Cochlear implant systems can include a cochlear electrode and a stimulator in electrical communication with the cochlear electrode. The stimulator can be in communication with a controller, which is in communication with a testing circuit and a switching network. The stimulator can include a plurality of source elements. The controller can control the switching network to place the plurality of source elements into communication with the testing circuit. The controller can further cause one of the plurality of source elements to emit an electrical current and can determine an amount of electrical current emitted from the source element using the testing circuit. The controller can compare the determined amount of electrical current emitted by the source element with a prescribed current. The controller can adjust the output of each of the plurality of source elements based on the determined amount of electrical current emitted by the stimulator.

Systems and methods for active charge-balancing for high frequency neural stimulation are disclosed. One illustrative method described herein includes: applying, through a pair of electrodes electrically coupled to a bundle of nerve fibers during a stimulation phase of a neural stimulation procedure, a first current to the bundle of nerve fibers; applying, through the pair of electrodes during a recovery phase of the neural stimulation procedure, a second current to the bundle of nerve fibers, the first current and the second current having opposite polarities; determining sampled voltages between the pair of electrodes during the stimulation phase, during the recovery phase, or between the stimulation phase and the recovery phase; determining a charge buildup in the bundle of nerve fibers based on the sampled voltages; applying, through the pair of electrodes during the stimulation phase or during the recovery phase, a delta current to the bundle of nerves based on the sampled voltages to minimize the charge build up.

Medical devices and methods of medical treatment for the electrical stimulation of target nerves to enhance waste clearance in the brain for treating neurological disorders such as Alzheimer's disease (AD), including prodromal, mild cognitive impairment (MCI) and early stage Alzheimer's disease.

Provided herein is a solution to the problem of stimulation of a target pudendal nerve such that the stimulation applied by the electrode at that position selectively modulates the external urtheral sphincter (EUS), or selectively modulates the external anal sphincter (EAS).

The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

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.

An implantable pulse generator (IPG) is disclosed having an improved ability to steer anodic and cathodic currents between the IPG's electrodes. Each electrode node has at least one PDAC/NDAC pair to source/sink or sink/source a stimulation current to an associated electrode node. Each PDAC and NDAC receives a current with a magnitude indicative of a total anodic and cathodic current, and data indicative of a percentage of that total that each PDAC and NDAC will produce in the patient's tissue at any given time, which activates a number of branches in each PDAC or NDAC. Each PDAC and NDAC may also receive one or more resolution control signals specifying an increment by which the stimulation current may be adjusted at each electrode. The current received by each PDAC and NDAC is generated by a master DAC, and is preferably distributed to the PDACs and NDACs by distribution circuitry.

Systems and methods for improving behavioral therapies encompassing therapies wherein a perceptual stimulus is administered to a subject or a motor behavior is performed by the subject. Such administration of perceptual stimuli or motor performance is paired with the delivery of vagus nerve stimulation to the subject. The vagus nerve stimulation is timed with the sensory stimulus administration or motor performance in a temporal alignment that maximizes neuroplasticity and performance. Systems for performance of the method and associated software are also disclosed

Differential charge-balancing can be used in high-frequency neural stimulation. For example, a neural stimulation apparatus can have first and second electrodes configured to be coupled proximate to a nerve fiber to implement a neural stimulation procedure. A neural stimulation circuit can be electrically coupled to the first and second electrodes. The neural stimulation circuit can apply stimulation currents to the nerve fiber through the first and second electrodes during a first stimulation phase of the neural stimulation procedure. The neural stimulation circuit can also apply a modified stimulation current to the nerve fiber through the first electrode during a second stimulation phase of the neural stimulation procedure. The modified stimulation current can be generated based on a difference between (i) a voltage at the first electrode, and (ii) a reference voltage derived from voltages on the first and second electrodes.

Techniques are disclosed for implementing the use of electrically evoked compound action potentials (ECAPs) to adaptively adjust parameters of high frequency electrical stimulation. In one example, a medical device delivers electrical stimulation therapy comprising a train of electrical stimulation pulses to a patient, wherein the train of electrical stimulation pulses comprises a pulse frequency greater than or equal to 500 Hertz. After delivering the train of electrical stimulation pulses, the medical device ceases delivery of the high frequency electrical stimulation therapy for a predetermined period of time. During the predetermined period of time, the medical device senses an ECAP from the patient and determines, based on the sensed ECAP, a value of a parameter at least partially defining the train of electrical stimulation pulses. Responsive to the predetermined period of time elapsing, the medical device resumes delivery of the high frequency electrical stimulation according to the determined parameter.