Cutaneous and subcutaneous TNS embodiments are disclosed for addressing autonomic nervous system imbalances. A cutaneous electrode assembly is applied to a patient's forehead, and a current is pulsed through the electrode assembly to stimulate the supraorbital and supratrochlear nerves on the patient to increase activity for the patient's parasympathetic nervous system. Pulsing the current increases the power spectral density for the patient's heart rate variability in a 0.1 to 0.15 Hz frequency band.

In an illustrative embodiment, methods and systems for attenuating effect(s) associated with reduction or cessation of substance use by an individual include providing a neurostimulation delivery system including a neurostimulation device having a first portion including at first electrode configured to electrically stimulate branch(s) of the auriculotemporal nerve, and a second portion including a second electrode configured to electrically stimulate auricular branch(es) of the vagus nerve, and a pulse generator including circuitry configured to deliver therapeutic stimulation pulses to the first and second electrodes. Methods and systems include positioning the neurostimulation device for administration of the neurostimulation treatment, whereby the first electrode is disposed on, over or adjacent to branch(s) of the auriculotemporal nerve, and the second electrode is disposed on, over or adjacent to auricular branch(es) of the vagus nerve, and administering the neurostimulation treatment.

A method for treating neural disorders is provided. The method includes the following operation. A stimulation is delivered to a layer of a cortex of a patient with a neural disorder, wherein the stimulation is delivered to less than all layers of the cortex of the patient. In another method for treating neural disorders, a stimulation is delivered to a cortex of a patient with a neural disorder, wherein the stimulation delivered to one of a plurality of layers of the cortex is stronger than to other layers of the cortex. The system for treating neural disorder is also provided. The system includes a stimulation signal generator and a layer-specific stimulation means. The layer-specific stimulation means is coupled to the stimulation signal generator, configured to deliver a stimulation to a specific layer of a cortex of a patient with a neural disorder.

A system includes processing circuitry configured to determine, for each electrode combination of a plurality of electrode combinations, a metric based on a sensed electrical signal from the electrode combination. The processing circuitry is further configured to determine, for each electrode of a plurality of electrodes, a subset of electrode combinations of the plurality of electrode combinations, each electrode combination of the subset of electrode combinations comprising the electrode, wherein the subset of electrode combinations comprises at least two electrode combinations. The processing circuitry is further configured to determine, for each electrode of the plurality of electrodes, a composite metric based on the metrics of the subset of electrode combinations. The processing circuitry is further configured to determine, select, based on the composite metrics of the plurality of electrodes, at least one electrode for at least one of sensing electrical signals or delivering electrical stimulation.

A method of determining brain stimulation parameters includes applying Low Frequency Stimulation (LFS) to a contact of a multi-contact electrode implanted in a target structure in an individual's brain. Evoked Compound Activity (ECA) evoked in the target structure by the LFS is measured. A range of frequencies for delivering brain stimulation within a predetermined range based on a phase space extracted from the ECA is determined. Stimulation frequencies are applied to the contact of the multi-contact electrode within the determined range of frequencies. High Frequency Oscillations (HFO) evoked in the target structure by the applied stimulation frequencies within the determined range are measured. A frequency evoking HFO above a predetermined threshold is determined. The determined frequency is selected as a treatment frequency for the target structure.

Example apparatus and methods concern a next generation clinical decision support system (ngCDSS) for the management of neurological conditions (e.g., advanced Parkinson's disease (PD)). Conventional coupled adjustment of pharmacologic therapy and stimulation parameter settings is a time-consuming process that sometimes yields sub-optimal outcomes. Example ngCDSS use a machine learning trained function that relates deep brain stimulation (DBS) parameters, medication dosages, and patient-specific pre and post operative clinical data with actual treatment outcomes for a population of previously treated patients. Example ngCDSS incorporate image-based patient-specific computer models of the estimated stimulation volume of tissue stimulated by DBS in a multi-linear regression analysis to produce a predictor function that is highly correlated with actual outcomes. Example ngCDSS facilitate predicting the outcomes of a combined pharmacologic-DBS therapy, which in turn facilitate optimizing patient-specific treatment for improved benefits with minimal adverse effects.

The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a burst mode stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder. The burst stimulus comprises a plurality of groups of spike pulses having a maximum inter-spike interval of 100 milliseconds. The burst stimulus is separated by a substantially quiescent period of time between the plurality of groups of spike pulses. This inter-group interval may comprise a minimum of 5 seconds.

In certain variations, systems and/or methods for electromagnetic induction therapy are provided. One or more ergonomic or body contoured applicators may be included. The applicators include one or more conductive coils configured to generate an electromagnetic or magnetic field focused on a target nerve, muscle or other body tissues positioned in proximity to the coil. One or more sensors may be utilized to detect stimulation and to provide feedback about the efficacy of the applied electromagnetic induction therapy. A controller may be adjustable to vary a current through a coil to adjust the magnetic field focused upon the target nerve, muscle or other body tissues based on the feedback provide by a sensor or by a patient. In certain systems or methods, pulsed magnetic fields may be intermittently applied to a target nerve, muscle or tissue without causing habituation.

Disclosed is a device for modulating a nerve of a patient by applying electrical stimulation to the nerve of the patient. The device includes a stimulation module that applies a signal to the nerve of the patient, and a controller that controls a signal to be applied to the stimulation module, wherein the signal to be applied to the stimulation module includes pulse bursts and a direct current (DC) waveform.

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a system includes a user interface and processing circuitry. The processing circuitry is configured to output, for display by the user interface, a message requesting the patient perform a set of actions, receive, from the user interface, user input indicative of a patient response associated with the set of actions, and determine, based on the user input, one or more adjustments to a control policy which controls electrical stimulation delivered by a medical device based on a plurality of evoked compound action potentials (ECAPs) sensed by the medical device.