Medtronic, Inc.

Covidien LP

Scott R Stanslaski

Robert S Raike

Eric J Panken

Thomas Adamski

Christopher L Pulliam

Timothy R Abraham

Jadin C Jackson

Jonathon E Giftakis

David L Carlson

David E Linde

Gabriela C Molnar

Todd Jon Sheldon

Douglas A Hettrick

Robert A Betzold

Paul H Stypulkowski

Jianping Wu

Michael O Sweeney

Duane L Bourget

Peng Cong

Erik J Peterson

Pedram Afshar

David A Dinsmoor

Steven M Goetz

Avram Scheiner

Jeffrey M Gillberg

Timothy J Denison

Wesley A Santa

Robert A Corey

Paul A Belk

Nathan Andrew Torgerson

Jian L Cao

Todd V Smith

William Frederick Kaemmerer

Paul R Mazanec

Randal C Schulhauser

Joel A Anderson

Richard J O'Brien

Kristin N Hageman

Rene A Molina

Randy M Jensen

Heather Diane Orser

Abbey Beuning Holt Becker

Timothy Denison

Benjamin P Isaacson

Thomas L Chouinard

Michelle A Case

William J Marks, Jr

Vincent Roczniak

Robert Devine

Gregory J Loxtercamp

Andrew H Houchins

Forrest C M Pape

Christopher M Arnett

Yizi Xiao

Evan Schnell

Jeffrey Herron

Lukas Valine

Alicia Weller Thompson

Caleb C Zarns

Karan Chitkara

Ilan D Gordon

Ankush Thakur

Brady N Fetting

Rucha Gokul G Samant

Hijaz M Haris

Paula Andrea Elma Dassbach Green

Mae Eng

Thaddeus S Brink

David J Miller

William C Harding

Becky L Dolan

Alan Shi

Kunal J Paralikar

Jalpa S Shah

Kevin M Johnson

Susan Heilman Kilbane

Nicholas D Buse

Susan E Heilman Kilbane

Lilian Kornet

Peter N Braido

Ryan Gertenbach

Brian L Bechard

William Valls, Jr

Kevin C Johnson

Heba Tareq Omar

Steven J Stroncek

Robert J Devine

Thomas H Adamski

Maneesh A Shrivastav

An example system includes a first lead configured to be positioned in or beside a left internal jugular vein (IJV) of a patient to deliver a first stimulation signal to a first vagus nerve, the first lead including one or more first segmented electrodes positioned on a distal portion of the first lead and a first anchoring mechanism; a second lead configured to be positioned in or beside a right IJV of the patient to deliver a second stimulation signal to a second vagus nerve, the second lead including one or more second segmented electrodes positioned on a distal portion of the second lead and a second anchoring mechanism; and circuitry configured to deliver electrical energy to the first lead to deliver the first stimulation signal and the second lead to deliver the second stimulation signal to provide bilateral stimulation to the first vagus nerve and the second vagus nerve.

Bilateral vagus nerve stimulation

Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first change of a first sensed signal of the patient to movement by the patient and a second change of a second sensed signal of the patient to the movement by the patient. Based on the first change and the second change, the medical system selects one of the first sensed signal and the second sensed signal of the patient for controlling the electrical stimulation therapy. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.

Adaptive deep brain stimulation using movement desynchronization

Devices, systems, and techniques for identifying electrodes closest to a target region of tissue are described. In one example, a device includes sensing circuitry configured to sense electrical signals from a plurality of electrode combinations. Processing circuitry identifies a first electrode combination of a first subset of electrode combinations. Each electrode combination of the first subset of electrode combination includes electrodes located at different axial positions along a length of the medical lead. The processing circuitry identifies a second electrode combination of a second subset of electrode combinations. Each electrode combination of the second subset of electrode combinations includes electrodes located at a same axial position and different circumferential positions around a perimeter of the medical lead. The processing circuitry then determines a third electrode combination and controls delivery of electrical stimulation via the third electrode combination.

Directional sensing for programming guidance

Devices and methods provide for the sensing of physiological signals by providing a stimulation waveform that includes a stimulation pulse followed by an active recharge pulse to clear the charge in capacitors within the stimulation path. The active recharge pulse is followed by a period of passive recharge and then a period of no recharge. Non-neurological sources of artifacts within the sensed physiological signal may be handled by providing a brief period of passive recharge followed by a lengthy period of no recharge, which is made possible by the use of the active recharge pulse prior to the passive recharge. The period of no recharge removes any low impedance path to ground from the stimulation electrodes, which allows an amplifier of the sensing circuit to provide common mode rejection of non-neurological signals, such as cardiac signals, present at the sensing electrodes.

Devices and methods for sensing physiological signals during stimulation therapy

An implantable medical device that includes a memory, stimulation circuitry configured to deliver electrical stimulation to a patient, and processing circuitry operably coupled to the memory. The processing circuitry is configured to: control the stimulation circuitry to output electrical stimulation therapy to a patient via a first electrode combination and control the stimulation circuitry to output a notification stimulation via a second electrode combination and interleaved with the electrical stimulation therapy. The notification stimulation may include an intensity above a perception level of the patient, and the second electrode combination may include an electrode disposed at an implant site of the implantable medical device.

Medical device patient alert using housing stimulation based on sensed event

Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be re-configured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.

Robust adaptive brain stimulation

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.

Stimulation induced neural response for parameter selection

Devices, systems, and techniques are disclosed for managing electrical stimulation therapy and/or sensing of physiological signals such as brain signals. For example, a system may assist a clinician in identifying one or more electrode combinations for sensing a brain signal. In another example, a user interface may display brain signal information and values of a stimulation parameter at least partially defining electrical stimulation delivered to a patient when the brain signal information was sensed.

Brain stimulation and sensing

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may be configured to deliver electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of therapy pulses at a predetermined pulse frequency over a period of time and deliver, over the period of time, a plurality of control pulses interleaved with at least some therapy pulses of the plurality of therapy pulses. The system may also be configured to sense, after one or more control pulses and prior to an immediately subsequent therapy pulse of the plurality of therapy pulses, a respective evoked compound action potential (ECAP), adjust, based on at least one respective ECAP, one or more parameter values that at least partially defines the plurality of therapy pulses, and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

ECAP based control of electrical stimulation therapy

An example method includes determining, by an implantable medical device (IMD), an electrode of a plurality of electrodes of a lead to be used to deliver electrical stimulation to a patient at a particular time; selecting, by the IMD and based on the determined electrode, a set of electrodes of the plurality of electrodes; and sensing, by the IMD and via the selected set of electrodes, electrical signals of the patient at the particular time.

Dynamically optimized neural sensing

Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first response of a first sensed signal of the patient to the electrical stimulation therapy and a second response of a second sensed signal of the patient to the electrical stimulation therapy. Based on the first response and the second response for controlling the electrical stimulation therapy, the medical system selects one of the first sensed signal and the second sensed signal of the patient. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.

Adaptive deep brain stimulation using frequency sub-bands

In some examples of selecting a target therapy delivery site for treating a patient condition, a relatively high frequency electrical stimulation signal is delivered to at least two areas within a first region (e.g., an anterior nucleus of the thalamus) of a brain of a patient, and changes in brain activity (e.g., as indicated by bioelectrical brain signals) within a second region (e.g., a hippocampus) of the brain of the patient in response to the delivered stimulation are determined. The target therapy delivery site, an electrode combination, or both, may be selected based on the changes in brain activity.

Identification of compromised components in a medical system

Techniques, systems, and devices are disclosed for delivering stimulation therapy to a patient. In one example, a medical device determines a first set of stimulation parameters that define entrainment stimulation pulses configured to entrain electrical activity in a patient. The medical device may control a stimulation generator to generate the entrainment stimulation pulses according to the first set of stimulation parameters. The medical device may further determine a second set of stimulation parameters that define at least one desynchronization stimulation pulse configured to disrupt at least a portion of the electrical activity entrained by the entrainment stimulation pulses. The medical device may subsequently control the stimulation generator to generate the desynchronization stimulation pulse(s) according to the second set of stimulation parameters.

Electrical stimulation modulation

Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be reconfigured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.

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Shoreview, MN, United States of America

Scott R Stanslaski