A lead assembly includes a central lead member having a distal portion configured to extend along a longitudinal axis. The lead assembly also includes two or more side lead members disposed around the central lead member. Each side lead member includes a deploying portion extending at an angle away from the longitudinal axis. Each deploying portion has a proximal portion and a distal portion. The distal portion is laterally spaced from the central lead member and extends more parallel to the longitudinal axis than the proximal portion. The lead assembly also includes one or more electrodes attached to the distal portion of the deploying portion of each side lead member. The lead assembly optionally includes a cannula comprising a lumen, an end portion, and a buckler disposed in the lumen on the end portion for deploying the lead members.

An Implantable Pulse Generator (IPG) is disclosed that is capable of sensing a degree to which recruited neurons in a patient's tissue are firing synchronously, and of modifying a stimulation program to promote desynchronicity and to reduce paresthesia. An evoked compound action potential (ECAP) of the recruited neurons is sensed as a measure of synchronicity by at least one non-active electrode. An ECAP algorithm operable in the IPG assesses the shape of the ECAP and determines one or more ECAP shape parameters that indicate whether the recruited neurons are firing synchronously or desynchronously. If the shape parameters indicate significant synchronicity, the ECAP algorithm can adjust the stimulation program to promote desynchronous firing.

A controller for implementing a method, device and/or system for generating arbitrary waveforms of a desired shape that can be used for generating a stimulation pulse for medical purposes such as for spinal cord stimulation therapy, where such arbitrary waveforms can also be used for charge balancing purposes.

An external data retrieval apparatus includes a transceiver, and a processing system coupled to the transceiver. The processing system obtains a plurality of measures over a period of time. The measures relate to a quality of a communications channel between the data retrieval apparatus and an active implantable medical device. The processing system determines a trend in the plurality of measures over the period of time, and then determines a preferred time during which to retrieve data based on the trend.

Techniques for determining the location of a physiological midline are disclosed. A first technique evaluates the response to stimulation of spinal electrodes at peripheral electrodes on different sides of the body. In this technique, a spinal electrode's position relative to a physiological midline is determined based on a relationship between responses to its stimulation observed on different sides of the body. A second technique evaluates the response of spinal electrodes to stimulation of peripheral electrodes on different sides of the body. In this technique, a spinal electrode's position relative to a physiological midline is determined based on the different responses that it observes to stimulation on different sides of the body.

Disclosed are methods and systems for optimized deep or superficial deep-brain stimulation using multiple therapeutic modalities impacting one or multiple points in a neural circuit to produce Long-Term Potentiation (LTP) or Long-Term Depression (LTD). Also disclosed are methods for treatment of clinical conditions and obtaining physiological impacts. Also disclosed are: methods and systems for Guided Feedback control of non-invasive deep brain or superficial neuromodulation; patterned neuromodulation, ancillary stimulation, treatment planning, focused shaped or steered ultrasound; methods and systems using intersecting ultrasound beams; non-invasive ultrasound-neuromodulation techniques to control the permeability of the blood-brain barrier; non-invasive neuromodulation of the spinal cord by ultrasound energy; methods and systems for non-invasive neuromodulation using ultrasound for evaluating the feasibility of neuromodulation treatment using non-ultrasound/ultrasound modalities; neuromodulation of the whole head, treatment of multiple conditions, and method and systems for neuromodulation using ultrasound delivered in sessions.

Methods and devices for tying management of an implantable medical device to the activities of a primary care physician are described, including access control, simplified parameter optimization, support for tuning a device in response to the effects of other treatments in parallel, and support for helping a primary physician and a patient work together to tune device configuration to the activity and performance needs of the patient. In some embodiments, a medical device is self-configuring in a device parameter domain, based on inputs provided in a patient performance domain. The self-configuring of the medical device is based, for example, on an automatically applied transformation of inputs derived from patient performance domain observations into changes in the configuration of the medical device which affect technical parameters of its operation.

Methods of providing therapy to a patient are provided. In one method, the patient has a neuron to which a sub-threshold biological electrical stimulus is applied. The method comprises applying electrical noise energy to the neuron, wherein resonance between the biological electrical stimulus and the electrical noise energy is created, such that an action potential is propagated along the axon of the neuron. In another method, the patient has a neuron to which a supra-threshold biological electrical stimulus is applied. This method comprises applying supra-threshold electrical noise energy to the neuron, thereby preventing an action potential from being propagated along the axon of the neuron. Still another method comprises applying an electrical stimulus to a neuron, and applying supra-threshold electrical noise energy to the neuron, thereby preventing or reversing any neurological accommodation of the neuron that may occur in response to the electrical stimulus.

An example of a neurostimulation system may include a storage device to store a stimulation waveform, a programming control circuit to generate a plurality of stimulation parameters controlling delivery of neurostimulation pulses according to the stimulation waveform, and waveform definition circuit configured to create and adjust the stimulation waveform. The waveform definition circuit includes a charge recovery module that may include a stimulation to receive the stimulation waveform including charge injection phases, a charge recovery scheme input to receive a charge recovery scheme, and a waveform adjuster configured to identify a need for recovering charges injected during the charge injection phases and adjust the received stimulation waveform by automatically inserting charge recovery phases into the received stimulation waveform based on the identified need for recovering the injected charges and the received charge recovery scheme.

Systems, devices, and methods are provided to assess connection quality between the electrodes of a bioelectrical signal measurement and/or electrical stimulation device and the tissue, typically skin, of the subject. A test signal is provided to a first electrode, voltage differences between the first electrode and additional electrodes are determined, an impedance of the first electrode is determined based on the voltages differences, and the determined impedance indicates connection quality. This process is typically repeated for all of the electrodes to determine connection quality. The user or subject can be alerted if the connection quality is poor, and the bioelectrical signal that is recorded can be provided with data points indicating connection quality during the signal recording.