A method and system of providing therapy to a patient implanted with an array of electrodes is provided. A train of electrical stimulation pulses is conveyed within a stimulation timing channel between a group of the electrodes to stimulate neural tissue, thereby providing continuous therapy to the patient. Electrical parameter is sensed within a sensing timing channel using at least one of the electrodes, wherein the first stimulation timing channel and sensing timing channel are coordinated, such that the electrical parameter is sensed during the conveyance of the pulse train within time slots that do not temporally overlap any active phase of the stimulation pulses.

A method and apparatus for using low levels of electrical stimulation to treat focal dystonia by stimulating the afferent nervous system and/or altering the function of the gamma motor neurons innervating muscles which experience symptomatic spasms.

Systems and methods for identifying and treating patients with high frequency electrical signals. A representative method for identifying a patient as a candidate for pain treatment includes identifying a first sensory threshold, delivering an electrical signal to a neural population of the patient at a frequency in a frequency range of 1.5 kHz to 100 kHz and, while and/or after delivering the electrical signal to the patient, identifying a second sensory threshold of the patient. If the second sensory threshold is less than the first, the method can include identifying the patient as a candidate for receiving an electrical signal at a frequency in the foregoing range for pain treatment.

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.

Methods and systems for providing neuromodulation therapy are disclosed. The methods and systems are configured to sense an evoked neural response and use the evoked neural response as feedback for providing neuromodulation therapy. Methods of reducing stimulation artifacts that obscure the sensed evoked neural response are disclosed. The methods of artifact reduction include recording a stimulation artifact in the absence of an evoked neural response, aligning and scaling the stimulation artifact with respect to the obscured signal, and subtracting the aligned and scaled artifact from the obscured signal.

In some examples, a technique for delivering electrical stimulation therapy to a patient includes determining, by processing circuitry, one or more cycle settings associated with delivery of the electrical stimulation therapy, determining, by the processing circuitry, a cycle time period associated with each cycle setting, and delivering, by a medical device, electrical stimulation therapy based on the determined cycle settings and the determined cycle time periods. Each cycle setting may define an on-cycle, during which electrical stimulation is delivered, and an off-cycle, during which electrical stimulation is not delivered. The technique further may include delivering electrical stimulation to the patient to provide one or more reminders to the patient, such as a reminder to void or a reminder of the existence of electrical stimulation.

Methods of providing therapy to a patient are provided. In one method, the patient has a neuron to which a sub-threshold biological electrical stimulus is applied. The method comprises applying electrical noise energy to the neuron, wherein resonance between the biological electrical stimulus and the electrical noise energy is created, such that an action potential is propagated along the axon of the neuron. In another method, the patient has a neuron to which a supra-threshold biological electrical stimulus is applied. This method comprises applying supra-threshold electrical noise energy to the neuron, thereby preventing an action potential from being propagated along the axon of the neuron. Still another method comprises applying an electrical stimulus to a neuron, and applying supra-threshold electrical noise energy to the neuron, thereby preventing or reversing any neurological accommodation of the neuron that may occur in response to the electrical stimulus.

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.

A system example may include electrodes operationally positioned for use in delivering sub-perception neural modulation, a neural modulator configured to use at least some electrodes to generate a modulation field, and a feedback system configured to receive a feedback signal that a generated modulation field provides a perceived or measurable response. A control system may implement a calibration process including controlling the neural modulator to generate the modulation field using a first and second stimulus pulse with a first and second pulse width, respectively, and using the feedback system to determine a first and second reference point that represents an intensity of the modulation field generated using the first and second pulse widths, respectively, that provides the response, and deriving sub-perception calibration data specific to sub-perception modulation delivered using a sub-perception pulse with a sub-perception pulse width.

Methods and systems for determining sub-perception stimulation for a patient having a spinal cord stimulator device are disclosed. In one example, an external device includes an algorithm configured to determine a stimulation program for the stimulator device. The algorithm includes a model that comprises pre-determined energy values that cause sub-perception stimulation. The algorithm is configured to determine stimulation parameters for the stimulation program that yield an energy value within the first model. The energy values in the model may be expressed as a function of frequency. The model in particular provides optimal sub-perception stimulation at low frequencies, such as at 1 kHz and below, or even at 400 Hz and below.