Abstract: A selection of parameter configurations for a neurostimulator using decision trees may be employed by a programming device to allow a clinician or other user to select parameter configurations, and then program an implantable neurostimulator to deliver therapy using the selected parameter configurations. The programming device executes a parameter configuration search algorithm to guide the clinician in selection of parameter configurations. The search algorithm relies on a decision tree to identify optimum parameter configurations. A decision tree is useful in classifying observations in a data set based upon one or more attributes or fields within the data. The data set includes parameter configurations matched with observed ratings of efficacy on patients of a similar indication. The learned attribute, on which classification occurs, will be the optimum parameter configuration for a set of rated configurations used to produce the classification.

Abstract: Method, controller and system for an implantable medical device capable of delivering therapeutic stimulation through a plurality of electrodes. A control module is operable to conduct a plurality of measurements of impedance values creating a plurality of measured impedance values for a plurality of selected sets of individual ones of the plurality of electrodes based on a plurality of active parameters. The control module conducts the plurality of measurements of impedance values in a plurality of stages in which at least one of said plurality of active parameters is varied between individual ones of the plurality of stages.

Abstract: Techniques that involve application of one or more rules to a “parent” program to generate a plurality of different “child” programs are described. Each of the rules may define a respective electrode configuration modification, and each child program may be a variation of the parent based on a modification of the electrode configuration of the parent according to one of the rules. The systems or devices may generate further generations of child programs from a previous generation child program using the same one or more rules. The child programs may be provided to a user, so that the user may test the efficacy of the new programs, assisting the user in identifying desirable programs. The child programs may be relatively minor variations of the parent program, and the user may “fine tune” a generally desirable parent program by testing the child programs.

Abstract: In general, the disclosure is related to electrode-to-lead association using post-implant imaging. An image analysis unit may calculate distances between representations of electrodes in an electronic image and identify groups based on the calculated distances. Each identified group may include a plurality of electrode representations. The distance between a first electrode representation and a second electrode representation may be substantially a same distance between the second electrode representation and a third electrode representation. A characterization unit may determine one or more lead types based on the identified groups.

Abstract: In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Abstract: An implantable medical device delivers neurostimulation therapy to a patient according to a parameter set, which may consist of a number of programs that are delivered substantially simultaneously. When programming the implantable medical device for the patient, a clinician programmer may maintain a session log that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs may be stored in a memory. One or both of the implantable medical device and a patient programmer may store usage information that provides an objective and accurate record of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Abstract: A programmer allows a clinician to identify combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The programmer executes an electrode combination search algorithm to select combinations of electrodes to test in a non-random order. According to algorithms consistent with the invention, the programmer may first identify a position of a first cathode for subsequent combinations, and then select electrodes from the set to test with the first cathode as anodes or additional cathodes based on the proximity of the electrodes to the first cathode. The programmer may store information for each combination tested, and the information may facilitate the identification of desirable electrode combinations by the clinician. The clinician may create neurostimulation therapy programs that include identified desirable program combinations.

Abstract: Verification that an implantable medical system within a patient is MRI safe is provided. Several verifications may be performed such as verifying that the device and leads are of an MRI safe type, that the leads have adequate electrical integrity, that the device has entered an MRI safe mode, that the lead routing and device placement are MRI safe, and that the MRI settings of the MRI machine are safe for the implantable medical system. The result of these verifications may lead to a conclusion that the implantable medical system of interest is or is not MRI safe for a given MRI scan. An indication of this result may be output such as via a display so that an MRI technician can have some assurance as to whether to conduct the MRI scan.

Abstract: The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination.

Abstract: The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination.

Abstract: An implantable medical device delivers neurostimulation therapy to a patient according to a parameter set. A parameter set may consist of a number of programs that are delivered substantially simultaneously. When programming the implantable medical device for the patient, a clinician programmer may maintain a session log for the patient that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs organized according to a directory structure may be stored in a memory. One or both of the implantable medical device and a patient programmer may store usage information that provides an objective assessment of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Abstract: Techniques that involve generating test stimulation programs based upon specific patient feedback to guide the programming process for stimulation therapy are described. The patient describes positive effects and adverse effects of the test stimulation by listing and/or rating specific types of effects, both positive and adverse, and the location of each effect. In this manner, a programming device, i.e. a programmer, uses the feedback to generate subsequent test stimulation programs. Initially, programs with unipolar electrode configurations are tested, but the programmer may generate bipolar electrode configurations to test if the patient rates the unipolar electrode combinations poorly. After the stimulation programs are tested and rated, the programmer sorts the tested programs based upon the feedback and presents the tested programs to the user. The user selects the best tested program to use for chronic stimulation therapy.

Abstract: Techniques are described, for medical devices that deliver electrical stimulation therapy, for controlling a transition from an initial stimulation location or initial stimulation shape to a user-specified target stimulation location or target stimulation shape in order to limit the rate of change of stimulation. One example method includes receiving, via a programmer for an electrical stimulator, user input indicating a target stimulation zone, and controlling the electrical stimulator to transition electrical stimulation from an initial stimulation zone to the target stimulation zone via one or more intermediate stimulation zones.

Abstract: A programmer allows a clinician to identify desirable combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The clinician may create neurostimulation therapy programs that include identified desirable electrode combinations. In some embodiments, the clinician may use the programmer to select a program, such as a program identified during a neurostimulation programming session, and direct the programmer to replicate the selected program. The programmer may change one or more parameters of the selected program, such as pulse amplitude or duty cycle, when generating the copy of the selected program.

Abstract: A programming system allows a user to program therapy parameter values for therapy delivered by a medical device by specifying a desired therapeutic outcome. In an example, the programming system presents a model of a brain network associated with a patient condition to the user. The model may be a graphical representation of a network of anatomical structures of the brain associated with the patient condition and may indicate the functional relationship between the anatomical structures. Using the model, the user may define a desired therapeutic outcome associated with the condition, and adjust excitatory and/or inhibitory effects of the stimulation on the anatomical structures. The system may determine therapy parameter values for therapy delivered to the patient based on the user input.

Abstract: This disclosure describes techniques that support delivering electrical stimulation current via at least two user-selected electrodes of an implantable medical device (IMD) and automatically delivering balancing current below via at least one non-selected electrode. Balancing currents delivered via the at least one non-selected electrode may be configured with an amplitude below a perception threshold of a patient. Delivery of balancing current via the at least one third electrode may allow an implantable medical device to automatically balance the total current delivered to a patient.

Abstract: One or more stimulation electrodes may be selected based on a bioelectrical signal sensed in a brain of a patient with a sense electrode combination that comprises at least one electrode and a physiological model that indicates one or more anatomical structures of the brain of the patient that are proximate the implanted at least one electrode. In some examples, the bioelectrical brain signal indicates which electrodes are located closest to a target tissue site. The physiological model can be generated based on a location of implanted at least one electrode within a patient and patient anatomy data, which can, for example, indicate one or more characteristics of patient tissue proximate to the implanted at least one electrode. In some example, the physiological model includes a therapy field model that represents a region of the tissue of the patient to which therapy is delivered via a selected set of electrodes.

Abstract: A fluid delivery system comprises a pump configured to deliver a therapeutic agent to a patient, a memory storing a therapy program defining the delivery of the therapeutic agent to the patient by the pump and a default infusion schedule based on the therapy program, and a processor configured to control the pump to deliver the therapeutic agent to the patient according to the therapy program, to determine an error condition that prevents the pump from continuing to deliver therapy according to the therapy program, and, upon determination of the error condition, to control the pump to deliver the therapeutic agent to the patient according to the default infusion schedule.

Abstract: Changes in electrical stimulation therapy delivered via a medical device are coordinated with Functional Magnetic Resonance Imaging (fMRI) scans. In one example, a medical device delivers electrical stimulation therapy to a patient in an MRI unit, where the medical device is configured to cycle electrical stimulation therapy between a plurality of stimulation states. An indication that the medical device will cycle the electrical stimulation therapy or has cycled the electrical stimulation therapy while the patient is in the MRI unit or being imaged by the MRI unit is generated, and an MRI scan of the patient via an MRI workstation is initiated based on the indication. In another example, a medical device detects activation of an MRI scan and automatically switches stimulation states based upon the detection of the MRI scan, such that the scan is associated with a particular stimulation state.

Abstract: Aspects of the present invention relate to automatic impedance measurements between one or more electrodes in a set of electrodes that may be associated with a lead of an implanted device. A voltage measurement that is associated with a stimulation pulse between the two electrodes may be made. The voltage measurement may be used to determine the impedance between the two electrodes. The impedance measurement may be made for each possible pair of electrodes in the set of electrodes. The impedance measurements may be displayed to a clinician on a user interface.