59 results about "Evoked potential recording" patented technology

Systems and methods for modelling a spatial distribution of evoked responses (ERs) to electrostimulation and using the model to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes positioned at respective sensing locations and selected from the electrodes on the at least one lead, generate a model representing a spatial distribution of ER features of the sensed ERs, and based on a comparison of the model to acceptance criteria, provide a recommendation to reposition the lead or to adjust the stimulation setting.

Systems and methods for collecting evoked responses (ERs), and using the same to guide neuromodulation are disclosed. An exemplary system includes an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs, and a controller circuit to collect first ERs sensed from a group of sensing electrodes in response to electrostimulation through first one or more stimulating electrodes. The controller circuit performs a quality check of the first ERs, determine or update an ER sampling routine including timings or an order of performing multiple stimulation and ER collection tests, and sequentially execute the multiple stimulation and ER collection tests, and collect second ERs according to the determined or updated ER sampling routine. When the second ERs satisfy an acceptance criterion, a recommendation can be provided to a user to reposition the lead or to set or adjust a stimulation setting.

This document discusses a computer-implemented method of operating a neurostimulation device to deliver electrical neurostimulation when connected to an implantable stimulation lead. The method includes delivering neurostimulation to a subject using the neurostimulation device; recording electrical signals sensed using the implantable stimulation lead; extracting one or more features from the recorded electrical signals; detecting clustering of the one or more extracted features of the recorded electrical signals; and identifying, by the neurostimulation device, an evoked response signal of interest from among the recorded electrical signals using the detected clustering of the one or more extracted features of the recorded electrical signals.

An exemplary system comprises a memory storing instructions and a processor configured to execute the instructions to perform a process. The process may comprise directing stimulation to be applied to a recipient of a hearing system, the stimulation configured to elicit an evoked response within the recipient, directing a cochlear implant included in the hearing system to continuously record, during an acquisition time window and using at least one electrode electrically coupled to the cochlear implant, data representative of the evoked response, and directing the cochlear implant to stream, by way of a back telemetry channel, the data to a computing device external to the recipient during the acquisition time window while the cochlear implant is continuously recording the data.

Systems and methods for selective sensing of evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes selected from and less than an entirety of the electrodes on the lead. The selected electrodes can be distinct from the stimulating electrode, or within a specific proximity to the stimulating electrode. The controller circuit can use a comparison of the sensed ERs to acceptance criterion to aid in lead placement and stimulation programming.

This document discusses a. computer-implemented method of operating a neurostimulation device to deliver electrical neurostimulation when connected to an implantable stimulation lead. The method includes delivering neurostimulation to a subject using the neurostimulation device; recording electrical signals sensed using the implantable stimulation lead; extracting one or more features from the recorded electrical signals; detecting clustering of the one or more extracted, features of the recorded electrical signals; and identifying, by the neurostimulation device, an evoked response signal of interest from among the recorded electrical signals using the detected clustering of the one or more extracted features of the recorded electrical signals.

Presented herein are techniques for measuring an evoked response to stimulation. One or more electrical stimulation signals are delivered to first ear of a recipient via a first hearing device implanted at the first ear of the recipient. One or more evoked potential evoked by the one or more electrical stimulation signals are measured with a second hearing device implanted at a second ear of the recipient.

A diagnostic system is disclosed that is configured to direct an acoustic stimulation generator to apply acoustic stimulation having a stimulus frequency to a recipient of a cochlear implant during an insertion procedure in which an electrode lead communicatively coupled to the cochlear implant is inserted into a cochlea of the recipient, direct the cochlear implant to use an electrode disposed on the electrode lead to record an evoked response signal during the insertion procedure, the evoked response signal representing amplitudes of a plurality of evoked responses that occur within the recipient in response to the acoustic stimulation applied to the recipient, and incrementally step, as the electrode lead is inserted into the values starting with an initial value and ending with a final value lower than the initial value.

Systems and methods for selective sensing of evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. -An exemplary system comprises at least one multi -electrode lead, an electrostimulator to provide electrostimulation to a. neural target, a. sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a. stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes selected from and less than an entirety of the electrodes on the lead. The selected electrodes can be distinct from the stimulating electrode, or within a specific proximity to the stimulating electrode. Based on a comparison of the sensed ERs to acceptance criteria, the controller circuit can provide a recommendation to reposition the lead or to adjust the stimulation setting.

This disclosure is directed to devices and techniques for classifying of pacing captures to evaluate effectiveness of pacing by a pacing device, such as an implantable medical device (IMD). An example system includes stimulation circuitry to generate a pacing stimulus, sensing circuitry to sense an evoked response after the pacing stimulus, and processing circuitry. The processing circuitry determines classification features from the evoked response and applies the classification features to a classification model, the classification model generated by a machine learning algorithm using one or more test sets comprising a plurality of sample evoked responses for each of a plurality of classifications. Based on the output of the model, the processing circuitry classifies the evoke response as one of the plurality of classifications.

Systems and methods for collecting evoked responses (ERs), and using the same to guide neuromodulation are disclosed. An exemplary system includes an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs, and a controller circuit to collect first ERs sensed from a group of sensing electrodes in response to electrostimulation through first one or more stimulating electrodes. The controller circuit performs a quality check of the first ERs, determine or update an ER sampling routine including timings or an order of performing multiple stimulation and ER collection tests, and sequentially execute the multiple stimulation and ER collection tests, and collect second ERs according to the determined or updated ER sampling routine. When the second ERs satisfy an acceptance criterion, a recommendation can be provided to a user to reposition the lead or to set or adjust a stimulation setting.

An exemplary system comprises memory that stores instructions and a processor communicatively coupled to the memory and configured to execute the instructions to perform a process. The process may comprise obtaining a pre-operative audiogram of a recipient, the pre-operative audiogram generated prior to a lead insertion procedure during which an electrode lead having a plurality of electrodes is inserted into a cochlea of the recipient, obtaining one or more attributes associated with the lead insertion procedure, and determining, based on the pre-operative audiogram and the one or more attributes, one or more stimulation frequencies for stimulation that is to be used during the lead insertion procedure to elicit evoked responses within the recipient, the evoked responses usable to monitor an insertion condition associated with the electrode lead.

Presented herein are techniques for generating a neural survival map of nervous tissue adjacent to a body cavity of a recipient of an implantable medical device that includes an implantable stimulation assembly. For example, during insertion of the implantable stimulation assembly into a recipient, the implantable medical device captures a plurality of evoked responses of nervous tissue adjacent to a body cavity, and a plurality of intra-operative measurements associated with the implantable stimulation assembly. The computing device is configured to determine a plurality of position estimates of the implantable stimulation assembly relative to the body cavity using the plurality of intra-operative measurements. The computing device generates a neural survival map of nervous tissue adjacent to the body cavity using the plurality of evoked responses and the plurality of position estimates.

Presented herein are techniques for recording an acoustically-evoked response of a recipient. In particular, an acoustic signal is detected, and at least one acoustically-evoked response of a recipient is recorded in response to detecting the acoustic signal to enable recording of the at least one acoustically-evoked response to be desirably initiated.

A system may include a stimulus circuit configured to provide electrostimulation to a neural target of a patient via electrodes on a lead, a sensing circuit configured to sense evoked response (ER) signals produced by the electrostimulation, a user interface, and a controller operably connected to the stimulus circuit, the sensing circuit, and the user interface. The controller is configured to initiate delivery of the electrostimulation to the electrodes, identify ER signal features of the sensed ER signals, compute a longitudinal distribution of the ER signal features for a longitudinal direction of the lead, compute a rotational distribution that is a is a periodic distribution of the ER signal features for an angular direction of the lead, and display peak regions of the longitudinal distribution and the rotational distribution as a hotspot view of the sensed ER signals on the user interface.

Systems and methods for selective sensing of evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. An exemplary system comprises at least one multi-electrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense ERs to electrostimulation, and a controller circuit. In response to electrostimulation delivered to the neural target in accordance with a stimulation setting via a stimulating electrode, the controller circuit can collect ERs from each of a group of sensing electrodes selected from and less than an entirety of the electrodes on the lead. The selected electrodes can be distinct from the stimulating electrode, or within a specific proximity to the stimulating electrode. Based on a comparison of the sensed ERs to acceptance criteria, the controller circuit can provide a recommendation to reposition the lead or to adjust the stimulation setting.

A neuromodulation device for measuring an evoked response comprising a first electrode; a second electrode, wherein the first and second electrodes are alternately configured as a stimulation electrode; a sensing electrode for sensing an evoked response to a stimulus pulse; and a controller configured to measure an evoked response at the sensing electrode after a stimulus pulse at a first stimulation electrode configuration and after a stimulus pulse at a second alternate stimulation electrode configuration, and to add said pair of measurements.

An illustrative system is configured to perform a process comprising: directing stimulation to be applied to a recipient of a bilateral hearing system that includes a first cochlear implant associated with a first ear of the recipient and a second cochlear implant associated with a second ear of the recipient; and causing the first cochlear implant and the second cochlear implant to simultaneously record, during an acquisition time window, one or more evoked responses within the recipient that are elicited by the stimulation.

Subject measurement systems can generate indications of neurological state, disease, dysfunction, or injury using a machine learning model. The machine learning model can include at least one encoding model and a sequential model pre-trained to perform language processing tasks. The machine learning model can further include a classifier configured to output classifications. The at least one encoding model, sequential model, and at least one decoding model can be jointly trained to predict timeseries output, thereby adapting the pre-trained sequential model for use with neurologically relevant input domains, such as medical images, EEG data, evoked response data, speech data, or the like. The at least one encoding model, sequential model, and classifier can be jointly trained to output indications of neurological state, disease, dysfunction, or injury. A subject measurement system can then generate such indications using patient data and the at least one encoding model, sequential model, and classifier.

An implantable device is configured to control application of a neural stimulus as defined by a stimulus parameter; measure via the measurement circuitry a characteristic of a neural compound action potential response evoked by the stimulus; and compute, using the stimulus parameter and the measured characteristic of the evoked neural compound action potential response, a characteristic of an evoked response that would be obtained from the neural stimulus if the patient were in a reference posture. A posture of the patient can be estimated from the computed characteristic and / or the computed characteristic can be used as a feedback variable of a feedback loop. Multidimensional histograms of datasets comprising at least one of the stimulus parameter and a feedback variable can be stored.

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.

Systems and methods for modeling a spatial distribution of evoked responses (ERs) of electrical stimulation and using the model to guide neuromodulation are disclosed. An exemplary system includes at least one multi-electrode lead, an electrical stimulator to provide electrical stimulation to a neural target, a sensing circuit to sense an ER to the electrical stimulation, and a controller circuit. In response to electrical stimulation delivered to the neural target via the stimulation electrodes according to stimulation settings, the controller circuit may collect an ER from each of a set of sensing electrodes located at a respective sensing location and selected from electrodes on the at least one lead, generate a model representing a spatial distribution of ER characteristics of the sensed ER, and providing a suggestion to reposition the lead or adjust the stimulation settings based on the comparison of the model to the acceptance criteria.

An illustrative system includes a sound processor configured to be worn by a patient and to direct a cochlear implant implanted within the patient to apply electrical stimulation to the patient; and a conductive contact configured to detect a signal representative of an evoked response generated by a brain of the patient, the conductive contact integrated with the sound processor so as to be located between the sound processor and an external surface of a head of the patient while the sound processor is worn by the patient.

Systems and methods for selectively sensing evoked responses (ERs) and using the ERs to guide neuromodulation are disclosed. An exemplary system includes at least one multi-electrode lead, an electrical stimulator to provide electrical stimulation to a neural target, a sensing circuit to sense an ER to the electrical stimulation, and a controller circuit. In response to electrical stimulation delivered to the neural target via the stimulation electrodes according to stimulation settings, the controller circuit may collect ER from each of a set of sensing electrodes selected from electrodes on the lead, but not including all of the electrodes. The selected electrode may be different from the stimulation electrode, or within a specific proximity distance of the stimulation electrode. Based on a comparison of the sensed ER to an acceptance criterion, the controller circuit may provide a suggestion to reposition the lead or adjust the stimulation setting.

An exemplary system directs a display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant, detects a selection by a user of the option, directs, in response to the selection of the option, an acoustic stimulation generator to apply acoustic stimulation having a frequency to the recipient, directs the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation, determines an amplitude of each of the evoked response measurements recorded by the plurality of electrodes, and presents, within the graphical user interface, a tuning curve that graphically indicates the amplitudes of the evoked response measurements.

To provide an instrument and a method for detecting evoked responses.SOLUTION: An instrument comprises: a stimulus generator configured to generate at least one stimulus or a plurality of consecutive stimuli according to a test protocol; at least one output unit comprising a transducer, the output unit being configured to receive the at least one stimulus or plurality of consecutive stimuli from the stimulus generator and to provide the at least one stimulus or plurality of consecutive stimuli to a test subject; at least one recording unit comprising one or more sensors for measuring one or more evoked responses of the test subject, in response to the provided at least one stimulus or a plurality of consecutive stimuli; and an analysis unit configured to receive and analyse the measured one or more evoked responses, where the analysis unit is configured to determine a probability p, of whether each of the responses is driven by an underlying background noise during an operation of the instrument, and where the analysis unit is configured to determine the probability p, on the basis of an F-value of the measured one or more evoked responses determined as a ratio between a variance of the average one or more evoked responses and a variance of a residual background noise.SELECTED DRAWING: Figure 1

The present application discloses an instrument for detecting an auditory evoked nerve response, the instrument comprising: a stimulation generator configured to generate at least one stimulation or a plurality of consecutive stimuli according to a test protocol; at least one output unit including a transducer, the output unit configured to receive at least one stimulus or a plurality of consecutive stimuli and provide the stimuli to the subject; comprising one or more sensors for measuring one or more evoked responses of the subject in response to the provided stimuli; an analysis unit configured to receive and analyze the measured one or more evoked responses, where the analysis unit is configured to determine a probability p that each of the responses is driven by potential background noise during operation of the instrument, the analysis unit is configured to determine the probability p based on a value F of the measured one or more evoked responses determined as a ratio between a variance of an average of the one or more evoked responses and a variance of residual background noise.

Controlling a neural stimulus comprises applying the neural stimulus to a neural pathway in order to give rise to an evoked action potential on the neural pathway, the stimulus being defined by at least one stimulus parameter. A neural compound action potential response evoked by the stimulus is measured, and from the measured evoked response a feedback variable is derived. Loop backoff behaviour is adjusted by applying a non-identity function to the feedback variable to produce a revised feedback variable, and completing a feedback loop by using the revised feedback variable to control the at least one stimulus parameter so as to maintain the feedback variable at a setpoint. Additionally, or alternatively, loop gain can be adjusted in response to a change in the loop setpoint, and / or a logarithm of the stimulus parameter can be controlled.

Systems and techniques are disclosed for determining and implementing neurostimulation programming, based on sensing and therapy capabilities. An example technique includes: identifying an arrangement for a plurality of electrical contacts of one or more implanted leads; identifying neurostimulation parameters for delivering therapy to a neurostimulation location using a first set of electrical contacts of the arrangement; determining a sensing capability for sensing an evoked response to the therapy delivered to the neurostimulation location, using a second set of electrical contacts of the arrangement, and determining the sensing capability based on the arrangement and the neurostimulation parameters; and changing at least a portion of the neurostimulation parameters for delivering the therapy, in response to a determination that the sensing capability is not available at the neurostimulation location. The changed neurostimulation parameters can be programmed and used for delivering therapy to a changed neurostimulation location that provides suitable sensing capabilities.

An illustrative system directs a display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant, directs, in response to a selection by a user of the option, an acoustic stimulation generator to apply acoustic stimulation having a frequency to the recipient, and directs the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation.