Methods and systems for using sensed neural responses for informing aspects of stimulation therapy are disclosed. For example, features of evoked neural responses, such as evoked compound action potentials (ECAPs) can be used for closed-loop feedback control of stimulation parameters. Aspects of the disclosed methods and systems can differentiate between changes in the sensed neural responses that are caused by the environment at stimulating electrodes and changes in the neural responses that are caused by the environment at sensing electrodes. Embodiments determine changes in the morphology of the neural responses, which morphology changes indicate a degree of change in the stimulating environment. Algorithms and systems for assigning and tracking likelihoods for underlying electrode-tissue changes based on sensed neural responses are disclosed. The feedback control modality may be updated based on such likelihoods. Also disclosed are methods and systems for determining which features of evoked neural responses are more sensitive to changes in the stimulating environment and less sensitive to changes in the sensing environment.

Endovascular nerve monitoring devices and associated systems and methods are disclosed herein. A nerve monitoring system configured in accordance with a particular embodiment of the present technology can include a shaft having a proximal portion and a distal portion and a nerve monitoring assembly at the distal portion. The shaft is configured to locate the distal portion intravascularly at a treatment site. The nerve monitoring assembly can include a bipolar stimulation electrode array and a bipolar recording electrode array disposed distal to the bipolar stimulation electrode assembly.

A device is provided for stimulating neurons that includes an implantable stimulation unit that generates stimuli in multiple stimulation elements. The stimulation unit generates the stimuli to stimulate a neuron population in the brain and/or spinal cord of a patient using the stimulation elements. Moreover, the device includes a control unit that controls the stimulation unit to repeatedly generates sequences of the stimuli with the order of the stimulation elements in which stimuli are generated within a sequence being constant for 20 or more successively generated sequences before it is varied.

The present disclosure provides systems and methods for disrupting neuronal oscillations. A neurostimulation system includes a stimulation lead comprising at least one contact, and an implantable pulse generator (IPG) communicatively coupled to the stimulation lead and configured to cause stimulation to be applied to a patient using no more than two contacts of the stimulation lead by causing a first burst of stimulation to be delivered, and causing a second burst of stimulation to be delivered within a neuronal refractory period that follows the first burst of stimulation.

Electrical stimulation of neural activity in the neural innervation of the spleen that is associated with neurovascular bundles provides a useful way to treat acute medical conditions, such as trauma, hemorrhaging, shock, acute respiratory distress syndrome (ARDS), severe respiratory distress syndrome (SARS), and coronavirus disease 19 (COVID-19).

In various embodiments electrical stimulators are provided for transcutaneous and/or epidural stimulation. In certain embodiments the stimulator provides one or more channels configured to provide one or more of the following stimulation patterns: i) monophasic electrical stimulation with a DC offset; ii) monophasic electrical stimulation with charge balance; iii) delayed biphasic electrical stimulation with a DC offset; iv) delayed biphasic electrical stimulation with charge balance; v) amplitude modulated dynamic stimulation; and/or vi) frequency modulated dynamic stimulation.

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.

An apparatus external to a patient and communicatively coupled to an implant within the patient is disclosed. The apparatus identifies a tentative stimulation parameter adjustment constraint and an absolute stimulation parameter adjustment constraint for a stimulation parameter associated with the implant. The apparatus also determines an impedance of an electrode implanted within the patient and coupled with the implant. Based on the impedance of the electrode, the apparatus automatically adjusts the stimulation parameter within a range between a present value and a first value defined by the tentative stimulation parameter adjustment constraint. Additionally, based on user input manually provided by the patient, the apparatus further adjusts the stimulation parameter within a range between the first value and a second value beyond the first value and defined by the absolute stimulation parameter adjustment constraint. Corresponding apparatuses, systems, and methods are also disclosed.

Neurostimulation is performed using electrical AC and/or DC stimulation pulses. Brain and/or spinal cord stimulation of a patient is achieved using an implanted neurostimulation device. Neurostimulation is performed using AC and/or DC stimulation pulses combined with a safe operation in DC mode by discharging build-up loads at the interfaces of the electrodes through short circuiting such stimulation electrodes with a counter electrode, for example a common ground electrode.

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.