A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

A flexible sheet for neurostimulation has a flexible non-conductive substrate matrix in which electrodes are embedded along a lower surface. Electrically conductive wires extend from the electrodes through the flexible substrate to another exterior surface of the substrate. Methods of making the flexible sheet and making a device using the flexible sheet are also disclosed.

A method of assessing or monitoring the normal skin sympathetic nerve activity in a living subject, the subject having a skin, comprises assessing or measuring electrodermal activity, wherein the electrodermal activity is skin conductance, galvanic skin response, electrodermal response, psychogalvanic reflex, skin conductance response, sympathetic skin response or skin conductance level. Skin conductance may be assessed by calculating skin conductance fluctuation peaks per time unit, and when the skin conductance fluctuations peaks are above a certain predefined value, the normal skin sympathetic nerve activity is defined in an analyzing window with a length of about 15 to 60 seconds, the normal skin sympathetic nerve activity is assessed as being obtained or successful. Alternatively, the skin conductance may be assessed by calculating rise time of the mean skin conductance level, the area under the skin conductance fluctuations or the size of the amplitude of the skin conductance fluctuation.

Disclosed herein are methods, devices, and systems for evaluation, diagnosis, prevention, and treatment of peripheral neuropathies.

A system is provided including an intravascular catheter or guidewire and a processor circuit. The processor circuit determines a metric corresponding to the state of the sympathetic nervous system. The processor circuit then controls the intravascular catheter to alter the blood flow within the vessel. The processor circuit then determines another metric corresponding to the state of the sympathetic nervous system while the blood flow is altered. The processor circuit then provides an output based on the metrics obtained while the blood flow was not altered and while the blood flow was altered.

A system includes a processor circuit configured to receive a first set of data. The first set of data includes two pressure measurements and a flow measurement from the vasculature of a patient obtained while the sympathetic nervous system of the patient is not under stimulation. The processor circuit calculates a blood flow resistance value based on the first set of data. The processor circuit then receives a second set of data. The second set of data also includes two pressure measurements and a flow measurement from the vasculature of the patient obtained while the sympathetic nervous system of the patient is stimulated. The processor circuit calculates another blood resistance value based on the second set of data. The processor circuit then compares the two blood flow resistance values to determine whether a denervation procedure would be effective to mitigate the nerve system's response to stimulation. The processor circuit outputs to a screen display metrics obtained from the measurement procedure.

A system includes a processor circuit in communication with an anatomical measurement device. The anatomical measurement device receives a metric associated with a sympathetic response of a patient. The sympathetic nervous system of the patient is then stimulated. The anatomical measurement device then receives another metric associated with a sympathetic response of the patient while the sympathetic nervous system is stimulated. The processor circuit then provides an output based on the comparison.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Methods are provided for measuring real-time concussive and vascular brain injuries, within seconds of the incident, by using a cascading decrease of optic nerve oxygen perfusion as captured by the retina oximetry, which is representative of inherent processes taking place within the brain subsequent to various degrees of cranial insult. The methods presented herein provide for establishing baseline databases and protocols that are intended to set standards for testing and protecting athletes on the field of play and creating emergency guidelines for early treatment of cerebrovascular accidents. Further, methods of investigation presented herein are capable of creating a database of demographically representative values, that are intended to provide statistical norms significant to demographics, such as age, sex, race, location, and athletic endeavors both at rest and within an active athletic state.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.