The present disclosure is directed to a system and method for selectively and reversibly modulating targeted neural and non-neural tissue of a nervous system for the treatment of pain. An electrical stimulation is delivered to the treatment site that selectively and reversibly modulates the targeted neutral- and non-neural tissue of the nervous structure, inhibiting the perception of pain while preserving other sensory and motor function, and proprioception.

An example method for delivering neurostimulation energy may include performing a training procedure by delivering the neurostimulation energy to a neural target of the patient when the patient is at one or more postures. Electrical activity is sensed from the spinal cord, such as an electrospinogram (ESG). A relationship is determined between the sensed electrical activity and neurostimulation intensity that reduces influence of noise in the sensed electrical activity caused by dynamically changing posture of the patient using mathematical or statistical modeling of the extracted features. Stimulation parameters are modulated according to the determined relationship.

An electrical stimulation therapeutic device includes a pair of application electrodes which are disposed at the back of a sacral bone of a person to be treated and supplies an electrical stimulation signal from the back of the sacral bone, a detection electrode which is disposed on a surface of a toe of the person to be treated and detects a myoelectric signal of the toe, a display portion which determines whether the myoelectric signal of the toe is generated in response to the stimulation signal, and a myoelectric signal processing portion which processes the myoelectric signal detected by the detection electrode to display it visually on the display portion, in which the myoelectric signal processing portion does not detect the myoelectric signal of the toe during a predetermined detection stop period of time from output of the stimulation signal, and the detection stop period of time is set on the basis of a quotient (x/v) obtained when a distance (x) from a sacral bone of a human body to a surface of a toe is divided by a transmission velocity (v) of a nerve which passes through the sacral bone of the human body or the vicinity of the sacral bone.

Systems and methods which provide for and enable sensing responsive signals with respect to the application of paresthesia-free stimulation are described. Sensing signal initiators may be utilized comprising one or more non-therapeutic and/or non-tonic pulses in the form of pinging-pulses configured for invoking responsive signals suitable for measurement and/or analysis in association with the application of neural stimuli. A sensing signal initiator technique may provide an interleaved implementation to introduce one or more pinging-pulses between burst groups of a burst stimulation regimen. Additionally or alternatively, a sensing signal initiator technique may provide a postfixed implementation to introduce one or more pinging-pulses by modifying a therapeutic stimulation burst so that the last phase of the passive discharge is replaced with pinging-pulse providing an active discharge.

A method of controlling a neural stimulus by use of feedback. The neural stimulus is applied to a neural pathway in order to give rise to an evoked action potential on the neural pathway. The stimulus is defined by at least one stimulus parameter. A neural compound action potential response evoked by the stimulus is measured. From the measured evoked response a feedback variable is derived. A feedback loop is completed by using the feedback variable to control the at least one stimulus parameter value. The feedback loop adaptively compensates for changes in a gain of the feedback loop caused by electrode movement relative to the neural pathway.

One or more systems, computer-implemented methods and/or computer program products to facilitate a process to produce a specified electrical output are provided. A system can comprise a memory that stores computer executable components and a processor that executes the computer executable components stored in the memory. The computer executable components can comprise an inverse modeling component that can generate an entity-based model and can determine updated one or more electrostatics parameters based on feedback relative to application of an electrical stimulation therapy employing an initial one or more electrostatics parameters on the entity. In one or more embodiments, a configuration component can determine the initial one or more electrostatics parameters based on an initial physical-based model based on an ideal entity, the configuration component can generate an initial physical-based model based on an ideal entity, and/or the inverse modeling component can update the initial model to generate the entity-based model.

The present invention improves control of currents in a multi-site direct current neurostimulation system. Precise control incorporates three constant current sources in a system consisting of spinal, polarizing and peripheral circuits. Constant current sources (sinks) are placed on the high side of the peripheral circuit and one sink in series on the low side of the spinal circuit in a four electrode configuration, for maintaining both predetermined currents, and current ratios, as the electrode/skin impedance and body impedance vary over the course of a treatment. Resistive steering is also implemented.

Provided is a medical apparatus for a patient comprising an external system and an implantable system. The external system can be configured to transmit one or more transmission signals, each transmission signal comprising at least power or data. The implantable system can be configured to receive the one or more transmission signals from the external system. The external system comprises a first external device comprising at least one external antenna configured to transmit a first transmission signal to the implantable system. The implantable system comprises a first implantable device comprising at least one implantable antenna configured to receive the first transmission signal from the first external device. At least one of the external antenna or implantable antenna comprises an antenna assembly comprising: at least one transmitting/receiving antenna; and at least one shielding element positioned between the at least one transmitting/receiving antenna and an interfering component.

A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

An example system includes stimulation generation circuitry configured to deliver electrical stimulation to a patient; sensing circuitry configured to sense one or more biomarker signals; and processing circuitry configured to: cause delivery of electrical stimulation with the patient in a first patient state; receive a first instance of a biomarker signal in presence of the electrical stimulation with the patient in the first patient state; cause delivery of electrical stimulation with the patient in a second patient state; receive a second instance of the biomarker signal in presence of the electrical stimulation with the patient in the second patient state; determine whether a difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies a threshold; select a therapy mode based on whether the difference satisfies the threshold; and cause delivery of electrical stimulation in accordance with the selected therapy mode.