Abstract: A durable nerve cuff electrode for achieving block of an action potential in a large diameter nerve.

Abstract: The invention relates to a system, which can be implanted in a human body, for neuromodulation of nerves, having an electronic signal generating or in an implantable signal generating housing (10), a voltage supply connected to the signal generating or, at least one elongated multi-channel wire electrode (12), which is connected to the signal generating housing and which is designed for implantation in the human body on a nerve (DNP), which multi-channel wire electrode forms a plurality of shell segment electrodes (16a-16d) on a nerve contact region (14) and has, on the ends thereof, a fixing (18) for anchoring the wire electrode means to an implantation location, wherein the signal generator housing has a flat fixing unit (20), which is flange-like and/or sits and/or protrudes in the manner of a piece of tissue, which enables the surgical fixation of the signal generating housing to a tissue, muscle or bone region (PB) in the body, in particular to a region of the pubic bone, to a muscle portion and/or to a

Abstract: A cuff electrode includes at least an array of electrodes to extend circumferentially about a nerve, and methods of making and using a cuff electrode.

Abstract: Systems and methods include a wearable device with an electrically conductive skin interface that excites the underlying nerves from a transcutaneous surface stimulator. The device may be sized for a range of user sizes with stimulation electrodes positioned to target the appropriate nerves, such as the saphenous and/or posterior tibial nerves. The therapy may be adjusted based on leg restlessness or movement.

Abstract: An example device for repairing a tissue is described herein. The device can include a flexible carrier layer, and a support member including a plurality of micro-protrusions extending therefrom. The support member can be at least partially integrated with the flexible carrier layer. Additionally, the flexible carrier layer can be configured to cover at least a portion of the tissue, and the micro-protrusions can be configured to mechanically interface with the tissue.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level. This titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: An apparatus for monitoring EMG signals of a patient's laryngeal muscles includes an endotracheal tube having an exterior surface and a first location configured to be positioned at the patient's vocal folds. A first electrode is formed on the exterior surface of the endotracheal tube substantially below the first location to receive EMG signals primarily from below the vocal folds. A second electrode is formed on the exterior surface of the endotracheal tube substantially above the first location to receive EMG signals primarily from above the vocal folds. The first and second electrodes are configured to receive the EMG signals from the laryngeal muscles when the endotracheal tube is placed in a trachea of the patient.

Abstract: An electrode lead comprises an elongated lead body, at least one lead connector terminal affixed to the proximal end of the lead body, and an electrically insulative cuff body affixed to the distal end of the lead body. The cuff body is configured for being circumferentially disposed around a nerve. The cuff body comprises cutouts, slits, a wrinkled portion, a thin stretchable portion, and/or a serpentine strap, which increases that increase the expandability of the cuff body when disposed around the nerve. The electrode lead further comprises at least one electrode contact affixed to the cuff body, and at least one electrical conductor extending through the lead body between the at least one lead connector terminal and the electrode contact(s). If the cuff body comprises cutouts or slits, the electrode lead can further comprise a thin stretchable film affixed to the cuff body over cutouts or slits.

Abstract: An electrode system for neuromodulation and for recording of signals indicative of nerve activity is provided. The system can include a plurality of electrodes provided on a flexible, non-conductive substrate. The substrate can be rolled into a cuff for encircling a nerve bundle of a patient. The plurality of electrodes on the cuff can be interconnected using flexible conductors provided on the substrate. In one implementation, the electrodes can be interconnected using conductors that have spring-like configuration. Flexibility of the conductors allows the cuff to expand and contract with the nerve without causing excessive stress/strain at the nerve-cuff interface.

Abstract: Systems and methods that deliver a continuous partial nerve conduction block are described. A waveform generator can configure one or more direct current (DC) waveforms to provide a continuous partial nerve conduction block. One or more electrodes can deliver the one or more DC waveforms to provide the partial block to the neural structure. Feedback can be provided to the waveform generator related to the partial block. The feedback includes monitoring a property associated with the partial block and altering a parameter associated with the one or more direct current waveforms in response to the property associated with the partial block.

Abstract: The invention relates to an implantable electric multi-pole connection between an electric implant and an electric feed and discharge structure. The invention is characterised in that a flexible, film-like, electrically non-conductive, strip-shaped surface element is arranged between the implant and the feed and discharge structure. The surface element comprises at least one first surface, on which a number of electrodes n greater than of equal to two is arranged, which are respectively connected to the electric implant by means of electric connection conductors extending at least in parts inside the surface element. The electric feed and discharge structure comprises at least n lines which are electrically insulated from each other and which are electrically connected to one of the n electrodes.

Abstract: An electrode cuff includes a first elongate portion and a second elongate portion. The first elongate portion is configured to removably contact a length of a nerve while the second elongate portion extends outwardly at an angle relative to a first side edge of the first elongate portion to at least partially wrap about the nerve. The electrode cuff includes a first series of electrodes that is spaced apart longitudinally along the first elongate portion. A width of the second elongate portion is sized to fit between adjacent branches extending from a nerve.

Abstract: An implantable medical device (IMD) includes an adjustable capacitive voltage multiplier (CVM) that is responsive to diagnostic circuitry configured to provide control signals within a single stimulation current pulse for adjusting the voltage output applied to an electrode of the IMD's lead system. A control counter is coupled to the diagnostic circuitry for incrementing or decrementing an N-bit counter output signal operative to reconfigure a charge pump arrangement of the CVM so as to facilitate an adjusted voltage output.

Abstract: An electrode lead comprises a lead body, connector contacts affixed to the proximal end of the lead body, and a cuff body affixed to the distal end of the lead body. The cuff body is pre-shaped to transition from an unfurled state to a furled state, wherein the cuff body, when in the furled state has an inner surface for contacting a nerve and an overlapping inner cuff region and an outer cuff region. The electrode lead further comprise electrode contacts circumferentially disposed along the cuff body when in the furled state, such that at least one of the electrode contacts is located on the inner surface of the cuff body, and at least another of the electrode contacts is located between the overlapping inner and outer cuff regions. The electrode lead further comprises electrical conductors extending through the lead body respectively between the connector contacts and the electrode contacts.

Abstract: The present disclosure relates to subcutaneous direct current (DC) nerve conduction block. A subcutaneous electrode can be implanted under a subject's skin between the subject's skin and a neural structure within the subject's body. The subcutaneous electrode can be coupled to a current generator. A DC can be configured by the current generator and delivered through the subcutaneous electrode to block conduction in the neural structure. The subcutaneous electrode eliminates an effect of an impedance of the subject's skin on the DC. The DC can be returned to the current generator by a return electrode.

Abstract: There is provided a neural interface device for unidirectional stimulation of a nerve including at least one A-type nerve fiber or at least one at least partially myelinated nerve fiber. The device includes an electrode arrangement for placing on or around the nerve. The electrode arrangement includes a first electrode configured to be positively charged and a second electrode configured to be negatively charged, where the surface area of the second electrode is larger than the surface area of first electrode.

Abstract: A bioelectric interface is provided. The bioelectric interface comprises a case having a channel configured to hold a nerve. An electrode array is slidably coupled to the case, wherein the electrode array comprises a number of electrode shanks. The case restricts movement of the electrode array to one degree of freedom toward or away from the nerve held in the channel for insertion of the electrode shanks into the nerve.

Abstract: Methods and devices are described for preventing diastolic flow reversal and/or reducing peripheral vascular resistance in a patient. Also described are methods of cosmetic treatment, and methods of promoting delivery of therapeutic agents or contrast agents to bones and related tissues.

Abstract: A medical device may include an elongated body, a balloon positioned at a distal portion of the elongated body, and one or more pressure-wave emitters positioned along a central longitudinal axis of the elongated body within the balloon. The one or more pressure-wave emitters may be configured to propagate pressure waves radially outward through the fluid to fragment a calcified lesion at the target treatment site. The at least one of the one or more pressure-wave emitters may include an electronic emitter comprising a first electrode and a second electrode. The first electrode and the second electrode may be arranged to define a spark gap between the first electrode and the second electrode, and the second electrode may comprise a portion of a hypotube.

Abstract: A method, electrical tissue stimulation system, and programmer for providing therapy to a patient are provided. Electrodes are placed adjacent tissue (e.g., spinal cord tissue) of the patient, electrical stimulation energy is delivered from the electrodes to the tissue in accordance with a defined waveform, and a pulse shape of the defined waveform is modified, thereby changing the characteristics of the electrical stimulation energy delivered from the electrode(s) to the tissue. The pulse shape may be modified by selecting one of a plurality of different pulse shape types or by adjusting a time constant of the pulse shape.

Abstract: The present technology is generally directed to spinal cord modulation leads having one or more sidewall openings configured for inserting stylets to steer and/or position the leads within a patient and/or with respect to a pulse generator, and associated systems and methods. In some embodiments, sidewall opening is generally positioned in an intermediate portion of the lead and is operatively coupled to a lumen extending distally to a distal end of the lead, and/or proximally to a proximal end of the lead.

Abstract: Methods for treating eating disorders and for reducing a risk associated with developing an eating disorder in patients via therapeutic renal neuromodulation and associated systems. Renal sympathetic nerve activity can be attenuated to improve a patient's eating disorder status or risk of developing an eating disorder. The attenuation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly configured to modulate the renal sympathetic nerve.

Abstract: An extravascular or intravascular neural interface is disclosed containing electrodes for neurostimulation of the vessel. The devices are housed in flexible substrates formed from a multilumen tubing housing conductors for electrodes positioned in a distal serpentine shaped end of the device. The distal serpentine shaped end includes rows or strips of electrodes or coil electrodes.

Abstract: A neuromodulation catheter is positionable in a blood vessel having a wall for use in delivering therapeutic energy to targets external to the blood vessel. An electrically insulative substrate such as an elongate finger is carried at a distal end of the catheter body. The substrate has a first face carrying a plurality of electrodes, and a second face on an opposite side of the substrate from the first face. The finger is biased such that when expanded within the blood vessel, it forms a spiral configuration with the first face facing outwardly to bias the electrodes in contact with the blood vessel wall.

Abstract: A medical electrical lead and methods of implanting medical electrical leads in lumens. Leads in accordance with the invention employ preformed biases to stabilize the lead within a lumen or lumen and to provide feedback to lead implanters.

Abstract: An implantable cuff electrode and/or optrode (40) adapted to encircle a substantially cylindrical tissue (70), is provided that includes a support sheet (43) rolled about a longitudinal axis, forming a cuff of inner diameter, Dc, and extending over a length, L a central portion, extending over a length, lc, of at least 50% of the length, L, and having a mean central thickness, tc, and wherein the central portion is flanked on either side by, a first edge portion (43e) of mean edge thickness, te1, and a second edge portion (43e) of mean edge thickness, te2, at least a first electrode contact or a first optrode exposed at an inner surface of the cuff, and remote from an outer surface forming the exterior of the cuff, Characterized in that, the mean edge thicknesses, te1, te2, of the first and second edge portions are each lower than tc.

Abstract: A motor device for stimulating muscle, including at least one electrode for generating electric current operatively attached to an electrode array and exposed on an inner surface of an array body, and a programming mechanism of a computer that executes an algorithm stored on non-transitory computer readable medium and includes an information storage mechanism and a user-operated interface in electrical connection with said at least one electrode for programming operation of said at least one electrode, said motor device being implanted in an individual and applying electric current to nerves at an area above an area of neurological damage.

Abstract: A nerve cuff for establishing a nerve block on a nerve can have a cuff body with a channel for receiving a nerve, a reservoir for holding a drug, and an elongate opening slit extending the length of the cuff body that can be opened to provide access to the channel and can be closed to enclose the cuff body around the nerve. The nerve cuff can also include an electrode for detecting and measuring electrical signals generated by the nerve. A controller can be used to control delivery of the drug based on the electrical signals generated by the nerve.

Abstract: An example device for repairing a tissue is described herein. The device can include a flexible carrier layer, and a support member including a plurality of micro-protrusions extending therefrom. The support member can be at least partially integrated with the flexible carrier layer. Additionally, the flexible carrier layer can be configured to cover at least a portion of the tissue, and the micro-protrusions can be configured to mechanically interface with the tissue.

Abstract: An implantable medical device (IMD) includes an adjustable capacitive voltage multiplier (CVM) that is responsive to diagnostic circuitry configured to provide control signals within a single stimulation current pulse for adjusting the voltage output applied to an electrode of the IMD's lead system. A control counter is coupled to the diagnostic circuitry for incrementing or decrementing an N-bit counter output signal operative to reconfigure a charge pump arrangement of the CVM so as to facilitate an adjusted voltage output.

Abstract: Systems, methods, and devices for neuromodulation are described herein. For example, a method for modulating inflammatory processes of a subject is described. The method can include stimulating the subject's vagus nerve to activate an efferent pathway, and stimulating the subject's vagus nerve to inhibit neural activity. Pairing activation of the efferent pathway and inhibition of neural activity can enhance an anti-inflammatory response of the subject.

Abstract: An electrode lead comprises an elongated lead body, at least one lead connector terminal affixed to the proximal end of the lead body, and an electrically insulative cuff body affixed to the distal end of the lead body. The cuff body is configured for being circumferentially disposed around a nerve. The cuff body comprises cutouts, slits, a wrinkled portion, a thin stretchable portion, and/or a serpentine strap, which increases that increase the expandability of the cuff body when disposed around the nerve. The electrode lead further comprises at least one electrode contact affixed to the cuff body, and at least one electrical conductor extending through the lead body between the at least one lead connector terminal and the electrode contact(s). If the cuff body comprises cutouts or slits, the electrode lead can further comprise a thin stretchable film affixed to the cuff body over cutouts or slits.

Abstract: The subject invention provides devices and methods for alleviating discomfort associated with neuroma formation. The devices and methods of the invention effectively use the body's natural response of reconstructing implanted biomaterials to minimize the size of, isolate, and protect a neuroma. In preferred embodiments, the subject device is a cylindrical cap, wherein the internal chamber of the cylindrical cap physically partitions the nerve to enable an arrangement of nerve fibers (as opposed to haphazardly arranged nerve fibers often produced in neuromas). Tabs arranged on the outside of the cap can be used to manipulate the cap into place on a nerve. The open end can also be configured with flaps that can be used to widen the open end for easier insertion of the nerve into the cap. In addition, the cap's material remodels into a tissue cushion after implantation, which protects the neuroma from being stimulated and inducing pain.

Abstract: The subject invention provides devices and methods for alleviating discomfort associated with neuroma formation. The devices and methods of the invention effectively use the body's natural response of reconstructing implanted biomaterials to minimize the size of isolate, and protect a neuroma. In preferred embodiments, the subject device is a cylindrical cap, wherein the internal chamber of the cylindrical cap physically partitions the nerve to enable an arrangement of nerve fibers (as opposed to haphazardly arranged nerve fibers often produced in neuromas). Tabs arranged on the outside of the cap can be used to manipulate the cap into place on a nerve. The open end can also be configured with flaps that can be used to widen the open end for easier insertion of the nerve into the cap. In addition, the cap's material remodels into a tissue cushion after implantation, which protects the neuroma from being stimulated and inducing pain.

Abstract: An extravascular or intravascular neural interface is disclosed and can include three C-ring portions, with at least two including an electrode, an electrode pair or an electrode array. The portions are formed of a flexible material that is configured to enable the portions to self-size to fit around or against a surface of a target vessel when the neural interface is released at a position along the target vessel. A spinal portion configured to house electrical conductors for the electrodes is connected to one or more portions. The portions may be spaced sufficient apart to permit radial expansion and contraction of a target vessel around or within which the neural interface is placed, to reduce nerve compression, open trench low-pressure unrestricted blood-flow, and to enhance fluid exchange with the target vessel. The portions may be arranged in a low helix angle forming at least two full turns.

Abstract: Some implementations provide a method for modulating excitable tissue in a body of a patient, the method including: placing a wireless implantable stimulator device at a target site in the patient's body, the stimulator device including one or more electrodes; reconfiguring the wireless implantable stimulator device to form an enclosure that substantially surrounds the excitable tissue at the target site with the electrodes on the inside of the enclosure and facing the nerve; and causing electrical impulses to be delivered to the electrodes on the wireless implantable stimulator device such that neural modulation is applied to the excitable tissue substantially surrounded by the enclosure.

Abstract: An implantable cuff electrode having a flexible cuff in form of a tube having a longitudinal slot, wherein the longitudinal slot defines a first edge and a second edge on the cuff, wherein a first lip is arranged at the first edge of the longitudinal slot, and a second lip is arranged at the second edge of the longitudinal slot, and wherein the longitudinal slot can be sealed by the first lip and the second lip in that the first lip and the second lip extend at least partially on the cuff jacket of the cuff one lying on top of the other, and the second lip holds the first lip in position by means of a surface pressure onto the cuff jacket.

Abstract: This document discusses, among other things, systems and methods for managing pain of a subject. A system includes a first sensor circuit to sense a first signal indicative of a functional state of the subject, a second sensor circuit to sense a second signal different from the first signal, and a controller circuit. The controller circuit may determine an operating mode of the second sensor circuit according to the sensed first signal, trigger the second sensor circuit to sense the second signal under the determined operating mode, and generate a pain score using at least the second signal sensed under the determined operating mode. The pain score may be output to a patient or used for closed-loop control of a pain therapy.

Abstract: The disclosure relates to implantable probes. An implantable probe includes a sleeve capable of being wound around an elongate organ of cylindrical shape, and includes a sheet of elastically deformable material that supports at least one electrode. The sheet is prestressed in such a way as to allow it to self-wind from an initial position, in which the sheet is kept stressed in the deployed state, to a final position, in which the sheet is wound freely in a spiral to form a sleeve around the organ, with the first face, which supports the electrodes, being directed towards the inside. The sheet is delimited by an outer lateral edge of the sleeve after winding, an inner lateral edge of the sleeve after winding, and a first transverse edge and a second, opposite transverse edge. The sheet includes perforations located in proximity to the first and/or second transverse edge.

Abstract: A device for neurostimulation including an electrode structure for delivering stimulation pulses to a nerve as well as for processing and extracting evoked compound action potentials, wherein the electrode structure comprises at least a first anode, at least a second anode opposing the first anode and a plurality of cathodes arranged between said anodes, wherein said cathodes are asymmetrically arranged with respect to said at least first and second anode to permit evoked compound action potential sensing via the anode electrodes simultaneously with stimulation.

Abstract: A durable nerve cuff electrode for achieving block of an action potential in a large diameter nerve.

Abstract: Conductors within an implantable medical lead that carry stimulation signal signals are at least partially embedded within a lead body of the medical lead over at least a portion of the length of the conductors while being surrounded by a radio frequency (RF) shield. A space between the shield and the conductors is filled by the presence of the lead body material such that body fluids that infiltrate the lead over time cannot pool in the space between the shield and the conductors. The dielectric properties of the lead body are retained and the capacitive coupling between the shield and the conductors continues to be inhibited such that current induced on the shield is inhibited from being channeled onto the conductors. Heating at the electrodes of the medical lead is prevented from becoming excessive.

Abstract: Peripheral nerve field stimulation (PNFS) may be controlled based on detected physiological effects of the PNFS, which may be an efferent response to the PNFS. In some examples, a closed-loop therapy system may include a sensing module that senses a physiological parameter of the patient, which may be indicative of the patient's response to the PNFS. Based on a signal generated by the sensing module, the PNFS may be activated, deactivated or modified. Example physiological parameters of the patient include heart rate, respiratory rate, electrodermal activity, muscle activity, blood flow rate, sweat gland activity, pilomotor reflex, or thermal activity of the patient's body. In some examples, a patient pain state may be detected based on a signal generated by the sensing module, and therapy may be controlled based on the detection of the pain state.

Abstract: Devices, systems, and methods for recording action potential (AP) from a nerve are provided. A device can include a cuff or a microchannel to be used to record an AP from a nerve. A recording electrode can be included within a channel of the cuff or microchannel, and the recording electrode can be offset or off-center such that it is not located mid-channel within the recording cuff or microchannel.

Abstract: A method including chronically implanting a nerve cuff electrode on a portion of a hypoglossal nerve, chronically implanting a respiration sensing lead subcutaneously in a thorax of a patient, the respiration sensing lead having a plurality of bio-impedance electrodes defining at least one bio-impedance vector. The method may also include sensing a bio-impedance signal corresponding to respiration via a bio-impedance vector on an anterior side of the thorax, analyzing the bio-impedance signal to identify onsets of expiration, predicting an onset of a future expiratory phase, and delivering a stimulus to the portion of the hypoglossal nerve via the nerve cuff electrode, wherein the stimulus is delivered as a function of the bio-impedance signal; wherein stimulus delivery is initiated before the onset of the future expiratory phase and continued during an entire inspiratory phase, and wherein the method is performed without identifying an onset of an inspiratory phase.

Abstract: Methods and devices are disclosed for inducing analgesia in a localized region of tissue. Inducing analgesia may be performed by identifying a nerve associated with the localized region, determining a resonant frequency for target neuronal cell membranes of the nerve, and generating a peripheral nerve blockade using the determined resonant frequency. The resonant frequency may be a frequency at which impedance of the nerve approaches a maximum.

Abstract: A nerve cuff for establishing a nerve block on a nerve can have a cuff body with a channel for receiving a nerve, a reservoir for holding a drug, and an elongate opening slit extending the length of the cuff body that can be opened to provide access to the channel and can be closed to enclose the cuff body around the nerve. The nerve cuff can also include an electrode for detecting and measuring electrical signals generated by the nerve. A controller can be used to control delivery of the drug based on the electrical signals generated by the nerve.

Abstract: A vestibular electrode is described that is for implantation into a vestibular semi-circular canal. An intra-labyrinthine electrode carrier with a C-shaped cross-section has an inner concave surface and an outer convex surface, and is configured to fit through an electrode opening in an outer surface of the bony labyrinth into the perilymph fluid without breaking the membranous labyrinth so as to fit the inner concave surface of the electrode carrier adjacent to the membranous labyrinth and the outer convex surface adjacent to the bony labyrinth. There are one or more electrode contacts on a surface of the electrode carrier that are configured for electrical interaction with adjacent neural tissue.

Abstract: An electrical stimulation lead includes at least one lead body having a distal end portion, a proximal end portion, and a longitudinal length. The lead further includes a paddle body extending from the distal end portion of the at least one lead body, electrodes disposed along the paddle body, terminals disposed along the proximal end portion of the at least one lead body, and conductors electrically coupling the terminals to the electrodes. The lead further includes an anchoring device threadably disposed in at least a portion of the paddle body. The anchoring device has a head element and a tissue-engagement element fixed to the head element such that actuation of the head element urges the tissue-engagement element away from or toward the paddle body.

Abstract: In one embodiment, a method for maintaining patency of an upper airway of a patient to treat obstructive sleep apnea may include delivering an electrical stimulation to a portion of a superior laryngeal nerve via a nerve cuff when the nerve cuff is adjacent an external surface of the superior laryngeal nerve, the nerve cuff having a plurality of electrodes, wherein the nerve cuff is configured to be connected to an electrical stimulator via a stimulation lead.