A patient external controller is provided for controlling sub-perception stimulation provided by a patients implantable stimulator device having an electrode array. Control circuitry in the controller renders a graphical user interface (GUI), including a location at which the sub-perception stimulation is provided within the electrode array, and a pre-defined region in which the location can be moved. The pre-defined region may be constrained to less than the entire electrode array. The control circuitry receives one or more first inputs to move the location of the sub-perception stimulation within the region and to program the stimulator to move the sub-perception stimulation to the moved location in the electrode array. The control circuitry can enable adjustment of an amplitude of the sub-perception stimulation to a value that is less than or equal to a perception threshold. Once moved, the sub-perception stimulation an be stored as a second stimulation program.

The present invention provides improved methods for positioning of an implantable lead in a patient with an integrated EMG and stimulation clinician programmer. The integrated clinician programmer is coupled to the implantable lead, wherein the implantable lead comprises at least four electrodes, and to at least one EMG sensing electrode minimally invasively positioned on a skin surface or within the patient. The method comprises delivering a test stimulation at a stimulation amplitude level from the integrated clinician programmer to a nerve tissue of the patient with a principal electrode of the implantable lead. Test stimulations are delivered at a same stimulation amplitude level for a same period of time sequentially to each of the four electrodes of the implantable lead. A stimulation-induced EMG motor response is recorded with the integrated clinician programmer for each test stimulation on each electrode of the implantable lead via the at least one pair of EMG sensing electrodes so as to facilitate initial positioning of the implantable lead at a target stimulation region.

An apparatus includes a flexible, electrically conducting layer disposed between a first flexible electrically insulating layer and a second flexible electrically insulating layer. At least one of the first electrically insulating layer, the electrically conducting layer, or the second electrically insulating layer includes multiple recesses defined therein, the recesses collectively having a predefined pattern. The apparatus also includes protrusions in the form of penetrating beam structures capable of accessing deep tissue structures, and at least one electrical access site electrically coupled to the electrically conducting layer, forming an electrode site. The apparatus also includes microelectronic circuitry/coils and components to serve as an implantable, flexible, conformally adjustable, interface for stimulating and/or recording electrical activity in biological tissue.

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 and shock.

Neuromodulation is used to enhance left ventricular relaxation and/or left ventricular contractility, during contemporaneous use of a mechanical circulatory support device to increase cardiac output or aid in unloading the heart. An exemplary neuromodulation system includes a therapy element positionable in proximity to at least one nerve fiber, and a stimulator configured to energize the therapy element to delivery therapy to the at least one nerve fiber such that left ventricular relaxation and left ventricular contractility are contemporaneously enhanced.

An apparatus for delivering a plurality of electromagnetic fields to a body of an individual. The apparatus includes a plurality of electrode elements and a control device coupled with the plurality of electrode elements. The control device is configured to detect temperatures of the plurality of electrode elements, determine alternate firing sequences of the plurality of electrode elements, and implement the determined alternate firing sequences for delivering the plurality of electromagnetic fields for treating tumors in the body of the individual and reducing temperatures of the plurality of electrode elements.

A system can utilize interleaving periods or waveforms to stimulate patient tissue and sense signals using the stimulation electrodes. For example, the system can utilize alternating therapeutic periods and sensing periods. As another example, the system can alternate between biphasic waveforms having opposite temporal orders of positive and negative phases. As another example, waveforms that differ in a parameter, such as amplitude or pulse width, can be interleaved to provide different information in the respective sensed signals.

The disclosure concerns a method for the treatment of cervical dystonia, comprising inserting a stimulation device into the brain of a patient, the stimulation device being configured to provide electrical stimulation to affect first and second stimulation targets within the brain. The first stimulation target is the subthalamic nucleus (STN); and the second stimulation target is the ventral intermediate nucleus (VIM), or the ventralis oralis posterior thalamus (VOP), or both the ventral intermediate nucleus (VIM) and the ventralis oralis posterior thalamus (VOP).

Devices, systems, and techniques are described for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

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.