The present invention relates to methods for remotely tuning treatment parameters in movement disorder therapy systems where the subject and clinician are located remotely from each other. The present invention still further provides methods of quantifying movement disorders for the treatment of patients who exhibit symptoms of such movement disorders including, but not limited to, Parkinson's disease and Parkinsonism, Dystonia, Chorea, and Huntington's disease, Ataxia, Tremor and Essential Tremor, Tourette syndrome, stroke, and the like. The present invention yet further relates to methods of remotely tuning a therapy device using objective quantified movement disorder symptom data to determine the therapy setting or parameters to be transmitted and provided to the subject via his or her therapy device. The present invention also provides treatment and tuning remotely, allowing for home monitoring of subjects.

Methods and systems for providing stimulation therapy are disclosed. Embodiments of the system include an implantable stimulator and an external controller configured to control the implantable stimulator. A clinician can prescribe a set amount of stimulation therapy to a patient. The external controller is programmed with the prescription. As the patient uses the external controller and the stimulator device the external controller tracks the amount of stimulation the patient uses. Once the patient has used all of the prescribed therapy the patient may return to the clinician for a follow-up appointment.

An example of a system for delivering neurostimulation pulses includes a stimulation output circuit setting a hardware resolution for each stimulation parameter. A control circuit may be configured to receive the stimulation parameters and may include a dithering mode enabler configured to enable a dithering mode and a parameter dithering processor configured to operate when the dithering mode is enabled. The parameter dithering processor may be configured to identify a received stimulation parameter to be dithered and to dither a received value of the identified stimulation parameter by programming the stimulation output circuit to deliver pulses at a higher value of the identified stimulation parameter interleaved with pulses at a lower value of the identified parameter at a ratio determined for producing an average value approximating to the received value. The higher value and the lower value are values available with the hardware resolution.

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.

An implantable electrical stimulation device includes an electrically conductive electrode structure configured for coupling with a pulse generator device and transmitting an electrical signal configured to generate a desirable electric field around a target tissue. The electrode structure includes a porous substrate constructed of a bio-compatible and bio-survivable material having a structure that mimics extracellular matrix embedding. The porous substrate supports an electrically conductive electrode element. The implantable device may further include a pulse generator also embedded, enmeshed, and supported within the porous substrate.

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.

An example of a system to program a neuromodulator to deliver neuromodulation to a neural target using a plurality of electrodes may comprise a programming control circuit configured to determine target energy allocations for the plurality of electrodes based on at least one target pole to provide a target sub-perception modulation field, and normalize the target sub-perception modulation field, including determine a time domain scaling factor to account for at least one property of a neural target or of a neuromodulation waveform, and apply the time domain scaling factor to the target energy allocations.

An electrode arrangement for stimulating and recording electrical signals in biological matter comprises: an array (110) of electrodes (112), wherein electrodes (112) are configured to be switchable between stimulating and recording of electrical signals; a control unit (120), wherein the control unit (120) is configured to select a plurality of electrodes (112) to form a combined macroelectrode site (114) for providing a stimulating signal, wherein the control unit (120) is further configured to determine a perimeter electrode (112b) and a central electrode (112a), wherein the perimeter electrode (112b) is arranged at a perimeter of the combined macroelectrode site (114) and the central electrode (112a) is arranged centrally within the combined macroelectrode site (114), and wherein the control unit (120) is further configured to provide a stimulation signal to the perimeter electrode (112b) that has a lower magnitude than a stimulation signal provided to the central electrode (112a).

Techniques for therapy delivery are described. A processing circuit may adjust a first therapy parameter from a first level to a second level, and responsive to the adjustment of the first therapy parameter, compare a level of an evoked compound action potential (ECAP) generated from therapy delivery based on the adjusted first therapy parameter to an ECAP threshold. The processing circuit may adjust a second therapy parameter from a third level to a fourth level based on the comparison. The second therapy parameter is different than the first therapy parameter. The processing circuit may cause therapy delivery with the first therapy parameter at the second level and the second therapy parameter at the fourth level.

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