A neuromodulation system and method of providing sub-threshold modulation therapy. Electrical modulation energy is delivered to a target tissue site of the patient at a programmed intensity value, thereby providing therapy to a patient without perception of stimulation. In response to an event, electrical modulation energy is delivered at incrementally increasing intensity values. At least one evoked compound action potential (eCAP) is sensed in a population of neurons at the target tissue site of the patient in response to the delivery of the electrical modulation energy at the incrementally increasing intensity values. One of the incrementally increased intensity values is selected based on the sensed eCAP(s). A decreased intensity value is automatically computed as a function of the selected intensity value. Electrical modulation energy is delivered to the target tissue site of the patient at the computed intensity value, thereby providing sub-threshold therapy to the patient.

A method of providing electrical stimulation to a patient, to treat a disorder from which the patient suffers, includes: detecting respiration of the patient with a sensor; and repeatedly administering electrical stimulations to a target site of the patient. Suitably, the repeated administration of said electrical stimulations is automatically synchronized with the respiration of the patient as detected by the sensor.

Disclosed are gastrointestinal dysfunction treatment protocols and kits for the testing, diagnosis, clinical intervention (diet, medications, temporary gastric electrical stimulation, and/or permanent gastric electrical stimulation), clinical feedback and/or associated treatment parameter adjustment for treating gastrointestinal dysfunctions in a patient. Embodiments of the present disclosure relate to how neuromodulation via gastric electrical stimulation, performed anywhere in the gastrointestinal (GI) tract, can help modulate inflammation and its resultant effects. Modulating inflammation via neuromodulation and gastric electrical stimulation enables treatment of a plurality of gastrointestinal dysfunctions.

Devices, systems, and techniques for monopolar recording of sensed electrical signals are disclosed. An example device includes sensing circuitry configured to sense electrical signals from a first plurality of electrode combinations, each of the first plurality of electrode combinations comprising a same reference electrode of the plurality of electrodes and at least one different sense electrode of the plurality of electrodes, the plurality of electrodes being associated with one or more leads. The example device includes processing circuitry configured to record the sensed electrical signals from the first plurality of electrode combinations. The processing circuitry is also configured to provide representations of the recorded sensed electrical signals.

Modulation of neural signaling of a pancreas-related sympathetic nerve is capable of improving glycaemic control by inhibiting T cell activation or migration to the pancreas, and hence providing a way of treating or preventing type 1 diabetes.

An example of a system for delivering neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a stimulation configuration. The stimulation control circuit may be configured to specify the stimulation configuration, and may include volume definition circuitry and stimulation configuration circuitry. The volume definition circuitry may be configured to determine one or more test volumes, determine a clinical effect resulting from the one or more test volumes each being activated by the neurostimulation, and determine a target volume using the determined clinical effect. The stimulation configuration circuitry may be configured to generate the specified stimulation configuration for activating the target volume.

Methods and systems are provided to improve SDB in a patient suffering therefrom by delivering an electrical neuromodulation signal to at least a target site comprising an efferent fiber of the glossopharyngeal nerve that innervates pharyngeal constrictor muscles or the stylopharyngeus muscle. Methods include further delivering electrical neuromodulation signals to other sites including one or more combinations of the ansa cervicalis, the hypoglossal nerve, the palatoglossus muscle, and/or the palatopharyngeus muscle. The electrical neuromodulation signal delivered to efferent fibers of the glossopharyngeal nerve can be done independent of a detected sensory or input signal that measures the neuromuscular state of the patient's airway.

Systems and methods are disclosed in which a time series analysis algorithm is used to analyze inputs such as adjustments a patient has made to the amplitude of stimulation in an implantable stimulator system. The algorithm uses these inputs to predict how the patient would likely adjust the amplitude in the future, i.e. to predict future amplitudes for the patient as a function of time. Preferably, the algorithm determines one or more of an amplitude level, at least one seasonal variation, or at least one trend when predicting the amplitude. This predicted amplitude can then be used to automatically adjust the amplitude of the stimulation provided by the patient's stimulator. The algorithm may only use previous amplitude adjustments to predict the amplitude, other time-varying inputs, or combinations of both.

A prosthetic device includes a closed loop system for maintaining a predetermined concentration of a target ion in a region in proximity to a cell, such as a nerve cell. The device includes a controller and an ion-selective electrode assembly operatively connected to the controller, wherein the ion-selective electrode configuration is configured to sense the concentration of the target ion by potentiometric measurement and to convey the concentration to the controller. The controller is configured to modulate the current to the ion-selective electrode assembly based on the concentration of the target ion to control the concentration of the target ion so as to maintain the predetermined concentration of the target ion.

A stimulation protocol determination system includes an input module and a selector module. The input module is provided to receive an indication of an upper airway flow limitation via sensed respiratory effort information. The selection module is provided to automatically select, based on the indicated upper airway flow limitation, a stimulation protocol.