Medtronic, Inc.

Melanie D Goodman Keiser

Nathan Andrew Torgerson

Andrew Jay Cleland

Lisa M Johanek

Louis P Vera-Portocarrero

Sheryl McCammon

Lachlan Davies

Ye Tan

David A Dinsmoor

Phillip C Falkner

Jiashu Li

Brooke Kelley

Sheryl Mccammon

Systems, devices, and techniques are described for determining stimulation parameters based on one or more stimulation thresholds (e.g., a perception threshold or a detection threshold). In one example, a medical device includes sensing circuitry configured to sense one or more ECAP signals, wherein the sensing circuitry is configured to sense each ECAP signal of the one or more ECAPs elicited by a respective control pulse of a plurality of control pulses, and the medical device includes processing circuitry configured to determine, based on the one or more ECAP signals, a stimulation level for the plurality of control pulses that achieves a stimulation threshold, determine, based on the stimulation level, a value of a stimulation parameter that at least partially defines a plurality of therapy pulses of electrical stimulation therapy, and control stimulation generation circuitry to deliver the electrical stimulation therapy according to the value of the stimulation parameter.

Sub-threshold stimulation based on ECAP detection

Techniques for providing therapy to a patient via electrical stimulation are described. The techniques include, for example, determining, relative to a start time of providing the electrical stimulation, one or more efficacy times that correspond to an efficacy indicator, determining, according to the efficacy times, efficacy data items for the patient, comparing the efficacy data items with the efficacy indicator, and generating, based on the comparison, a prediction of an expected response to the therapy manifesting in the patient at a prospective time.

Stimulation response profiles

A system comprises a bendable, pre-formed lead body operable to be implanted proximate a neural pathway of a patient. A first electrode comprising a plurality of first segments at a first longitudinal location of the lead body is configured to be positioned at a lateral epidural region proximate at least one nerve root of the patient, and a second electrode comprising a plurality of second segments at a second longitudinal location of the lead body is configured to be positioned along a midline of the patient's spinal column. The system further includes a signal generator electrically coupled to at least one of the first and second electrodes and a processor coupled to the signal generator and operable to apply a stimulation signal to at least one of the first and second electrodes.

Nerve root and dorsal root ganglion stimulation from the lateral epidural space

In some examples, a medical device is configured to automatically determine a paresthesia threshold or a perception threshold of a patient in a second posture based on the paresthesia threshold or perception threshold of that patient in a first posture. The medical device may deliver an electrical stimulation signal to a patient and determine the paresthesia threshold or perception threshold for the patient in the first posture. The medical device may change the intensity of the electrical signal and receive an indication from the patient that they are experiencing paresthesia or perceiving the electrical stimulation signal. The medical device may then automatically determine a predicted paresthesia threshold or predicted perception threshold for a second posture based on the paresthesia threshold or perception threshold.

Posture-based paresthesia threshold or perception threshold determination

In some examples, a medical device is configured to deliver sub-threshold electrical stimulation therapy to a patient at a stimulation intensity that is significantly less than a perception or paresthesia threshold intensity level for the patient. The medical device may determine the particular intensity level for the patient through a titration process. The medical device may titrate automatically or based upon the input of the patient, a clinician or a physician.

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Otsego, MN, United States of America

Melanie D Goodman Keiser