An example of a neurostimulation system may include a stimulation output circuit to deliver the neurostimulation, a sensing circuit to sense a signal indicative of a response to the neurostimulation, and a stimulation control circuit to control the delivery of the neurostimulation using stimulation parameters. The stimulation control circuit may include a response detector and a steering module. The response detector may be configured to detect signal feature(s) from the sensed signal and to determine a response parameter indicative of an intensity of the response to the neurostimulation using the detected signal feature(s). The steering module may be configured to receive user commands for moving a stimulation field and to adjust the stimulation parameters to move the stimulation field according to the user commands while maintaining a value of the response parameter between thresholds.

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 neural- and non-neural tissue of the nervous structure, inhibiting the perception of pain while preserving other sensory and motor function, and proprioception.

The present disclosure is directed to providing digital health services. In some embodiments, systems and methods for conducting virtual or remote sessions between patients and clinicians are disclosed. During the sessions, media content (e.g., images, video content, audio content, etc.) may be captured as the patient performs one or more tasks. The media content may be presented to the clinician and used to evaluate a condition of the patient or a state of the condition, adjust treatment parameters, provide therapy, or other operations to treat the patient. The analysis of the media content may be aided by one or more machine learning/artificial intelligence models that analyze various aspects of the media content, augment the media content, or other functionality to aid in the treatment of the patient.

Systems and methods for creating, maintaining, and remotely modifying stimulation settings for a neuromodulation therapy are discussed. An exemplary system includes an implantable stimulator to provide electrostimulation via a lead comprising a plurality of electrodes, and a programming device. The programming device identifies a search space of electrode configurations and parameter values for the lead, and determines, based on a clinical response indicator under a first patient state, at least one base stimulation setting including an optimal electrode configuration and an optimal stimulation parameter value from the identified search space. The system includes a remotely controlled therapy titration device that can modify the base stimulation setting under a second patient state based on an evaluation of a modified clinical response indicator. The modified base stimulation setting may be stored in the memory, or used by the implantable stimulator to deliver electrostimulation.

An example of a system for delivering neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a stimulation configuration. The stimulation control circuit may be configured to specify the stimulation configuration, and may include volume definition circuitry and stimulation configuration circuitry. The volume definition circuitry may be configured to determine one or more test volumes, determine a clinical effect resulting from the one or more test volumes each being activated by the neurostimulation, and determine a target volume using the determined clinical effect. The stimulation configuration circuitry may be configured to generate the specified stimulation configuration for activating the target volume.

Devices, systems and methods are described for providing muscle contraction stimulation therapy to treat myriad diseases, including heart failure, Type 2 diabetes, and peripheral vascular disease using a skin patch or implantable stimulator that includes a multiplicity of electrodes, a processor, a stimulation circuit, one or more sensors and programming for a patient interface unit, wherein the processor is programmed to control selection of a subset of the multiplicity of electrodes and of operation of the stimulation circuit responsive to an indication of an adverse physiologic response. The indication of patient discomfort may be determined by monitoring a physiologic parameter of the subject using the one or more sensors, by direct input from the subject via the patient interface unit programming, or a combination thereof. The devices, systems and methods also provide for automatically optimizing the stimulation parameters applied by the stimulation circuit responsive to feedback from the one or more sensors and/or by using direct input from the subject.

An apparatus includes an implant that includes circuitry and an elongate housing having a first half and a second half. A paresthesia-inducing electrode is disposed on the first half, and a blocking electrode is disposed on the second half. The circuitry has a first mode in which the circuitry simultaneously drives the paresthesia-inducing electrode to apply a paresthesia-inducing current having a frequency of 2-400 Hz, and the blocking electrode to apply a blocking current having a frequency of 1-20 kHz, and a second mode in which the circuitry drives the blocking electrode to apply the blocking current, but does not drive the paresthesia-inducing electrode to apply the paresthesia-inducing current. The implant is injectable into a subject along a longitudinal axis of the implant. Other embodiments are also described.

Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.

The invention provides an EPG system and lead configuration which boasts both a novel optical folding assembly and compact package size. The percutaneous leads provided offer additional advantages over the prior art including integral formation of optical and electrical components in a compact size.

Methods, system, and computer-implementable algorithms are disclosed for determining time-varying pulses for a patient having an implantable stimulator device (ISD). At least one time-invariant tonic stimulation pulse parameter (e.g., amplitude, pulse width, or frequency) is modified by a modulation function to produce time-varying pulses (TVPs), and one or more measurements are taken to determine the effectiveness of the TVP. The measurements may be objective and taken from the patient, and/or subjective and determined based on feedback from the patient. In one example, objective measurements may comprise one or more features determined from an electrospinogram (ESG) signal detected by the ISD, which may include evoked compound action potentials The one or more measurements are used to determine a score for the TVP, which is useful in selecting a best TVP for use with the patient, or for adjusting the modulation function applied to the tonic stimulation parameters.