A neuromodulation device for measuring an evoked response comprising a first electrode; a second electrode, wherein the first and second electrodes are alternately configured as a stimulation electrode; a sensing electrode for sensing an evoked response to a stimulus pulse; and a controller configured to measure an evoked response at the sensing electrode after a stimulus pulse at a first stimulation electrode configuration and after a stimulus pulse at a second alternate stimulation electrode configuration, and to add said pair of measurements.

Disclosed is a neurostimulation system comprising an implantable device for controllably delivering a neural stimulus, and a processor. Signals evoked by a stimulus are sensed at each pair of sense electrodes, each sensed signal including a differential evoked compound action potential (ECAP) evoked by the delivered neural stimulus. The differential ECAP is decomposed in each sensed signal into a first single-ended ECAP corresponding to one sense electrode of the pair of sense electrodes and a second single-ended ECAP corresponding to the other sense electrode of the pair of sense electrodes. ECAP propagation model parameters are determined from the first single-ended ECAP model and the second single-ended ECAP model and from distances of the respective sense electrodes from the stimulus electrode configuration. An indication may be given to a user if one of the one or more ECAP propagation model parameters departs from a predetermined range. Or, originating ECAP model parameters may be determined from the first single-ended ECAP model and from the distance of the corresponding sense electrode from the stimulus electrode configuration. Parameters of a model of a differential ECAP at a second pair of sense electrodes may be computed; and an optimal combination of parameters for a parametric ECAP detector at the second pair of sense electrodes may be computed from the parameters of the model of the differential ECAP.

Disclosed is a neurostimulation system comprising an implantable device for controllably delivering a neural stimulus, and a processor. Signals evoked by a stimulus are sensed at each pair of sense electrodes, each sensed signal including a differential evoked compound action potential (ECAP) evoked by the delivered neural stimulus. The differential ECAP is decomposed in each sensed signal into a first single-ended ECAP corresponding to one sense electrode of the pair of sense electrodes and a second single-ended ECAP corresponding to the other sense electrode of the pair of sense electrodes. ECAP propagation model parameters are determined from the first single-ended ECAP model and the second single-ended ECAP model and from distances of the respective sense electrodes from the stimulus electrode configuration. An indication may be given to a user if one of the one or more ECAP propagation model parameters departs from a predetermined range. Or, originating ECAP model parameters may be determined from the first single-ended ECAP model and from the distance of the corresponding sense electrode from the stimulus electrode configuration. Parameters of a model of a differential ECAP at a second pair of sense electrodes may be computed; and an optimal combination of parameters for a parametric ECAP detector at the second pair of sense electrodes may be computed from the parameters of the model of the differential ECAP.

An electrode assembly (preferably in the form of a nerve cuff) comprises a base with first and second arms extending from opposite sides of the base, and which, in combination, define an arc. First and second electrically conductive electrodes extend along the inner surface of the first and second arms. Each electrode can comprise a single length of foil can or can comprise multiple discrete foil segments. The foils are electrically isolated from each other. Electrical wires, which are in electrical communication with the each of the foils, extend from the nerve cuff and are adapted to be electrically connected to a signal monitor. When the nerve cuff is applied to a nerve, the foils, in combination, substantially surround the nerve, with the first and second electrodes being on opposite sides of the nerve from each other. Also disclosed is a method of using the nerve cuff to monitor a nerve during a lumbar spinal surgery while the patient is anesthetized and paralyzed.

An electrode assembly (preferably in the form of a nerve cuff) comprises a base with first and second arms extending from opposite sides of the base, and which, in combination, define an arc. First and second electrically conductive electrodes extend along the inner surface of the first and second arms. Each electrode can comprise a single length of foil can or can comprise multiple discrete foil segments. The foils are electrically isolated from each other. Electrical wires, which are in electrical communication with the each of the foils, extend from the nerve cuff and are adapted to be electrically connected to a signal monitor. When the nerve cuff is applied to a nerve, the foils, in combination, substantially surround the nerve, with the first and second electrodes being on opposite sides of the nerve from each other. Also disclosed is a method of using the nerve cuff to monitor a nerve during a lumbar spinal surgery while the patient is anesthetized and paralyzed.

The present disclosure provides a peripheral nerve signal acquisition method and system. The method includes: wearing a wearable device on a human wrist, disposing a perturbation unit in the wearable device, and applying mechanical perturbations perpendicular to a neural pathway to a skin surface during electrical stimulation cycles; under the action of the mechanical perturbations, acquiring a first signal, a second signal, and a third signal; performing multi-channel time-delay encoding on the first signal and the second signal to generate an interference signal set with temporal phase differences; constructing an artifact template signal associated with the electrical stimulation based on the third signal; performing artifact cancellation processing on the first signal and the second signal; and performing spatial analytical analysis in combination with a peripheral nerve pathway map, identifying an initiation site and a conduction pathway of peripheral nerve discharges, and outputting authentic discharge signals of the peripheral nerves.

The present disclosure provides a peripheral nerve signal acquisition method and system. The method includes: wearing a wearable device on a human wrist, disposing a perturbation unit in the wearable device, and applying mechanical perturbations perpendicular to a neural pathway to a skin surface during electrical stimulation cycles; under the action of the mechanical perturbations, acquiring a first signal, a second signal, and a third signal; performing multi-channel time-delay encoding on the first signal and the second signal to generate an interference signal set with temporal phase differences; constructing an artifact template signal associated with the electrical stimulation based on the third signal; performing artifact cancellation processing on the first signal and the second signal; and performing spatial analytical analysis in combination with a peripheral nerve pathway map, identifying an initiation site and a conduction pathway of peripheral nerve discharges, and outputting authentic discharge signals of the peripheral nerves.

Example devices and techniques for improving signal quality of a sensed evoked response signal include processing circuitry communicatively coupled to stimulation generation circuitry and sensing circuitry. The processing circuitry is configured to control the stimulation generation circuitry to generate a stimulation signal and receive from the sensing circuitry the sensed evoked response signal. The processing circuitry is configured to determine that a characteristic value of at least one of the artifact or the sensed evoked response signal meets a threshold and automatically change, based on the determination that the characteristic value of the at least one of an artifact in the sensed evoked response signal or the sensed evoked response signal meets the threshold, at least one sensing parameter.

A system for recording, processing, and monitoring biosignals is provided, the system being configured to suspend data acquisition whenever an electric surgical tool or other generator of high frequency interference is in use. Such a system may protect the hardware of the system and reduce or eliminate the acquisition of distorted signals. The system of some embodiments includes an amplifier system configured to detect the presence of high frequency interference. Related methods are also disclosed.

A system for recording, processing, and monitoring biosignals is provided, the system being configured to suspend data acquisition whenever an electric surgical tool or other generator of high frequency interference is in use. Such a system may protect the hardware of the system and reduce or eliminate the acquisition of distorted signals. The system of some embodiments includes an amplifier system configured to detect the presence of high frequency interference. Related methods are also disclosed.