Systems and methods for closed-loop control of electrostimulation while avoiding, or maintaining a substantially low level of, evoked neural activity are disclosed. A system comprises an electrostimulator to deliver a stimulation pulse train, a sensing circuit to sense evoked responses to respective pulses in the pulse train, and a controller to detect an evoked neural activity from an averaged evoked response by averaging evoked responses to respective pulses. The averaging operation can be controlled by a noise level of the averaged evoked response, or by a count of epochs (pulses) being used for averaging. Responsive to the evoked neural activity satisfying a detection criterion, the controller recursively adjusts stimulation parameters until the detection criterion is no longer satisfied. The electrostimulator delivers electrostimulation according to the recursively adjusted stimulation parameters.

In some embodiments, a method of providing a neurostimulation therapy to a patient, comprises: generating a noise pulse pattern defining a pulse train of pulses to be generated according to a noise profile in an external device; communicated the generated noise pulse pattern to an implantable pulse generator (IPG) of a patient; generating, by the IPG, a series of pulses in sequence for noise stimulation of the patient using the noise pulse pattern from the external device, wherein the IPG applies one or more randomization operations to the pulse pattern from the external device without expanding memory storage for the pulse pattern while maintaining the noise profile of the pulse pattern from the external device; and applying the series of pulses in sequence to neural tissue of the patient using one or more electrodes of one or more stimulation leads.

In some embodiments, a method of providing a neurostimulation therapy to a patient, comprises: generating electrical pulses, by an implantable pulse generator (IPG), comprising respective bursts of a plurality of anodic pulses with each anodic pulse being separated by a time gap, wherein (1) the plurality of anodic pulses comprise successively increasing charge; (2) the plurality of anodic pulses are charge limited to be sub-threshold; (3) each burst of anodic pulses is followed by a discharge phase of intermittent time periods to discharge charge build up from the anodic pulses; and (4) each successive intermittent time period increases in time through the discharge phase to avoid action potential (AP) generation; and applying the generated electrical pulses to neural tissue of the patient to inhibit neural activity of the patient.

This application is generally related to systems and methods for providing a medical therapy to a patient by tracking patient activity and adjusting medical therapy based on occurrence of different types of activities performed by the patient while automatically rescheduling stimulation programs based on detected patient activity.

A computer implemented method and system is provided for managing neural stimulation therapy. The method comprises under control of one or more processors configured with program instructions. The method delivers a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest. A parameter defines the candidate stimulation waveforms is changed to vary the stimulation intensity. The method identifies a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect. The method further identifies a second candidate stimulation waveform that does not induce the select analgesic effect. The method sets a stimulation therapy based on the first and second candidate stimulation waveforms.

An implantable pulse generator (IPG) is disclosed having a plurality of electrode nodes, each electrode node configured to be coupled to an electrode to provide stimulation pulses to a patient's tissue. The IPG includes a digital-to-analog converter configured to amplify a reference current to a first current specified by first control signals; a first resistance configured to receive the first current, wherein a voltage across the first resistance is held to a reference voltage at a first node; a plurality of branches each comprising a second resistance and configured to produce a branch current, wherein a voltage across each second resistance is held to the reference voltage at second nodes; and a switch matrix configurable to selectively couple any branch current to any of the electrode nodes via the second nodes.

A device is provided for stimulating neurons that includes a non-invasive stimulation unit that generates stimuli in multiple stimulation channels. The stimulation unit generates the stimuli to stimulate a neuron population in the brain and/or spinal cord of a patient using the stimulation channels in different locations. 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 channels in which stimuli are generated within a sequence being constant for 20 or more successively generated sequences before it is varied.

Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.

A system and method are provided to deliver interleaved stimulation to nerve tissue of interest. The system and method comprises an array of stimulation electrodes. The array is configured to be implanted proximate to nerve tissue of interest. An implantable medical device (IMD) is coupled to the array. The IMD includes memory storing a composite resultant pulse (CRP) sequence comprising first and second component sequences of first and second resultant pulse trains, respectively. One or more pulses from at least one of the first or second component sequences are temporally shifted relative to a corresponding target component sequence. The IMD further comprises a pulse generating circuit and switching circuit coupled to an output of the pulse generating circuit and the array. The switching circuit is configured to connect the pulse generating circuit to different combinations of the electrodes. The IMD further comprises a processor, configured to execute program instructions stored in the memory, directs the pulse generating circuit to generate the CRP sequence and manages the switching circuit to deliver the pulses of the first and second component sequences, in an interleaved manner, to first and second electrode combinations, respectively.

The present disclosure provides systems and methods for combining tonic deep brain stimulation (DBS) and random DBS. A system includes a stimulation lead including a plurality of contacts, and an implantable pulse generator (IPG) communicatively coupled to the stimulation lead and configured to cause tonic stimulation to be delivered using one contact of the plurality of contacts, and cause random stimulation to be delivered using a subset of the remaining contacts of the plurality of contacts.