A tibial nerve stimulation therapy device configured to provide an electrical stimulation therapy to branches of the tibial nerve includes a plurality of stimulation electrodes, a support member, a stimulation circuit, and a sensing circuit. The support member is configured to support the plurality of electrodes on a top surface of an ankle area of the patient. The stimulation circuit is configured to generate electrical stimulation pulses. The sensing circuit is configured to generate an output signal indicative of an electromyogram (EMG) signal generated by the patient.

An example of a system may include electrodes on at least one lead configured to be operationally positioned for use in modulating neural tissue where the neural tissue including dorsal horn tissue or nerve root tissue, a neural modulation generator, and a controller. The neural modulation generator may be configured to use at least some electrodes to generate a modulation field. The neural modulation generator maybe configured to use a programmed modulation parameter set to promote uniformity of the modulation field in the dorsal horn tissue. The controller may be configured to control the neural modulation generator to generate the modulation field in pulse trains of at least two pulses.

A system for adjusting neuromodulation parameters used by a neuromodulator operably connected to a plurality of electrodes to modulate a neural target, may comprise a translation trigger detector configured to determine that a translation trigger has occurred, a first parameter setting storage configured to store first parameter settings for use by the neuromodulator to modulate the neural target, and a neuromodulation parameter translator. The neuromodulation parameter translator may be operably connected to the translation trigger detector to automatically translate the first parameter settings into a second parameter settings in response to determining the translation trigger has occurred, and replace the first parameter settings with the second parameter settings, or store the second parameter settings in a second parameter setting storage. Automatically translating may include either automatically translating from cathodic parameter settings to anodic parameter settings, or automatically translating from anodic parameter settings to cathodic parameter settings.

An implantable medical device is configured to receive an input that specifies a time domain allocation between two or more stored stimulation programs and to provide control signals corresponding to each of the two or more stimulation programs to stimulation circuitry to interleave the two or more stimulation programs in time according to the input. The time domain allocation may set a proportion of time during which each of the stimulation programs is active during repeating epochs. The time domain allocation may be set by a user to transition between configured stimulation programs or to specify stimulation that is based on two or more different stimulation programs. The time domain allocation may also be adjusted automatically to optimize an indication of an effectiveness of stimulation that is provided by the patient.

Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

An example of a system for delivering neurostimulation may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a pulse sequence. The pulse sequence may include a series of neurostimulation pulses and be defined by sequence parameters and one or more modulation functions each modulating an adjustable parameter selected from the sequence parameters. The user interface may be configured to set the pulse sequence to a tonic pulse sequence by determining an initial value for each adjustable parameter and set the pulse sequence to a modulated pulse sequence by selecting one or more adjustable parameters, determining a modulation function for each selected adjustable parameter, and applying the determined modulation function to that selected adjustable parameter to modulate the tonic pulse sequence.

There is provided a stimulation device for treatment of gait impairment of a patient. The stimulation device is configured to apply respective stimulation signals to electrodes bilaterally implanted in two subcortical regions of the left and right hemispheres of the brain of the patient, the subcortical regions being associated with motor control. The stimulation device is configured to apply respective stimulation signals having a rate of electrical energy delivered that is modulated with alternating waveforms at a gait frequency and out of phase with each other.

A deep brain stimulation (DBS) system provides for treating a human brain exhibiting a pathological condition. A controller generates a signal waveform defining a series of DBS pulses within an amplitude modulation envelope. The frequency of the amplitude modulation envelope may be less than or equal to half of a frequency of the DBS pulses. A driver circuit generates an amplified, amplitude-modulated electrical waveform corresponding to the signal waveform. A DBS electrode electrically coupled to the driver circuit converts the electrical waveform to a stimulation waveform to entrain neurons of the deep brain tissue in a normal oscillation pattern, thereby suppressing the pathological oscillation pattern to treat the pathological condition.

An implant unit delivery tool is provided. The implant delivery tool may include a body, a holder disposed at a distal end of the body and adapted to hold an implant unit, and an implant activator associated with the body, the implant activator configured to receive power from a power source. The implant activator may be configured to selectively and wirelessly transfer power from the power source to the implant unit during implantation of the implant unit into the body of a subject to cause modulation of at least one nerve in the body of the subject, and determine a degree of nerve modulation response resulting from the selective and wireless transfer of power from the power source to the implant unit claims.

A method of performing personalized neuromodulation on a subject is provided. The method includes acquiring functional magnetic resonance imaging (fMRI) data of a brain of the subject. The method also includes calculating functional connectivity of the brain between a voxel in a subcortical region of the brain and a voxel in a cortical region of the brain, based on the fMRI data. The method also includes identifying a target location in the brain to be targeted by neuromodulation based on the calculated functional connectivity.