An example method includes delivering, via an electrical stimulation device, one or more electrical stimulation signals to a patient, sensing one or more stimulation-evoked signals that are evoked by stimulation of nerves or muscles of the patient due to the delivery of the one or more electrical stimulation signals, determining a quality of the one or more stimulation-evoked signals, and outputting, based on the quality of the one or more sensed stimulation-evoked signals being below a quality threshold, one or more instructions to improve the quality of one or more subsequent stimulation-evoked signals.

A system can utilize interleaving periods or waveforms to stimulate patient tissue and sense signals using the stimulation electrodes. For example, the system can utilize alternating therapeutic periods and sensing periods. As another example, the system can alternate between biphasic waveforms having opposite temporal orders of positive and negative phases. As another example, waveforms that differ in a parameter, such as amplitude or pulse width, can be interleaved to provide different information in the respective sensed signals.

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.

Devices, systems, and techniques are described for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

A system for stimulating a tissues to obtain therapeutic effects, such as pain relief. The system can include stimulating leads that are operably coupled to a control unit. The control unit can include processors for generating desired waveform pattern of electrical pulses. The system can further include magnetic sensors to measure the magnetic fields generated by action potentials in the excited tissue and using the measured magnetic field to optimize the neurostimulation pattern.

This document discusses, among other things, systems and methods for managing pain of a subject. A system includes one or more physiological sensors configured to sense a physiological signal indicative of patient brain activity. The physiological signals may include an electroencephalography signal, a magnetoencephalography signal, or a brain-evoked potential. The system may extract from the brain activity signal one or more signal metrics indicative of strength or pattern of brain electromagnetic activity associated with pain, and generate a pain score using the one or more signal metrics. The pain score can be output to a patient or a process. The system may select an electrode configuration for pain-relief electrostimulation based on the pain score, and deliver a closed-loop pain therapy according to the selected electrode configuration.

One aspect of the present disclosure relates a method of diagnosis and/or treatment of a solid tumor. The method includes directly measuring neural activity within a solid tumor for a time and determining a state of the solid tumor based on the neural activity. The diagnosis and/or treatment can be determined based on the state of the solid tumor. In some instances, the neural activity can be used in a closed loop to detect the neural activity, determine the state, determine the risk, apply treatment, check again for neural activity, and cease treatment when the neural activity is gone.

Methods and systems for optimizing invasive and noninvasive brain stimulation are described herein. In a particular embodiment, methods and systems for a combinatorial, iterative approach to modify behavior are presented wherein deep brain stimulation (DBS) and other brain stimulation therapies are implemented in combination with monitoring the brain activity of an individual to optimize the effectiveness of the combinatorial approach to modify behavior. Methods described herein are iterative and systems described herein are utilized in iterative fashion. In a particular embodiment, modifying behavior provides a therapy for an individual in need thereof.

In a method of performing spinal reflex conditioning for an anatomical limb of a person, a spinal reflex is evoked by electrically stimulating a peripheral nerve of the anatomical limb, for example using stimulation electrodes disposed on an armband or leg band. The resulting spinal reflex is measured using electromyography (EMG) signals acquired from the anatomical limb. Vagus nerve stimulation (VNS) is performed in response to the measured spinal reflex satisfying a positive reinforcement criterion. The EMG may be high density EMG (HD-EMG) measured using a sleeve with a high density array of electrodes (e.g., at least 100 electrodes in an arm sleeve).