Abstract: An implantable medical device (IMD) includes a drug reservoir located within a reservoir chamber of the IMD that includes a first side and a second side directly opposite the first side defining a reservoir volume there between. The IMD further includes and a volume sensor system including an ultrasound transmitter within the reservoir chamber and positioned to transmit an ultrasound signal toward the second side at an angle relative to the second side and a plurality of ultrasound sensors adjacent to at least one of the first side or second side of the drug reservoir with each sensor positioned to selectively receive the signal from the transmitter at different reservoir volume levels to indicate a current volume capacity of the drug reservoir.

Abstract: A system may receive first information relating to a patient captured during a baseline period that is prior to the patient receiving stimulation. The system may receive second information relating to the patient captured during an initial therapy assignment. The second information may include testing data generated by delivering stimulation during an implant procedure. The system may determine initial stimulation program settings based on the first information, the second information and population-informed information. The population-informed information may be related to other patients. The system may cause, during a training period, delivery of therapy based on the initial stimulation program settings.

Abstract: An implantable electrical stimulation device including an implant sized and configured to be implanted subcutaneously, the implant being configured to rectify a received pulse train of ultrasound into a single electrical pulse configured to stimulate a tibial nerve of a patient.

Abstract: Examples of implantable medical leads or implantable medical systems with implantable medical leads to be anchored to a sacrum are disclosed. The implantable medical leads include a lead body having a distal portion. A fixation mechanism is coupled to the distal portion. An electrode array is mechanically coupled to the fixation mechanism. In one example, the electrode array is directly coupled to the fixation mechanism. The electrode array is electrically coupled to the lead body and configured to generate a stimulation field. The fixation mechanism is configured to anchor the implantable medical lead to a sacrum and effect the stimulation field in a foramen of the sacrum.

Abstract: An example method includes: delivering one or more electrical stimulation pulses to one or more nerves of a patient via one or more inserted electrodes on a lead or formed on an evaluation needle and prior to implantation of an implantable medical device, the one or more nerves being associated with stimulation therapy; sensing an evoked signal generated by one or more signal sources in response to delivery of the one or more electrical stimulation pulses; determining, based at least in part on the evoked signal, a therapy response group of a plurality of therapy response groups for the patient, wherein the therapy response group indicates whether implantation of the implantable medical device is recommended; and outputting information indicative of the determined therapy response group.

Abstract: Examples of implantable medical leads or implantable medical systems with implantable medical leads to be anchored to a sacrum are disclosed. The implantable medical leads include a lead body having a distal portion. A fixation mechanism is coupled to the distal portion. An electrode array is mechanically coupled to the fixation mechanism. In one example, the electrode array is directly coupled to the fixation mechanism. The electrode array is electrically coupled to the lead body and configured to generate a stimulation field. The fixation mechanism is configured to anchor the implantable medical lead to a sacrum and effect the stimulation field in a foramen of the sacrum.

Abstract: Methods, systems, and devices are configured delivering one or more sequences of different pulse trains to a patient. For example, a system includes processing circuitry configured to control stimulation circuitry to deliver a sequence of a plurality of trains of electrical stimulation pulses, wherein each train of the plurality of trains of electrical stimulation pulses comprises respective pulses at least partially defined by a unique parameter variation pattern of a plurality of parameter variation patterns, and control the stimulation circuitry to repeatedly deliver the sequence of the plurality of trains of electrical stimulation pulses.

Abstract: An implantable tibial nerve electrical stimulation therapy device, system and method configured to detect unintentional and intentional body signals to control and modify the electrical stimulation therapy, thereby enabling selective pausing of electrical stimulation therapy and increase/decrease in amplitude or frequency of the electrical stimulation therapy for improved safety, comfort and effective therapy.

Abstract: A leadless neurostimulation device having a header unit having at least one primary electrode that defines an external surface of the device, and a housing that includes a secondary electrode positioned on the same side of device as the primary electrode, a footer coupled to the housing opposite of the header unit, and a controller. The controller configured to operate in a closed-loop to transmit an electrical stimulation signal between the primary electrode to the secondary electrode to provide electrical stimulation therapy to a tibial nerve of a patient, measure a physiologic parameter in response to transmission of the electrical stimulation therapy, and adjust one or more parameters of the electrical stimulation signal based on the measured physiologic parameter.

Abstract: Closed loop control of electrical stimulation therapy by measuring a neuromuscular response to determine that the electrical stimulation therapy is adequately stimulating the target nerve. In some examples, a system using the techniques of this disclosure may measure a reflex response, e.g., using electromyography (EMG), which measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. In some examples, the techniques of this disclosure may measure an H-reflex, such as an evoked motor response that occurs caused by a first afferent stimulation, through a signal synapse, and an efferent alpha-motor neuron excitation.

Abstract: A sacral lead system including a sacral lead configured to for insertion within a sacral foramen of a patient. The sacral lead supports one or more electrodes which may be configured as one or more stimulation electrodes and/or one or more sensing electrodes. The sacral lead is configured to deliver a stimulation signal to a patient using at least one stimulation electrode and sense an evoked signal produced in response to the stimulation signal using at least one sensing electrode. The sacral lead system may be configured to position the at least one stimulation electrode and/or the at least one sensing electrode within, dorsal, or ventral to the sacral foramen. The sacral lead system may include stimulation circuitry configured to generate the stimulation signal and sensing circuitry configured to receive a signal indicative of the evoked signal.

Abstract: An example method includes delivering, via an electrical stimulation device, one or more electrical stimulation signals to a patient, sensing one or more stimulation-evoked signals that are evoked by stimulation of nerves or muscles of the patient due to the delivery of the one or more electrical stimulation signals, determining a quality of the one or more stimulation-evoked signals, and outputting, based on the quality of the one or more sensed stimulation-evoked signals being below a quality threshold, one or more instructions to improve the quality of one or more subsequent stimulation-evoked signals.

Abstract: An example method includes delivering one or more electrical stimulation signals to a patient, sensing a composite stimulation-evoked signal comprising a composite of signals generated by one or more signal sources in response to the one or more electrical stimulation signals, and controlling delivery of electrical stimulation therapy to the patient based on the composite stimulation-evoked signal.

Abstract: An implantable electrical stimulation device including an implant sized and configured to be implanted subcutaneously, the implant being configured to rectify a received pulse train of ultrasound into a single electrical pulse configured to stimulate a tibial nerve of a patient.

Abstract: A medical system for treating incontinence includes an implantable medical device (IMD) implantable proximate to a tibial nerve of a patient comprising therapy delivery circuitry configured to provide electrical stimulation therapy proximate the tibial nerve of the patient for treating incontinence, and processing circuitry configured to: during an implant period, determine a set of stimulation parameters to control the therapy delivery circuitry, during an induction period after the implant period, initiate electrical stimulation therapy according to the set of stimulation parameters, during a first maintenance period, determine an adjustment to the set of stimulation parameters as first maintenance period stimulation parameters to reduce the electrical stimulation therapy from the induction period, and during a second maintenance period, determine an adjustment to the set of stimulation parameters as second maintenance period stimulation parameters to reduce the electrical stimulation therapy from the first

Abstract: A leadless neurostimulation device having a header unit including at least one primary electrode having a contact surface that defines an external surface of the leadless neurostimulation device, a housing including a secondary electrode positioned on the same side of the leadless neurostimulation device as the at least one primary electrode, and a anchor device including at least one suture point for securing the leadless neurostimulation device to patient tissue or at least one protrusion nub configured to create mechanical resistance that impedes relative movement between wherein the leadless neurostimulation device and the patient tissue when implanted, where the at least one primary electrode and the secondary electrode are configured to transmit an electrical stimulation signal therebetween to provide electrical stimulation therapy to a target nerve of a patient.

Abstract: An implantable medical device (IMD) includes a drug reservoir located within a reservoir chamber of the IMD that includes a first side and a second side directly opposite the first side defining a reservoir volume there between. The IMD further includes and a volume sensor system including an ultrasound transmitter within the reservoir chamber and positioned to transmit an ultrasound signal toward the second side at an angle relative to the second side and a plurality of ultrasound sensors adjacent to at least one of the first side or second side of the drug reservoir with each sensor positioned to selectively receive the signal from the transmitter at different reservoir volume levels to indicate a current volume capacity of the drug reservoir.

Abstract: An example method includes receiving, by an implantable device and from an external device, an energy signal; transducing, by the implantable device, the energy signal into electrical power; outputting, by the implantable device and to the external device, a feedback signal that represents an absolute level of the electrical power transduced from the energy signal, wherein the feedback signal includes a first portion that represents a relative level of the electrical power transduced from the energy signal and a second portion that represents a reference voltage level; and delivering, by the implantable device, a level of electrical stimulation therapy proportional to the absolute level of the electrical power transduced from the energy signal.

Abstract: An implantable medical lead for sacral modulation therapy is disclosed. The implantable medical lead includes a lead body having a distal portion. An electrode is electrically coupled to the lead body and configured to generate a stimulation field or to sense electrical fields. A fixation mechanism is coupled to the distal portion. The fixation mechanism is configured to anchor the implantable medical lead against an interior wall of a blood vessel. The electrode can effect the stimulation field from within the vessel to stimulate a selected sacral nerve or sense electrical signals such as muscle or nerve responses. Guided implantation of the medical lead or other medical leads through the body to a nerve of interest for neurostimulation via remote sensor is also disclosed.

Abstract: The invention provides methods for treating a neurological disorder or deficit, such as tinnitus and phantom limb pain.