A neurostimulation system comprises a sensor and a control system. The sensor is configured to detect a cardiac physiological measure of a patient. The control system is programmed to monitor, via the sensor, the cardiac physiological measure during the treatment. The control system is further programmed to detect a change in the cardiac physiological measure during the treatment. The control system is further programmed to determine, based on the detected change in the cardiac physiological measure, a first transition time in a duty cycle of a neurostimulation signal delivered to the patient where the neurostimulation signal transitions between a stimulation OFF period and a stimulation ON period.

An example of a system may include a processor; and a memory device comprising instructions, which when executed by the processor, cause the processor to access at least one of: patient input, clinician input, or automatic input; use the patient input, clinician input, or automatic input in a search method, the search method designed to evaluate a plurality of candidate neuromodulation parameter sets to identify an optimal neuromodulation parameter set; and program a neuromodulator using the optimal neuromodulation parameter set to stimulate a patient.

This document discusses, among other things, systems and methods for managing pain in a subject. A system may include one or more sensors configured to sense from the subject information corresponding to emotional reaction to pain, such as emotional expression. The emotional expression includes facial or vocal expression. A pain analyzer circuit may generate a pain score using signal metrics of facial or vocal expression extracted from the sensed information. The pain score may be output to a user or a process. The system may additionally include a neurostimulator that can adaptively control the delivery of pain therapy by automatically adjusting stimulation parameters based on the pain score.

A virtual or augmented reality system is disclosed which is capable of both (i) evaluating prospective implantable neurostimulator patient candidates, and (ii) determining optimal stimulation settings for already-implanted neurostimulation patients. Physiological sensors are included with the system to provide objective measurements relevant to a patient's symptoms, such as pain in a Spinal Cord Stimulation (SCS) system. Such objective measurements are determined during the presentation of various virtual or augmented environments, and can be useful to determining which patients are suitable candidates to consider for implantation. Stimulation settings for already-implanted patients may be adjusted while presenting a virtual or augmented environment to the patient, with objective measurements being determined for each stimulation setting. Such objective measurements can then be used to determine optimal stimulation settings for the patient.

A system and method for determining parameters of stimulation electrical signals for vagus nerve stimulation is discussed. Initial parameters of the signals are selected to provide reliable response to stimulation in physiological measurements of a subject. One or more physiological and neurological indices are determined based on a vagus nerve response model. For a selected vagus nerve activation, the electrical parameters of the signals are varied while monitoring changes in physiological parameters and values of the indices. The electrical parameters are varied until desired response in the physiological measurements and the values of the indices is observed. The electrical parameters are then stored as preferred parameters and can be used to activate the selected vagus nerve of the subject.

The present invention relates to a multi-target electrical stimulation circuit, an electrical stimulator, and a signal output method of the electrical stimulator. The electrical stimulation circuit includes a control module, a plurality of brain wave acquisition modules and a plurality of stimulation adjustment modules. Each electrode is correspondingly provided with one brain wave acquisition module and one stimulation adjustment module, and different electrodes are used for stimulating different targets. The brain wave acquisition modules are used for acquiring brain wave signals in the corresponding electrodes and transmitting the brain wave signals to the control module. The control module is used for acquiring brain rhythm phase signals according to the received brain wave signals and outputting stimulation signals at preset waveform phase points after phase locking of the brain rhythm phase signals. The stimulation adjustment modules are used for adjusting brain wave stimulation signals output to the corresponding electrodes according to the received stimulation signals. The multi-target electrical stimulation circuit, the electrical stimulator and the signal output method provided by the present invention are beneficial for achieving electrical stimulation of a plurality of targets as well as time-locked matching of electrical stimulation of a plurality of targets.

Methods and systems for providing peripheral nerve stimulation are disclosed. Stimulation is delivered to a trunk of the nerve using electrodes configured at different circumferential locations about the nerve. Action potentials evoked by the stimulation within branches of the nerve are measured to map neural element within the trunk to the branches. The mapping can inform the selection of stimulation parameters that provide a therapeutic benefit and/or avoid unwanted side effects.

In Spinal Cord Stimulation (SCS) systems having sensing capability, conventional wisdom seeks to minimize or avoid sensing of stimulation artifacts caused by the stimulation. Despite this, the present disclosure recognizes that stimulation artifacts in and of itself can include useful information relevant to operation of the SCS implant and/or the status of the patient. In particular, stimulation artifact features as sensed canbe used to determine a posture or activity of the patient, or more generally to adjust the stimulation program that the SCS implant is providing. Furthermore, sensing of stimulation artifact features can be as useful as, and possibly even more useful than, information gleaned from sensing neural responses to stimulation, such as Evoked Compound Action Potentials (ECAPs).

A method for assessing treatment of a subject who has overactive bladder (OAB) includes using an implant to stimulate a tibial nerve of the subject according to a stimulation protocol. An electronic processor is used to receive, from one or more sensors, data indicative of activity of the subject over a time period extending over at least one week. Based on the data, a characteristic of a response of the subject to the stimulation is assessed. Other embodiments are also described.

The present disclosure provides systems and methods for providing neurostimulation therapy using multi-dimensional patient features. The multi-dimensional patient features may include features in respective frequency bands for selected cortical sites from EEG localization data. Additionally or alternatively, the multi-dimensional patient features may include features from patient physiological data or other patient activity data. The multi-dimensional feature data may be compared against AI/ML models of patient and/or healthy population members. Closed-loop therapy adjustments may be applied to a respective patient’s neurostimulation therapy using the multi-dimensional patient feature analysis.