Abstract: An examples of a system for delivering neurostimulation to a patient may include a stimulation output circuit configured to deliver the neurostimulation, a sensing circuit configured to sense a neural signal indicative of neural responses to the neurostimulation, and stimulation control circuit. The stimulation control circuit may be configured to control the delivery of the neurostimulation using a plurality of stimulation parameters and may be configured to detect morphological features of the neural responses, to produce a neural response parameter using the detected morphological features, to detect a change in the sensed neural signal, to analyze the produced neural response parameter for attributing the detected change to one of a neural activation change in the patient or a body movement of the patient, and to control a dynamically controlled stimulation parameter of the plurality of stimulation parameters using the sensed neural signal and an outcome of the analysis.

Abstract: Disclosed methods respond to detecting the receipt, by a management controller, such as a baseboard management controller (BMC), of an information handling system, of a provisioning request from a management client, by rebooting the information handling system to initiate a Universal Extensible Firmware Interface (UEFI) boot sequence that is configured to load an EFI application, referred to herein a provisioning application. A two way communication channel such as a WebSocket is established between the management client and the management controller to stream OS image data corresponding to an OS image to the management controller. The OS image data streamed to the management controller is written to an OS image partition of a boot device, after which the stored OS image may be booted to load the OS. The provisioning request may be communicated as a representational state transfer (REST) compliant (RESTful) request using, in at least some deployments, a Redfish application programming interface (API).

Abstract: Systems and methods for closed-loop control of electrostimulation based on signal features derived from evoked neural activities are disclosed. A system comprises an electrostimulator to deliver a stimulation therapy, a sensing circuit to sense an evoked response induced by the stimulation therapy, and a controller circuit to identify, from a plurality of candidate signal features, a target signal feature that satisfies a performance criterion for distinguishing a first stimulation effect according to a first stimulation setting from a second stimulation effect according to a different second stimulation setting. The target signal feature can be identified based on evaluations of a discrimination metric for each of the candidate signal features. The controller circuit can determine a value of the target signal feature from the sensed evoked response, and control the electrostimulator to adjust the stimulation therapy based on the value of the target signal feature.

Abstract: A system for delivering electrical pulse stimulation to a subject includes a remote control device configured to at least intermittently transmit temporal pulse pattern programming and a stimulation device comprising a control interface, at least one electrode in electrical communication with the control interface, and an input device in at least intermittent communication with the remote control device to receive the temporal pulse pattern programming. The stimulation device is configured to deliver electrical pulse stimulation to a subject via the at least one electrode according to the temporal pulse pattern programming.

Abstract: Methods and systems for providing neuromodulation therapy are disclosed. The systems include an Implantable Pulse Generator (IPG) or External Trial Stimulator (ETS) that is capable of sensing an Evoked Compound Action Potential (ECAP), and (perhaps in conjunction with an external device) is capable of adjusting a stimulation program while based on the sensed ECAP. The stimulation program may include a pre-pulse component that may be adjusted based on the sensed ECAP. Moreover, stimulation may be applied to neural elements timed to coincide with the arrival of ECAPs at those neural elements. The stimulation may enhance or suppress activation of those neural elements.

Abstract: Methods and systems for spinal cord stimulation (SCS) are disclosed. The methods and systems involve using electrode leads implanted within the patient's spinal column to record neural responses evoked by the stimulation. The disclosed neural responses are different in several respects from electrical responses that have previously been measured in the context of SCS, such as stimulation artifacts and evoked compound action potentials (ECAPs). The disclosed neural responses typically occur later in time following the evoking stimulation pulse. Another distinguishing feature is that disclosed neural responses are generally most prominently observed with consistent, relatively unchanging amplitudes when the evoking stimulation frequency is ultra-low, for example, about 10 Hz or less.

Abstract: Methods and systems are described for detecting if a stimulation lead implanted in a patient's brain has moved. Lead movement occurring between a first time and a second time may be determined by comparing features extracted from evoked potentials recorded at the two times. The disclosed methods and systems are particularly useful for determining if a stimulation lead has moved between the time it was implanted in the patient's brain and the time that stimulation parameters are being optimized. Lead movement during implantation, during parameter optimization, and during or between other lead optimization processes may be determined as well.

Abstract: A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

Abstract: Methods and systems are described for detecting if a stimulation lead implanted in a patient's brain has moved. Lead movement occurring between a first time and a second time may be determined by comparing features extracted from evoked potentials recorded at the two times. The disclosed methods and systems are particularly useful for determining if a stimulation lead has moved between the time it was implanted in the patient's brain and the time that stimulation parameters are being optimized. Lead movement during implantation, during parameter optimization, and during or between other lead optimization processes may be determined as well.

Abstract: This document discusses a computer-implemented method of calibration of an implantable neurostimulation device. The method includes sensing one or more symptoms of a neurological condition of a subject using a sensor external to the neurostimulation device; delivering neurostimulation to the subject using the neurostimulation device and adjusting neurostimulation parameters based on the sensed symptom; sensing one or more neural response signals resulting from the neurostimulation using a sensor of the neurostimulation device; correlating the sensed symptom with the one or more sensed neural response signals; determining a target neural response using the correlating; and recurrently adjusting the neurostimulation parameters according to a comparison of subsequently sensed neural response signals to the target neural response signal.

Abstract: An example of a system for delivering neurostimulation and sensing one or more signals may include a programming control circuit and a parameter control circuit. The programming control circuit may be configured to control the delivery of the neurostimulation according to stimulation parameters and the sensing of a target neural signal including target neural responses according to sensing parameters. The parameter control circuit may be configured to determine the stimulation parameters and the sensing parameters and may include a recording analyzer. The recording analyzer may be configured to evaluate a sequence of test recording configurations each including a set of recording configuration parameters selected from the stimulation parameters and the sensing parameters and to determine one or more recording configurations suitable for detection of the target neural responses using an outcome of the evaluation.

Abstract: A method of controlling operation of a neurostimulation device comprises receiving, by the neurostimulation device, an indication of a physiological search area of a subject for delivering electrical neurostimulation and a prioritized search list of neurostimulation parameters for neurostimulation therapy delivered to the search area; delivering the neurostimulation therapy to the search area and varying the neurostimulation parameters according to the parameter priority, wherein a highest priority parameter is varied first while lower priority parameters are held constant; determining the optimum value of the highest priority parameter; delivering neurostimulation to the search area using the determined optimum value of the highest priority parameter and varying one or more lower priority parameters according to the parameter priority; and determining optimum lower priority parameters for the neurostimulation.

Abstract: A system may include neuromodulation electrode contacts, a waveform generator, and a controller. The neuromodulation electrode contacts may be configured and arranged for use in delivering neuromodulation to a target peripheral nerve, where the target peripheral nerve includes a plurality of fibers, and the plurality of neuromodulation electrode contacts is configurable into a plurality of electrode configurations for stimulating different subsets of fibers within the plurality of fibers. The waveform generator may be configured for use to generate neuromodulation energy.

Abstract: Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.

Abstract: A system may include a neuromodulator, a local field potential sensor, a feature extractor, a comparator and control circuitry. The neuromodulator may be configured to use neuromodulation parameters to deliver a neuromodulation signal to neural tissue in or near a spinal cord. The LFP sensor may be configured to sense local field potentials within a spinal cord or a peripheral nerve that are indicative of spinal cord oscillations. The feature extractor may be configured to extract one or more features for the local field potentials indicative of the spinal cord oscillations. The comparator may be configured to provide a comparison of the one or more extracted features to corresponding one or more setpoints. The control circuitry may be configured to control the delivery of the neuromodulation signal based on the comparison.

Abstract: A method for determining an intensity index for electrical stimulation includes receiving stimulation information; determining a stimulation field from the stimulation information; determining at least one stimulation field function using the stimulation field; and analyzing the determined at least one stimulation field function to determine the intensity index. The intensity index corresponds to a stimulation target and indexes at least one dosing reference for electrical stimulation for that stimulation target.

Abstract: External system software is disclosed that automatically varies the location at which stimulation is applied to the patient in an Implantable Pulse Generator (IPG). Location variation occurs in an area defined with reference to the electrode array, and may occur randomly or via pre-defined path within the area. Preferably the area is defined around a single location deemed optimal for the patient. Parameters relating to the area and to how often the stimulation is moved can be set automatically or manually by a user of the software. The area may be defined using a probability distribution function (PDF) that tends to keep the stimulation at or close to an optimal position, while still allowing the location to be set anywhere in the area. The area may also be defined in the software using measured parameters indicative of the effectiveness of stimulation at different locations.

Abstract: Systems and methods for closed-loop control of electrostimulation while avoiding, or maintaining a substantially low level of, evoked neural activity are disclosed. A system comprises an electrostimulator to deliver a stimulation pulse train, a sensing circuit to sense evoked responses to respective pulses in the pulse train, and a controller to detect an evoked neural activity from an averaged evoked response by averaging evoked responses to respective pulses. The averaging operation can be controlled by a noise level of the averaged evoked response, or by a count of epochs (pulses) being used for averaging. Responsive to the evoked neural activity satisfying a detection criterion, the controller recursively adjusts stimulation parameters until the detection criterion is no longer satisfied. The electrostimulator delivers electrostimulation according to the recursively adjusted stimulation parameters.

Abstract: A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

Abstract: Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.