Example devices and methods of tongue stimulation for communication of information to a user are disclosed herein. In an example, a tongue stimulation device may include a body configured to be placed entirely within a mouth of the user and atop the tongue of the user. An array of electro-tactile elements may be distributed on the body, wherein each of the electro-tactile elements is configured to stimulate an area of the tongue adjacent the electro-tactile element. A wireless receiver coupled to the body may be configured to receive stimulation information wirelessly from outside the mouth of the user. At least one processing unit coupled to the body may be configured to transform the received stimulation information into a stimulation signal for each of the electro-tactile elements, and to provide the stimulation signals to the electro-tactile elements.

A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity.

Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.

An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine activity metrics from the activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower pacing rate set point based on the activity metric value at the predetermined percentile.

A system for providing stimulation to a patient includes one or more processors implemented in circuitry and one or more accelerometers configured to generate one or more accelerometer signals. The one or more processors are configured to determine accelerometer information for a medical device associated with the patient based on the one or more accelerometer signals and convert the accelerometer information into frequency domain coefficients. The one or more processors are further configured to determine an activity level for the patient based on the frequency domain coefficients and determine one or more stimulation parameters based on the activity level. The one or more processors are further configured to output electrical stimulation to the patient based on the one or more stimulation parameters.

Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the sensing amplifier is not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals. A common mode voltage is applied to the stimulation electrodes while sensing during a recharge period where the common mode voltage approximates the stimulation pulse being received at the sensing electrodes. This common mode voltage is determined based on measuring a common mode signal for at least one of the inputs of the amplifier or by deriving the proper common mode from monitoring the output signal of the amplifier to observe the elimination of artifacts during stimulation. Blanking switches may be used to blank the sensing of the peak of the recharge period should that peak be relatively large.

A system example may include electrodes operationally positioned for use in delivering sub-perception neural modulation, a neural modulator configured to use at least some electrodes to generate a modulation field, and a feedback system configured to receive a feedback signal that a generated modulation field provides a perceived or measurable response. A control system may implement a calibration process including controlling the neural modulator to generate the modulation field using a first and second stimulus pulse with a first and second pulse width, respectively, and using the feedback system to determine a first and second reference point that represents an intensity of the modulation field generated using the first and second pulse widths, respectively, that provides the response, and deriving sub-perception calibration data specific to sub-perception modulation delivered using a sub-perception pulse with a sub-perception pulse width.

An example of a system for delivering neurostimulation may include a display and an interface control circuit. The interface control circuit may be configured to define a stimulation waveform according to which the neurostimulation is delivered. The stimulation waveform is defined by waveform parameters including one or more user-adjustable parameters. The interface control circuit may include a parameter selector, an effect analyzer, and a parameter generator. The parameter selector may be configured to present values for each user-adjustable parameter on the display and allow the user to select a value for each user-adjustable parameter from the presented values. The effect analyzer may be configured to estimate an interactive effect of different stimuli of the neurostimulation. The parameter generator may be configured to select a rate rule based on the estimated interactive effect and to generate the values for each user-adjustable parameter according to the selected rate rule.

An example of a system comprises a patch of electrodes for placement on tissue containing neural tissue, and a tissue tester configured to measure an electrical characteristic of tissue. The tissue tester may include a test controller and switches. The test controller and the switches may be configured to connect different combinations of the electrodes to create subsets of two or more electrodes to measure the electrical characteristic of tissue using the subsets. The test controller may be configured to measure an electrical characteristic of tissue using the subsets within the set of electrodes placed on the tissue, and compare measurements of the electrical characteristic and identify a neural target for a therapy based on the comparison of the measurements of the electrical characteristic for tissue at the neural target relative to adjacent non-neural tissue.

A medical device system and associated method determine an implantable medical device state prior to implantation. An impedance monitoring module monitors for a change in impedance between a pair of electrodes coupled to the impedance monitoring circuit. The system includes an enclosure for carrying the implantable medical device. The enclosure has a surface having an electrical impedance. A control module is configured to detect one of a first pre-implant state and a second pre-implant state of the implantable medical device in response to the impedance monitoring module detecting a change in impedance between the electrodes and adjust operation of the implantable medical device in response to detecting the impedance change.