An implantable neurostimulator (INS) and method of use, the INS including an electrical lead having formed thereon at least a pair of bi-polar electrodes, wherein the electrical lead is configured for placement of the pair of bi-polar electrodes proximate protrusor muscles of a patient, a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bi-polar electrodes, the pulse generator having mounted therein a sensor and a control circuit, and the sensor is configured to generate signals representative of an orientation of the pulse generator and communicate the signals to the control circuit and the control circuit is configured to determine the orientation of the pulse generator and deliver electrical energy to the bi-polar electrodes when the determined orientation correlates to a pre-determined orientation.

Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to determine an implant location for a lead. An example method includes receiving first information representative of a first evoked compound action potential (ECAP) signal sensed in response to a first control stimulus delivered to a first location adjacent to a spinal cord of a patient. The method also includes receiving, second information representative of a second ECAP signal in response to a second control stimulus delivered to a second location adjacent to the spinal cord of the patient. Additionally, the method includes outputting a first indication of the first information representative of the first ECAP signal and a second indication of the second information representative of the second ECAP signal.

Described here is a deep brain stimulation (“DBS”) approach that targets several relevant nodes within brain circuitry, while monitoring multiple symptoms for efficacy. This approach to multi-symptom monitoring and stimulation therapy may be used as an extra stimulation setting in extant DBS devices, particularly those equipped for both stimulation and sensing. The therapeutic efficacy of DBS devices is extended by optimizing them for multiple symptoms (such as sleep disturbance in addition to movement disorders), thus increasing quality of life for patients.

A neuromodulator may output stimuli that causes a user to fall asleep faster than the user would in the absence of the stimuli. Alternatively, the stimuli may modify a sleep state or behavior associated with a sleep state, or may cause or hinder a transition from a waking state to a sleep state or from a sleep state to another sleep state. The neuromodulator may take electroencephalography measurements. Based on these measurements, the neuromodulator may detect, in real time, instantaneous amplitude and instantaneous phase of an endogenous brain signal. The neuromodulator may output stimulation that is, or that causes sensations which are, phase-locked with the endogenous brain signal. In the course of calculating instantaneous phase and amplitude, the neuromodulator may perform an endpoint-corrected Hilbert transform. The stimuli may comprise auditory, visual, electrical, magnetic, vibrotactile or haptic stimuli.

An implantable neurostimulator system including an electrical lead having formed thereon a pair of bipolar electrodes, the electrical lead is configured for placement of the pair of bipolar electrodes proximate protrusor muscles of a patient. The system also includes a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bipolar electrodes, the pulse generator having mounted therein a sensor configured to detect one or more physiological parameters, a memory, a control circuit, and a telemetry circuit. The system also including a communications telemetry module (CTM) in communication with the telemetry circuit and configured to receive a data collected by the sensor and data related to delivery of electrical energy to the bipolar electrodes, and an external programmer in communication with the CTM and configured to display a user interface the data collected by the sensor and data related to delivery of electrical energy to the bipolar electrodes.

An implantable medical device (IMD) includes therapy delivery circuitry, sensing circuitry, and processing circuitry. The processing circuitry is configured to determine one or more sleep apnea therapy parameters, control the therapy delivery circuitry to deliver sleep apnea therapy via a first set of electrodes implantable within the patient in accordance with the one or more sleep apnea therapy parameters, and at least one of: (1) monitor a cardiac signal sensed with the sensing circuitry, or (2) determine one or more cardiac therapy parameters, and control the therapy delivery circuitry to deliver cardiac therapy via a second set of electrodes implantable within the patient in accordance with the one or more cardiac therapy parameters.

Various embodiments of the present technology generally relate to closed loop deep brain stimulation based on inferred sleep stage from physiological data using machine learning classifiers. Some embodiments, for example, may use subthalamic nucleus (STN) deep brain stimulation (DBS) to treat advanced Parkinsons Disease motor symptoms and improve sleep by identifying sleep stages commensurate with clinician-scored polysomnography (PSG). The DBS may be adapted to include novel artificial neural network (ANN) that triggers targeted stimulation in response to inferred sleep state from STN local field potentials (LFPs) recorded from implanted DBS electrodes. A feedforward neural network can be trained to prospectively identify sleep stage with PSG-level accuracy. In some embodiments, the machine learning model stored within the DB S may also adapt stimulation during specific sleep stages to treat targeted sleep deficits.

Restless Leg Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) can be treated using high frequency (HF) electrostimulation. This can include selecting or receiving a subject presenting with RLS or PLMD. At least one electrostimulation electrode can be located at a location associated with at least one of, or at least one branch of, a sural nerve, a peroneal nerve, or a femoral nerve. HF electrostimulation can be delivered to the subject, which can include delivering subsensory, subthreshold, AC electrostimulation at a frequency that exceeds 500 Hz and is less than 15,000 Hz to the location to help reduce or alleviate the one or more symptoms associated with RLS or PLMD. A charge-balanced controlled-current HF electrostimulation waveform can be used.

A method to provide non-invasive neurostimulation to enhance a subject's attention span, concentration, multitasking ability, or alertness includes (a) engaging a subject in a brain exercise requiring use of the subject's attention span, concentration, multitasking ability, or alertness; (b) providing intraoral cutaneous stimulation of at least one of the subject's trigeminal nerve, facial nerve or lingual nerve by delivering electrical pulses to one or more stimulators situated within the subject's oral cavity, the delivery of electrical pulses occurring contemporaneously with the subject's engagement in the brain exercise; and (c) repeating steps (a) and (b) on a periodic basis.

Techniques for placing implantable electrodes to treat sleep apnea, and associated devices, systems, and methods are disclosed herein. A representative method includes percutaneously implanting one or more signal delivery devices, each at or near a respective target signal delivery location in a patient. Each signal delivery device can include one or more electrodes, and individual ones of the electrodes can be positioned to produce a net positive protrusive motor response of the patient’s tongue. The representative method further includes providing power to one or more of the electrodes from a wearable power source to cause the electrode(s) to deliver an electrical signal to the respective target signal delivery location(s) to produce the net positive protrusive motor response.