A neuromodulation system for use with electrodes to modulate a volume of neural tissue may include a waveform generator and a controller. The waveform generator may be configured to be electrically connected to the electrodes and provide an electrical waveform through at least some of the electrodes to provide a neuromodulation therapy. The controller may be configured to use a program to control the waveform generator to deliver a neuromodulation therapy by delivering both a fast-acting sub-perception neuromodulation and a slow-acting sub-perception neuromodulation. The fast-acting neuromodulation has a wash-in transition period less than a first time duration, and the slow-acting sub-perception neuromodulation has a wash-in transition period more than a second time duration, the second time duration being longer than the first time duration.

Recognizing that anodic stimulation may require higher amplitudes or charge than cathodic stimulation in some tissues, new pulsing waveforms for a stimulator device, and particularly useful during monopolar stimulation, are described employing therapeutically-effective anodic and cathodic stimulation pulses at the lead-based electrode(s). The pulses are monophasic, with the amplitude or charge of the anodic monophasic pulses being higher than the cathodic monophasic pulses. To provide charge balance at each electrode, a pulse packet may be defined having a plurality of cathodic monophasic pulses and perhaps only a single anodic monophasic pulse. Because the polarity of cathodic monophasic pulses in each packet may charge balance with the anodic monophasic pulse(s), active charge recovery such as by the use of biphasic pulses may not be necessary, although passive charge recovery can be used if desired.

A neuromodulation device is configured with a set of testing program configuration instructions including therapeutic neuromodulation field-setting parameters. The device determines a custom priming program in response to the testing program configuration instructions. The custom priming program controls the neuromodulation device to generate a priming field with specific correspondence to the therapeutic neuromodulation field to be produced by the testing program.

Temporary or sub-threshold electrical stimulation to promote recovery of a damaged or injured nerve. Methods include promoting neuroregeneration of a nerve iatrogenically injured during a medical procedure performed on a target site of a patient's body. Methods include placing an electrical lead in electrical communication with the injured or damaged nerve. Methods further include temporarily stimulating the nerve and/or applying sub-threshold stimulation to the nerve to promote neuroregeneration of the nerve. The nerve can be a peripheral nerve.

A neuromodulation system and method of providing sub-threshold therapy to a patient. An anodic perception threshold of super-threshold electrical energy and a cathodic perception threshold of super-threshold electrical energy are determined for a plurality of electrode sets. A ratio between the anodic perception threshold and the cathodic perception threshold is calculated for each of the electrode sets. An effective electrode set is selected based on the ratio between the anodic perception threshold and the cathodic perception threshold.

Methods, devices and systems for developing new therapy options for patient suffering from neurological disorders. An example may include the use of a therapy patterning system that allows significant freedom to program therapy patterns using arbitrary shapes and functions. For such patterning to be implemented, a physician may identify a condition needing new and/or alternative therapy options, link the identified condition one or more therapy parameters, program, test and assess the therapy. The process may include multiple iterations to address an initial condition and then to mitigate side effects of the initial therapy. Some embodiments comprises devices configured to deliver combinations of therapy patterns to accomplish at least first and second therapeutic purposes.

An implantable stimulator device is disclosed for executing a stimulation program comprising a plurality of sub-programs, wherein the sub-programs are configured to be automatically sequentially executed by stimulation circuitry in the device. Control circuitry periodically stores log data to indicate where each sub-program is in its execution. If the device experiences an interruption that prevents the stimulation circuitry from executing the stimulation program, and upon receiving an indication that the stimulation circuitry can continue execution of the stimulation program, the control circuitry is configured to query the log data to determine a sub-program during which the interruption occurred, and using the log data, cause the stimulation circuitry to continue execution of the stimulation circuitry either at the beginning of the sub-program, or at a point during the sub-program when the interruption occurred.

The present disclosure provides a device for state-dependent pudendal nerve stimulation for bladder control in a subject and methods of making and using the same.

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.

Methods and systems for assisting a patient to reprogram parameters of an implantable medical device, such as a spinal cord stimulator, are disclosed. A patient may use an external controller, which may be either a dedicated device or a personal computing device, to interact with their implantable medical device and evaluate the efficacy of their therapy. If the efficacy diminishes, the patient may use their external controller to adjust either the neural dosage (i.e., frequency, pulse width, and/or amplitude) and/or the location at which stimulation is provided. A reprogramming assistant is provided, which guides the patient in adjusting their stimulation using their external controller. The patient may use supra-perception or sub-perception stimulation for the adjustment. The implantable medical device may include pre-programmed rescue programs to assist the patient in recovering the efficacy of their therapy.