A peripheral nerve stimulator can be used to stimulate a peripheral nerve to treat essential tremor, Parkinson tremor, and other forms of tremor. The peripheral nerve stimulator can be either a noninvasive surface stimulator or an implanted stimulator. Stimulation can be electrical, mechanical, or chemical. Stimulation can be delivered using either an open loop system or a closed loop system with feedback.

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.

Methods and systems are provided for multi-channel and/or variable neurostimulation. In one example, overlapping of stimulation events between a plurality of pulse train provided by the neurostimulation system is determined, and one or more parameters of one or more of the plurality of pulse trains are adjusted so as to reduce or avoid overlapping of stimulation events of the plurality of pulse train. The one or more parameters may include a start time, a frequency, and a pulse shape.

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.

Apparatus and methods for managing pain uses a multiplexed modulation/stimulation signal to provide pain relief during spinal cord stimulation or peripheral nerve stimulation.

A system and method for calculating representative frequency signatures for target regions of the brain. The method includes aggregating representative classified microelectrode recordings taken from regions of the brain of multiple patients to an initial database. The classified microelectrode recording data is then transformed into the frequency domain. Frequencies profiles, grouped according to each target region of the brain they represent, are stored in a database. A coherence or Z-score representing the prominence of a frequency with respect to other frequencies within a group of frequencies profiles for each target region of the brain they represent is then calculated and stored, as well as the average power of the frequencies within the group of frequency profiles. Redundant frequencies or frequencies above or below pre-determined thresholds are removed from the group of frequency. The resulting representative frequency signature for each target region of the brain is stored as a group of frequencies, a coherence or Z-score and an average power of the respective frequencies. During a DBS surgery, the desired representative frequency signature file(s) representing target regions of the brain are selected, which representative frequency signature file(s) include a list of frequencies, their respective powers, and Z-scores. During DBS surgery, real time microelectrode recordings of brain signals from a patient are obtained, and the powers of frequencies of the real time microelectrode recordings are calculated at frequencies found in the signatures. The calculated powers of frequencies of the real time microelectrode recordings are compared to the respective powers in the pre-selected representative frequency signature files, and a percent error via the commonly accepted method, and averaging the group of errors via the commonly accepted root mean square calculation is calculated. A negative averaged percent error over time is plotted and displayed as a measure of frequency signature strength in order to detect movement of the stimulating electrode being implanted with respect to the target region of the brain.

Systems and methods for stimulation of neurological tissue and generation stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. The features of the stimulation trains may be selected and arranged algorithmically to by clinical trial. These stimulation trains are generated to target a specific neurological disorder, by arranging sets of features which reduce symptoms of that neurological disorder into a pattern which is effective at reducing those symptoms while maintaining or reducing power consumption versus regular stimulation signals. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide increased efficacy and/or a lower than average frequency.

Improved stimulation circuitry for controlling the stimulation delivered by an implantable stimulator is disclosed. The stimulation circuitry includes memory circuitry that stores pulse programs that define pulse shapes, steering programs that define electrode configurations, and aggregate programs that link a selected pulse program with a selected steering program. The aggregate programs also include an amplitude modulation factor that modulates the amplitude defined by the pulse program. The inclusion of an amplitude modulation factor in the aggregate program allows complex amplitude-modulated waveforms to be produced. Pulse definition circuits in the stimulation circuitry execute aggregate programs to generate stimulation waveforms, which stimulation waveforms can be generated simultaneously by the different pulse definition circuits.

A bruxism prevention system has a mouthpiece comprising a pressure sensor, an electrode, and an electrical stimulation generator. The bruxism prevention system also includes a controller configured to manage application of electrical stimulation to a user via the electrode in response to a pressure sensed by the pressure sensor. A method of preventing bruxism includes disposing an electrode within a user's mouth, disposing a pressure sensor between the user's upper jaw and the user's lower jaw, disposing an electrical stimulation generator within the user's mouth, sensing a predetermined pressure, and applying electrical stimulation to the user's mouth via the electrode in response to the sensed predetermined pressure.

An example of a system for delivering neurostimulation energy may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters according to a neurostimulation program including a pattern of interferential stimulation configured to effect asynchronous and/or non-regular activation of nerve fibers by simultaneously delivering a first stimulation current having a first waveform with a first frequency using a first electrode configuration and a second stimulation current having a second waveform with a second frequency using a second electrode configuration. The user interface may be configured to determine the neurostimulation program and to provide the pattern of interferential stimulation with modulation of the first waveform, the second waveform, the first electrode configuration, and/or the second electrode configuration to result in a time-varying beat frequency capable of effecting the asynchronous and/or non-regular activation of the nerve fibers.