System for providing stimulation pattern to modulate neural activity

Abstract

According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. Other embodiments are provided herein.

1 . (canceled) 
     
     
         2 . An implantable neuromodulation system for use with at least one electrode to modulate neural activity in a spinal cord, comprising:
 a sensor configured to sense nerve activity and a neurostimulation generator configured for use to generate electrical stimulation in the spinal cord using the at least one electrode; and   controller circuitry operably connected to the neurostimulation generator and configured to control generation of the electrical stimulation to provide a stimulation pattern, and configured to adjust the stimulation pattern based on the sensed nerve activity,   wherein the neuromodulation generator, the sensor, and the controller circuitry are implantable as part of the implantable modulation system.   
     
     
         3 . The implantable neuromodulation system of  claim 2 , wherein the stimulation pattern includes a pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a wave morphology, the pattern of bursts with multiple burst durations and multiple burst interval sequences being different from a simple burst pattern of repeated bursts with one burst duration and burst interval. 
     
     
         4 . The implantable neuromodulation system of  claim 2 , wherein the stimulation pattern includes a burst pattern of repeated bursts with one burst duration and burst interval. 
     
     
         5 . The implantable neuromodulation system of  claim 2 , wherein the stimulation pattern includes a burst frequency, and the burst frequency is changed in response to the sensed nerve activity. 
     
     
         6 . The implantable neuromodulation system of  claim 2 , wherein the stimulation pattern includes a morphology, the morphology is changed in response to the sensed nerve activity. 
     
     
         7 . The implantable neuromodulation system of  claim 2 , wherein the controller circuitry is configured to adjust the stimulation pattern based on a circadian rhythm. 
     
     
         8 . The implantable neuromodulation system of  claim 2 , further comprising an activity sensor configured to sense patient activity, wherein the controller circuitry is configured to adjust the stimulation pattern based on the sensed patient activity. 
     
     
         9 . The implantable neuromodulation system of  claim 2 , further comprising an adverse event detector configured for use to identify an adverse event, wherein the controller circuitry is configured to adjust the neurostimulation waveform based on the identified adverse event. 
     
     
         10 . The implantable neuromodulation system of  claim 2 , further comprising a respiration monitor configured for monitoring at least one respiration parameter, wherein the controller circuitry is configured to adjust the neurostimulation waveform based on the at least one respiration parameter. 
     
     
         11 . A method performed by an implantable system, including a sensor configured to sense nerve activity and a neurostimulation generator configured to generate electrical stimulation in a spinal cord using at least one electrode, wherein the implantable system has controller circuitry and the neurostimulation generator, the sensor and the controller circuitry are all implantable as part of the implantable system, the method comprising:
 providing the electrical stimulation with a stimulation pattern, sensing nerve activity, and adjusting the stimulation pattern based on the sensed nerve activity.   
     
     
         12 . The method of  claim 11 , wherein the stimulation pattern includes a pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a wave morphology, the pattern of bursts with multiple burst durations and multiple burst interval sequences being different from a simple burst pattern of repeated bursts with one burst duration and burst interval. 
     
     
         13 . The method of  claim 11 , wherein the stimulation pattern includes a burst pattern of repeated bursts with one burst duration and burst interval. 
     
     
         14 . The method of  claim 11 , wherein the stimulation pattern includes a burst frequency, and the burst frequency is changed in response to the sensed nerve traffic. 
     
     
         15 . The method of  claim 11 , wherein the stimulation pattern includes a morphology, the morphology is changed in response to the sensed nerve activity. 
     
     
         16 . The method of  claim 11 , wherein:
 the stimulation pattern includes a pulse amplitude, the pulse amplitude is changed in response to the sensed nerve activity;   the stimulation pattern includes a pulse width, the pulse width is changed in response to the sensed nerve activity; or.   the stimulation pattern includes a pulse frequency, the pulse frequency is changed in response to the sensed nerve activity.   
     
     
         17 . A method performed by an implantable system, including a sensor configured to sense nerve activity and a neurostimulation generator configured to generate electrical stimulation in a spinal cord using at least one electrode, wherein the implantable system has controller circuitry and the neurostimulation generator, the sensor and the controller circuitry are all implantable as part of the implantable system, the method comprising:
 using the at least one electrode to sense nerve activity and deliver a neurostimulation waveform to the spinal cord in bursts of pulses having a burst frequency where the pulses have a burst morphology;   
       and
 responding to the sensed nerve activity, using the controller circuitry by changing at least one of the burst frequency or the morphology of the neurostimulation waveform. 
 
     
     
         18 . The method of  claim 17 , further comprising adjusting the neurostimulation waveform based on a circadian rhythm. 
     
     
         19 . The method of  claim 17 , further comprising sensing patient activity and adjusting the neurostimulation waveform based on the sensed patient activity. 
     
     
         20 . The method of  claim 17 , further comprising identifying an adverse event and adjusting the neurostimulation waveform based on the identified adverse event. 
     
     
         21 . The method of  claim 17 , further comprising monitoring respiration and adjusting the neurostimulation waveform based on the monitored respiration.