Neural stimulation with transient response between doses

Abstract

In various method embodiments for operating an implantable neural stimulator to deliver a neural stimulation therapy to an autonomic neural target, the method comprises using the implantable neural stimulator to deliver the neural stimulation therapy to the autonomic neural target, and evaluating an evoked response to the neural stimulation bursts. The neural stimulation therapy includes a plurality of neural stimulation bursts where each neural stimulation burst includes a plurality of neural stimulation pulses and successive neural stimulation bursts are separated by a time without neural stimulation pulses. Evaluating the evoked response includes sensing the evoked response to the neural stimulation bursts where sensing the evoked response includes sensing at least one physiological parameter affected by the neural stimulation bursts, comparing the sensed evoked response against a baseline, and determining if the evoked response substantially returns to the baseline between neural stimulation bursts.

1 . (canceled) 
     
     
         2 . A method performed by a neural stimulator system having a waveform generator, a nerve activity sensor and a controller, the method comprising:
 delivering neural stimulation therapy using the waveform generator, the neural stimulation therapy including one or more neural stimulation bursts;   sensing, using the nerve activity sensor, evoked nerve activity responses to the one or more neural stimulation bursts of the neural stimulation therapy; and   using the controller to mathematically analyze the evoked nerve activity responses and control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses.   
     
     
         3 . The method of  claim 2 , wherein the using the controller to mathematically analyze the evoked nerve activity responses includes performing an autocorrelation of the evoked nerve activity responses. 
     
     
         4 . The method of  claim 2 , wherein the using the controller to mathematically analyze the evoked nerve activity responses includes performing cross-correlation of the evoked nerve activity responses. 
     
     
         5 . The method of  claim 2 , wherein the using the controller to mathematically analyze the evoked nerve activity responses includes averaging the evoked nerve activity responses. 
     
     
         6 . The method of  claim 2 , wherein the using the controller to mathematically analyze the evoked nerve activity responses includes filtering the evoked nerve activity responses. 
     
     
         7 . The method of  claim 2 , wherein the using the controller to mathematically analyze the evoked nerve activity responses includes integrating the evoked nerve activity responses. 
     
     
         8 . The method of  claim 2 , further comprising sensing, using the nerve activity sensor, nerve activity before delivering the one or more neural stimulation bursts, wherein the using the controller to mathematically analyze the evoked nerve activity responses includes using the sensed nerve activity before delivering the neural stimulation bursts to mathematically analyze the evoked nerve activity responses. 
     
     
         9 . The method of  claim 2 , wherein the sensing evoked nerve activity responses includes providing a time-series of parameter data points, and the using the controller to mathematically analyze the evoked nerve activity responses includes mathematically analyzing the time-series of parameter data points. 
     
     
         10 . The method of  claim 9 , wherein the mathematically analyzing the time-series of parameter data points includes performing a Fourier decomposition of the time series of parameter data points. 
     
     
         11 . The method of  claim 2 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing a dose of the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses. 
     
     
         12 . The method of  claim 2 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing neural stimulation parameters for the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses. 
     
     
         13 . The method of  claim 2 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing a neural stimulation waveform based on the mathematically-analyzed evoked nerve activity responses. 
     
     
         14 . The method of  claim 2 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing a neural stimulation location based on the mathematically-analyzed evoked nerve activity responses. 
     
     
         15 . The method of  claim 2 , further comprising using the controller to record information indicative of the mathematically-analyzed evoked nerve activity responses. 
     
     
         16 . The method of  claim 2 , further comprising sensing at least one physiological parameter indicative of a clinical treatment effect. 
     
     
         17 . A method performed by a neural stimulator system having a waveform generator, a nerve activity sensor and a controller, the method comprising:
 delivering neural stimulation therapy using the waveform generator, the neural stimulation therapy including one or more neural stimulation bursts;   sensing, using the nerve activity sensor, evoked nerve activity responses to the one or more neural stimulation bursts of the neural stimulation therapy;   using the controller to mathematically analyze the evoked nerve activity responses and control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses, including using the mathematically-analyzed evoked nerve activity responses in an automated search for a set of neurostimulation parameter values for the neurostimulation therapy.   
     
     
         18 . The method of  claim 17 , wherein the automated search includes an algorithmic search technique for optimal evoked nerve activity responses. 
     
     
         19 . The method of  claim 17 , wherein the automated search is performed according to a defined search schedule. 
     
     
         20 . The method of  claim 17 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing a neural stimulation waveform based on the mathematically-analyzed evoked nerve activity responses. 
     
     
         21 . The method of  claim 17 , wherein the using the controller to control the neural stimulation therapy based on the mathematically-analyzed evoked nerve activity responses includes changing a neural stimulation location based on the mathematically-analyzed evoked nerve activity responses.