An example method for delivering neurostimulation energy may include performing a training procedure by delivering the neurostimulation energy to a neural target of the patient when the patient is at one or more postures. Electrical activity is sensed from the spinal cord, such as an electrospinogram (ESG). A relationship is determined between the sensed electrical activity and neurostimulation intensity that reduces influence of noise in the sensed electrical activity caused by dynamically changing posture of the patient using mathematical or statistical modeling of the extracted features. Stimulation parameters are modulated according to the determined relationship.

An electrical stimulation therapeutic device includes a pair of application electrodes which are disposed at the back of a sacral bone of a person to be treated and supplies an electrical stimulation signal from the back of the sacral bone, a detection electrode which is disposed on a surface of a toe of the person to be treated and detects a myoelectric signal of the toe, a display portion which determines whether the myoelectric signal of the toe is generated in response to the stimulation signal, and a myoelectric signal processing portion which processes the myoelectric signal detected by the detection electrode to display it visually on the display portion, in which the myoelectric signal processing portion does not detect the myoelectric signal of the toe during a predetermined detection stop period of time from output of the stimulation signal, and the detection stop period of time is set on the basis of a quotient (x/v) obtained when a distance (x) from a sacral bone of a human body to a surface of a toe is divided by a transmission velocity (v) of a nerve which passes through the sacral bone of the human body or the vicinity of the sacral bone.

A method for automating selection of stimulation parameters for a stimulation device implanted in a patient includes setting, by a user, at least one limit on each of at least one stimulation parameter and performing, automatically using at least one processor, the following actions for each of a plurality of sets of the stimulation parameters constrained by the at least one limit: stimulating the patient, by the stimulation device, using the set of stimulation parameters, sensing one or more effects arising in response to the stimulation, and updating, by the at least one processor, a collection of the effects and sets of stimulation parameters with the one or more effects and the set of stimulation parameters. The method further includes selecting, by the processor, one of the sets of stimulation parameters based on the effects.

Methods and systems for treating epilepsy by stimulating a cranial nerve and administering to the patient a responsiveness test and comparing a result of the responsiveness test to a baseline responsiveness test and initiating a second therapy or issuing a warning based on the comparison of the result of the responsiveness test to the baseline responsiveness test.

Systems and methods which provide for and enable sensing responsive signals with respect to the application of paresthesia-free stimulation are described. Sensing signal initiators may be utilized comprising one or more non-therapeutic and/or non-tonic pulses in the form of pinging-pulses configured for invoking responsive signals suitable for measurement and/or analysis in association with the application of neural stimuli. A sensing signal initiator technique may provide an interleaved implementation to introduce one or more pinging-pulses between burst groups of a burst stimulation regimen. Additionally or alternatively, a sensing signal initiator technique may provide a postfixed implementation to introduce one or more pinging-pulses by modifying a therapeutic stimulation burst so that the last phase of the passive discharge is replaced with pinging-pulse providing an active discharge.

An apparatus, system and technique selectively eliminates the noxious signal components in a neuronal signal by creating an interfering electrical signal that is tuned to a given frequency corresponding to the oscillatory pattern of the noxious signal, resulting in a modified neuronal signal that substantially reproduces a normal, no-pain neuronal signal. The disclosed system and technique of pain relief is based on the hypothesis that the temporal profile of pain signals encodes particular components that oscillate at unique and quantifiable frequencies, which are responsible for pain processing in the brain.

A method of controlling a neural stimulus by use of feedback. The neural stimulus is applied to a neural pathway in order to give rise to an evoked action potential on the neural pathway. The stimulus is defined by at least one stimulus parameter. A neural compound action potential response evoked by the stimulus is measured. From the measured evoked response a feedback variable is derived. A feedback loop is completed by using the feedback variable to control the at least one stimulus parameter value. The feedback loop adaptively compensates for changes in a gain of the feedback loop caused by electrode movement relative to the neural pathway.

A neurostimulation system senses electrographic signals from the brain of a patient, extracts features from the electrographic signals, and when the extracted features satisfy certain criteria, detects a neurological event type. A mapping function relates the detected neurological event type to a stimulation parameter subspace and a default stimulation parameter set where the values of the stimulation parameters define an instance of stimulation therapy for the patient. The decision whether to implement a stimulation parameter subspace or a default stimulation parameter set may be informed by integrating other information about a state of the patient. A stimulation parameter subspace or stimulation parameter set may optimized by testing it against various thresholds until certain effectiveness criteria is satisfied. The neurological event type may be one of several electrographic seizure onset types.

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.

An implantable medical device comprises a control circuit and a memory. The memory is operably coupled to the control circuit. The memory comprises instructions that, when executed by the control circuit, cause the control circuit to monitor an output of at least one comparator, the output of the at least one comparator being responsive to a cardiac signal of a patient. The instructions further cause the control circuit to automatically adjust a gain level applied to the cardiac signal over time based on the monitored output of the at least one comparator.