CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Serial No. 62/193,472, filed July 16, 2015, which is incorporated herein by reference.

FIELD

The present invention is directed to the area of implantable electrical stimulation systems and methods of making and using the systems. The present invention is also directed to implantable electrical stimulation systems having connector contact arrays for receiving split proximal contact arrays, as well as methods of making and using the elongated devices, contact arrays, and electrical stimulation systems.

BACKGROUND

Implantable electrical stimulation systems have proven therapeutic in a variety of diseases and disorders. For example, spinal cord stimulation systems have been used as a therapeutic modality for the treatment of chronic pain syndromes. Peripheral nerve stimulation has been used to treat incontinence, as well as a number of other applications under investigation. Functional electrical stimulation systems have been applied to restore some functionality to paralyzed extremities in spinal cord injury patients.

Stimulation of the brain, such as deep brain stimulation, can be used to treat a variety of diseases or disorders.

Stimulators have been developed to provide therapy for a variety of treatments. A stimulator can include a control module (with a pulse generator), one or more leads, and an array of stimulator electrodes on each lead. The stimulator electrodes are in contact with or near the nerves, muscles, or other tissue to be stimulated. The pulse generator in the control module generates electrical pulses that are delivered by the electrodes to body tissue.

BRIEF SUMMARY

One embodiment is a connector for an implantable electrical medical device that includes an elongated connector body having a first end and an opposing second end; a connector lumen defined in the connector body to receive a lead or lead extension; a non- conductive carrier disposed in the connector body and including at least two rails extending parallel to the connector lumen and a plurality of pairs of contact holders spaced-apart along the rails, where each pair of contact holders includes two opposing contact holders; contacts with each contact disposed between one of the pairs of contact holders; and connector conductors coupled to the contacts.

In at least some embodiments, the carrier further includes a retainer element coupled to the at least two rails. In at least some embodiments, the carrier further includes a stop element coupled to the at least two rails opposite the retainer element. In at least some embodiments, one of the pair of contact holders is coupled to either the retainer element or the stop element.

In at least some embodiments, the carrier defines openings between adjacent pairs of contact holders, the connector further including a non-conductive spacer disposed in each of the openings. In at least some embodiments, the connector further includes a tapered snout coupled to the first end of the connector body. In at least some

embodiments, the tapered snout defines a lumen extending to the connector lumen and ridged features disposed within the lumen to form a seal when the lead or lead extension is received by the connector lumen.

Another embodiment is a connector for an implantable electrical medical device that includes an elongated connector body having a first end and an opposing second end; a connector lumen defined in the connector body and configured and arranged to receive a lead or lead extension; and contact assemblies disposed in the connector lumen. Each contact assembly includes a non-conductive contact carrier defining a lumen with two nodes, and two contacts, each contact disposed in one of the two nodes such that the two contacts are not in electrical contact with one another, each contact including a coil and a sheath disposed around at least a portion of the coil. The connector also includes connector conductors electrically coupled to the contact assemblies.

In at least some embodiments, a longitudinal axis of the coil of each contact is parallel to the connector lumen. In at least some embodiments, the sheath extends around at least 50% of a circumference of the coil. In at least some embodiments, the connector conductors are attached to the sheaths of the contacts of the contact assemblies. In at least some embodiments, the two nodes of each contact carrier are disposed opposite each other. In at least some embodiments, the two nodes of all of the contact carriers are aligned along the connector lumen. In at least some embodiments, the connector further includes a retainer element, an end stop element, or both disposed in the connector body. Yet another embodiment is a connector for an implantable electrical medical device that includes an elongated connector body having a first end and an opposing second end; a connector lumen defined in the connector body and configured and arranged to receive a lead or lead extension; a non-conductive carrier disposed in the connector body and including contact openings spaced apart from each other, contacts where each contact is a rod disposed in one of the contact openings of the carrier; and of connector conductors coupled to the contacts.

In at least some embodiments, the contacts are aligned perpendicular the connector lumen. In at least some embodiments, the contact openings form pairs of contact openings disposed opposite each other with respect to the connector lumen. In at least some embodiments, the contact openings forms two rows of contact openings with one of the rows of contact openings offset from another of the rows of contact openings. In at least some embodiments, the carrier is formed of a springy material that is compressed by the contacts when the lead or lead extension is received in the connector lumen. In at least some embodiments, the connector further includes a retainer element, an end stop element, or both disposed in the connector body.

A further embodiment is a lead extension including a lead extension body with a proximal portion, a distal portion, a circumference, and a longitudinal length; any one of the connectors described above disposed along the distal portion of the lead extension body; and lead extension terminals disposed along the proximal portion of the lead extension body. The connector conductors electrically couple the contacts of the connector to the lead extension terminals.

Another embodiments is a control module including a sealed housing; an electronic subassembly disposed in the sealed housing; a header coupled to the sealed housing; and any one of the connectors described above disposed in the header. BRIEF DESCRIPTION OF THE DRAWINGS

Non-limiting and non-exhaustive embodiments of the present invention are described with reference to the following drawings. In the drawings, like reference numerals refer to like parts throughout the various figures unless otherwise specified.

For a better understanding of the present invention, reference will be made to the following Detailed Description, which is to be read in association with the accompanying drawings, wherein:

FIG. 1 is a schematic view of one embodiment of an implantable medical device that includes a paddle body coupled to a control module via lead bodies, according to the invention;

FIG. 2 is a schematic view of another embodiment of an implantable medical device that includes a percutaneous lead body coupled to a control module via a lead body, according to the invention;

FIG. 3 A is a schematic view of one embodiment of a plurality of connectors disposed in the control module of FIG. 1, the connectors configured and arranged to receive the proximal portions of the lead bodies of FIG. 1, according to the invention;

FIG. 3B is a schematic view of one embodiment of a connector disposed in the control module of FIG. 2, the connector configured and arranged to receive the proximal portion of one of the lead body of FIG. 2, according to the invention;

FIG. 3C is a schematic view of one embodiment of a proximal portion of the lead body of FIG. 2, a lead extension, and the control module of FIG. 2, the lead extension configured and arranged to couple the lead body to the control module, according to the invention;

FIG. 4 is a schematic side view of yet another embodiment of an implantable medical device for brain stimulation, according to the invention;

FIG. 5A is a schematic perspective view of one embodiment of a distal end of a lead containing segmented electrodes, according to the invention; FIG. 5B is a schematic perspective view of a second embodiment ot a distal end of a lead containing segmented electrodes, according to the invention;

FIG. 5C is a schematic perspective view of a third embodiment of a distal end of a lead containing segmented electrodes, according to the invention; FIG. 5D is a schematic perspective view of a fourth embodiment of a distal end of a lead containing segmented electrodes, according to the invention;

FIG. 5E is a schematic perspective view of a fifth embodiment of a distal end of a lead containing segmented electrodes, according to the invention;

FIG. 5F is a schematic perspective view of a sixth embodiment of a distal end of a lead containing segmented electrodes, according to the invention;

FIG. 5G is a schematic perspective view of a seventh embodiment of a distal end of a lead containing segmented electrodes, according to the invention;

FIG. 6A is a schematic side view of one embodiment of a proximal end of a lead containing segmented terminals and an alignment slit, according to the invention; FIG. 6B is a schematic side view of a second embodiment of a proximal end of a lead containing segmented terminals and an alignment slit, according to the invention;

FIG. 6C is a schematic cross-sectional view of any one of the leads of FIGS. 6A- 6B, according to the invention;

FIG. 6D is a schematic side view of a third embodiment of a proximal end of a lead containing segmented terminals and an alignment slit, according to the invention;

FIG. 6E is a schematic cross-sectional view of the lead of FIG. 6D, according to the invention;

FIG. 7 A is schematic end view of one embodiment of a connector for receiving a lead containing segmented terminals, according to the invention; FIG. 7B is schematic end view of a second embodiment of a connector for receiving a lead containing segmented terminals, according to the invention; FIG. 7C is schematic side view of one embodiment ot a connector tor receiving a lead containing segmented terminals, according to the invention;

FIG. 7D is schematic side view of a second embodiment of a connector for receiving a lead containing segmented terminals, according to the invention; FIG. 8A is a schematic perspective view of one embodiment of a carrier for a connector, according to the invention;

FIG. 8B is a schematic perspective view of one embodiment of a contact for a connector, according to the invention;

FIG. 8C is a schematic perspective view of one embodiment of a spacer for a connector, according to the invention;

FIG. 8D is a schematic perspective view of one embodiment of a connector incorporating the elements of FIGS. 8A-8C, according to the invention;

FIG. 8E is a schematic perspective cut-away view of the connector of FIG. 8D, according to the invention; FIG. 9A is a schematic perspective view of one embodiment of a contact for a connector, according to the invention;

FIG. 9B is a schematic perspective view of one embodiment of a contact carrier for a connector, according to the invention;

FIG. 9C is a schematic perspective view of one embodiment of a connector incorporating the elements of FIGS. 9A-9B, according to the invention;

FIG. 9D is a schematic perspective cut-away view of the connector of FIG. 9C, according to the invention;

FIG. 1 OA is a schematic perspective view of one embodiment of a contact for a connector, according to the invention; FIG. 1 OB is a schematic perspective view of one embodiment of a contact carrier for a connector, according to the invention; FIG. IOC is a schematic end view of one embodiment ot a connector with portions of the connector made translucent for purposes of illustrating an arrangement of the contacts, according to the invention;

FIG. 10D is a schematic perspective view of one embodiment of a connector incorporating the elements of FIGS. 10A and 1 OB, according to the invention;

FIG. 10E is a schematic perspective cut-away view of the connector of FIG. 10D, according to the invention; and

FIG. 11 is a schematic overview of one embodiment of components of an electrical stimulation system, according to the invention. DETAILED DESCRIPTION

The present invention is directed to the area of implantable electrical stimulation systems and methods of making and using the systems. The present invention is also directed to implantable electrical stimulation systems having connector contact arrays for receiving split proximal contact arrays, as well as methods of making and using the elongated devices, contact arrays, and electrical stimulation systems.

Suitable implantable electrical stimulation systems include, but are not limited to, an electrode lead ("lead") with one or more electrodes disposed on a distal end of the lead and one or more terminals disposed on one or more proximal ends of the lead. Leads include, for example, deep brain stimulation leads, percutaneous leads, paddle leads, and cuff leads. Examples of electrical stimulation systems with leads are found in, for example, U.S. Patents Nos. 6, 181,969; 6,516,227; 6,609,029; 6,609,032; 6,741,892;

7,244,150; 7,450,997; 7,672,734;7,761, 165; 7,783,359; 7,792,590; 7,809,446; 7,949,395; 7,974,706; 6, 175,710; 6,224,450; 6,271,094; 6,295,944; 6,364,278; and 6,391,985; U.S. Patent Applications Publication Nos. 2007/0150036; 2009/0187222; 2009/0276021; 2010/0076535; 2010/0268298; 2011/0004267; 2011/0078900; 2011/0130817;

2011/0130818; 2011/0238129; 2011/0313500; 2012/0016378; 2012/0046710;

2012/0071949; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320;

2012/0203321; 2012/0316615; and 2013/0105071; and U.S. Patent Applications Serial Nos. 12/177,823 and 13/750,725, all of which are incorporated by reference in their entirety. Figure 1 illustrates schematically one embodiment ot an electrical stimulation system 100. The electrical stimulation system includes a control module (e.g., a stimulator or pulse generator) 102 and a lead 103. The lead 103 including a paddle body 104 and one or more lead bodies 106 coupling the control module 102 to the paddle body 104. The paddle body 104 and the one or more lead bodies 106 form the lead 103. The paddle body 104 typically includes a plurality of electrodes 134 that form an array of electrodes 133. The control module 102 typically includes an electronic subassembly 1 10 and an optional power source 120 disposed in a sealed housing 1 14. In Figure 1, two lead bodies 106 are shown coupled to the control module 102. The control module 102 typically includes one or more connectors 144 into which the proximal end of the one or more lead bodies 106 can be plugged to make an electrical connection via connector contacts (e.g., 316 in Figure 3 A) disposed in the connector 144 and terminals (e.g., 310 in Figure 3 A) on each of the one or more lead bodies 106. The connector contacts are coupled to the electronic subassembly 1 10 and the terminals are coupled to the electrodes 134. In Figure 1, two connectors 144 are shown.

The one or more connectors 144 may be disposed in a header 150. The header 150 provides a protective covering over the one or more connectors 144. The header 150 may be formed using any suitable process including, for example, casting, molding (including injection molding), and the like. In addition, one or more lead extensions 324 (see Figure 3C) can be disposed between the one or more lead bodies 106 and the control module 102 to extend the distance between the one or more lead bodies 106 and the control module 102.

It will be understood that the electrical stimulation system can include more, fewer, or different components and can have a variety of different configurations including those configurations disclosed in the electrical stimulation system references cited herein. For example, instead of a paddle body 104, the electrodes 134 can be disposed in an array at or near the distal end of a lead body 106' forming a percutaneous lead 103, as illustrated in Figure 2. The percutaneous lead may be isodiametric along the length of the lead body 106". The lead body 106' can be coupled with a control module 102' with a single connector 144. The electrical stimulation system or components ot the electrical stimulation system, including one or more of the lead bodies 106, the control module 102, and, in the case of a paddle lead, the paddle body 104, are typically implanted into the body of a patient. The electrical stimulation system can be used for a variety of applications including, but not limited to, spinal cord stimulation, brain stimulation, neural stimulation, muscle activation via stimulation of nerves innervating muscle, and the like.

The electrodes 134 can be formed using any conductive, biocompatible material. Examples of suitable materials include metals, alloys, conductive polymers, conductive carbon, and the like, as well as combinations thereof. In at least some embodiments, one or more of the electrodes 134 are formed from one or more of: platinum, platinum iridium, palladium, titanium, or rhenium.

The number of electrodes 134 in the array of electrodes 133 may vary. For example, there can be two, three, four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, or more electrodes 134. As will be recognized, other numbers of electrodes 134 may also be used. In Figure 1, sixteen electrodes 134 are shown. The electrodes 134 can be formed in any suitable shape including, for example, round, oval, triangular, rectangular, pentagonal, hexagonal, heptagonal, octagonal, or the like.

The electrodes of the paddle body 104 or one or more lead bodies 106 are typically disposed in, or separated by, a non-conductive, biocompatible material including, for example, silicone, polyurethane, and the like or combinations thereof. The paddle body 104 and one or more lead bodies 106 may be formed in the desired shape by any process including, for example, molding (including injection molding), casting, and the like. Electrodes and connecting wires can be disposed onto or within a paddle body either prior to or subsequent to a molding or casting process. The non-conductive material typically extends from the distal end of the lead 103 to the proximal end of each of the one or more lead bodies 106. The non-conductive, biocompatible material of the paddle body 104 and the one or more lead bodies 106 may be the same or different. The paddle body 104 and the one or more lead bodies 106 may be a unitary structure or can be formed as two separate structures that are permanently or detachably coupled together. Terminals (e.g., 310 in Figure 3 A) are typically disposed at the proximal end ot the one or more lead bodies 106 for connection to corresponding conductive contacts (e.g., 316 in Figure 3 A) in connectors (e.g., 144 in Figure 1) disposed on, for example, the control module 102 (or to other devices, such as conductive contacts on a lead extension, an operating room cable, a splitter, an adaptor, or the like).

Conductive wires (not shown) extend from the terminals (e.g., 310 in Figure 3 A) to the electrodes 134. Typically, one or more electrodes 134 are electrically coupled to a terminal (e.g., 310 in Figure 3 A). In some embodiments, each terminal (e.g., 310 in Figure 3 A) is only coupled to one electrode 134.

The conductive wires may be embedded in the non-conductive material of the lead or can be disposed in one or more lumens (not shown) extending along the lead. In some embodiments, there is an individual lumen for each conductive wire. In other

embodiments, two or more conductive wires may extend through a lumen. There may also be one or more lumens (not shown) that open at, or near, the proximal end of the lead, for example, for inserting a stylet rod to facilitate placement of the lead within a body of a patient. Additionally, there may also be one or more lumens (not shown) that open at, or near, the distal end of the lead, for example, for infusion of drugs or medication into the site of implantation of the paddle body 104. The one or more lumens may, optionally, be flushed continually, or on a regular basis, with saline, epidural fluid, or the like. The one or more lumens can be permanently or removably sealable at the distal end.

As discussed above, the one or more lead bodies 106 may be coupled to the one or more connectors 144 disposed on the control module 102. The control module 102 can include any suitable number of connectors 144 including, for example, two three, four, five, six, seven, eight, or more connectors 144. It will be understood that other numbers of connectors 144 may be used instead. In Figure 1, each of the two lead bodies 106 includes eight terminals that are shown coupled with eight conductive contacts disposed in a different one of two different connectors 144.

Figure 3 A is a schematic side view of one embodiment of a plurality of connectors 144 disposed on the control module 102. In at least some embodiments, the control module 102 includes two connectors 144. In at least some embodiments, the control module 102 includes four connectors 144. In Figure 3A, proximal ends 3U6 ot the plurality of lead bodies 106 are shown configured and arranged for insertion to the control module 102. Figure 3B is a schematic side view of one embodiment of a single connector 144 disposed on the control module 102' . In Figure 3B, the proximal end 306 of the single lead body 106' is shown configured and arranged for insertion to the control module 102' .

In Figures 3A and 3B, the one or more connectors 144 are disposed in the header 150. In at least some embodiments, the header 150 defines one or more lumens 304 into which the proximal end(s) 306 of the one or more lead bodies 106/106' with terminals 310 can be inserted, as shown by directional arrows 312, in order to gain access to the connector contacts disposed in the one or more connectors 144.

The one or more connectors 144 each include a connector housing 314 and a plurality of connector contacts 316 disposed therein. Typically, the connector housing 314 provides access to the plurality of connector contacts 3 16 via the lumen 304. In at least some embodiments, one or more of the connectors 144 further includes a retaining element 318 configured and arranged to fasten the corresponding lead body 106/106' to the connector 144 when the lead body 106/106' is inserted into the connector 144 to prevent undesired detachment of the lead body 106/106' from the connector 144. For example, the retaining element 318 may include an aperture 320 through which a fastener (e.g., a set screw, pin, or the like) may be inserted and secured against an inserted lead body 106/106' .

When the one or more lead bodies 106/106' are inserted into the one or more lumens 304, the connector contacts 316 can be aligned with the terminals 310 disposed on the one or more lead bodies 106/106' to electrically couple the control module 102 to the electrodes (134 of Figure 1) disposed at a distal end of the one or more lead bodies 106. Examples of connectors in control modules are found in, for example, U. S. Patents Nos. 7,244, 150 and 6,224,450, which are incorporated by reference in their entirety.

In at least some embodiments, the electrical stimulation system includes one or more lead extensions. The one or more lead bodies 106/106' can be coupled to one or more lead extensions which, in turn, are coupled to the control module 102/102' . In Figure 3C, a lead extension connector 322 is disposed on a lead extension 324. The lead extension connector 322 is shown disposed at a distal end 325 ot the lead extension .324. The lead extension connector 322 includes a connector housing 344. The connector housing 344 defines at least one lumen 330 into which a proximal end 306 of the lead body 106' with terminals 310 can be inserted, as shown by directional arrow 338. The lead extension connector 322 also includes a plurality of connector contacts 340. When the lead body 106' is inserted into the lumen 330, the connector contacts 340 disposed in the connector housing 344 can be aligned with the terminals 310 on the lead body 106 to electrically couple the lead extension 324 to the electrodes (134 of Figure 1) disposed at a distal end (not shown) of the lead body 106' . The proximal end of a lead extension can be similarly configured and arranged as a proximal end of a lead body. The lead extension 324 may include a plurality of conductive wires (not shown) that electrically couple the connector contacts 340 to terminal on a proximal end 348 of the lead extension 324. The conductive wires disposed in the lead extension 324 can be electrically coupled to a plurality of terminals (not shown) disposed on the proximal end 348 of the lead extension 324. In at least some embodiments, the proximal end 348 of the lead extension 324 is configured and arranged for insertion into a lead extension connector disposed in another lead extension. In other embodiments (as shown in Figure 3C), the proximal end 348 of the lead extension 324 is configured and arranged for insertion into the connector 144 disposed on the control module 102' .

It will be understood that the control modules 102/102' can receive either lead bodies 106/106' or lead extensions 324. It will also be understood that the electrical stimulation system 100 can include a plurality of lead extensions 324. For example, each of the lead bodies 106 shown in Figures 1 and 3 A can, alternatively, be coupled to a different lead extension 324 which, in turn, are each coupled to different ports of a two- port control module, such as the control module 102 of Figures 1 and 3 A.

Turning to Figure 4, in the case of deep brain stimulation, the lead may include stimulation electrodes, recording electrodes, or a combination of both. At least some of the stimulation electrodes, recording electrodes, or both are provided in the form of segmented electrodes that extend only partially around the perimeter (for example, the circumference) of the lead. These segmented electrodes can be provided in sets of electrodes, with each set having electrodes circumferentially distributed about the lead at a particular longitudinal position.

In at least some embodiments, a practitioner may determine the position of the target neurons using recording electrode(s) and then position the stimulation electrode(s) accordingly. In some embodiments, the same electrodes can be used for both recording and stimulation. In some embodiments, separate leads can be used; one with recording electrodes which identify target neurons, and a second lead with stimulation electrodes that replaces the first after target neuron identification. In some embodiments, the same lead may include both recording electrodes and stimulation electrodes or electrodes may be used for both recording and stimulation.

Figure 4 illustrates one embodiment of a device 400 for brain stimulation. The device includes a lead 410, a plurality of electrodes 425 disposed at least partially about a perimeter of the lead 410, a plurality of terminals 435, a connector 444 for connection of the electrodes to a control unit, and a stylet 440 for assisting in insertion and positioning of the lead in the patient's brain. The stylet 440 can be made of a rigid material.

Examples of suitable materials for the stylet include, but are not limited to, tungsten, stainless steel, and plastic. The stylet 440 may have a handle 450 to assist insertion into the lead 410, as well as rotation of the stylet 440 and lead 410. The connector 444 fits over a proximal end of the lead 410, preferably after removal of the stylet 440. In Figure 4, the electrodes 425 are shown as including both ring electrodes, such as ring electrode 420, and segmented electrodes, such as segmented electrodes 430. In some embodiments, the electrodes 425 are all segmented. In other embodiments, the electrodes 425 are all ring-shaped. In Figure 4, each of the terminals 435 is shown as being ring-shaped. The segmented electrodes of Figure 4 are shown in sets of two, where the two segmented electrodes of a particular set are electrically isolated from one another and are circumferentially offset along the lead 410. Any suitable number of segmented electrodes can be formed into a set including, for example, two, three, four, or more segmented electrodes.

Segmented electrodes can be used to direct stimulus current to one side, or even a portion of one side, of the lead. When segmented electrodes are used in conjunction with an implantable pulse generator that delivers current stimulus, current steering can be achieved to more precisely deliver the stimulus to a position around an axis ot the lead (i.e., radial positioning around the axis of the lead). Segmented electrodes may provide for superior current steering than ring electrodes because target structures in deep brain stimulation are not typically symmetric about the axis of the distal electrode array.

Instead, a target may be located on one side of a plane running through the axis of the lead. Through the use of a segmented electrode array, current steering can be performed not only along a length of the lead but also around a perimeter of the lead. This provides precise three-dimensional targeting and delivery of the current stimulus to neural target tissue, while potentially avoiding stimulation of other tissue. Examples of leads with segmented electrodes include U.S. Patent Nos. 6,295,944; and 6,391,985; and U.S. Patent Applications Publication Nos. 2011/0005069; 2010/0268298; 2011/0130817;

2011/0130818; 2011/0078900; 2011/0238129; 2011/0313500; 2012/0016378;

2012/0046710; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320; and 2012/0203321, all of which are incorporated herein by reference in their entirety. Figures 5A-5H illustrate leads 500 with segmented electrodes 550, optional ring electrodes 520 or tip electrodes 520a, and a lead body 510. The sets of segmented electrodes 550 each include either two (Figure 5B), three (Figures 5E-5H), or four (Figures 5A, 5C, and 5D) or any other number of segmented electrodes including, for example, three, five, six, or more. The sets of segmented electrodes 550 can be aligned with each other (Figures 5A-5G) or staggered (Figure 5H).

When the lead 500 includes both ring electrodes 520 and segmented electrodes 550, the ring electrodes 520 and the segmented electrodes 550 may be arranged in any suitable configuration. For example, when the lead 500 includes two ring electrodes 520 and two sets of segmented electrodes 550, the ring electrodes 520 can flank the two sets of segmented electrodes 550 (see e.g., Figures 1, 5A, and 5E-5H). Alternately, the two sets of ring electrodes 520 can be disposed proximal to the two sets of segmented electrodes 550 (see e.g., Figure 5C), or the two sets of ring electrodes 520 can be disposed distal to the two sets of segmented electrodes 550 (see e.g., Figure 5D). One of the ring electrodes can be a tip electrode (see, tip electrode 520a of Figures 5E and 5G). It will be understood that other configurations are possible as well (e.g., alternating ring and segmented electrodes, or the like). By varying the location of the segmented electrodes 550, ditterent coverage ot the target neurons may be selected. For example, the electrode arrangement of Figure 5C may be useful if the physician anticipates that the neural target will be closer to a distal tip of the lead body 510, while the electrode arrangement of Figure 5D may be useful if the physician anticipates that the neural target will be closer to a proximal end of the lead body 510.

Any combination of ring electrodes 520 and segmented electrodes 550 may be disposed on the lead 500. For example, the lead may include a first ring electrode 520, two sets of segmented electrodes; each set formed of four segmented electrodes 550, and a final ring electrode 520 at the end of the lead. This configuration may simply be referred to as a 1-4-4-1 configuration (Figures 5 A and 5E - ring electrodes 520 and segmented electrode 550). It may be useful to refer to the electrodes with this shorthand notation. Thus, the embodiment of Figure 5C may be referred to as a 1-1-4-4

configuration, while the embodiment of Figure 5D may be referred to as a 4-4-1-1 configuration. The embodiments of Figures 5F, 5G, and 5H can be referred to as a 1-3-3- 1 configuration. Other electrode configurations include, for example, a 2-2-2-2 configuration, where four sets of segmented electrodes are disposed on the lead, and a 4-4 configuration, where two sets of segmented electrodes, each having four segmented electrodes 550 are disposed on the lead. The 1-3-3-1 electrode configuration of Figures 5F, 5G, and 5H has two sets of segmented electrodes, each set containing three electrodes disposed around the perimeter of the lead, flanked by two ring electrodes (Figures 5F and 5H) or a ring electrode and a tip electrode (Figure 5G). In some embodiments, the lead includes 16 electrodes. Possible configurations for a 16-electrode lead include, but are not limited to 4-4-4-4; 6-8; 5-3-3-3-3-1 (and all rearrangements of this configuration); and 2-2-2-2-2-2-2-2. Any other suitable segmented electrode arrangements (with or without ring electrodes) can be used including, but not limited to, those disclosed in U.S.

Provisional Patent Application Serial No. 62/113,291 and U.S. Patent Applications Publication Nos. 2012/0197375 and 2015/0045864, all of which are incorporated herein by reference in their entirety. In at least some embodiments, a lead with 16 electrodes also includes 16 terminals. Many conventional control modules and connectors are designed to accept a proximal end of a lead or lead extension with an array of eight terminals. To instead have 16 terminals could extend the length of the proximal end ot the lead or lead extension and a consequent increase in the size of connector or control module.

Instead, in at least some embodiments it may be advantageous to design an elongate member (e.g., a lead, lead extension, splitter, adaptor, or the like) with segmented terminals forming a split proximal contact array. In at least some

embodiments, the elongate member also includes segmented electrodes. Utilizing a split proximal contact array may reduce the physical size of the terminal array when compared to conventional terminal arrays with ring-shaped terminals. Consequently, the portion of the elongate member that is inserted into a connector to make electrical contact with the pulse generator can be reduced, as compared to conventional electrical stimulation systems. Alternately, the number of terminals that can be disposed along a proximal portion of an elongate member and that can be inserted into a conventionally sized connector may be increased from conventional electrical stimulation systems. Some examples of such arrangements are found in, for example, U. S. Provisional Patent Application Serial No. 62/1 13,291, incorporated herein by reference in its entirety.

Although the embodiments described below are presented as leads, it will be understood that the arrangement of segmented terminals, a retention sleeve, and an alignment slit, described below, can also be applied to a lead extension or other elongate member having terminals. In general, any elongate member can have first contacts (for example, electrode for a lead or conductive contacts for a lead extension) disposed along a distal portion of the elongate member and second segmented contacts (for example, segmented terminals) disposed along a proximal portion of the elongate member.

Figure 6A illustrates one embodiment of a proximal portion of a lead 603 (or other elongate member) with a split proximal contact array of segmented terminals 610 and an optional retention sleeve 670. To ensure proper alignment between of the lead 603 (or other elongate member) in a connector 644 (Figures 7A-7D) so that each terminal is electrically connected to a single connector contact, the lead includes an alignment slit 682 formed along a portion of the proximal end of the lead. The alignment slit 682 extends completely through the lead 603 and intersects a central lumen 686 (or stylet lumen) of the lead, as shown in Figure 6C. The alignment slit 682 separates the proximal portion of the lead into at least two sections 603 a, 603b that are laterally spaced-apart and separated by the alignment slit.

The segmented terminals 610 can be formed in sets of two or more terminals at a same position along the longitudinal axis of the lead. Each of the segmented terminals of a particular set extends around less than (for example, no more than 45%, 40%, 33%, 30%), or 25%) of) the entire perimeter of the elongate member. The segmented terminals of the set are not in electrical contact with one another and are circumferentially offset from one another along the elongate member. In at least some embodiments, the terminal array includes at least one segmented terminal set, such as segmented terminal set 611 which, in turn, includes multiple segmented terminals 610, such as segmented terminals 610a and 610b. In some embodiments, a set of segmented terminals can have two, three, four, or more segmented terminals disposed at the same position along the longitudinal axis of the elongate member, but circumferentially offset from each other. In at least some embodiments, the alignment slit 682 extends between at least two of the segmented terminals of one or more (or even each) of the sets of segmented terminals. In at least some of these embodiments, each set includes exactly two segmented terminals.

In some embodiments, the terminal array is formed exclusively from segmented terminals. In other embodiments, the terminal array includes a combination of one or more ring-shaped terminals and one or more segmented terminal sets. The terminal array can include any suitable number of segmented terminal sets

611 including, for example, one, two, three, four, five, six, seven, eight, nine, ten eleven, twelve, thirteen, fourteen, fifteen, sixteen, or more segmented-terminal sets. In Figure 6A, eight segmented terminal sets 611 are shown disposed along the lead 603.

In at least some embodiments, the elongate member includes a single proximal portion and multiple distal portions. One advantage of implementing segmented terminals is that it may increase the number of terminals disposed along a lead from conventional leads. The increased number of terminals may enable the lead to be designed with multiple distal portions, where a different electrode array is disposed along each of the distal portions, and where electrodes of each of the multiple electrode arrays are coupled to terminals disposed along a single proximal portion. Such a design may be useful, for example, in deep brain stimulation where bilateral stimulation may be desirable.

When the lead has multiple distal portions and a single proximal portion with segmented terminals, the single proximal portion can be received by a single connector port. Such an arrangement enables each of multiple electrode arrays disposed along different distal portions to be operated by a single control module. Additionally, such a design enables multiple electrode arrays to be controlled by a single control module via a single connector with a single lead-receiving port.

In Figure 6A, the alignment slit 682 extends from the proximal end of the lead to a point beyond the retention sleeve 670. The alignment slit 682 separates the terminals 610a, 610b in each set 611 and divides the retention sleeve 670 into two parts that are laterally spaced-apart and separated from each other by the alignment slit. Figure 6B illustrates an alternative embodiment of the lead 603 and the alignment slit 682 where the alignment slit 682 terminates distal to all of the terminals 610, but proximal to the retention sleeve 670. It will be understood that in other embodiments, the alignment slit can terminate anywhere along the array of terminals 610.

In the embodiment of Figure 6D, the alignment slit 682 only extends partway into the lead 603 to the central lumen 686, as illustrated in Figure 6E.

In Figures 6 A, 6B, and 6D, the terminals 610 of each set are aligned with each other to form longitudinal columns (i.e., columns parallel to the longitudinal axis of the lead) of terminals that are aligned. In other embodiments, segmented terminals can be arranged in longitudinal columns with the columns being longitudinally offset from each other (for example, the terminals on the left could be longitudinally offset from those on the right). In some embodiments, the terminals of different longitudinal columns do not overlap and in other embodiments, the terminals of different longitudinal columns do overlap. It will be recognized that other arrangements of segmented terminals, including any of those arrangements described above with respect to arrangements of segmented terminals, can be used.

With respect to leads with the terminal arrays illustrated in Figures 6A, 6B, and 6D, the corresponding electrodes can be segmented electrodes, ring electrodes, other electrodes disclosed herein, or any other suitable electrode, or any combination thereol. In particular, although the terminals of a lead may be all or part segmented terminals, the corresponding electrodes may be segmented electrodes, non-segmented electrodes, or any combination thereof. Turning to Figures 7A-7D, the proximal portion of the elongate member, such as the lead 603 (Figures 6A, 6B, and 6D), is typically inserted into a connector 644 disposed on or along a lead extension, control module, adaptor, splitter, or the like. The connector 644 includes segmented connector contacts 640 suitable for coupling with the segmented terminals. The connector 644 includes an elongated connector housing 660 that defines a connector lumen 662 suitable for receiving a portion of an elongate member, such as the lead 603 (Figure 6A, 6B, and 6D); a lead extension (e.g., 324 in Figure 3C); or the like. Although the illustrated connector lumen has a circular cross-section, it will be understood that lumens with other cross-sections (and leads with non-circular cross- sections) can also be used including, but not limited to, oval, square, rectangular, triangular, pentagonal, hexagonal, octagonal, cruciform, or any other suitable regular or irregular cross-sectional shape.

The connector 644 also includes an alignment structure 680 (for example, a pin, blade, seal, wall, rod, or rail) that extends into the connector lumen 662 and can be used to align the lead with the connector by mating with the alignment slit 682 of the lead. The embodiment of Figure 7 A illustrates the alignment structure 680 extending across the entire diameter of the connector lumen 662 and can be used with, for example, the leads of Figures 6 A and 6B. The embodiment of Figure 7B illustrates the alignment structure 680 extending only partway (for example, 30%, 40%, 50%, or 60% or less) across the diameter of the connector lumen 662 and can be used with, for example, the lead of Figure 6D (or even the leads of Figures 6 A and 6B).

Multiple connector contacts 640 are disposed in a spaced-apart relationship along the longitudinal length of the connector housing 660 such that the connector contacts are exposed to the connector lumen 662 (Figures 7A and 7B) and individually attached to an array of conductive members (for example, wires, pins, traces, terminals, or the like) that couple the connector contacts to other components. When, for example, the connector 644 is disposed on a lead extension (e.g., 324 in Figure 3C), the conductive members (for example, wires or other conductors) may couple the connector contacts to lead extension terminals. When, for example, the connector 644 is disposed on a control module, the conductive members (for example, wires, traces, pins, or the like) may couple the connector contacts 640 to the electronic subassembly (110 in Figure 1). In at least some embodiments, the conductive members 664 couple the connector contacts 640 to the electronic subassembly (1 10 in Figure 1) via feedthrough pins extending through the sealed housing (1 14 in Figure 1).

In at least some embodiments, the segmented connector contacts 640 can be formed in sets of two or more terminals at a same position along the longitudinal axis of the connector lumen 662. Each of the segmented connector contacts of a particular set extends around less than (for example, no more than 45%, 40%, 33%, 30%, 25%, 20%, 15%, or 10% of) the entire perimeter of the connector lumen. The segmented connector contacts of the set are not in electrical contact with one another and are circumferentially offset from one another along the connector lumen. In at least some embodiments, the connector contact array includes at least one segmented connector contacts set, such as segmented connector contacts set 641 which, in turn, includes multiple segmented connector contacts 640, such as segmented terminals 640a and 640b. In some

embodiments, a set of segmented connector contacts can have two, three, four, or more segmented connector contacts disposed at the same position along the longitudinal axis of the connector lumen, but circumferentially offset from each other.

Optionally, a retention block 666 is disposed along the connector 644. The retention block 666 can be used to facilitate retention of an elongate member when the elongate member is inserted into the connector lumen 662. In at least some embodiments, the retention block 666 defines a fastening aperture 668 configured to receive a fastener (e.g., a set screw, pin, or the like) which can engage the optional retention sleeve 670

(Figure 6A) of the lead. In at least some embodiments, the fastener, when received by the fastener aperture 668, is configured to tighten against a portion of the elongate member (e.g., a retention sleeve) when the elongate member is inserted into the connector lumen 662. The connector 644 includes an alignment structure 680 that mates with or fits within the alignment slit 682 of the lead 603. Engagement of the alignment structure 680 of the connector 644 with the alignment slit 682 of the lead 603 ensures that the lead and connector have the proper rotational alignment for correctly coupling the segmented terminals 610 of the lead 603 with the connector contacts 640 of the connector 644.

In the embodiment of Figures 7C, the alignment structure 680 is disposed in the proximal end of the retention block 666. This particular arrangement is useful with the leads 603 of Figures 6 A and 6D where the alignment slit 670 extends through the retention sleeve 670. The alignment structure 680 can be placed elsewhere in the connector 644. For example, in the embodiment illustrated in Figure 7D, the alignment structure 680 is placed at the distal end of the retention block 666. This arrangement can be used with any of the lead illustrated in Figure 6B (and also the leads of Figures 6A and 6D). In other embodiments, the alignment structure 680 can be placed outside the retention block. In at least some embodiments, the alignment structure can extend between one or more (or even all) of the connector contacts 640. In yet other

embodiments, the alignment structure 680 can be placed in other portions of the connector lumen 662, such as near the end of the connector lumen.

When using a split proximal contact array, the corresponding connector on a lead extension or within a control module, splitter, operating room cable, or the like also includes a split array of contacts within the connector. A variety of different contact arrays can be used. Figures 8A-8E illustrate one embodiment of a connector 844 for receiving a split proximal contact array. Figure 8A illustrates one embodiment of a carrier 850 that fits within the connector 844 (Figures 8D and 8E). The carrier 850 includes a body 851 having opposing rails 852, opposing contact holders 853 spaced-apart along the rails, openings 854 between pairs of contact holders, an optional retainer element 855 with an opening 856, and an optional stop element 857. A pair of opposing contact holders 853a, 853b is illustrate in Figure 8A with each of the contact holders coupled to a different one of the rails 852. In addition, optionally, a pair of opposing contact holders can be integrated with one of, or each of, the optional retainer element 855 and the optional stop element 857, as illustrated in Figure 8A.

The carrier 850 can be formed of any non-conductive material including, for example, a plastic material such as silicone, polyurethane, polyetheretherketone, or the like. In at least some embodiments, the non-conductive material is a plastic material that is more rigid than the plastic material used in a lead body. The carrier 850 can be formed as a single piece or as multiple pieces that are joined together. The opening 856 in the optional retainer element 855 can be sized to receive a fastener, such as a screw or rod that can engage a lead inserted into the connector 844 to hold the lead within the connector. The optional stop element 857 can be arranged to resist further insertion of the lead into a connector 844 and, thereby, facilitate proper alignment of the terminals of the lead with the contacts 840 (Figure 8B) of the connector.

Figure 8B illustrates one embodiment of a contact 840 that can be disposed between two of the opposing contact holders 853 (see, Figures 8D and 8E). Two contacts 840 are disposed between each pair of opposing contact holders 853a, 853b (Figure 8A) of the carrier 850. These two contacts 840 are typically not in electrical contact with each other, but are separated by, for example, the rails 852 and the connector lumen 662. In at least some embodiments, the contacts 840 are fit into the contact holders 853 so that the contacts can shift slightly backwards when a lead is inserted into the connector lumen and passes the contact. This shifting can create a contact point between the contact and a terminal on the lead.

Each contact 840 is formed of a conductive material, including any of the material described above for use in making electrodes or terminals. Each contact 840 is coupled to a conductor (not shown), such as a wire that extends from the connector 844 along an extension body if the connector is part of a lead extension or to a wire or feedthrough if the connector 844 is part of a control module. In some embodiments, the contact 840 can be stamped from a metal sheet and folded or otherwise formed into the shape illustrated in Figure 8B. In the illustrated embodiment, the contact 840 includes an opening 840a along one edge and an open interior 840b.

Figure 8C illustrates one embodiment of a non-conductive spacer 858. The spacer 858 is arranged to fit within the opening 854 between longitudinally adjacent contact holder 853 to space apart and electrically isolate contacts 840 that are longitudinally adjacent to each other. The spacer 858 can include an opening 858a which receives one of the rails 852. In some embodiments, the spacer 858 can include an indent opposite the opening 858a to receive the other rails 852. The spacers 858 can be made of any suitable non-conductive material including, but not limited to, silicone, polyurethane,

polyetheretherketone (PEEK), or the like.

Figures 8D and 8E illustrate the connector 844 with an extension body 845 extending from the connector 844. The connector 844 includes a connector body 860 and an entrance snout 859. The connector body 860 fits around the carrier 850, contacts 840, and spacers 858 and can optionally include an opening corresponding to the opening 856 in the optional retainer element 855 of the carrier 850 so that a fastener can be inserted, as described above. The connector body 860 can be made of any biocompatible, non- conductive material such as, for example, silicone, polyurethane, polyetheretherketone (PEEK), or the like. In at least some embodiments, the connector body 860 is made of a material that is less rigid than the material used to form the carrier 850 so that the connector body 860 provides a flexible or compressible surface that is less damaging to tissue than the carrier.

The entrance snout 859 has an opening to receive the lead and may have ridged features 861 on the interior surface to reduce or prevent tissue entry into the connector 844. Moreover, the ridged features 861 may also form a seal with the lead to reduce or prevent fluid entry into the connector 844. The entrance snout 859 may be tapered, as illustrated in Figure 8D. The entrance snout can also be incorporated in any of the other connectors described herein. Figures 9A-9D illustrate one embodiment of a connector 944 for receiving a split proximal contact array. Figure 9A illustrates one embodiment of a contact 940 and Figure 9B illustrates one embodiment of a contact carrier 950. Two contacts 940 are disposed opposite one another in each contact carrier 950. These two contacts 940 are typically not in electrical contact with each other, but are separated by the contact carrier 950 and the connector lumen 662.

Each contact 940 is formed of a coil 941 disposed in a curved conductive sheath 943, as illustrated in Figure 9 A. The coil 941 and sheath 943 can be formed of any conductive material, including any of the material described above for use in making electrodes or terminals. Each sheath 943 is coupled to a conductor (not shown), such as a wire that extends from the connector 944 along an extension body if the connector is part of a lead extension or to a wire or feedthrough if the connector 944 is part of a control module. The coil 941 can be, for example, a spring or other resilient construct. The sheath 943 can extend around the entire circumference of the sheath or only around a portion (for example, at least 80%, 75%, 67%, or 50%) of the circumference of the sheath, as illustrated in Figure 9 A. The coil 941 can compress against the sheath 943 when the lead is inserted into the connector 944 and provide a contact point with a terminal on the lead.

Figure 9B illustrates one embodiment of the non-conductive contact carrier 950. The contact carrier 950 has a body 970 and a lumen 972 that includes two nodes 874 designed to each receive one of the two contacts 940. The contact carrier 950 can be made of any suitable non-conductive material including, but not limited to, silicone, polyurethane, polyetheretherketone (PEEK), or the like. In at least some embodiments, the contacts 940 can fit in the contact carrier 950 in the longitudinal orientation (i.e., with the longitudinal axis of the coil 941 parallel to the longitudinal axis of the connector 944), as illustrated in Figures 9A-9D. In other embodiments, the contacts 940 and contact carrier can be arranged so that the contacts are disposed vertically with the longitudinal axis of the coil perpendicular to the longitudinal axis of the connector (similar to the arrangement described below with respect to Figures 10A-10E). In yet other

embodiments, the longitudinal axis of the coil of the contact may be at an angle between 0 to 90 degrees (i.e., not parallel or perpendicular) with respect to the longitudinal axis of the connector. In these other embodiments, the lumen of the contact carrier would be different from that illustrated in Figure 9B to accommodate the alternative arrangement of the contacts within the contact carrier.

Figures 9C and 9D illustrate the connector 944 with an extension body 945 extending from the connector 944. The connector 944 includes a connector body 960, an optional retainer element 955, and an optional end stop element 957. The connector body 960 and the optional retainer element 955 can include an opening 956 through which a fastener (such as a screw, rod, or the like) can be inserted to contact and hold a lead disposed within the connector 944. The connector body 960 fits around the contact carriers 950 and contacts 940. The connector body 960 can be made of any

biocompatible, non-conductive material such as, for example, silicone, polyurethane, polyetheretherketone (PEEK), or the like. In at least some embodiments, the contacts 940 are disposed in the contact carriers 950 which are then disposed in a mold with the optional retainer element 955 and optional end stop element 957. The connector body 960 is formed by molding around the contact carriers 950, optional retainer element 955, and optional end stop element. A mandrel or other element can be positioned in the mold to form the connector lumen.

Figures 10A-10E illustrate one embodiment of a connector 1044 for receiving a split proximal contact array. Figure 10A illustrates one embodiment of a contact 1040 and Figure 10B illustrates one embodiment of a contact carrier 1050. Each contact 1040 is a rod or spring that can be formed of any conductive material, including any of the material described above for use in making electrodes or terminals. Each contact 1040 is coupled to a conductor (not shown), such as a wire that extends from the connector 1044 along an extension body if the connector is part of a lead extension or to a wire or feedthrough if the connector 1044 is part of a control module.

Figure 10B illustrates one embodiment of the non-conductive contact carrier 1050. The contact carrier 1050 has a body 1078 and multiple openings 1076 designed to receive the contacts 1040. The openings 1076 can be arranged in pairs, as illustrated in Figure 10B, so that two contacts 1040 are disposed opposite each other, as illustrated in Figure IOC. Other arrangements of openings and contacts can also be used including, for example, an arrangement where the openings on one side are offset from the openings on the other side of the contact carrier. The contact carrier 1050 can be made of any suitable non-conductive material including, but not limited to, silicone, polyurethane,

polyetheretherketone (PEEK), or the like. In at least some embodiments, the contact carrier is formed of a material that can act as a spring so that when a lead or lead extension is inserted into the connector, the lead or lead extension pushes against the contacts and the contact carrier is compressed.

In at least some embodiments, the contacts 1040 can fit in the contact carrier 1050 in perpendicular to the longitudinal axis of the connector 1044, as illustrated in Figures 10A-10E. In other embodiments, the contacts 1040 and contact carrier can be arranged so that the contacts are disposed vertically with the longitudinal axis of the coil

perpendicular to the longitudinal axis of the connector (similar to the arrangement described below with respect to Figures 10A-10E). In yet other embodiments, the longitudinal axis of the coil of the contact may be at an angle between 0 to yo degrees with respect to the longitudinal axis of the connector. In these other embodiments, the openings of the contact carrier would be arranged to accommodate this angle of the contacts. Figures IOC to 10E illustrate the connector 1044 with an extension body 1045 extending from the connector 1044. The connector 1044 includes a connector body 1060, an optional retainer element 1055, and an optional end stop element 1057. The connector body 1060 and the optional retainer element 1055 can include an opening 1056 through which a fastener 1080 (Figure IOC) (such as a screw, rod, or the like) can be inserted to contact and hold a lead disposed within the connector 1044. The connector body 1060 fits around the contact carriers 1050 and contacts 1040. The connector body 1060 can be made of any biocompatible, non-conductive material such as, for example, silicone, polyurethane, polyetheretherketone (PEEK), or the like.

In at least some embodiments, the contacts 1040 are disposed in the contact carrier 1050 which is then disposed in a mold with the optional retainer element 1055 and optional end stop element 1057. The connector body 1060 is formed by molding around the contact carriers 1050, optional retainer element 1055, and optional end stop element. A mandrel or other element can be positioned in the mold to form the connector lumen.

Figure 11 is a schematic overview of one embodiment of components of an electrical stimulation system 1100 including an electronic subassembly 1110 disposed within a control module. It will be understood that the electrical stimulation system can include more, fewer, or different components and can have a variety of different configurations including those configurations disclosed in the stimulator references cited herein. Some of the components (for example, power source 1112, antenna 1118, receiver

1102, and processor 1104) of the electrical stimulation system can be positioned on one or more circuit boards or similar carriers within a sealed housing of an implantable pulse generator, if desired. Any power source 1112 can be used including, for example, a battery such as a primary battery or a rechargeable battery. Examples of other power sources include super capacitors, nuclear or atomic batteries, mechanical resonators, infrared collectors, thermally-powered energy sources, flexural powered energy sources, bioenergy power sources, fuel cells, bioelectric cells, osmotic pressure pumps, and the like including the power sources described in U.S. Patent No. 7,437, 193, incorporated herein by reference in its entirety.

As another alternative, power can be supplied by an external power source through inductive coupling via the optional antenna 1118 or a secondary antenna. The external power source can be in a device that is mounted on the skin of the user or in a unit that is provided near the user on a permanent or periodic basis.

If the power source 1112 is a rechargeable battery, the battery may be recharged using the optional antenna 1118, if desired. Power can be provided to the battery for recharging by inductively coupling the battery through the antenna to a recharging unit 1116 external to the user. Examples of such arrangements can be found in the references identified above.

In one embodiment, electrical current is emitted by the electrodes 134 on the paddle or lead body to stimulate nerve fibers, muscle fibers, or other body tissues near the electrical stimulation system. A processor 1104 is generally included to control the timing and electrical characteristics of the electrical stimulation system. For example, the processor 1104 can, if desired, control one or more of the timing, frequency, strength, duration, and waveform of the pulses. In addition, the processor 1104 can select which electrodes can be used to provide stimulation, if desired. In some embodiments, the processor 1104 may select which electrode(s) are cathodes and which electrode(s) are anodes. In some embodiments, the processor 1104 may be used to identify which electrodes provide the most useful stimulation of the desired tissue.

Any processor can be used and can be as simple as an electronic device that, for example, produces pulses at a regular interval or the processor can be capable of receiving and interpreting instructions from an external programming unit 1108 that, for example, allows modification of pulse characteristics. In the illustrated embodiment, the processor 1104 is coupled to a receiver 1102 which, in turn, is coupled to the optional antenna 1118. This allows the processor 1104 to receive instructions from an external source to, for example, direct the pulse characteristics and the selection of electrodes, if desired. In one embodiment, the antenna 1118 is capable ot receiving signals {e.g., Kt signals) from an external telemetry unit 1106 which is programmed by a programming unit 1108. The programming unit 1108 can be external to, or part of, the telemetry unit 1106. The telemetry unit 1106 can be a device that is worn on the skin of the user or can be carried by the user and can have a form similar to a pager, cellular phone, or remote control, if desired. As another alternative, the telemetry unit 1106 may not be worn or carried by the user but may only be available at a home station or at a clinician's office. The programming unit 1108 can be any unit that can provide information to the telemetry unit 1106 for transmission to the electrical stimulation system 1100. The programming unit 1108 can be part of the telemetry unit 1106 or can provide signals or information to the telemetry unit 1106 via a wireless or wired connection. One example of a suitable programming unit is a computer operated by the user or clinician to send signals to the telemetry unit 1106.

The signals sent to the processor 1104 via the antenna 1118 and receiver 1102 can be used to modify or otherwise direct the operation of the electrical stimulation system. For example, the signals may be used to modify the pulses of the electrical stimulation system such as modifying one or more of pulse duration, pulse frequency, pulse waveform, and pulse strength. The signals may also direct the electrical stimulation system 1100 to cease operation, to start operation, to start charging the battery, or to stop charging the battery. In other embodiments, the stimulation system does not include an antenna 1118 or receiver 1102 and the processor 1104 operates as programmed.

Optionally, the electrical stimulation system 1100 may include a transmitter (not shown) coupled to the processor 1104 and the antenna 1118 for transmitting signals back to the telemetry unit 1 106 or another unit capable of receiving the signals. For example, the electrical stimulation system 1 100 may transmit signals indicating whether the electrical stimulation system 1100 is operating properly or not or indicating when the battery needs to be charged or the level of charge remaining in the battery. The processor 1104 may also be capable of transmitting information about the pulse characteristics so that a user or clinician can determine or verify the characteristics. The above specification, examples and data provide a description of the manufacture and use of the composition of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope ot the invention, the invention also resides in the claims hereinafter appended.