A neurostimulation system comprises at least one stimulation electrode configured to deliver an electrical stimulus to neural tissue and at least one measurement electrode configured to record a neural recording of a response of the neural tissue to the stimulus. A processor is configured to assess the neural recording to produce a measure of postsynaptic activation.

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.

Numerous aspects of communication devices, methods, and systems are described in this application. One aspect is a system comprising a body having a skin facing surface and an opposing surface and an energy generator operably coupled to the body and comprising a plurality of generator elements operable to output a plurality of different energy types in a signal direction toward skin. Each generator element of the plurality of generator elements may be independently operable to output one energy type of the plurality of different energy types in the signal direction. When the skin facing surface of the body is positioned relative to the skin, the energy generator may affect tissues associated with or adjacent to the skin by causing one or more generator elements of the plurality of generator elements to output an energy signal in the signal direction with one or more different energy types.

Stimulation and recording electrode assemblies that are particularly useful for Automatic Period Stimulation (APS). Such embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Certain embodiments include an electrode assembly having cuff including a body and two ears extending from the body. Within the body, at least one electrode is supported and connected to a lead wire assembly. The ears can be brought together to enlarge a gap in the body so that the electrode assembly can be fixated around a nerve. Other embodiments include an electrode assembly including first and second needle electrodes that each have a tip. A body is provided to interconnect the needle electrodes and can be manipulated to move the tips either toward or away from one another. Disclosed embodiments provide nerve monitoring and stimulation in cases where the nerve is only partially dissected.

The various embodiments herein disclose a method and a system with a portable handheld diagnostic device for detecting and/or monitoring the prognosis of nerve impairment or diabetic peripheral neuropathy. The system provides a multi-parameter diabetic neuropathy-screening device to perform a combination of tactile threshold test, vibration threshold test, thermal threshold test and contactless skin-temperature measurement. The present invention provides a smartphone application that helps a user to operate/control the device, store and share the results. The smartphone application interacts with the hardware modules in the device and guides the user to perform the various tests. Further, the neuropathy diagnostic system provides a wireless feedback button that enables the subject to respond to various sensations during the course of the test.

Systems and methods of generating and applying a synthetic neuromodulatory signal are described. A subject may be put under a particular condition that causes an effect in the subject. While the subject is under the condition, a recording of neurogram signals derived from the condition can be made from the subject. For example, neuronal signals traveling on the vagus nerve of the subject may be monitored and recorded. The neurogram may then be used to create a synthetic neuromodulatory signal that can be administered to a user. When the synthetic neuromodulatory signal is administered to the user, the user may experience the same effect as the subject that had been placed in the condition, even though the user was never put under the same condition.

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.

Stimulation and recording electrode assemblies that are particularly useful for Automatic Period Stimulation (APS). Such embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Certain embodiments include an electrode assembly having cuff including a body and two ears extending from the body. Within the body, at least one electrode is supported and connected to a lead wire assembly. The ears can be brought together to enlarge a gap in the body so that the electrode assembly can be fixated around a nerve. Other embodiments include an electrode assembly including first and second needle electrodes that each have a tip. A body is provided to interconnect the needle electrodes and can be manipulated to move the tips either toward or away from one another. Disclosed embodiments provide nerve monitoring and stimulation in cases where the nerve is only partially dissected.

System and methods for monitoring and/or controlling nerve activity in a subject are provided. In one embodiment, a system includes electrodes configured to be placed proximate to a subject's skin, and a signal detector configured to detect electrical signals using the electrodes. The system also includes a signal processor configured to receive the electrical signals from the signal detector, and apply a filter to the received electrical signals to generate filtered signals, the filter configured to attenuate at least signals having frequencies corresponding to heart muscle activity during a heartbeat. The signal processor is also configured to identify a skin nerve activity using the filtered signals, estimate a sympathetic nerve activity using the identified skin nerve activity, and further to generate a report indicative of the estimated sympathetic nerve activity. In some aspects, the system further includes a signal generator to deliver the electrical stimulation to the subject's skin.

The invention relates to in vitro method for quantitating the antibodies specific for High mobility group box I (HMGB1) contained in a sample, in particular a serum sample or a cerebrospinal fluid sample obtained from a patient, and the use of this method in the prognostic and/or diagnosis of neurological disorders. These methods are in particular applicable to the monitoring of the human immunodeficiency virus (HIV) infection of a subject who is known to be infected with HIV and in the prognostic and/or diagnostic of the state of progression of Acquired immune deficiency syndrome (AIDS) or the state of progression toward AIDS, in particular the state of progression or the state of progression toward neurological disorders associated with AIDS. Finally, the invention is also about method to determine the immune deficiency or level of immune activation of a patient, in particular a HIV-infected patient.