Methods for electrical modulation of inflammation or serum TNF levels in a subject.

The present invention relates to methods for improvement in lower urinary tract function in an individual with neurogenic urological dysfunction through epidural stimulation of the spinal cord. In certain embodiments, the methods comprise applying a pattern of epidural electrical stimulation to the spinal cord of an individual with impaired lower urinary tract under stimulation parameters sufficient to improve the storage of fluid in the bladder, sensations of fullness and/or emptying, detrusor over-activity, high detrusor pressure, voiding the bladder, transitioning from a storage state to a voiding state, and decreasing detrusor-external urethral sphincter dyssynergia. In certain embodiments, additional patterns of epidural electrical stimulation may be applied simultaneously, such as to maintain a normotensive cardiovascular state of the individual.

Systems and methods for using sensory threshold and/or adaptation for neurological therapy screening and/or parameter selection. A representative method for establishing a treatment regimen for a patient includes: in response to a first indication of a characteristic of the patient's sensory response to an electrical stimulus, providing a second indication indicating suitability of an electrical signal for delivery to the patient to address a patient condition, wherein the electrical signal has a frequency in a frequency range from 1.2 kHz to 100 kHz.

A pulse generator stores a neural dose prescription for releasing electrical signals to stimulate neural tissue. The pulse generator generates the electrical signals for delivery through a lead to the neural tissue, the electrical signals being programmed to mitigate symptoms by stimulating the neural tissue. The pulse generator records delivery of the electrical signals, and calculates a total amount of energy delivered to the neural tissue.

Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be reconfigured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.

A closed loop control system automatically ensures that an output of a device is constant. The system can receive an input to set a fixed value for a variable (e.g., a current, a heart rate, a tissue perfusion, an ion level, etc.), and this variable can be delivered to a feedback component. The system can also include the device to deliver the variable to a load. The feedback component can be coupled to the delivery device to sample the output of the delivery device at different times. Based on the sampling, the feedback component can vary a property of the delivery device related to the delivery of the variable to the load to ensure that the variable remains constant at the fixed value. In some instances, the system can be implemented as a stimulator that delivers the constant current of a current source and has a low output impedance of a voltage source.

A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Systems and techniques are disclosed to adjust programming of an implantable electrical neurostimulation device for treating chronic pain of a human subject, through the use of a dynamic model adapted to identify pain treatment parameters for a human patient and determine a best device operational program to implement the pain treatment parameters to address the chronic pain condition. In an example, the system to adjust programming of the neurostimulation device performs operations that: obtain data related to a state of pain of the human subject; identify pain treatment parameters using a dynamic model adapted to evaluate the pain treatment parameters in the human subject over a time period, based on the data related to the state of pain; and select a neurostimulation program for the neurostimulation device, corresponding to at least a portion of the identified pain treatment parameters.

One aspect of the present disclosure relates to a system that can modulate the intensity of a neural stimulation signal over time. A pulse generator can be configured to generate a stimulation signal for application to neural tissue of an individual and modulate a parameter related to intensity of a pattern of pulses of the stimulation signal over time. An electrode can be coupled to the pulse generator and configured to apply the stimulation signal to the neural tissue. A population of axons in the neural tissue can be recruited with each pulse of the stimulation signal.

In some examples, a medical device is configured to deliver high dose electrical stimulation therapy to a patient by at least generating and delivering an electrical stimulation signal having a relatively high duty cycle, and a stimulation intensity less than a perception or paresthesia threshold intensity level for the patient. The pulses of the electrical stimulation signal may each have a relatively low amplitude, but due at least in part to a relatively high number of pulses per unit of time, a dose of the electrical stimulation may be high enough to elicit a therapeutic response from the patient.