Abstract: One embodiment includes a method for monitoring nerve tissue which includes inserting a dilator into muscle, the dilator including first and second electrodes at the distal tip. While the dilator is in muscle, a system may communicate (a) a first series of unequal current amplitude applications (e.g., a series including 0.5, 7, 3, 5 mA applications) to the first electrode to produce at least a first evoked potential (e.g., a MAP or NAP), and (b) a second series of unequal current amplitude applications to the second electrode to produce at least a second evoked potential. The method further includes sensing the first and second evoked potentials and determining a relative location of a nerve based on the sensing of at least one of the first and second evoked potentials.

Abstract: A medical apparatus includes a shaft, an expandable frame, a membrane, a diagnostic electrode, a reference electrode, and a processor. The shaft is configured for insertion into an organ of a patient. The expandable frame is coupled to a distal end of the shaft. The diagnostic electrode, which is disposed on an external surface of the expandable frame, is configured to sense diagnostic signals when in contact with tissue. The reference electrode is disposed on a surface of the expandable frame directly opposite the diagnostic electrode, wherein the reference electrode is electrically insulated from the tissue and is configured to sense interfering signals.

Abstract: A method of optimally placing spinal cord stimulator (SCS) leads includes acquiring components of somatosensory evoked potentials (SSEPs), compound action potentials and triggered EMG; analyzing the waveforms; and quantifying waveform features in a single display such that a surgeon can quickly and easily determine optimal placement (as it relates to laterality and level of placement on the spinal cord) of SCS leads in a patient under general anesthesia without additional expert help.

Abstract: The invention consists of a device to evaluate hemodynamic response generated by the spinal cord in response to a suprasensorial stimulus applied to a peripheral nerve (medium or posterior tibial) by the use of functional near-infrared spectroscopy (fNIRS). The device consists of 3 main components, an electrical stimulator, an optical recording unit and a signal processing and control module. The device allows non-invasive, comfortable, harmless, portable, home-based, and low-cost evaluation of changes in local hemodynamic parameters in response to neuronal activation of the spinal cord by electrical stimulation of a peripheral nerve. The invention also includes a corresponding method of using the device and monitoring the spinal function.

Abstract: A medical image processing apparatus comprises processing circuitry configured to: obtain image data representative of a brain of a subject; obtain data representing a clinical sign or symptom of the subject, wherein the clinical sign or symptom is relevant to a brain condition; process the image data to obtain an estimation of an abnormality in the brain of the subject; and determine whether the estimation of the abnormality is consistent with the data representing the clinical sign or symptom.

Abstract: The present disclosure relates to a medical image analysis method, a medical image analysis device, and a computer-readable storage medium. The medical image analysis method includes receiving a medical image acquired by a medical imaging device; determining a navigation trajectory by performing navigation processing on the medical image based on an analysis requirement, the analysis requirement indicating a disease to be analyzed; extracting an image block set along the navigation trajectory; extracting image features using a first learning network based on the image block set; and determining an analysis result using a second learning network based on the image features and the navigation trajectory.

Abstract: The present invention relates to a system and methods generally aimed at surgery. More particularly, the present invention is directed at a system and related methods for performing surgical procedures and assessments involving the use of neurophysiology.

Abstract: Various analytics systems are disclosed. An analytics system is configured to communicably couple to a surgical hub. The surgical hub is configured to communicably couple to a modular device that is controlled by a control program. The analytics system comprises a processor and a memory coupled to the processor.

Abstract: A neuromuscular sensing method includes transmitting an electrical stimulus from a distal end portion of an elongate stimulator extending within an intracorporeal treatment area of a subject and detecting an artificially induced response of at least two muscles of the subject in response to the transmitted electrical stimulus, each response being detected by a respective sensor in mechanical communication with the muscle. A graphical user interface (GUI) is transitioned from a first state to a second state; the first state indicating to the transmission of a stimulus with no artificially induced response detected, and the second state indicating the detection of the artificially induced response of the at least two muscles, and further identifying one of the at least two muscles as a primary muscle response.

Abstract: Systems, methods and computer program products are provided for reading and scoring ultrasound and/or optoacoustic (US/OA) images that include at least one of OA images or US images acquired in connection with an examination for a region of interest (ROI). The system displays a first image that has an interior ROI outline separating an internal zone from a boundary zone. In some aspects, feature scores are obtained in connection with at least the boundary zone and peripheral zone of the first image and the feature scores are applied to a classification model to obtain at least one of a prognostic result or predictive result indicative of a trait of the lesion. In accordance with some aspects, an order in which feature scores are entered is automatically managed to obtain for the at least one of the peripheral zone or the boundary zone before the feature score is obtained for the internal zone.

Abstract: A method for treating pain or discomfort in a patient is disclosed. The method comprises stimulating a cranial nerve with an electrical signal. The pain or discomfort may be a withdrawal symptom. The cranial nerve may be in an auricular area of the patient. The cranial nerve may be cranial nerve V, cranial nerve VII, cranial nerve IX, cranial nerve X, or branches of greater and lesser occipital nerves thereof and their associated neurovascular bundles. The withdrawal symptom may result from cessation of an opioid. The method may further comprise administering a secondary drug treats one or more of the withdrawal symptoms and addiction. The secondary drug may be administered about one day to about one week after initiating the stimulating step.

Abstract: An electrode management solution for neuromonitoring applications such as electroencephalography (EEG) procedures provides for the verification of the locations and connections of electrodes. The brain is modeled as a volume conductor and an expected attenuated signal generated by an electrical signal present in the form of an electrical dipole at any other point in the brain is calculated. A known signal is connected between electrodes at ‘presumed’ locations. This action generates a defined electrical field which can be measured between any of the other electrode locations. The amplitude and phase of the measured signals are a function of the input signal, the volume conductor, and the geometric relations of the two electrodes. By comparing the expected values with the measured values, the relation between the electrodes is verified.

Abstract: A nerve mapping system includes an elongate medical device, a non-invasive mechanical sensor, and a processor. The elongate medical device includes a distal end portion configured to explore an intracorporeal treatment area of a subject, and the distal end portion includes an electrode. The non-invasive mechanical sensor is configured to provide a mechanomyography output signal corresponding to a monitored mechanical response of a muscle innervated by the nerve. The processor is in communication with the electrode and the sensor, and is configured to provide a plurality of electrical stimuli to the electrode. Each of the plurality of stimuli is provided when the electrode is located at a different position within the intracorporeal treatment area. The processor determines the likelihood of a nerve existing at a particular point using the magnitudes of each of the stimuli and the detected response of the muscle.

Abstract: Systems and related methods for identifying and/or ablating targeted nerves are provided. A probe with stimulating electrodes and/or ablation members are provided. The probe may be inserted into a nasal cavity and current may be introduced through the electrodes to stimulate a targeted area. The response to stimulation may be used to identify the targeted nerve. Once identified, the ablation member may ablate the targeted nerve.

Abstract: A method of programming an implantable medical device (IMD) configured to provide electrical stimulation via a plurality of stimulation vectors during delivery of the electrical stimulation of a plurality of pulse widths to a neural target. The method may comprise comparing strength-duration curve data for the plurality of stimulation vectors to one another, the strength-duration curve data representing, for respective pulse widths and stimulation vectors, a corresponding stimulation strength that evokes a physiological response associated with the neural target. The method may comprise selecting at least one stimulation vector of the plurality of stimulation vectors based on the comparison of the strength-duration curve data for the plurality of stimulation vectors. The method may comprise programming, in response to the selection, the IMD to deliver the electrical stimulation to the neural target via the selected at least one stimulation vector.

Abstract: A multifunctional neurophysiologic monitoring and probing system, having a main unit (1), a main wire (2), negative electrode neurophysiologic monitoring and probing parts and positive electrode neurophysiologic monitoring and probing parts; one end of the main wire (2) is connected with the main unit (1); another end of the main wire is divided into two branch wires connecting with the negative electrode neurophysiologic monitoring and probing parts and the positive electrode neurophysiologic monitoring and probing parts respectively.

Abstract: The perceptive faculties of a subject are determined by way of a brain-computer interface 20. At least two mutually distinguishable types of stimuli SA, SB which are applicable to a subject are prescribed. A multiplicity of temporally successive stimuli are applied to the subject and combined to form blocks. Calibration data are created from the EEG data ascertained thus by virtue of a number of ascertained EEG data and stimuli associated with these EEG data are combined to form calibration blocks. A classification function is ascertained by a classification analysis on the basis of ascertained calibration blocks. The classification function specifies a position of the stimulus of the first type in the respective calibration block. Finally, the EEG data of a number of test blocks selected from the blocks are subjected to the classification function.

Abstract: A touch sensor comprises a first electrode, a second electrode arranged spaced apart from the first electrode, and an insulator arranged between the first electrode and the second electrode, wherein at least one of the first electrode and the second electrode is energized, and an energy difference exists between the first electrode and the second electrode. At least one of the first electrode and the second electrode is a stressed electrode. When the stressed electrode is not stressed, no electrical signal is generated, and when the stressed electrode is stressed, the stressed electrode deforms at a stressed point and changes the distance between the stressed point and the other electrode to generate a tunneling current, and the touch sensor generates the electrical signal according to whether the tunneling current is generated. Therefore, the invention solves a limitation of the conventional touch sensor in touching and provides good touching sensitivity.

Abstract: A nerve monitoring system facilitates monitoring an integrity of a nerve.

Abstract: Neuromuscular stimulation is widely used for rehabilitation and movement assist devices, due to its safety, efficacy, and ease of operation. For repeatable and accurate muscular contractions, a voltage controlled current sources (VCCS) with high compliance is required. Conventional VCCS design requires high-voltage rated operational amplifiers, which are expensive and consume large power. Moreover, conventional stimulators are not viable for simultaneous stimulation of muscle synergies, as they require multiple VCCS operating at the same time. This invention presents a neuromuscular stimulator with a multistage driver circuit wherein, a VCCS connected to an output driving stage comprising of folded-cascode transistor buffers and a bidirectional current mirror circuit. The multistage driver circuit uses inexpensive low-voltage rated operational amplifiers that consume 95% less power.

Abstract: Devices and methods for treating obstructive sleep apnea by first performing an assessment of the patient that involves observing the patient's upper airway during a tongue protrusion maneuver. The assessment may, for example, be done using endoscopy to observe the upper airway while the patient is awake in the supine position. An adequate response of the upper airway during the tongue protrusion maneuver is indicative of likely therapeutic success with hypoglossal nerve stimulation, and may be used for making clinical decisions. The principles of the present invention may be applied to other therapeutic interventions for OSA involving the upper airway.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.

Abstract: The present disclosure relates to an array of electrodes on a flexible scaffolding, with the ability to collapse into an axial configuration suitable for deploying through a narrow cylindrical channel. The electrode arrays can be placed into the ventricular system of the brain, constituting a minimally invasive platform for precise spatial and temporal localization of electrical activity within the brain, and precise electrical stimulation of brain tissue, to diagnose and restore function in conditions caused by abnormal electrical activity in the brain.

Abstract: A vestibular stimulation array is disclosed having one or more separate electrode arrays each operatively adapted for implantation in a semicircular canal of the vestibular system, wherein each separate electrode array is dimensioned and constructed so that residual vestibular function is preserved. In particular, the electrode arrays are dimensioned such that the membranous labyrinth is not substantially compressed. Furthermore, the electrode array has a stop portion to limit insertion of the electrode array into the semi-circular canal and is still enough to avoid damage to the anatomical structures.

Abstract: A computer-implemented method and system of hardware for acquiring objective data relating to biometric and physiological parameters of an individual to diagnose, devise a treatment plan, and/or monitor an emotional and mental state of the individual. The method and system are designed to capture and process in real time clinical observations of patient responses and reactions in different clinical and patient settings and situations.

Abstract: A surgical instrument includes a first member having an inner surface and an outer surface. A second member has an inner surface and an outer surface. At least one of the inner surfaces defines at least one mating element and the outer surfaces are engageable with tissue. The members are relatively movable between a first configuration and a second configuration to space the tissue and define an opening between the members. At least one third member defines at least one mating element engageable with the at least one mating element of the inner surface such that the at least one third member is disposed within the opening. Systems and methods are disclosed.

Abstract: An intraoperative nerve evaluation device includes a flexible substrate, and a plurality of detection units disposed on the substrate and spaced apart from one another. Each of the detection units includes an electrode and a conductive wire electrically connected to the electrode. When the electrodes are attached to a nerve, a selected one of the electrodes is configured to receive an input signal via the corresponding conductive wire and to transmit the input signal to the nerve, and each of the electrodes other than the selected one is configured to receive from the nerve a response signal associated with the input signal and to transmit the response signal via the corresponding conductive wire.

Abstract: An example a system includes a neuromodulation generator that may be configured to use electrodes to generate a first modulation field over a test region of neural tissue along the electrodes to prime the neural tissue throughout the test region and a second modulation field to test targeted locations within the test region for therapeutic effectiveness. A memory may be configured to store a first modulation field parameter for generating the first modulation field and a second modulation field parameter set for generating the second modulation field to modulate a targeted location within the test region. The second modulation field parameter set is programmable for modulating other targeted locations. The controller may be configured to control the neuromodulation generator to use the first modulation field parameter set to deliver the first modulation field and to use the second modulation field parameter set to deliver the second modulation field.

Abstract: A navigable probe system and method of use is provided. The system may include a handle assembly having a locking mechanism enclosed and a stylus, a cannula, and a tracking device extending from the handle assembly. The stylus may include undercuts for receiving pins of the locking mechanism. A cam of the handle assembly may rotate such that in a first position, the pins of the locking mechanism may be engaged with the undercuts and in a second position, the pins of the locking mechanism may be disengaged from the undercuts releasing the stylus from the locking mechanism. The stylus may be slidably engaged with an inner diameter of the cannula. In some arrangements, the handle assembly may include a quick connect system that in a first position attaches the cannula to the handle assembly and in a second position releases the handle assembly and thus stylus from the cannula.

Abstract: In one respect, there is provided an apparatus for neural stimulation. The apparatus may include an antenna, a plurality of electrodes, and a voltage supply generator. The antenna may be configured to receive, from an external source, radio frequency energy. The voltage supply generator configured to generate a voltage supply by at least ramping up a voltage of the radio frequency energy in successive increments, wherein the voltage supply drives a current to the plurality of electrodes during neural stimulation. Related methods and computer program products are also disclosed.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Provided is an electric stimulation treatment device which is capable of outputting a stimulation voltage more efficiently than a conventional device. A urination disorder treatment device includes a pair of body-surface electrode pads 37, an indifferent electrode pad 39 which is larger in area than a body-surface electrode pad 37 with a relatively larger area, of the pair of body-surface electrode pads 37, and disposed in the vicinity of the pair of body-surface electrode pads 37, and a control portion 48 which supplies an electric signal to the pair of body-surface electrode pads 37 and the indifferent electrode pad 39.

Abstract: Among other things, a user interface device has a sensor configured to detect, at a wrist of a human, nerve or other tissue electrical signals associated with an intended contraction of a muscle to cause a rapid motion of a finger. An output provides information representative of the nerve or other tissue electrical signals associated with the intended contraction of the muscle to an interpreter of the information.

Abstract: A method of programming an implantable medical device (IMD) configured to provide electrical stimulation via a plurality of stimulation vectors during delivery of the electrical stimulation of a plurality of pulse widths to a neural target. The method may comprise comparing strength-duration curve data for the plurality of stimulation vectors to one another, the strength-duration curve data representing, for respective pulse widths and stimulation vectors, a corresponding stimulation strength that evokes a physiological response associated with the neural target. The method may comprise selecting at least one stimulation vector of the plurality of stimulation vectors based on the comparison of the strength-duration curve data for the plurality of stimulation vectors. The method may comprise programming, in response to the selection, the IMD to deliver the electrical stimulation to the neural target via the selected at least one stimulation vector.

Abstract: A method for determining a desired location at which to apply a neural therapy. An array of electrodes is positioned proximal to neural tissue. A stimulus is applied from the array which evokes a neural compound action potential response in the neural tissue proximal to the array. A plurality of electrodes of the array simultaneously obtain respective measurements of the neural compound action potential response. From the measurements of the neural compound action potential response a desired location for a neural therapy is determined.

Abstract: An example of a system for delivering neurostimulation pulses to a patient using a plurality of electrodes and controlling the delivery of the neurostimulation pulses by a user may include a programming control circuit and a user interface. The programming control circuit may be configured to generate a plurality of stimulation parameters controlling delivery of neurostimulation pulses according to one or more stimulation waveforms. The interface may include a display screen and an interface control circuit. The interface control circuit may be configured to define the one or more stimulation waveforms, and may include an impedance presentation module. The impedance presentation module may be configured to determine values of impedances each between two electrodes of the plurality of electrodes for all of combinations of two electrodes available from the plurality of electrodes and display the determined values of impedances on the display screen.

Abstract: A system for monitoring relative nerve health and the presence of neuropraxia is described. The system utilizes the integration of a waveform function of an elicited or monitored nerve response to provide an indication of the strength of a detected signal from a nerve and thus the relative health and integrity of the nerve. In some embodiments motor nerve stimulation innervates muscle and an EMG waveform is obtained in response thereto. The integration under the waveform is expressed and an indexed value indicating a percentage of a certain threshold value. Methods set forth provide a more reliable status of a nerve in real-time and allow action to be taken to reduce neuropraxia or prevent permanent nerve damage.

Abstract: The present invention involves systems and related methods for performing surgical procedures and assessments, including the use of neurophysiology-based monitoring to: (a) determine nerve proximity and nerve direction to surgical instruments employed in accessing a surgical target site; (b) assess the pathology (health or status) of a nerve or nerve root before, during, or after a surgical procedure; and/or (c) assess pedicle integrity before, during or after pedicle screw placement, all in an automated, easy to use, and easy to interpret fashion so as to provide a surgeon-driven system.

Abstract: One aspect of the present disclosure relates to a system for monitoring a diaphragmatic twitch response. The diaphragmatic twitch response can be used to determine a depth of neuromuscular blockade. The system includes a neural stimulation device to stimulate a phrenic nerve of a subject, which has the effect of stimulating the subject's diaphragm. The system also includes a monitor to detect the diaphragm's response to the stimulation. For example, the monitor can include a nasogastric tube with two distally positioned inflatable balloons. Each of the inflatable balloons is coupled to a sensor to measure a corresponding pressure (e.g., an esophageal pressure and a gastric pressure). The pressure differential between the esophagus above the diaphragm and the stomach below the diaphragm (also referred to as the transdiaphragmatic pressure) can be used as a measure of the diaphragmatic twitch response.

Abstract: Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques.

Abstract: Improved assemblies, systems, and methods provide safeguarding against tissue injury during surgical procedures and/or identify nerve damage occurring prior to surgery and/or verify range of motion or attributes of muscle contraction during reconstructive surgery. A stimulation control device may incorporate a range of low and high intensity stimulation to provide a stimulation and evaluation of both nerves and muscles. A stimulation control device is removably coupled to a surgical device or is imbedded within the medical device to provide a stimulation and treatment medical device. A disposable hand held stimulation system includes an operative element extending from the housing, the housing includes a visual indication to provide feedback or status to the user.

Abstract: The present invention involves systems and related methods for performing percutaneous pedicle integrity assessments involving the use of neurophysiology.

Abstract: Via a pulse generator, a trigger signal is generated. The trigger signal indicates one or more stimulation pulses are about to be delivered, or is being delivered, to a patient. The trigger signal is sent to a measurement instrument. Via the pulse generator, the one or more stimulation pulses are generated. The one or more stimulation pulses are delivered to the patient. With the measurement instrument and in response to the trigger signal, one or more action potentials are measured. The one or more action potentials are produced by the patient in response to the one or more stimulation pulses.

Abstract: Methods of using hardware (e.g., bone screws, anchors or other devices) previously inserted within the body to facilitate energy delivery are disclosed. The energy delivery (e.g., thermal energy) may be used for neuromodulation (such as stimulation or denervation), tissue heating and ablation, curing, and other applications in the spine and non-spine orthopedic locations.

Abstract: A method of modeling a nerve disposed within an intracorporeal treatment area of a patient includes locating an electrode at a plurality of locations within a virtual workspace and providing an electrical stimulus from the electrode to the intracorporeal treatment area. The response of a muscle to the electrical stimulus is monitored and used to determine a distance to the nerve from each of the plurality of locations. A virtual model of the nerve is then constructed within the virtual workspace using the determined distance to the nerve from each of the different positions, and the plurality of locations within the virtual workspace.

Abstract: An implantable nerve stimulator is implanted in a patient near a nerve target. The implantable nerve stimulator has a plurality of electrodes through which stimulation is provided to the nerve target. The relative location of the nerve target and the electrodes may be determined by applying stimulation to the nerves via each of the electrodes, determining an effect of the stimulation for each of the electrodes, and mapping a location of the nerve relative to the electrodes based on the effect of the stimulation for each of the electrodes.

Abstract: A stimulation electrode assembly configured to be positioned relative to a patient for an operative procedure is disclosed. An evoked stimulation response may be sensed by a sensor near a portion of a subject. The evoked response may be sensed by an electrode and determined with a monitoring system.

Abstract: Methods and systems for selecting stimulation parameters using targeting and steering techniques are presented. For example, a method or system (via actions performed by a processor) can include receiving a name of an anatomical or physiological target or a name of a disease or disorder; receiving a clinical goal; and using at least 1) the anatomical or physiological target or disease or disorder and 2) the clinical goal, selecting a set of stimulation parameters. Another method or system (via actions performed by its processor) can include receiving a first set of stimulation parameters; receiving a command to alter the first set of stimulation parameters that does not include, or is not composed exclusively of, a numerical value for any of the stimulation parameters; and modifying the first set of stimulation parameters to create a second set of stimulation parameters based on the command.

Abstract: A problem to be solved is to use a measured pain degree for comparison with a pain degree of another subject or for diagnosis of a disease. A pain measuring device has an electrode to be attached to a subject and a stimulation current generation means generating a stimulation current to be supplied to the electrode. Then, the pain measuring device measures pain felt by the subject based on the stimulation current applied from the electrode to the subject. The pain measuring device has a means to display a relation between a pain measurement value being a logarithmic value or a logarithmic-type value of a value founded on the stimulation current and a value of a VAS or a face scale which the subject selects.