Methods are provided to treat a neurological disorder in a patient by adjusting connectivity between network nodes in a brain of patient using electrical stimulation. Electrical stimulation including a carrier wave component is employed to adjust connectivity using infraslow frequencies of less than 1 Hz.

Described here are bioelectric modulation systems and methods for generating rotating or spatially-selective electromagnetic fields. A modulation system includes a multichannel electrode with independently controllable electrode channels that can be operated to generate rotating electromagnetic fields that stimulate cells regardless of their orientation, or to generate spatially-selective electromagnetic fields that preferentially stimulate cells oriented along a particular direction. The bioelectric modulation system may be implemented for stimulation of neurons or other electrically active cells. The bioelectric modulation described here may be used for a variety applications including deep brain stimulation (DBS), spinal cord and vagus nerve stimulation, stimulation of myocardial (heart) tissue, and directional stimulation of muscles.

Systems and methods are provided for stimulating the brain of a patient to treat a medical condition. In some aspects, a method includes positioning a stimulating device comprising electrical contacts configured to electrically stimulate locations associated with a patient's brain, and initiating a rehabilitation process to include the patient performing a task. The method also includes acquiring feedback from the patient at least while the patient is performing the task, generating, based on the acquired feedback, electrical stimulations to treat the medical condition of the patient. In some aspects, the method further includes generating a report indicative of a patient performance.

Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

A method of treating osteoarthritis includes an implantable stimulator generating stimulation sessions at a duty cycle that is less than 0.05 and applying the stimulation sessions by way of the central electrode and the annular electrode to a location within a patient that includes at least one of an acupoint labeled ST35, an acupoint labeled EX-LE-4, or a location on a line that intersects the acupoints labeled ST35 and EX-LE-4.

Devices, systems, and techniques are described for adjusting therapy parameters defining electrical stimulation therapy. An example system includes a stimulation generator comprising a voltage stack configured to provide a stack voltage based on a multiplier of a battery voltage and processing circuitry. The processing circuitry receives a first set of parameter values that use a first stack voltage of the voltage stack to provide a first electrical stimulation defining a first therapy. The processing circuitry also determines, based on a second stack voltage lower than the first stack voltage, a second set of parameter values that define a second electrical stimulation, the second set of parameters defining a lower amplitude of electrical stimulation. Additionally, the processing circuitry controls the stimulation generator to deliver the second electrical stimulation according to the second set of parameter values using the second stack voltage of the voltage stack.

Devices, systems, and techniques are disclosed for managing electrical stimulation therapy and/or sensing of physiological signals such as brain signals. For example, a system is configured to receive, for each electrode combination of a plurality of electrode combinations, information representing a signal sensed in response to first electrical stimulation delivered to a patient via a lead, wherein the plurality of electrode combinations comprise different electrode combinations comprising electrode disposed at different positions around a perimeter of the lead implanted in the patient. The system may also be configured to determine, based on the information for each electrode combination of the plurality of electrode combinations, values for a threshold at different locations around the perimeter of the lead and determine, based on the values for the threshold, one or more stimulation parameter values that at least partially define second electrical stimulation deliverable to the patient via the lead.

An example method includes determining, by an implantable medical device (IMD), an electrode of a plurality of electrodes of a lead to be used to deliver electrical stimulation to a patient at a particular time; selecting, by the IMD and based on the determined electrode, a set of electrodes of the plurality of electrodes; and sensing, by the IMD and via the selected set of electrodes, electrical signals of the patient at the particular time.

A premodulated interferential current, particularly for spinal cord stimulation, is generated using a pulse generator having multiple electrodes. The premodulated current, which is delivered through at least one of the electrodes, includes a train of biphasic pulses having a repetition frequency, wherein each biphasic pulse includes a stimulating phase and a balancing phase. The premodulated current includes an amplitude modulation envelope having an envelope beat frequency smaller than the repetition frequency of the biphasic pulses, wherein the modulation envelope is generated in the pulse generator.

In various embodiments electrical stimulators are provided for transcutaneous and/or epidural stimulation. In certain embodiments the stimulator provides one or more channels configured to provide one or more of the following stimulation patterns: i) monophasic electrical stimulation with a DC offset; ii) monophasic electrical stimulation with charge balance; iii) delayed biphasic electrical stimulation with a DC offset; iv) delayed biphasic electrical stimulation with charge balance; v) amplitude modulated dynamic stimulation; and/or vi) frequency modulated dynamic stimulation.