Cloud based neurostimulation programming optimization

A method of providing electrostimulation using a medical-device system, the method comprising:

• under a first patient state, delivering electrostimulation to a neural target using an implantable stimulator coupled to a lead comprising a plurality of electrodes, the electrostimulation delivered in accordance with first stimulation settings defined in a search space of electrode configurations and parameter values;
• collecting clinical effect data from the patient in response to the electrostimulation and evaluating a clinical response indicator using the collected clinical effect data;
• identifying a subspace of the search space based at least in part on the clinical response indicator associated with the first stimulation settings, the identified subspace comprising stimulation positions and a stimulation parameter value zone defined between first and second characteristic parameter values for each of the stimulation positions, the first and second characteristic parameter values each corresponding to respective clinical response indicators satisfying respective conditions;
• under a second patient state different from the first patient state, delivering electrostimulation to the neural target using the implantable stimulator, the electrostimulation delivered in accordance with candidate stimulation settings defined in the identified subspace;
• collecting the clinical effect data from the patient in response to the electrostimulation and evaluating a clinical response indicator using the collected clinical effect data;
• selecting a stimulation setting from the candidate stimulation settings based at least in part on the clinical response indicator associated with the candidate stimulation settings, the selected stimulation setting including a stimulation parameter value falling within the stimulation parameter value zone;
• and
• generating a control signal to the implantable stimulator to deliver electrostimulation in accordance with the selected stimulation setting.

A system for providing electrostimulation to a patient, comprising:

• an implantable stimulator configured to provide electrostimulation to a neural target of the patient via a lead comprising a plurality of electrodes;
• a programming device configured to:
• under a first patient state, evaluate a clinical response indicator using (i) first clinical effect data collected from the patient in response to electrostimulation delivered in accordance with first stimulation settings defined in a search space of electrode configurations and parameter values for the lead with respect to the neural target, and (ii) second clinical effect data estimated for second stimulation settings defined in the search space different than the first stimulation settings without delivering electrostimulation to the patient, the second clinical effect data estimated based at least on the collected clinical effect data corresponding to the first stimulation settings;
• and
• identify a subspace of the search space based at least in part on the clinical response indicator associated with the first and the second stimulation settings;
• and
• a therapy titration device configured to:
• under a second patient state different from the first patient state, evaluate the clinical response indicator using clinical effect data collected from the patient in response to electrostimulation delivered in accordance with candidate stimulation settings defined in the identified subspace;
• select a stimulation setting from the candidate stimulation settings based at least in part on the clinical response indicator associated with the candidate stimulation settings;
• and
• generate a control signal to the implantable stimulator to deliver electrostimulation in accordance with the selected stimulation setting.