Abstract: Waveforms for a stimulator device, and methods and circuitry for generating them, are disclosed having high- and low-frequency aspects. The waveforms comprise a sequence of pulses issued at a low frequency which each pulse comprising first and second charge-balanced phases. One or both of the phases comprises a plurality a monophasic sub-phase pulses issued at a high frequency in which the sub-phase pulses are separated by gaps. The current during the gaps in a phase can be zero, or can comprise a non-zero current of the same polarity as the sub-phase pulses issued during that phase. The disclosed waveforms provide benefits of high frequency stimulation such as the promotion of paresthesia free, sub-threshold stimulation, but without drawbacks inherent in using high-frequency biphasic pulses.

Abstract: A method for photobiomodulation of tissue includes emitting light from a lead implanted in the tissue using an implanted light source according to a first delivery program; repeatedly estimating an amount, speed, or time of a temperature or temperature change of, or amount of heat generated by, the implanted light source or repeatedly estimating an amount, speed, or time of a temperature or temperature change of tissue receiving the emitted light; and when the estimate exceeds a first threshold value and the light is emitted according to the first delivery program, emitting light from the implanted lead using the implanted light source according to a second delivery program, wherein the second delivery program results in lower heat generation by the implanted light source over a period of time than the first delivery program.

Abstract: Medical device systems and methods for providing spinal cord stimulation (SCS) are disclosed. The SCS systems and methods provide therapy below the perception threshold of the patient. The methods and systems are configured to measure neurological responses to stimulation and use the neurological responses as biomarkers to maintain and adjust therapy. An example of neurological responses includes an evoked compound action potential (ECAP).

Abstract: Waveforms for a stimulator device, and methods and circuitry for generating them, are disclosed having high- and low-frequency aspects. The waveforms comprise a sequence of pulses issued at a low frequency which each pulse comprising first and second charge-balanced phases. One or both of the phases comprises a plurality a monophasic sub-phase pulses issued at a high frequency in which the sub-phase pulses are separated by gaps. The current during the gaps in a phase can be zero, or can comprise a non-zero current of the same polarity as the sub-phase pulses issued during that phase. The disclosed waveforms provide benefits of high frequency stimulation such as the promotion of paresthesia free, sub-threshold stimulation, but without drawbacks inherent in using high-frequency biphasic pulses.

Abstract: Medical device systems and methods for providing spinal cord stimulation (SCS) are disclosed. The SCS systems and methods provide therapy below the perception threshold of the patient. The methods and systems are configured to measure neurological responses to stimulation and use the neurological responses as biomarkers to maintain and adjust therapy. An example of neurological responses includes an evoked compound action potential (ECAP).

Abstract: An example of a neurostimulation system may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to program a stimulation device for delivering the neurostimulation according to a stimulation program specifying a present stimulation field set including stimulation field(s) each defined by a set of active electrodes selected from a plurality of electrodes. The stimulation control circuit may be configured to determine the stimulation program and may include field programming circuitry that may be configured to set the present stimulation field set to an initial stimulation field set specifying stimulation fields allowing for the delivery of the neurostimulation to produce an intended effect and to identify an optimal stimulation field set that satisfies one or more optimization criteria by removing stimulation field(s) from the initial stimulation field set.

Abstract: An example of a neurostimulation system may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to program a stimulation device for delivering the neurostimulation according to a stimulation program specifying a present stimulation field set including stimulation field(s) each defined by a set of active electrodes selected from a plurality of electrodes. The stimulation control circuit may be configured to determine the stimulation program and may include field programming circuitry that may be configured to set the present stimulation field set to an initial stimulation field set specifying stimulation fields allowing for the delivery of the neurostimulation to produce an intended effect and to identify an optimal stimulation field set that satisfies one or more optimization criteria by removing stimulation field(s) from the initial stimulation field set.

Abstract: An example of a system for delivering neurostimulation to a patient and controlling the delivery of neurostimulation using sensors may include a stimulation output circuit, a sensing circuit, and a control circuit. The stimulation output circuit may be configured to deliver the neurostimulation. The sensing circuit may be configured to receive sensed signals from the sensors and to process the sensed signals. The sensing circuit has adjustable settings controlling the processing of the sensed signals. The control circuit may be configured to control the delivery of the neurostimulation using the processed sensed signals and to control the settings of the sensing circuit according to a sequence of sensing blocks each including a set of sensing parameters.

Abstract: Systems and methods for selectable lateral spinal cord stimulation are discussed. An exemplary neuromodulation system includes a programming device and an electrostimulator. The programming device can receive information about placement of at least one lead in a vicinity of a lateral portion of a spinal cord, identify one or more lateral spinal neural targets based on the information about placement of the at least one lead, and receive a user selection from selectable stimulation modes for stimulating the identified one or more lateral spinal neural targets. The electrostimulator can apply electrostimulation energy to the identified one or more lateral spinal neural targets via the at least one lead in accordance with the user selection from the selectable stimulation modes.

Abstract: An external control device and method for programming an implantable neuromodulator coupled to an electrode array implanted adjacent tissue of a patient having a medical condition. Electrical modulation energy is conveyed to tissue of the patient in accordance with a series of modulation parameter sets. The patient perceives paresthesia in response to the conveyance of the electrical modulation energy to the tissue in accordance with at least one of the modulation parameter sets. One of the modulation parameter set(s) is identified based on the perceived paresthesia. Another modulation parameter set is derived from the identified modulation parameter set. Electrical modulation energy is conveyed to the tissue of the patient in accordance with the other modulation parameter set without causing the patient to perceive paresthesia. An external control device, neuromodulation system, and method of providing therapy to a patient.

Abstract: A method of treating an ailment suffered by a patient using one or more electrodes adjacent spinal column tissue of the patient, comprises delivering electrical modulation energy from the one or more electrodes to the spinal column tissue in accordance with a continuous bi-phasic waveform having a positive phase and a negative phase, thereby modulating the spinal column tissue to treat the ailment. An implantable electrical modulation system, comprises one or more electrical terminals configured for being coupled to one or more modulation leads, output modulation circuitry capable of outputting electrical modulation energy to the electrical terminal(s) in accordance with a continuous bi-phasic waveform, and control circuitry configured for modifying a shape of the continuous bi-phasic waveform, thereby changing the characteristics of the electrical modulation energy outputted to the electrode(s).

Abstract: An external control device, neuromodulation system, and method of providing therapy to a patient using an implantable neuromodulator implanted within the patient. Electrical modulation energy is delivered from the neuromodulator to the patient in accordance with the pre-existing modulation program when in one of the super-threshold delivery mode and the sub-threshold delivery mode. Operation of the neuromodulator is switched to the other of the super-threshold delivery mode and the sub-threshold delivery mode. A new modulation program may be derived from a pre-existing modulation program, and the neuromodulator may deliver the electrical modulation energy to the patient in accordance with the pre-existing modulation program during the other of the super-threshold delivery mode and the sub-threshold delivery mode.

Abstract: An algorithm programmed into the control circuitry of a rechargeable-battery Implantable Medical Device (IMD) is disclosed that can adjust the charging current (Ibat) provided to the rechargeable battery over time (e.g., the life of the IMD) in accordance with one or more of the parameters having an effect on rechargeable battery capacity, such as number of charging cycles, charging current, discharge depth, load current, and battery calendar age. The algorithm consults such parameters as stored over the history of the operation of the IMD in a parameter log, and in conjunction with a battery capacity database reflective of the effect of these parameters on battery capacity, estimates a change in the capacity of the battery, and adjust the charging current in one or both of trickle and active charging paths to slow the loss of battery capacity and extend the life of the IMD.

Abstract: Systems of techniques for controlling charge flow during the electrical stimulation of tissue. In one aspect, a method includes receiving a charge setting describing an amount of charge that is to flow during a stimulation pulse that electrically stimulates a tissue, and generating and delivering the stimulation pulse in a manner such that an amount of charge delivered to the tissue during the stimulation pulse accords with the charge setting.

Abstract: Waveforms for a stimulator device, and methods and circuitry for generating them, are disclosed having high- and low-frequency aspects. The waveforms comprise a sequence of pulses issued at a low frequency which each pulse comprising first and second charge-balanced phases. One or both of the phases comprises a plurality a monophasic sub-phase pulses issued at a high frequency in which the sub-phase pulses are separated by gaps. The current during the gaps in a phase can be zero, or can comprise a non-zero current of the same polarity as the sub-phase pulses issued during that phase. The disclosed waveforms provide benefits of high frequency stimulation such as the promotion of paresthesia free, sub-threshold stimulation, but without drawbacks inherent in using high-frequency biphasic pulses.

Abstract: Medical device systems and methods for providing spinal cord stimulation (SCS) are disclosed. The SCS systems and methods provide therapy below the perception threshold of the patient. The methods and systems are configured to measure neurological responses to stimulation and use the neurological responses as biomarkers to maintain and adjust therapy. An example of neurological responses includes an evoked compound action potential (ECAP).

Abstract: Waveforms for a stimulator device, and methods and circuitry for generating them, are disclosed having high- and low-frequency aspects. The waveforms comprise a sequence of pulses issued at a low frequency which each pulse comprising first and second charge-balanced phases. One or both of the phases comprises a plurality a monophasic sub-phase pulses issued at a high frequency in which the sub-phase pulses are separated by gaps. The current during the gaps in a phase can be zero, or can comprise a non-zero current of the same polarity as the sub-phase pulses issued during that phase. The disclosed waveforms provide benefits of high frequency stimulation such as the promotion of paresthesia free, sub-threshold stimulation, but without drawbacks inherent in using high-frequency biphasic pulses.

Abstract: Medical device systems and methods for providing spinal cord stimulation (SCS) are disclosed. The SCS systems and methods provide therapy below the perception threshold of the patient. The methods and systems are configured to measure neurological responses to stimulation and use the neurological responses as biomarkers to maintain and adjust therapy. An example of neurological responses includes an evoked compound action potential (ECAP).

Abstract: An example of a neurostimulation system may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to program a stimulation device for delivering the neurostimulation according to a stimulation program specifying a present stimulation field set including stimulation field(s) each defined by a set of active electrodes selected from a plurality of electrodes. The stimulation control circuit may be configured to determine the stimulation program and may include field programming circuitry that may be configured to set the present stimulation field set to an initial stimulation field set specifying stimulation fields allowing for the delivery of the neurostimulation to produce an intended effect and to identify an optimal stimulation field set that satisfies one or more optimization criteria by removing stimulation field(s) from the initial stimulation field set.

Abstract: An algorithm programmed into the control circuitry of a rechargeable-battery Implantable Medical Device (IMD) is disclosed that can quantitatively forecast and determine the timing of an early replacement indicator (tEOLi) and an IMD End of Life (tEOL). These forecasts and determinations of tEOLi and tEOL occur in accordance with one or more parameters having an effect on rechargeable battery capacity, such as number of charging cycles, charging current, discharge depth, load current, and battery calendar age. The algorithm consults such parameters as stored over the history of the operation of the IMD in a parameter log, and in conjunction with a battery capacity database reflective of the effect of these parameters on battery capacity, determines and forecasts tEOLi and tEOL. Such forecasted or determined values may also be used by a shutdown algorithm to suspend therapeutic operation of the IMD.