Evoked signal based deep brain stimulation (DBS) programming

1 . A system for therapy parameter determination, the system comprising:

memory; and

processing circuitry coupled to the memory and configured to:

deliver, with stimulation generation circuitry, a first plurality of electrical stimulation signals, wherein a frequency of each electrical stimulation signal of the first plurality of electrical stimulation signals is lower than a threshold frequency, and an amplitude or pulse width of a first electrical stimulation signal of the first plurality of electrical stimulation signals is different than an amplitude or pulse width of a second electrical stimulation signal of the first plurality of electrical stimulation signals, and wherein delivery of each of the first plurality of electrical stimulation signals evokes a respective evoked potential signal of a plurality of evoked potential signals;

deliver, with the stimulation generation circuitry, a second plurality of electrical stimulation signals, wherein a frequency of a first electrical stimulation signal of the second plurality of electrical stimulation signals is different than a frequency of a second electrical stimulation signal of the second plurality of electrical stimulation signals, and wherein delivery of each of the second plurality of electrical stimulation signals evokes a respective evoked resonant neural activity (ERNA) signal of a plurality of ERNA signals;

determine at least one of an amplitude or pulse width of a therapeutic electrical stimulation signal and a frequency of the therapeutic electrical stimulation signal, wherein the amplitude or pulse width of the therapeutic electrical stimulation signal is determined based on the evoked potential signals, and wherein the frequency of the therapeutic electrical stimulation signal is determined based on the ERNA signals; and

deliver, with the stimulation generation circuitry, the therapeutic electrical stimulation signal.

2 . The system of claim 1 , wherein the processing circuitry is configured to determine a plurality of local field potential (LFP) measurements of an LFP, wherein the LFP is intrinsically generated by a signal source within a brain of a patient, and wherein to determine the plurality of LFP measurements, the processing circuitry is configured to receive each of the LFP measurements as measured with different electrodes implantable within the brain of the patient.

3 . The system of claim 1 ,

wherein to deliver the second plurality of electrical stimulation signals, the processing circuitry is configured to deliver, with the stimulation generation circuitry, the second plurality of stimulation signals having characteristics that a frequency of each of the plurality of electrical stimulation signals is higher than the threshold frequency.

4 . The system of claim 1 , wherein the processing circuitry is configured to:

select an evoked potential signal from the plurality of evoked potential signals based on at least one of amplitude, peak latency, or trough latency of the evoked potential signals, wherein delivery of one of the first plurality of electrical stimulation signals evoked the selected evoked potential signal; and

determine parameters of the one of the first plurality of electrical stimulation signals that evoked the selected evoked potential signal,

wherein to determine at least one of the amplitude or pulse width of the therapeutic electrical stimulation signal, the processing circuitry is configured to determine at least one of the amplitude or pulse width of the therapeutic electrical stimulation signal based on the determined parameters of the one of the first plurality of electrical stimulation signals that evoked the selected evoked potential signal.

5 . The system of claim 1 , wherein the processing circuitry is configured to:

select an ERNA signal from the plurality of ERNA signals based on resonant activity of the ERNA signals, wherein delivery of one of the second plurality of electrical stimulation signals evoked the selected ERNA; and

determine parameters of the one of the second plurality of electrical stimulation signals that evoked the selected ERNA,

wherein to determine the frequency of the therapeutic electrical stimulation signal, the processing circuitry is configured to determine the frequency of the therapeutic electrical stimulation signal based on the determined parameters of the one of the second plurality of electrical stimulation signals that evoked the selected ERNA.

6 . The system of claim 5 , wherein the resonant activity of the ERNA signals includes one or more of peak-to-trough amplitude, time between peak-to-peak, change in peak amplitudes, amount of oscillations, rise or fall times, and frequency shift from early resonance to late resonance of the ERNA signals.

7 . The system of claim 2 , wherein the processing circuitry is configured to determine one or more electrodes for delivering the therapeutic electrical stimulation signal based on the LFP measurements, and wherein to determine the one or more electrodes for delivering the therapeutic electrical stimulation signal based on the LFP measurements, the processing circuitry is configured to:

determine an LFP measurement from the plurality of LFP measurements having a highest powered signal in one or more of a 4-8 Hertz (Hz) band, 8-33 Hz band, or 35-100 Hz band; and

determine the one or more electrodes based on the LFP measurement having the highest powered signal in the 4-8 Hz band, 8-33 Hz band, or 35-100 Hz band.

8 . The system of claim 1 , wherein to the processing circuitry is configured to:

select at least one electrode from which to receive the evoked potential signals and the ERNA signals.

9 . The system of claim 1 , wherein the processing circuitry is configured to control the stimulation generation circuitry to deliver the therapeutic electrical stimulation signal.

10 . The system of claim 1 , further comprising an implantable medical device (IMD), wherein the IMD includes the processing circuitry.

11 . The system of claim 1 , further comprising an implantable medical device (IMD) and a programmer, and wherein the processing circuitry is part of the IMD, the programmer, or both the IMD and the programmer.

12 . The system of claim 1 , wherein the processing circuitry is configured to receive information indicative of one or more electrodes used for delivering the therapeutic electrical stimulation signal.

13 . The system of claim 1 , wherein to determine the amplitude, pulse width, or frequency of the therapeutic electrical stimulation signal, the processing circuitry is configured to receive information indicative of the amplitude, pulse width, or frequency of the therapeutic electrical stimulation signal.

14 . The system of claim 2 , further comprising an implantable medical device (IMD), the IMD comprising the processing circuitry, wherein the processing circuitry is configured to determine one or more electrodes for delivering the therapeutic electrical stimulation signal based on the LFP measurements, and wherein to determine the one or more electrodes, the processing circuitry is configured to determine the one or more electrodes based on the LFP measurement being an input to the processing circuitry.

15 . The system of claim 1 , further comprising an implantable medical device (IMD), the IMD comprising the processing circuitry, and wherein to determine the at least one of the amplitude or pulse width of the therapeutic electrical stimulation signal and the frequency of the therapeutic electrical stimulation signal, the processing circuitry is configured to determine the at least one of the amplitude or pulse width of the therapeutic electrical stimulation signal and the frequency of the therapeutic electrical stimulation signal based on the evoked potential signals and the ERNA signals being input to the processing circuitry.

16 . A method for therapy parameter determination, the method comprising:

delivering, with stimulation generation circuitry, a first plurality of electrical stimulation signals, wherein a frequency of each electrical stimulation signal of the first plurality of electrical stimulation signals is lower than a threshold frequency, and an amplitude or pulse width of a first electrical stimulation signal of the first plurality of electrical stimulation signals is different than an amplitude or pulse width of a second electrical stimulation signal of the first plurality of electrical stimulation signals, and wherein delivery of each of the first plurality of electrical stimulation signals evokes a respective evoked potential signal of a plurality of evoked potential signals;

delivering, with the stimulation generation circuitry, a second plurality of electrical stimulation signals, wherein a frequency of a first electrical stimulation signal of the second plurality of electrical stimulation signals is different than a frequency of a second electrical stimulation signal of the second plurality of electrical stimulation signals, and wherein delivery of each of the second plurality of electrical stimulation signals evokes a respective evoked resonant neural activity (ERNA) signal of a plurality of ERNA signals;

determining at least one of an amplitude or pulse width of a therapeutic electrical stimulation signal and a frequency of the therapeutic electrical stimulation signal, wherein the amplitude or pulse width of the therapeutic electrical stimulation signal is determined based on the evoked potential signals, and wherein the frequency of the therapeutic electrical stimulation signal is determined based on the ERNA signals; and

delivering, with the stimulation generation circuitry, the therapeutic electrical stimulation signal.

17 . The method of claim 16 , further comprising determining a plurality of local field potential (LFP) measurements of an LFP, wherein the LFP is intrinsically generated by a signal source within a brain of a patient, and wherein determining the plurality of LFP measurements comprises receiving each of the LFP measurements as measured with different electrodes implantable within the brain of the patient.

18 . The method of claim 16 , wherein delivering the second plurality of electrical stimulation signals comprises delivering, with the stimulation generation circuitry, the second plurality of stimulation signals having characteristics that a frequency of each of the plurality of electrical stimulation signals is higher than the threshold frequency.

19 . A computer-readable storage medium storing instructions thereon that when executed cause one or more processors to:

deliver, with stimulation generation circuitry, a first plurality of electrical stimulation signals, wherein a frequency of each electrical stimulation signal of the first plurality of electrical stimulation signals is lower than a threshold frequency, and an amplitude or pulse width of a first electrical stimulation signal of the first plurality of electrical stimulation signals is different than an amplitude or pulse width of a second electrical stimulation signal of the first plurality of electrical stimulation signals, and wherein delivery of each of the first plurality of electrical stimulation signals evokes a respective evoked potential signal of a plurality of evoked potential signals;

deliver, with the stimulation generation circuitry, a second plurality of electrical stimulation signals, wherein a frequency of a first electrical stimulation signal of the second plurality of electrical stimulation signals is different than a frequency of a second electrical stimulation signal of the second plurality of electrical stimulation signals, and wherein delivery of each of the second plurality of electrical stimulation signals evokes a respective evoked resonant neural activity (ERNA) signal of a plurality of ERNA signals;

determine at least one of an amplitude or pulse width of a therapeutic electrical stimulation signal and a frequency of the therapeutic electrical stimulation signal, wherein the amplitude or pulse width of the therapeutic electrical stimulation signal is determined based on the evoked potential signals, and wherein the frequency of the therapeutic electrical stimulation signal is determined based on the ERNA signals; and

deliver, with the stimulation generation circuitry, the therapeutic electrical stimulation signal.