Abstract: An example of a system for delivering neurostimulation energy may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters according to a neurostimulation program including a pattern of interferential stimulation configured to effect asynchronous and/or non-regular activation of nerve fibers by simultaneously delivering a first stimulation current having a first waveform with a first frequency using a first electrode configuration and a second stimulation current having a second waveform with a second frequency using a second electrode configuration.

Abstract: Multi-phasic fields are produced at a neuromodulation site using electrodes. A first phase is directed at a target region such that a first-polarity electrical charge is injected to the target region, and a second phase is directed at portions of the neuromodulation site other than the target region, such that a second-polarity electrical charge opposite the first-polarity electrical charge is injected to those portions of the neuromodulation site to essentially neutralize the first-polarity charge injected at the neuromodulation site while maintaining at least a portion of the first-polarity charge at the target region. In some embodiments, each anode used to produce the first phase is used as a cathode to produce the second phase, and each cathode used to produce the first phase is used as an anode to produce the second phase, and the quantity of charge injected by each electrode in both phases is essentially zero.

Abstract: A fitting algorithm for a spinal cord stimulator is disclosed, which is preferably implemented in a clinician programmer having a graphical user interface. In one example, coupling parameters indicative of coupling to neural structures are determined for each electrode in an implanted electrode array. The user interface associates different pole configurations with different anatomical targets and with different measurement techniques (subjective or objective) to gauge the effectiveness of the pole configuration at different positions in the electrode array. The pole configuration, perhaps as modified by the coupling parameters, is then steered in the array, and effectiveness is measured along with a paresthesia threshold at each position. Using at least this data, the fitting algorithm can determine one or more candidate positions in the electrode array at which a therapeutic stimulation program can be centered.

Abstract: Method and systems for determining a set of stimulation parameters for an implantable stimulation device include performing the following steps or actions: receiving a stimulation target; determining a target stimulation field based on the stimulation target; receiving a weighting for a plurality of spatial regions defined relative to a lead including a plurality of electrodes, where a weighting for at least one of the spatial regions is different from a weighting for another one of the spatial regions; and determining, using the weightings for the plurality of spatial regions, a set of stimulation parameters to produce a generated stimulation field that approximates the target stimulation field.

Abstract: Delivering stimulation includes delivering temporal patterns of stimulation pulses to respective transducers of an array of transducers, wherein the delivery of the pattern to a particular transducer of the array is different from at least some of the deliveries of the patterns to the other transducers of the array at least according to a time delay. The patterns delivered may include regular temporal patterns each having a respective constant inter-pulse interval. The constant inter-pulse intervals may be about the same. The patterns may be staggered. The transducers may deliver electrical, optical, acoustic, thermal or magnetic stimulation.

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: 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 may include electrodes on at least one lead configured to be operationally positioned for use in modulating a volume of neural tissue, a neural modulation generator configured to deliver energy using at least some electrodes to modulate the volume of neural tissue, a programming system configured to program the programmed modulation parameter set, including determine electrode fractionalizations for the electrodes based on a target multipole. The programmed parameter set may include the determined electrode fractionalizations. The target multipole may be used to determine electrode fractionalizations having at least three target poles that directionally and progressively stack fractionalizations of target poles to provide a linear electric field over the volume of tissue. The neural modulation generator may be configured to use the programmed modulation parameter set to provide the linear electric field over the volume of tissue.

Abstract: A method for generating a stimulation program for electrical stimulation of a patient includes providing, by a processor on a display, a first grid of first pixels and a representation of a portion of an electrical stimulation lead with electrodes; obtaining, by the processor, a user selection of a first set of the first pixels in the first grid for stimulation; generating, by the processor, a stimulation program based, at least in part, on the user-selected first set of first pixels for stimulation using at least one of the electrodes of the electrical stimulation lead; and initiating, by the processor, a signal that provides an implantable pulse generator with the stimulation program. In other methods, instead of a grid of pixels, user-selectable primitives or selectable-objects are used to determine a desired stimulation region and generate the stimulation program.

Abstract: Disclosed are systems and methods for providing stimulation using waveforms with long duration phases in a spinal cord stimulator. Simulation shows the effectiveness of using phase durations of greater than 2.0 ms, or even 2.6 ms or greater, in recruiting inhibitory interneurons in the dorsal horn of the spinal cord, or in recruiting dorsal column axons of the dorsal column, both of which promote pain suppression in spinal cord stimulation (SCS) patients. Traditional SCS devices may not allow the programming of phase durations of such lengths, and so examples of how long phase durations can be effectively created is shown by way of a non-limiting example, preferably in a single timing channel. The waveforms preferably have at least two phases of opposite polarities, at least one of which is long, although phases may be split into sub-phases. The waveforms may be charge balanced at each electrode.

Abstract: A system may include electrodes on at least one lead configured to be operationally positioned for use in modulating a volume of neural tissue, a neural modulation generator configured to deliver energy using at least some electrodes to modulate the volume of neural tissue, a programming system configured to program the programmed modulation parameter set, including determine electrode fractionalizations for the electrodes based on a target multipole. The programmed parameter set may include the determined electrode fractionalizations. The target multipole may be used to determine electrode fractionalizations having at least three target poles that directionally and progressively stack fractionalizations of target poles to provide a linear electric field over the volume of tissue. The neural modulation generator may be configured to use the programmed modulation parameter set to provide the linear electric field over the volume of tissue.

Abstract: Methods and systems for providing dosed and calibrated thermal stimulation using an implantable stimulation device are disclosed. Aspects of the disclosure provide bioheat models based on physiological and thermal properties of target anatomy and thermopole algorithms that interact with the bioheat models to derive thermal stimulation parameters for providing dosed and calibrated thermal stimulation. Also, graphical user interfaces (GUIs) are disclosed for configuring and targeting heat delivery into specific targets.

Abstract: Methods and systems for providing neuromodulation therapy are disclosed. The methods and systems are configured to sense an evoked neural response and use the evoked neural response as feedback for providing neuromodulation therapy. Methods of reducing stimulation artifacts that obscure the sensed evoked neural response are disclosed. The methods of artifact reduction include recording a stimulation artifact in the absence of an evoked neural response, aligning and scaling the stimulation artifact with respect to the obscured signal, and subtracting the aligned and scaled artifact from the obscured signal.

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: 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 using a first low-pass filter and a second moving average filter. Model reduction schemes such as independent component analysis can additionally or alternatively be employed to extract the cardiac signal. 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.

Abstract: Method and systems for determining a set of stimulation parameters for an implantable stimulation device include receiving a set of stimulation parameters including at least one electrode for delivery of stimulation and a stimulation amplitude for each electrode; determining, using the set of stimulation parameters, an axial stimulation field for neural elements oriented axially with respect to a longitudinal axis of the lead; and outputting the first axial stimulation field for viewing by a user; receiving, by the computer processor. The methods and systems can be used to model other neural elements oriented non-orthogonally with respect to the longitudinal axis of the lead and determine a non-orthogonal stimulation field.

Abstract: Paddle or percutaneous leads for gliomodulation include electrodes arranged for preferentially stimulating glial cells. The leads may also include at least one non-electrical sensor or optical stimulator.

Abstract: A system for planning or conducting stimulation includes a display; and a processor that executes instructions configured for: displaying, on the display, a representation of a stimulation effect; obtaining and displaying, on the display, a path for migration of the stimulation effect; receiving a duration or rate for migration of the stimulation effect; and determining a selection of one of more electrodes or optical stimulators for one or more stimulation leads of a stimulation system to produce the stimulation effect and conduct the migration of the stimulation effect along the path according to the duration or rate.

Abstract: Techniques are described for providing a therapeutic pseudo-constant DC current in an implantable stimulator using pulses whose positive and negative phases are not charge balanced. Such charge imbalanced pulses act to charge any capacitance in the current path between selected electrode nodes, such as the DC-blocking capacitors and/or any inherent capacitance such as those present at the electrode/tissue interface. These charged capacitances act during quiet periods between the pulses to induce a pseudo-constant DC current. Beneficially, these DC currents can be small enough to stay within charge density limits and hence not corrode the electrode or cause tissue damage, and further can be controlled to stay within such limits or for other reasons. Graphical user interface (GUI) aspects for generating the charge imbalanced pulses and for determining and/or controlling the pseudo-constant DC current are also provided.

Abstract: This document discusses, among other things, systems and methods for delivering electrostimulation to specific tissue of a patient. An example of a system can receive a three-dimensional voxelized model representing a plurality of regions each specified as a target region or an avoidance region. The system includes control circuitry to determine a metric value using the voxelized model. The metric value indicates a clinical effect of electrostimulation on the plurality of regions according to a stimulation current and a current fractionalization. The control circuitry can determine a desired stimulation current that results in a first metric value satisfying a clinical effect condition. The system can generate a stimulation configuration including the desired stimulation current and the current fractionalization corresponding to the first metric value, and deliver tissue stimulation according to the stimulation configuration.