Disclosed is a method of adapting the operation of an implantable device for delivering neurostimulation therapy to a patient. The method comprises: delivering the neurostimulation therapy to electrically excitable tissue of the patient according to at least one therapy parameter; measuring a physiological characteristic of the patient; adjusting the at least one therapy parameter according to a schedule of adjustment and the measured physiological characteristic; and repeating the delivering, measuring, and adjusting.

Sense amplifier circuits particularly useful in sensing neural responses in an Implantable Pulse Generator (IPG) are disclosed. The IPG includes a plurality of electrodes, with one selected as a sensing electrode and another selected as a reference to differentially sense the neural response in a manner that subtracts a common mode voltage (e.g., stimulation artifact) from the measurement. The circuits include a differential amplifier which receives the selected electrodes at its inputs, and comparator circuitries to assess each differential amplifier input to determine whether it is of a magnitude that is consistent with the differential amplifier's input requirements. Based on these determinations, an enable signal is generated which informs whether the output of the differential amplifier validly provides the neural response at any point in time. Further, clamping circuits are connected to the differential amplifier inputs to clamp these inputs in magnitude to prevent the differential amplifier from damage.

Devices, systems, and techniques are disclosed for determining spatial relationships between electrodes implanted within a patient. In one example, a medical device delivers, via a first electrode, an electrical stimulus and senses, for each other electrode, a respective electrical signal indicative of the electrical stimulus. The medical device determines, for each other electrode, a respective value for each respective electrical signal. The medical device determines, based on the respective values for each respective electrical signal and values of tissue conductivity of tissues of the patient interposed between the first electrode and the other electrodes, spatial relationships between the first electrode and each other electrode of the plurality of electrodes.

Devices and methods to effectuate closed loop electrical stimulation of nerve tissue, based on feedback data, to mitigate pain of a patient are disclosed. Feedback data corresponding to bioelectric signals of neurons stimulated by stimulation pulses may be received and analyzed. Based on receipt of the feedback data, it may be determined to modify one or more stimulation parameters, corresponding to the stimulation pulses, to enhance an efficacy of the stimulation pulses at blocking generation and/or propagation of one or more pain signals through a neuroanatomy of the patient. Subsequent and additional stimulation pulses may be provided based on a modified set of stimulation parameters and configured to enhance attenuation of generation and/or transmission of pain signals through the neuroanatomy of the patient to ultimately reduce a level of pain experienced by the patient.

A modified polyisobutylene-based polymer, method of making, and a medical device that includes such polymer, wherein the modified polyisobutylene-based polymer includes urethane, urea, or urethane-urea groups, hard segments, and soft segments, wherein the soft segments comprise phenoxy-containing polyisobutylene residues, and the hard segments include diisocyanate residues and optionally chain extender residues.

A system may be used with a medical imaging system and a programming system. The medical imaging system may be configured to display a medical image and the programming system may be configured to implement a program used in programming a neuromodulation device. The system may comprise a mobile device having at least one processor, a camera and a user interface including a display. The mobile device may be configured to acquire a displayed medical image from the medical imaging system, determine based on the acquired medical image location data indicative of the position of at least one of the electrodes relative to at least one of the anatomy or at least another one of the electrodes, and provide the location data for use by the program implemented by the programming system.

A charging energy control system includes an implantable medical device (IMD) and an external charger for effectuating wireless power transfer. The IMD receives charging energy to recharge a battery during an ON period and rejects the charging energy during an OFF period. A series switch is disposed between the IMD's coil and rectifier circuitry that is controlled by voltage regulation circuitry operative to generate a clamp control signal configured to detune the coil in the OFF state.

Techniques are disclosed for implementing the use of electrically evoked compound action potentials (ECAPs) to adaptively adjust parameters of high frequency electrical stimulation. In one example, a medical device delivers electrical stimulation therapy comprising a train of electrical stimulation pulses to a patient, wherein the train of electrical stimulation pulses comprises a pulse frequency greater than or equal to 500 Hertz. After delivering the train of electrical stimulation pulses, the medical device ceases delivery of the high frequency electrical stimulation therapy for a predetermined period of time. During the predetermined period of time, the medical device senses an ECAP from the patient and determines, based on the sensed ECAP, a value of a parameter at least partially defining the train of electrical stimulation pulses. Responsive to the predetermined period of time elapsing, the medical device resumes delivery of the high frequency electrical stimulation according to the determined parameter.

The present disclosure relates to a system for neuromodulation and/or neurostimulation, for the treatment of a subject. The system comprises a stimulation controller, a stimulation pattern storage means including stimulation data connected to the stimulation controller, an electrical stimulation device and electrical interface between the electrical stimulation device and the subject, the electrical interface being connectable with a bio-interface of the nervous system of the subject. The stimulation data are pre-programmed patterns comprising spatial and temporal components, The stimulation controller sends configuration signals on the basis of the stimulation data to the electrical stimulation device such that via the electrical interface electrical stimulation is provided to the bio-interface, wherein the electrical stimulation provided is characterized by stimulation parameters that vary over time in a pre-programmed manner.

Patients with spinal cord injuries have benefited from neurostimulation therapy comprising delivery of electrical stimulation to enable or excite neurological responses using an implantable neurostimulator having an electrode array. Dangerous levels of charge are avoided while providing multiple, simultaneous stimulation waveforms by inducing a short in an electrode when a monitored value reaches or exceeds a predetermined threshold.