more selected electrodes of the electrical stimulation system using the at least one stimulation parameter. In some embodiments, a power spectrum is determined from the biosignal. In some embodiments, the biosignal is at least two different biosignals measured at the same or different locations on the patient and a coherence, correlation, or association between the two biosignal is determined.

Abstract: A computer implemented system and method facilitates a cycle of generation, sharing, and refinement of volumes related to stimulation of anatomical tissue, such as brain or spinal cord stimulation. Such volumes can include target stimulation volumes, side effect volumes, and volumes of estimated activation. A computer system and method also facilitates analysis of groups of volumes, including analysis of differences and/or commonalities between different groups of volumes.

Abstract: A method of providing therapy to a patient having a medical condition comprises delivering electrical stimulation energy to the spinal cord of the patient in accordance with a stimulation program that preferentially stimulates dorsal horn neuronal elements over dorsal column neuronal elements in the spinal cord. The delivered electrical stimulation energy generates a plurality of electrical fields having different orientations that stimulate the dorsal horn neuronal elements.

Abstract: A transcutaneous electrical-stimulation system includes a transcutaneous control module including a processor. The transcutaneous control module provides electrical-stimulation signals to electrode sets electrically-coupled to the transcutaneous control module. A first electrode set is electrically-coupled to the transcutaneous control module and is placed along patient skin over a first stimulation location. The first electrode set generates a first effective electric field suitable for transcutaneous stimulation of patient tissue at the first stimulation location. A second electrode set is electrically-coupled to the transcutaneous control module and is placed along patient skin over a second stimulation location. The second electrode set generates a second effective electric field suitable for stimulating patient tissue at the second stimulation location.

Abstract: A neuromodulation customization system includes a field definition user interface, a neuromodulation signaling engine, and a supervisor engine. The field definition user interface is to facilitate entry of a customized electrotherapy field definition, with the field definition user interface including a set of input controls for defining field shape, field intensity, and field steering parameters of the customized electrotherapy field. The neuromodulation signaling engine is to produce commands for neuromodulation output circuitry to control generation of a customized electrotherapy field via a set of electrodes based on the customized electrotherapy field definition. The supervisor engine is to assess compliance of the customized electrotherapy field to be generated with applicable predefined criteria, and to modify generation of the customized electrotherapy field in response to an assessed non-compliance with the criteria.

Abstract: A method for providing therapy to a patient using intermittent electrical stimulation includes advancing a plurality of electrodes disposed along a distal portion of a lead to a target stimulation location within a patient. A proximal portion of the lead is coupled to an electrical stimulator disposed external to the patient. Patient tissue at the target stimulation location is stimulated for a first duration of time that is no greater than one day using the plurality of electrodes. The stimulation provides efficacious treatment to the patient for a second duration of time that is at least twice as long as the first duration of time. Stimulation is ceased after completion of the first duration of time. The lead is removed from the patient after ceasing stimulation and prior to an end of the second duration of time.