The subject matter of the present disclosure generally relates to techniques for following a treatment protocol having one or more treatment parameters to cause a targeted physiological outcome at a distal site, assessing an expression level of a gene in a region of interest after completing the treatment protocol, and modifying the one or more treatment parameters based on the expression level of the gene. The treatment protocol may include one or more ultrasound energy treatments to the region of interest.

A system and/or method are disclosed to inhibit sorption to a surface in a biological medium and/or biofouling by means of an alternating electric field. For example, one or more insulated electrodes may be positioned near the surface. For example, insulation may limit electric current flow between the biological medium and the electrode and/or between the surface and the electrode and/or between the electrodes. In some embodiments, the alternating charge in the vicinity of the surface may inhibit the buildup of biological films and/or sorption to the surface. For example, the system may be used to inhibit fouling of an implanted medical device (e.g. a catheter).

A neuromodulation system includes a medical device; a first computing device; a second computing device; and a third computing device. The system is configured to control communications by: permitting only unidirectional communication between the first computing device and the second computing device while: preventing communication between the first computing device and the third computing device, and preventing communication between the second computing device and the third computing device; permitting only unidirectional communication between the first computing device and the third computing device while: preventing communication between the first computing device and the second computing device, and preventing communication between the second computing device and the third computing device; or permitting only unidirectional communication between the second computing device and the third computing device while: preventing communication between the first computing device and the second computing device, and preventing communication between the first computing device and the third computing device.

Systems and techniques are disclosed to establish programming of an implantable electrical neurostimulation device for treating chronic pain of a human subject, through the use of a dynamic model adapted to determine pain treatment parameters for a human patient and identify a new device operational program to implement the pain treatment parameters to address the chronic pain condition. In an example, the system to establish programming of the neurostimulation device performs operations that: obtain state data indicating a measured value that is correlated to pain experienced by the human subject; determine neurostimulation programming parameters, using a dynamic model, for pain treatment in the human subject, as the dynamic model is used to identify values of the neurostimulation programming parameters that predict an improvement to the measured value; and indicate a neurostimulation program for the neurostimulation device, that includes the neurostimulation programming parameters for the implantable electrical neurostimulation device.

A neuromodulation system comprises a plurality of electrical terminals configured for being respectively coupled to a plurality of electrodes, a user interface configured for receiving input from a user that selects one of a plurality of different shapes of a modulating signal and/or selects one of a plurality of different electrical pulse parameters of an electrical pulse train, neuromodulation output circuitry configured for outputting an electrical pulse train to the plurality of electrical terminals, and pulse train modulation circuitry configured for modulating the electrical pulse train in accordance with the selected shape of the modulating signal and/or selected electrical pulse parameter of the electrical pulse train.

Systems, apparatus, and methods for treating medication refractory epilepsy are disclosed. In one embodiment, a method of treating epilepsy is disclosed comprising detecting, using a first electrode array coupled to a first endovascular carrier, an electrophysiological signal of a subject. The method further comprises analyzing the electrophysiological signal using a neuromodulation unit electrically coupled to the first electrode array and stimulating an intracorporeal target of the subject using a second electrode array coupled to a second endovascular carrier implanted within a part of a bodily vessel superior to a base of the skull of the subject.

Systems, apparatus, and methods for treating medication refractory epilepsy are disclosed. In one embodiment, a method of treating epilepsy is disclosed comprising detecting, using a first electrode array coupled to a first endovascular carrier, an electrophysiological signal of a subject. The method further comprises analyzing the electrophysiological signal using a neuromodulation unit electrically coupled to the first electrode array and stimulating an intracorporeal target of the subject using a second electrode array coupled to a second endovascular carrier implanted within a part of a bodily vessel superior to a base of the skull of the subject.

A neuromodulation system comprises a plurality of electrical terminals configured for being respectively coupled to a plurality of electrodes, a user interface configured for receiving input from a user that selects one of a plurality of different shapes of a modulating signal and/or selects one of a plurality of different electrical pulse parameters of an electrical pulse train, neuromodulation output circuitry configured for outputting an electrical pulse train to the plurality of electrical terminals, and pulse train modulation circuitry configured for modulating the electrical pulse train in accordance with the selected shape of the modulating signal and/or selected electrical pulse parameter of the electrical pulse train.

Systems and techniques are disclosed to establish programming of an implantable electrical neurostimulation device for treating pain of a human subject, through the use and adjustment of analgesic stimulation parameters based on trust dynamics and trust measurements. In an example, the system to establish programming of the neurostimulation device performs operations that: determine a trust measurement value that is derived from results of at least one commitment made with a human subject, via observable interactions; determine a modification of at least one neurostimulation programming parameter, based on the trust measurement value; and to cause the implantable neurostimulation device to implement the modification of the at least one neurostimulation programming parameter. Further examples are provided to produce and track the trust measurement value, as well as identify a pain susceptibility value and determine a receptiveness to analgesic effects based on these and other trust dynamics.

A medical device stores a set of stimulation profiles, wherein each stimulation profile of the set of stimulation profiles is associated with a set of values for stimulation parameters; selects from the set of stimulation profiles, one or more active stimulation profiles; produces, by a stimulation generator, multiple electrical pulses based on the one or more active stimulation profiles; and separately controls parameter values of respective individual pulses of the multiple pulses.