Devices, systems, and techniques are disclosed for determining spatial relationships between electrodes implanted within a patient. In one example, a medical device delivers, via a first electrode, an electrical stimulus and senses, for each other electrode, a respective electrical signal indicative of the electrical stimulus. The medical device determines, for each other electrode, a respective value for each respective electrical signal. The medical device determines, based on the respective values for each respective electrical signal and values of tissue conductivity of tissues of the patient interposed between the first electrode and the other electrodes, spatial relationships between the first electrode and each other electrode of the plurality of electrodes.

A group select matrix is added to an implantable stimulator device to allow current sources to be dedicated to particular groups of electrodes at a given time. The group select matrix can time multiplex the current sources to the different groups of electrodes to allow therapy pulses to be delivered at the various groups of electrodes in an interleaved fashion. Each of the groups of electrodes may be confined to a particular electrode array implantable at a particular non-overlapping location in a patient's body. A switch matrix can be used in conjunction with the group select matrix to provide further flexibility to couple the current sources to any of the electrodes.

In the present invention, an IPG incorporates electrical resistivity monitoring with a reflectometry trigger. The IPG is configured to determine both optically and electrically if migration occurs between the electrodes. If the light intensity variation in the optical trigger is greater than an optical threshold value, then the system will pause stimulation and conduct a resistivity test. A resistivity test is also conducted periodically in the absence of the reflectometry trigger to verify that no lead migration has occurred. The stimulation signal is automatically adjusted if a variation in resistivity values is detected above a resistivity threshold value. The resistivity threshold value is set above the normal variation that occurs due to routine movement of the spinal cord in the spinal canal.

A medical device for electrical stimulation therapy including an implantable lead with multiple levels of lead electrodes in a first segmented electrode configuration, at least one level of the lead electrodes comprising segmented electrodes. A flexible member is configured to be disposed over the first electrode segmented electrode configuration, the flexible member having a first inner side and a first set of member electrodes, at least some of the first set of member electrodes configured to be positioned to electrically contact corresponding lead electrodes of the first segmented electrode configuration. The flexible member having a second outer side and a second set of member electrodes in a second segmented electrode configuration which is different than the first segmented electrode configuration, at least some of the second set of member electrodes electrically coupled to corresponding member electrodes of the first set of member electrodes.

This document discusses, among other things, systems and methods for managing pain of a subject. A system includes one or more physiological sensors configured to sense a physiological signal indicative of patient brain activity. The physiological signals may include an electroencephalography signal, a magnetoencephalography signal, or a brain-evoked potential. The system may extract from the brain activity signal one or more signal metrics indicative of strength or pattern of brain electromagnetic activity associated with pain, and generate a pain score using the one or more signal metrics. The pain score can be output to a patient or a process. The system may select an electrode configuration for pain-relief electrostimulation based on the pain score, and deliver a closed-loop pain therapy according to the selected electrode configuration.

A method and system are provided for determining a relation between stimulation settings for a brain stimulation probe and a corresponding V-field. The brain stimulation probe comprises multiple stimulation electrodes. The V-field is an electrical field in brain tissue surrounding the stimulation electrodes. The method comprises sequentially applying a test current to n stimulation electrodes, n being a number between 2 and the number of stimulation electrodes of the brain stimulation probe, for each test current at one of the n stimulation electrodes, measuring a resulting excitation voltage at m stimulation electrodes, m being a number between 2 and the number of stimulation electrodes of the brain stimulation probe, from the stimulation settings and the measured excitation voltages, deriving a coupling matrix, an element in the coupling matrix reflecting an amount of electrical impedance between two of the stimulation electrodes, and using the coupling matrix for determining the relation between the stimulation settings and the corresponding V-field.

A device for decreasing the pain associated with biopsies for cancer determination. The device includes electrical stimulation and injection of anesthetics.

Systems and methods are disclosed to permit a patient to use his external controller to move the location of stimulation in an implantable stimulator system. The external controller can be programmed with a steering algorithm, which prompts the patient to enter certain data regarding their symptoms (e.g., pain), such as pain scores and stimulation coverage. Such data is preferably entered for a plurality of different regions of the patient's body. The algorithm can compute for each body regions a targeting precision value (TP), and from these values determine a steering vector D that suggests a direction and/or a magnitude that stimulation can be moved in the electrode array to more precisely target the patient's pain. The patient may then move the location of the stimulation in accordance with the steering vector using their external controller. The algorithm can be repeated if necessary to again move the stimulation.

An example of a system for delivering neurostimulation may include a programming control circuit and a stimulation control circuit. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation according to a stimulation configuration. The stimulation control circuit may be configured to specify the stimulation configuration, and may include volume definition circuitry and stimulation configuration circuitry. The volume definition circuitry may be configured to determine one or more test volumes, determine a clinical effect resulting from the one or more test volumes each being activated by the neurostimulation, and determine a target volume using the determined clinical effect. The stimulation configuration circuitry may be configured to generate the specified stimulation configuration for activating the target volume.

Systems and methods are disclosed in which a time series analysis algorithm is used to analyze inputs such as adjustments a patient has made to the amplitude of stimulation in an implantable stimulator system. The algorithm uses these inputs to predict how the patient would likely adjust the amplitude in the future, i.e. to predict future amplitudes for the patient as a function of time. Preferably, the algorithm determines one or more of an amplitude level, at least one seasonal variation, or at least one trend when predicting the amplitude. This predicted amplitude can then be used to automatically adjust the amplitude of the stimulation provided by the patient's stimulator. The algorithm may only use previous amplitude adjustments to predict the amplitude, other time-varying inputs, or combinations of both.