This present disclosure provides devices, systems, and methods for the treatment of conditions pertaining to bladder control. In particular, the present disclosure provides devices, systems, and methods directed to the application of electrical stimulation to the proximal urethra and associated nervous tissue to elicit voiding contractions that normalize bladder function.

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.

Electrical stimulation of a target (e.g., nervous tissue) is performed, wherein balance phases are automatically determined, and at least one of the electrodes is indirectly monitored during therapy delivery. The stimulation system is further configured to generate correction currents when a voltage accumulated at associated double layer capacitances crosses pre-defined thresholds so as to reduce or cancel the accumulated voltages without therapy interruption. A finer automatic determination of balance phases permits minimizing the stimulus artifact for evoked response sensing. Closed-loop neurostimulation may be performed based on such evoked responses.

Circuitry for generating a compliance voltage (V+) for the current sources and/or sinks in an implantable stimulator device in disclosed. The circuitry assesses whether V+ is optimal for a given pulse, and if not, adjusts V+ for the next pulse. The circuitry uses amplifiers to measure the voltage drop across active PDACs (current sources) and NDAC (current sinks) at an appropriate time during the pulse. The measured voltages are assessed to determine whether they are high or low relative to optimal values. If low, a V+ regulator is controlled to increase V+ for the next pulse; if not, the V+ regulator is controlled to decrease V+ for the next pulse. Through this approach, gradual changes that may be occurring in the implant environment can be accounted for, with V+ adjusted on a pulse-by-pulse basis to keep the voltage drops at or near optimal levels for efficient DAC operation.

Described is a low voltage, pulsed electrical stimulation device for upregulating expression of klotho, a useful protein, by tissues. Also described are methods of enhancing expression of klotho in cells.

Disclosed are various examples and embodiments of systems, devices, components and methods configured to rehabilitate or strengthen one or more muscles in a patient, and to reduce pain sensed by the patient, through a unique combination of electrical stimulation signals delivered to one or more target peripheral nerves. Medical electrical lead(s) comprising electrode(s) are positioned adjacent to, in contact with, or in operative positional relationship to, one or more target peripheral nerves of the patient. The target peripheral nerves typically comprise motor and sensory nerves. In one embodiment, first stimulation signals having a first range of frequencies are delivered through the electrode(s) to the target nerves to rehabilitate muscles enervated by the motor nerves. Second stimulation signals having a second range of frequencies are delivered through the electrode(s) to the target nerves to provide pain relief to the patient. The first range of frequencies is lower than the second range of frequencies.

Described herein are methods for treating a subject suffering from or at risk for a condition mediated by an inflammatory cytokine cascade, by electrically or mechanically stimulating vagus nerve activity in an amount sufficient to inhibit the inflammatory cytokine cascade.

The present disclosure is directed to a system and method for selectively and reversibly modulating targeted neural and non-neural tissue of a nervous system for the treatment of pain. An electrical stimulation is delivered to the treatment site that selectively and reversibly modulates the targeted neural- and non-neural tissue of the nervous structure, inhibiting pain while preserving other sensory and motor function, and proprioception.

An implantable medical device (IMD) includes multiple stimulation engines for independently stimulating respective electrode sets of a lead system while avoiding collisions and/or channel contention during stimulation delivery. A first voltage multiplier is configured to generate an adjustable target voltage having sufficient headroom at an output node that is commonly coupled to anodic nodes of respective stimulation engines. Each stimulation engine includes a secondary voltage multiplier to drive the respective anode and a current regulator powered by a floating voltage supply, wherein the current regulator is coupled to a cathodic node and configured to control how much stimulation current is pulled from the patient tissue.

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a system includes a user interface and processing circuitry. The processing circuitry is configured to output, for display by the user interface, a message requesting the patient perform a set of actions, receive, from the user interface, user input indicative of a patient response associated with the set of actions, and determine, based on the user input, one or more adjustments to a control policy which controls electrical stimulation delivered by a medical device based on a plurality of evoked compound action potentials (ECAPs) sensed by the medical device.