A system for electrical stimulation delivery, the system comprising: stimulation generation circuitry configured to deliver electrical stimulation to a patient; sensing circuitry configured to sense one or more biomarker signals; and processing circuitry configured to: cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a first patient state; receive a first instance of a biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the first patient state; cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a second patient state; receive a second instance of the biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the second patient state; determine whether a difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies a threshold; select a therapy mode for electrical stimulation delivery based on whether the difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies the threshold; and cause the stimulation generation circuitry to deliver electrical stimulation in accordance with the selected therapy mode. stimulation generation circuitry configured to deliver electrical stimulation to a patient; sensing circuitry configured to sense one or more biomarker signals; and processing circuitry configured to: cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a first patient state; receive a first instance of a biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the first patient state; cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a second patient state; receive a second instance of the biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the second patient state; determine whether a difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies a threshold; select a therapy mode for electrical stimulation delivery based on whether the difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies the threshold; and cause the stimulation generation circuitry to deliver electrical stimulation in accordance with the selected therapy mode. cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a first patient state; receive a first instance of a biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the first patient state; cause the stimulation generation circuitry to deliver electrical stimulation with the patient in a second patient state; receive a second instance of the biomarker signal of the sensed one or more biomarker signals in presence of the electrical stimulation from the stimulation generation circuitry delivering the electrical stimulation with the patient in the second patient state; determine whether a difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies a threshold; select a therapy mode for electrical stimulation delivery based on whether the difference between the first instance of the biomarker signal and the second instance of the biomarker signal satisfies the threshold; and cause the stimulation generation circuitry to deliver electrical stimulation in accordance with the selected therapy mode.