Abstract: Stimulation using N-lets (e.g., doublets, triplets, etc.) in a Deep Brain Stimulation system are disclosed. Pulses are issued in packets of N-lets, resulting in a waveform with both high and low frequency aspects, which are independently adjustable to treat different symptoms. For example, adjustment of higher frequency aspects can be used to treat tremor, while adjustment of lower frequency aspects can be used to treat freezing gait. Such adjustments may be made manually via a graphical user interface, or automatically using an algorithm.

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 testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: A neurostimulation system may include a stimulation output circuit to deliver neurostimulation pulses using a stimulation electrode positioned at a stimulation distance from a neural target, a sensing circuit to sense neural signals using a sensing electrode positioned at a sensing distance from the neural target, and a stimulation control circuit that may include a test controller and a test processor. The test controller may be configured to control performance of an electrode distance test including sensing a first neural signal of the neural signals using the sensing electrode while delivering the neurostimulation pulses using the stimulation electrode and sensing a second neural signal of the neural signals using the stimulation electrode while delivering the neurostimulation pulses using the sensing electrode. The test processor may be configured to analyze the stimulation and sensing distances using the first and second neural signals.

Abstract: A system may include a training system configured for training or improving a nervous system by responding to an event. The training system may include a neuromodulator configured for delivering neuromodulation to a nervous system, an event detector configured for detecting the event and sending a signal to the neuromodulator when the event is detected, and a timer configured for timing a predefined time period after receiving the signal. The neuromodulator may be configured to change neuromodulation to the nervous system at the end of the time period. The predefined time period may be a programmable time period in some embodiments.

Abstract: Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: An electrical stimulation lead includes electrodes disposed on a cuff body and arranged into at least a first row, a second row, and a third row, where the second row is disposed between the first and third rows, and each electrode in the first row is electrically coupled to a corresponding electrode in the third row. In another electrical stimulation lead the electrodes are arranged so that the first and third rows each include multiple electrodes and the second row, between the first and third rows, includes at least one electrode with each electrode in the second row at least twice as long as each of the electrodes of the first and third rows. In another electrical stimulation lead the electrodes are arranged so that each electrode in the first and third rows is at least twice as long as each of the electrodes of the second row.

Abstract: An example of a system may include a processor and a memory device comprising instructions, which when executed by the processor, cause the processor to: access a patient metric of a subject; use the patient metric as an input to a machine learning algorithm, the machine learning algorithm to search a plurality of neuromodulation parameter sets and to identify a candidate neuromodulation parameter set of the plurality of neuromodulation parameter sets, the candidate neuromodulation parameter set designed to produce a non-regular waveform that varies over a time domain and a space domain; and program a neuromodulator using the candidate neuromodulation parameter set to stimulate the subject.

Abstract: A method of stimulating the nucleus basalis of Meynert (NBM) includes implanting an electrical stimulation lead in a lateral-to-medial trajectory into a brain of a patient, wherein the electrical stimulation lead includes electrodes and at least one of the electrodes is disposed adjacent to or within the NBM of the patient; and delivering electrical stimulation to the NBM through at least one of the electrodes. Other methods include implanting multiple electrical stimulation leads in or near the NBM. Instead of, or in addition to, electrical stimulation leads, optical stimulation leads can be used to stimulate the NBM.

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 system for stimulation of a nucleus basalis of Meynert (NBM) of a patient includes an implantable electrical stimulation lead including electrodes and configured for implantation of at least one of the electrodes adjacent to or within the NBM of the patient; and an implantable pulse generator coupleable to the implantable electrical stimulation lead and configured for delivering electrical stimulation to the NBM through at least one of the electrodes of the implantable electrical stimulation lead, the implantable pulse generator including at least one processor configured to, upon user request, during an initial stimulation period, which is at least 1 month in duration and has a start and an end, increase over time at least one of a duration or an amplitude of the electrical stimulation from an initial value at the start of the initial stimulation period to a final value at the end of the initial stimulation period.

Abstract: An example of a system may include a processor and a memory device comprising instructions, which when executed by the processor, cause the processor to: access a patient metric of a subject; use the patient metric as an input to a machine learning algorithm, the machine learning algorithm to search a plurality of neuromodulation parameter sets and to identify a candidate neuromodulation parameter set of the plurality of neuromodulation parameter sets, the candidate neuromodulation parameter set designed to produce a non-regular waveform that varies over a time domain and a space domain; and program a neuromodulator using the candidate neuromodulation parameter set to stimulate the subject.

Abstract: Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain.

Abstract: New waveforms for use in an implantable pulse generator or external trial stimulator are disclosed which mimic actively-driven biphasic pulses, and which are particularly useful for providing sub-perception Spinal Cord Stimulation therapy using low frequency pulses. The waveforms comprise anodic and cathodic pulses which are effectively monophasic in nature, although low-level, non-therapeutic charge recovery can also be used.

Abstract: A system is disclosed in one example which allows for modelling the wellness of a given Implantable Pulse Generator (IPG) patient. The modelling, embodied in an algorithm, uses one or more qualitative measurements and one or more quantitative measurements taken from the patient. The algorithm correlates the qualitative measurements to the various quantitative measurements to eventually, over time, learn which quantitative measurements best correlate to the qualitative measurements provided by the patient. The algorithm can then using current quantitative measurements predict a wellness factor or score for the patient, which is preferably weighted to favor the quantitative measurements that best correlate to that patient's qualitative assessment of therapy effectiveness. Additionally, the wellness factor may be used to adjust the stimulation program that the IPG device provides to the patient.

Abstract: An example of a system for delivering neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a stimulation configuration. The stimulation control circuit may be configured to specify the stimulation configuration, and may include volume definition circuitry and stimulation configuration circuitry. The volume definition circuitry may be configured to determine one or more test volumes, determine a clinical effect resulting from the one or more test volumes each being activated by the neurostimulation, and determine a target volume using the determined clinical effect. The stimulation configuration circuitry may be configured to generate the specified stimulation configuration for activating the target volume.

Abstract: A system and method for selecting leadwire stimulation parameters includes a processor iteratively performing, for each of a plurality of values for a particular stimulation parameter, each value corresponding to a respective current field: (a) shifting the current field longitudinally and/or rotationally to a respective plurality of locations about the leadwire; and (b) for each of the respective plurality of locations, obtaining clinical effect information regarding a respective stimulation of the patient tissue produced by the respective current field at the respective location; and displaying a graph plotting the clinical effect information against values for the particular stimulation parameter and locations about the leadwire, and/or based on the obtained clinical effect information, identifying an optimal combination of a selected value for the particular stimulation parameter and selected location about the leadwire at which to perform a stimulation using the selected value.

Abstract: An example of a system may include a processor and a memory device comprising instructions, which when executed by the processor, cause the processor to access at least one of: patient input, clinician input, or automatic input, use the patient input, clinician input, or automatic input in a search method. The search method may be designed to evaluate a plurality of candidate neuromodulation parameter sets to identify an optimal neuromodulation parameter set and to program a neuromodulator using the optimal neuromodulation parameter set to stimulate a patient.

Abstract: A method and external device for providing sub-perception stimulation to a patient via an implantable stimulator device is disclosed. Stimulation parameters for the patient are determined that provide sub-perception stimulation to address a symptom of the patient. A schedule is determined to provide scheduled boluses of stimulation, where each bolus comprises a duration during which stimulation is applied to the patient in accordance with the stimulation parameters, and where the scheduled boluses are separated by off times when no stimulation is provided to the patient. Preferably, the duration of each of the scheduled boluses is 3 minutes or longer, and the duration of each of the off times is 30 minutes or greater. Additional boluses can be provided on demand in addition to the scheduled boluses by selecting an option on the external device, although the provision of such additional boluses may be constrained by a lockout period.

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.