Applying therapeutic neural stimuli involves monitoring for at least one of sensory input and movement of a user. In response to detection of sensory input or user movement, an increased stimulus dosage is delivered within a period of time corresponding to a duration of time for which the detected sensory input or user movement gives rise to masking, the increased stimulus dosage being configured to give rise to increased neural recruitment.

A method of downregulating and/or upregulating neural activity by applying a high frequency alternating current electrical signal to a nerve in a subject is disclosed. The signal comprises more than one microsecond cycle comprising one or more periods, each period comprising a charge recharge phase, and optionally, a pulse delay, each period having a frequency of at least 1000 Hz; and a microsecond inactive phase. In embodiments, an electrical signal treatment comprises more than one microsecond cycle to form a millisecond cycle, each millisecond cycle separated by a millisecond inactive phase during an on time. In embodiments, the electrical signal patterns can differ in amplitude.

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.

A medical device for electrical stimulation of a patient. A pulse generator generates current pulses for the electrical stimulation. An electrode lead with a plurality of electrode contacts delivers the pulses to tissue of the patient. The pulse generator repeatedly delivers a current pulse between two electrodes forming a first group and delivers a charge balancing current pulse after each current pulse between the electrodes of the first group. The respective current pulse is separated from the succeeding charge balancing current pulse by an inter pulse interval. The respective current pulse has an amplitude with the same absolute magnitude as the succeeding charge balancing current pulse, but is of opposite sign. The pulse generator delivers between each current pulse and the succeeding charge balancing current pulse a current pulse between two further electrodes forming a second group of electrode contacts of the plurality of electrode contacts.

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.

A system for stimulating a tissues to obtain therapeutic effects, such as pain relief. The system can include stimulating leads that are operably coupled to a control unit. The control unit can include processors for generating desired waveform pattern of electrical pulses. The system can further include magnetic sensors to measure the magnetic fields generated by action potentials in the excited tissue and using the measured magnetic field to optimize the neurostimulation pattern.

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.

A premodulated interferential current, particularly for spinal cord stimulation, is generated using a pulse generator having multiple electrodes. The premodulated current, which is delivered through at least one of the electrodes, includes a train of biphasic pulses having a repetition frequency, wherein each biphasic pulse includes a stimulating phase and a balancing phase. The premodulated current includes an amplitude modulation envelope having an envelope beat frequency smaller than the repetition frequency of the biphasic pulses, wherein the modulation envelope is generated in the pulse generator.

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.

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.