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.

An example of a system for programming neurostimulation according to a stimulation configuration may include stimulation configuration circuitry, volume definition circuitry, stimulation effect circuitry, and recording circuitry. The stimulation configuration circuitry may be configured to determine the stimulation configuration. The volume definition circuitry may be configured to determine stimulation field model(s) (SFM(s)) each representing a volume of tissue activated by the neurostimulation. The stimulation effect circuitry may be configured to determine a stimulation effect type for each tagging point specified for the SFM(s) and to tag the SFM(s) at each tagging point with the stimulation effect type determined for that tagging point. The stimulation effect type for each tagging point is a type of stimulation resulting from the neurostimulation as measured at that tagging point. The recording circuitry may be configured to generate SFM data representing the determined SFM(s) with the stimulation effect type tagged at each tagging point.

A method (of treating a patient who has tinnitus) includes: providing to the patient a series of tones including at least a single tone which is at least a half-octave outside a tinnitus frequency of the patient; and applying vagus nerve stimulation to the patient to induce a period of plasticity in a cortex of the patient that is transitory and that represents a transitory opportunity for learning to occur; and wherein the at least a single tone occurs during the transitory opportunity for learning.

An active implantable stimulating device (10) includes: (a) a tissue coupling unit (40) for being implanted directly onto a vagus nerve (Vn) of a patient, (b) an EEG-unit (70) for measuring an electroencephalogram of the patient, (c) an encapsulation unit (50) configured for being subcutaneously implanted, (d) an energy transfer lead (30) for transferring pulses of electrical and/or optical energy, (e) a signal transfer lead (60) for transferring signals between the EEG unit and the encapsulation unit. EEG electrodes (70a-70d) monitor the electric activity of the brain of a patient. The EEG signal is conveyed to the electronic circuit (53) in the form of EEG conditioned data. The electronic circuit analyses the EEG conditioned data to yield analysis results. The electronic circuit takes a decision to trigger energy pulses to stimulate the vagus nerve (VN).

A method of applying a neural stimulus with an implanted electrode array involves applying a sequence of stimuli configured to yield a therapeutic effect while suppressing psychophysical side effects. The stimuli sequence is configured such that a first stimulus recruits a portion of the fibre population, and a second stimulus is delivered within the refractory period following the first stimulus and the second stimulus being configured to recruit a further portion of the fibre population. Using an electrode array and suitable relative timing of the stimuli, ascending or descending volleys of evoked responses can be selectively synchronised or desynchronised to give directional control over responses evoked.

Embodiments of the present disclosure include a method for treating a condition of a subject. An implant defining a longitudinal axis is implanted between a nerve and skin of the subject. The implant includes an insulating member disposed, along the longitudinal axis, on at least a skin-facing side of the implant. Exactly two electrodes are disposed, along the longitudinal axis, at respective portions of a nerve-facing side of the implant. While the electrodes are driven to apply a treatment that stimulates the nerve, the insulating member is used to inhibit direct stimulation of sensory nerve fibers of the skin that are adjacent to the skin-facing side of the implant. Other embodiments are also described.

A method of providing a sleep apnea nerve stimulation therapy to a subject may include detecting a respiratory waveform of the subject with a sensor. The sensor may be configured for coupling to the subject. The respiratory waveform may include a plurality of respiratory cycles each corresponding to at least one of a breath and an attempted breath of the subject. The method may also include identifying a breathing pattern within the respiratory waveform over a period of time. The breathing pattern may include a repeating pattern of a plurality of respiratory cycles followed by at least one respiratory cycle corresponding to a disordered breathing event. The method may also include generating a series of stimulation pulses with an implantable nerve stimulator configured for coupling to a hypoglossal nerve of the subject. The series of stimulation pulses may be coordinated with the breathing pattern.

Methods, implantable devices, and systems for treating a cancer or inhibiting cancer growth or recurrence in a subject are described herein. Such methods can include electrically stimulating a thoracic splanchnic nerve (such as a greater splanchnic nerve) of the subject with a plurality of electrical pulses emitted from one or more electrodes m electrical communication with the splanchnic nerve, wherein the plurality of electrical pulses triggers one or more action potentials in the splanchnic nerve to increase circulating natural killer (NK) cells in the subject. An implantable device may include one or more electrodes configured to be in electrical communication with a thoracic splanchnic nerve of a subject with cancer, and be configured to operate the one or more electrodes to electrically stimulate the splanchnic nerve with a plurality of electrical pulses that triggers one or more action potentials in the splanchnic nerve that increase circulating NK cells.

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.

An example of a system for delivering neurostimulation energy may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters according to a neurostimulation program including a pattern of interferential stimulation configured to effect asynchronous and/or non-regular activation of nerve fibers by simultaneously delivering a first stimulation current having a first waveform with a first frequency using a first electrode configuration and a second stimulation current having a second waveform with a second frequency using a second electrode configuration. The user interface may be configured to determine the neurostimulation program and to provide the pattern of interferential stimulation with modulation of the first waveform, the second waveform, the first electrode configuration, and/or the second electrode configuration to result in a time-varying beat frequency capable of effecting the asynchronous and/or non-regular activation of the nerve fibers.