Apparatus for delivering enhanced stimulation waveforms

1 . A method for treating a patient, comprising:

delivering a plurality of pulses to tissue of the patient via one or more stimulation elements of an implantable device;

measuring, via a sensor of the implantable device, a first neural response induced by a first pulse of the plurality of pulses and a second neural response induced by a second pulse of the plurality of pulses, wherein the first pulse is a discrete pulse and the second pulse is an initial pulse of a pulse train;

comparing a magnitude of the second neural response to a neural response threshold, wherein the neural response threshold is defined by a percentage of the magnitude of the first neural response; and

configuring one or more stimulation parameters of a stimulation waveform for the patient based on the comparison.

2 . The method of claim 1 further comprising measuring a neural response after each pulse of the pulse train.

3 . The method of claim 1 , wherein the neural response threshold is less than or equal to 50% of the magnitude of the first neural response.

4 . The method of claim 1 , wherein the one or more stimulation parameters comprises a number of pulses of the stimulation waveform, and wherein the configuring comprises setting the number of pulses such that a third, subsequent neural response is below the neural response threshold.

5 . The method of claim 4 further comprising adjusting a number of pulses of the pulse train to change a magnitude of the third neural response.

6 . The method of claim 1 , wherein the neural response threshold is equal to or within 20% of the magnitude of the first neural response.

7 . The method of claim 1 , wherein the one or more stimulation parameters comprise a refractory waiting period (RWP), wherein the RWP is a time period configured to allow neurons of the tissue of the patient to repolarize.

8 . The method of claim 7 , wherein configuring the one or more stimulation parameters comprises increasing the RWP.

9 . The method of claim 7 , wherein the RWP is at least 0.5 ms.

10 . The method of claim 1 , wherein an external device communicably coupled to the implantable device configures the one or more stimulation parameters.

11 . The method of claim 1 , wherein both of the first and second neural responses comprise one or both of an eCAP measurement and an EMG measurement.

12 . A method for treating a patient, comprising:

delivering energy to tissue of the patient via one or more stimulation elements of an implantable device;

measuring, via sensor of the implantable device, a plurality of neural responses induced by the delivered energy;

determining a measured neural response of the plurality of measured neural responses meets a neural response condition, wherein the neural response condition defines a threshold for a magnitude of the measured neural response; and

configuring one or more stimulation parameters of a stimulation waveform for the patient based on the determination.

13 . The method of claim 12 , wherein the energy comprises one or more pulse trains and one or more discrete pulses, wherein each pulse train comprises a plurality of pulses.

14 . The method of claim 12 , wherein delivering the energy to the tissue comprises delivering a discrete pulse and a pulse train, wherein the plurality of neural responses comprises a discrete neural response induced by the discrete pulse, wherein a first pulse of the pulse train is configured to induce the measured neural response, and wherein the threshold for the magnitude of the measured neural response is equal to a magnitude of the discrete neural response.

15 . The method of claim 12 , wherein the one or more stimulation parameters comprise a refractory waiting period (RWP), wherein the RWP is a time period configured to allow neurons of the tissue of the patient to repolarize.

16 . The method of claim 15 , wherein configuring one or more stimulation parameters comprises increasing the time period of the RWP.

17 . The method of claim 15 , wherein the RWP is at least 0 . 5 ms.

18 . The method of claim 12 , wherein the energy comprises a pulse train, and wherein measuring the plurality of neural responses comprises measuring a first neural response after a first pulse of the pulse train and a second neural response after a last pulse of the pulse train.

19 . The method of claim 18 further comprising comparing a magnitude of the second neural response to a neural response threshold and adjusting a number of pulses of the stimulation waveform based on the comparison.

20 . The method of claim 12 , wherein the implantable device comprises a trial implantable device, wherein the energy is delivered and the measured neural response is determined during a trialing session for the trial implantable device.

21 . The method of claim 20 further comprising delivering the stimulation waveform to the patient via one or both of the trial implantable device and a long-term implantable device based on the measured neural response determined with the trial implantable device.

22 . The method of claim 12 , wherein the implantable device comprises a long-term implantable device, and wherein the energy is delivered and the measured neural response is determined during an implantation procedure of the long-term device.

23 . A stimulation system for a patient, comprising:

an implantable device comprising:

one or more stimulation elements configured to deliver a plurality of pulses to tissue of the patient; and

a sensor configured to interface with the tissue of the patient and measure a first neural response induced by a first pulse of the plurality of pulses and a second neural response induced by a second pulse of the plurality of pulses, wherein the first pulse is a discrete pulse and the second pulse is an initial pulse of a pulse train; and

an external device communicably coupled to the implantable device and configured to;

compare a magnitude of the second neural response to a neural response threshold, wherein the neural response threshold is defined by a percentage of the magnitude of the first neural response; and

configure one or more stimulation parameters of a stimulation waveform for the patient based on the comparison.

24 . A stimulation system for a patient, comprising:

an implantable device comprising:

one or more stimulation elements configured to deliver stimulation energy to tissue of the patient; and

a sensor configured to interface with the tissue of the patient and measure a plurality of neural responses induced by the delivered energy; and

an external device communicably coupled to the implantable device and configured to:

determine a measured neural response of the plurality of measured neural responses meets a neural response condition, wherein the neural response condition defines a threshold for a magnitude of the measured neural response; and

configure one or more stimulation parameters of a stimulation waveform for the patient based on the determination.