A neurostimulation device has a stimulus, and a position of a measurement electrode relative to the stimulus, configured such that in artefact as arising relative to distance from the stimulus electrode a minima region of the artefact is substantially co-located with the measurement electrode. Or, a ratio of the inter-electrode spacing to the electrode length is between 2 and 3.66. Or, an impedance is connected to a passive electrode and is configured to reduce artefact arising on the measurement electrode.

An implantable medical device is configured to receive an input that specifies a time domain allocation between two or more stored stimulation programs and to provide control signals corresponding to each of the two or more stimulation programs to stimulation circuitry to interleave the two or more stimulation programs in time according to the input. The time domain allocation may set a proportion of time during which each of the stimulation programs is active during repeating epochs. The time domain allocation may be set by a user to transition between configured stimulation programs or to specify stimulation that is based on two or more different stimulation programs. The time domain allocation may also be adjusted automatically to optimize an indication of an effectiveness of stimulation that is provided by the patient.

A neurostimulation device has at least three stimulation electrodes configured to deliver an electrical stimulus to neural tissue. A control unit is configured to deliver a first stimulus phase in which a first stimulus electrode delivers a supra-threshold stimulus component, returned by at least two other of the stimulation electrodes. The control unit is further configured to deliver at least a second stimulus phase in which at least two of the stimulus electrodes deliver a sub-threshold stimulus component, returned by the first stimulus electrode.

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.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during “sweet spot searching” during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain. Beneficially, sub-perception stimulation at such low frequencies significantly lowers power consumption in the patient's neurostimulator.

A method is disclosed for programming a patient's stimulator device using an external device. The method provides a Graphical User Interface (GUI) on the external device that allows the patient to select from a plurality of displayed stimulation modes to program stimulation provided by one or more electrodes of the stimulator device. The external device stores a model derived for the patient, which model comprises information indicative of a plurality of frequency/pulse width/amplitude coordinates predicted to provide optimal stimulation for the patient. Each stimulation mode corresponds with a subset of coordinates defined in accordance with the plurality of coordinates in the model. Selection of one of the stimulation modes limits programming the stimulator device with coordinates that are within the corresponding subset of coordinates.

Methods and systems for obtaining and analyzing electromyography responses of electrodes of an implanted neurostimulation lead for use neurostimulation programming are provided herein. System setups for neural localization and/or programming include a clinician programmer coupleable with a temporary or permanent lead implantable in a patient and at least one pair of EMG sensing electrodes minimally invasively positioned on a skin surface or within the patient. The clinician programmer is configured to determine a plurality of recommended electrode configurations based on thresholds and EMG responses of the plurality of electrodes and rank the electrode configuration according to pre-determined criteria. The clinician programmer further includes graphical user interface on which the plurality of recommended electrode configurations are displayed for modification and/or selection by a clinician in programming an IPG or EPG coupled with the lead to apply a neurostimulation treatment according to the selected electrode configuration.

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.

A stimulation therapy system dynamically modifies therapy intensity based on measured neurotransmitter levels. In some examples, the system delivers, via an electrode implanted in a brain of a patient and stimulation circuitry, an electrical stimulus; monitors an electrical current generated by the stimulation circuitry to deliver the electrical stimulus; determines, based on the electrical current, a value representative of a concentration of dopamine in the brain of the patient; determines, based on the value representative of the concentration of dopamine, a value for one or more stimulation parameters that at least partially define electrical stimulation therapy; and delivers, via the electrode, the electrical stimulation therapy.

Electrical stimulation, including high frequency stimulation, for altering autonomic functions, and associated systems and methods are disclosed. A representative method includes directing an electrical signal to a target tissue at (a) a ventral region of the patient's spinal canal, (b) a sympathetic chain structure, or (c) both (a) and (b), at a frequency in a range from 1 kHz to 100 kHz, and an amplitude that does not generate an objectionable, patient-detectable sensation.