Patent Description:
Neuromodulation systems typically comprise at least a medical device for applying neuromodulation, a controller and at least one programmer.

Medical professionals (e.g. therapists, nurses, physiotherapists, clinicians) and patients typically communicate with a medical device using an electronic programmer, in particular a clinician programmer (e.g. space time programmer) and a patient programmer respectively. Each of these programmers can be a handheld device. A clinician programmer allows a medical professional to define the particular electrical stimulation therapy to be delivered to a target area of the patient's body, while a patient programmer allows e.g. a patient or his/her relatives, to alter one or more parameters of the electrical stimulation therapy and/or start and/or stop stimulation and/or monitor properties of the neuromodulation system or a patient's health metrics (e.g. physiological data while receiving electrical stimulation therapy).

<CIT> discloses techniques for increasing the safety of medical device programming using general purpose hardware, such as a general-purpose personal computer. In some embodiments, a system includes an intermediate computing device comprising an applications module. Information from the applications module, such as instructions for an implantable medical device (IMD), may be presented to a user via a user input terminal that is separate from the intermediate computing device. A user may interact with the user input terminal to select an instruction from the applications module, and the intermediate computing device may transmit the selected instruction to the IMD. In some embodiments, the intermediate computing device comprises a web server and the user input terminal comprises a web browser configured to access the web server. In other embodiments, the intermediate computing device comprises a client server and the user input terminal comprises a client.

<CIT> discloses system for remote programming of a programmable personal medical device, in particular an implantable medical device such as a cardiac pacemaker, defibrillator, or the like. A patient intermediary device may be positioned in proximity to the patient and thus in proximity to the implantable medical device. A programming device is located at a distance from the patient and from the patient intermediary device. The programming device and the patient intermediary device are tuned to the implantable medical device, at least for the duration of the remote programming. The patient intermediary device is equipped with a first interface and a second interface that are designed for a transmission of a data set from the programming device to the patient intermediary device. The patient intermediary device receives the data set, and an authentication unit verifies the data set for the presence of a valid authentication. The data set including the programming instruction is only transmitted to the implantable medical device when the presence of a valid authentication in the data set is confirmed by the authentication unit. The object of the present invention is to provide an alternative system for planning and/or controlling and/or programming neuromodulation, wherein the system ensures secure and controlled data transfer.

This object is solved according to the present invention with a system for planning and/or controlling neuromodulation, with the features of claim <NUM>. Accordingly, a system for planning and/or controlling neuromodulation, at least comprising:.

The invention is based on the basic idea that in the context of neuromodulation, especially neurostimulation, stimulation parameters can be reliably planned and/or controlled with said system, wherein precise stimulation protocols are enabled by avoiding data interference, in particular by means of the connection managing module. In particular, interference of data and/or signals transmitted between one user input terminal and the other user input terminal and/or the intermediate computing device is avoided and/or excluded by avoiding bidirectional connection and/or data transfer between these units. In other words, unidirectional communication channels are provided. In other words, one device, module or terminal may send data and/or instructions in one direction to another device, module or terminal. Therefore, controlled and secure transmission of data and/or signals at all time while the system is operating is enabled. Further, encryption of data may be enabled. Further, reduced energy consumption of the system and prolonged battery life may be achieved through unidirectional data transfer and/or selective temporal connections.

Data interference may occur when transmissions are sent from a transmitter (device, module or terminal) to a receiver (other device, module or terminal) and when transmissions are simultaneously sent from said receiver (which is then also a transmitter) to the transmitter (which is then also a receiver). Also, data interference may occur within a system when transmissions are sent from a transmitter (device, module or terminal) to a receiver (other device, module or terminal) and when transmissions are simultaneously sent from another transmitter to another or the same receiver.

Data interference may alternatively and/or additionally occur when data are stored in at least one unit of the system (e.g. intermediate computing device, first user input terminal, second user input terminal, medical device or controller). In particular, the data stored on it may be newer or older than what is stored in another, connected device (other element of the system). In particular, interference of data may then be avoided and/or excluded by adapting the data stored in both units to the newer version and/or avoiding simultaneous data transfer between each of these units with a third unit.

In particular, the intermediate computing device may enable doing sanity-checks on commands received from the first user input terminal and/or the second user input terminal, preventing that the first user input terminal and/or the second user input terminal send invalid commands directly into the medical device. In particular, the intermediate computing device may comprise and/or use a security system that monitors and/or controls incoming and/or outcoming signal traffic based on predetermined security rules, such as an unauthorized access block method, e.g. 'a firewall'. This may, for instance, enable secure data transfer.

In one embodiment, the at least one connection managing module may be embodied as software module, in particular in the intermediate computing device. Additionally, or alternatively, the connection managing module may be embodied as software module in the first user input terminal. Additionally, or alternatively, the connection managing module can be embodied in the second user input terminal. Alternatively, the connection managing module may be embodied in another device comprised within or linked to the system.

Alternatively, the at least one connection managing module may be or may comprise a communication controller, in particular an electrical communication controller.

The medical device may be a neuromodulator, in particular a neurostimulator. Also, the medical device may be a battery powered device. The medical device may be implanted. In a preferred embodiment, the medical device is or comprises a pulse generator, in particular an implantable pulse generator (IPG), which comprises or is linked to one or multiple stimulation leads, each with at least one electrode. Its intended use is to deliver electrical stimulation via the at least one lead to at least one stimulation site of a patient equipped with the system based on commands (neuromodulation control data) received from the intermediate computing device.

The intermediate computing device may be or may comprise a controller. In particular, the intermediate computing device may be a body worn-platform (directly or indirectly) to execute the control software. In particular, in a specific embodiment, the intermediate computing device can be implanted.

The intermediate computing device processes data that is acquired e.g. from the first user input terminal, the second user input terminal and/or the medical device and programs the medical device to deliver correct (planned) stimulation. In other words, the intermediate computing device is configured and arranged to provide neuromodulation control data to the medical device, in particular neuromodulation control data for at last one specific task (e.g. an activity training/exercise/muscular response/ autonomic system response/sphincter response/blood pressure response) and/or at least one specific neuromodulation therapy (e.g. to restore motoric function, autonomic function, blood pressure (hypotension, hypertension), bladder control, bowel control, sphincter control and/or sexual function), at least partially on the basis of the information obtained from the first user input terminal and/or the second user input terminal.

The first user input terminal, in some embodiments also called the patient programmer (PP) may inter alia allow the user, e.g. the patient or a relative of the patient, to select a specific stimulation program and/or input therapy parameter (e.g. for a specific task or a specific medical indication) and/or to alter one or more parameters of the stimulation therapy program and/or to start and/or stop and/or ramp up and/or ramp down and/or modify and/or pause stimulation and/or to monitor properties of the neuromodulation system or at least one of patient's health metrics (e.g. physiological data while receiving electrical stimulation therapy).

In particular, the first user input terminal may comprise and/or may offer a list of pre-installed (simplified) control commands to be selected from and/or altered by the user, e.g. the patient or a relative of the patient. In particular, by selecting and/or altering at least one of a pre-installed control commands simple handling of the system is enabled for the user.

In one embodiment, the first user input terminal is capable to receive data from the intermediate computing device or the second user input terminal, display data, receive input from the user (e.g. patient), send it back to the intermediate computing device or the second user input terminal. In other words, the first user input terminal can receive, display, process and/or resend data.

The second user input terminal, or also called the clinician programmer, can inter alia be used to receive inter alia stimulation parameters, patient data, physiological data, training data etc. and/or for defining and/or altering stimulation parameters (inter alia electrode configuration, frequency, pulse width, amplitude) and/or allowing adjustment(s) to the stimulation. The second user input terminal may additionally and/or alternatively read and/or monitor properties of the neuromodulation system or at least one of patient's health metrics (e.g. physiological data before, while or after receiving electrical stimulation therapy, such as blood pressure, heartrate, SpO<NUM>, movement, number of steps, etc.). It may comprise a space time programmer (STP) for e.g. programming spatial and temporal parameters of the stimulation.

In one embodiment, the second user input terminal is capable to receive data from the intermediate computing device or from the first user input terminal display data, receive input from the user (e.g. clinician or therapist), send it back to the intermediate computing device or the first user input terminal. In other words, second user input terminal can receive, display, process and/or resend data. In other words, the second user input terminal can be embodied such that it is possible to receive inter alia but not limited to stimulation parameters, patient data and the like, check and/or reprogram the stimulation settings and send it back to e.g. the intermediate computing device/controller.

Also, the first and/or the second user input terminal by be capable to send and receive data to or from a remote database.

In particular, the first and/or the second user input terminal may comprise a display and/or a graphical user interface.

The first and the second user input terminal can be embodied as applications installed on a mobile device that communicate with the intermediate computing device/ controller. They are used by the patient and the treating physician or physiotherapist, respectively, to provide inputs to the intermediate computing device/controller.

The first user input terminal and/or the second user input terminal can allow adjusting the stimulation parameters of a task, while the task (i.e. a stimulation program aimed at addressing a specific neurological function, such as locomotion) is running. This enables the user to tune the stimulation without having to start and stop the task, which would be very cumbersome and clinically undesired at the start of the rehabilitation training, when all stimulation partitures are developed and tuned.

In a further embodiment, the system further comprises a telemetry module and/or Bluetooth module and/or communication module and/or wireless network enabling connection between the medical device, the intermediate computing device, the first user input module and/or the second user input module. This may advantageously enable wireless and/or remote control and/or programming of the stimulation. For instance, the second user input terminal and its user can be remote from the first user input terminal.

In one embodiment, the connection between the medical device and the intermediate computing device is a bidirectional connection. In particular, the connection may be a wireless or cable-bound connection. Also, this connection may be a constant connection. This may enable continuous data transfer between the medical device and the intermediate computing device. For instance, the medical device can provide the intermediate computing device with patient data (sensed by a linked sensor), while the intermediate computing device provides the medical device with neuromodulation control data. This may be advantageous for settings where the stimulation program provided by the intermediate computing device shall be adapted to data provided by the medical device (e.g. patient data, in particular patient-feedback data).

Further, it is generally possible that the first user input terminal and/or the second user input terminal and/or the intermediate computing device are connected by a wireless connection. This has the advantage that the first user input terminal and/or the second user input terminal can be remote from the intermediate computing device. The wireless connection may be any remote telemetry techniques known in the art,
In one embodiment, the first user input terminal and/or the second user input terminal are remote from the intermediate computing device and/or the medical device. This has the advantage that the user of the first user input terminal can be remote from the user of the second user input terminal, and the user of the fist user input terminal and/or the user of the second user input terminal can be remote from the intermediate computing device and/or the medical device. For instance, a patient equipped with the first user input terminal, the medical device, and the intermediate computing device can be at home and thus remote from the second user input terminal (which may be e.g. placed in a hospital or laboratory).

In one embodiment, the system is configured and arranged for transferring data from the first user input terminal to the second user input terminal or vice versa, the first user input terminal to the intermediate computing device or vice versa, the second user input terminal to the intermediate computing device and/or the intermediate computing device to the medical device and/or vice versa. In particular, this may enable selective data transfer between respective transmitting devices/ terminals and/or receiving devices/terminals without transferring data to non-targeted devices/terminals.

In a further embodiment, the intermediate computing device comprises an applications module, wherein the first user input terminal and/or the second user input terminal are configured and arranged for accessing and/or controlling the applications module, in particular remotely accessing and/or controlling the applications module. In particular, the intermediate computing device may present information from the applications module to a user, e.g. via a display of the fist user input terminal and/or e.g. via a display of the second user input terminal, where the information includes a plurality of instructions for the medical device. In particular, remote access and control of the applications module may enable user-friendly and uncomplicated application of the system.

In a further embodiment, the first user input terminal and/or the second user input terminal comprise a display, wherein the intermediate computing device presents information from the applications module to a user via the display of the first user input terminal or the second user input terminal. This may be advantageous by enabling user-friendly application of the system, as e.g. patient data, programming options and/or instructions to be selected may be clearly arranged on the display. Thus, understanding and handling of the system is enabled.

In a further embodiment the first user input terminal and/or the second user input terminal comprise a user interface configured and arranged for receiving input from a user. In particular, the user interface may be a graphical user interface, or the display may present a graphical user interface that enables remote control of features of the intermediate computing device. This may enable easy and user-friendly application of the system.

Also, the intermediate computing device may be configured and arranged for receiving an indication of an input from a user, especially an indication of a selected instruction from a plurality of instructions for the medical device, and transmit the selected instruction to the medical device. In other words, the user input terminal may provide a plurality of possible instructions for instruction of the medical device to a user, and the user can select desired instructions which are transmitted to the intermediate computing device.

In particular, the selected instruction may include at least a request for diagnostic data from the medical device, patient data stored in the medical device or an input therapy parameter for programming into the implantable medical device. For instance, diagnostic data may be or may comprise neurological signals from the patient (e.g. sensed by a connected electrode), patient data may comprise physiological and/or pathological data, input therapy parameter may comprise starting and/or stopping and/or ramping up and/or ramping town stimulation for a task and/or configuration of stimulation parameters (electrode configuration, pulse width, amplitude, frequency, electrode configuration). In other words, a user may select at least one instruction, and the medical device operates according to the selected instruction, after the selected instructions is transmitted from the intermediate computing device to the medical device.

Further, the invention relates to a method for planning neuromodulation comprising:.

wherein the method further comprises the step of configuring and arranging a connection managing module for:.

The method can be performed with the above-described system.

Further described is a method for planning neuromodulation, comprising:.

The control commands can also be understood as input therapy parameter.

As in c), the first user input terminal and the second user input terminal are connected for unidirectional data transfer from the first user input terminal to the second user input terminal while both the first user input terminal and the second user input terminal are not connected to the intermediate computing device, incidental overwriting of neuromodulation control data is avoided.

As in step d) there is no connection and/or data transfer between the first user input terminal, the second user input terminal and/or the intermediate computing device, incidental control commands and/or overwriting of neuromodulation control data provided is avoided.

As in step e) the second user input terminal and the intermediate computing device are connected and/or data are transferred unidirectionally from the second user input terminal to the intermediate computing device while the first user input terminal and the intermediate computing device and the first user input terminal and the second user input terminal are not connected, incidental control commands and/or overwriting of neuromodulation control data provided from the first user input terminal is avoided.

As in step f) the second user input terminal and the first user input terminal are connected and/or data are transferred unidirectionally from the second user input terminal to the first user input terminal while both the first user input terminal and the second user input terminal are not connected to the intermediate computing, interference of transferred data with neuromodulation control commands stored in the intermediate computing device is avoided.

As in step g), the first user input terminal and the intermediate computing device are connected and/or data are transferred unidirectionally from the first user input terminal to the intermediate computing device while the second user input terminal and the intermediate computing device and the second user input terminal and the first user input terminal are not connected, data interference is avoided. Also, as pre-installed control commands are presented the user, this enables keeping the handling of the system by the user (e.g. patient) simple and increases usability safety.

In particular, the methods described herein enable avoiding interference of data and/or signals transmitted between one user input terminal and the other user input terminal and/or the intermediate computing device. Therefore, controlled and secure transmission of data and/or signals at all time while the system is operating is enabled. Further, encryption of data may be enabled. Also, the system may enable saving energy and/or power and thus allow prolonging battery life time.

Further details and advantages of the present invention shall now be disclosed in connection with the drawings.

<FIG> shows a general layout of an embodiment of the system <NUM> according to the present invention.

The system <NUM> comprises a medical device <NUM>.

In this embodiment, the medical device <NUM> is an implantable pulse generator <NUM> which is implanted subcutaneously in a patient.

The system <NUM> further comprises an intermediate computing device <NUM>.

In this embodiment, the intermediate computing device <NUM> is a controller <NUM>, in particular a motion controller <NUM>.

In this embodiment, the controller <NUM> is implanted in the patient.

In this embodiment, the controller <NUM> comprises an applications module.

The system <NUM> further comprises a first user input terminal <NUM>.

In this embodiment, the first user input terminal <NUM> is a programmer <NUM>, in particular a patient programmer <NUM>.

In this embodiment, the first user input terminal <NUM> comprises a display.

Also, the first user input terminal <NUM> comprises a user interface, in particular a graphical user interface.

Also, the system <NUM> comprises a second user input terminal <NUM>.

In this embodiment, the second user input terminal <NUM> is a programmer <NUM>, in particular a clinician programmer <NUM>.

In this embodiment, the second user input terminal <NUM> comprises a display.

Also, the second user input terminal <NUM> comprises a user interface, in particular a graphical user interface.

Alternatively, only the first user input terminal <NUM> or the second user input terminal <NUM> could comprise a display and/or a graphical user interface.

In this embodiment, the second user input terminal <NUM> is remote from the controller <NUM> and/or the implantable pulse generator <NUM>.

Also, in general, the first user input terminal <NUM> can be remote from the controller <NUM> and/or the implantable pulse generator <NUM>.

Also, the system <NUM> comprises a connection managing module <NUM>.

In an alternative embodiment, the system <NUM> can comprise more than one connection managing module <NUM>.

In this embodiment, the implantable pulse generator <NUM> and the controller <NUM> are connected.

The connection between the implantable pulse generator <NUM> and the controller <NUM> is a bidirectional connection.

The connection between the implantable pulse generator <NUM> and the controller <NUM> is a permanent and cable-bound connection.

In an alternative embodiment, the connection could be a wireless connection, e.g. a telemetry connection, wireless network connection, etc..

In general, also a unidirectional connection could be possible.

The first user input terminal <NUM> and the second user input terminal <NUM> are at least temporarily connected, in particular for data transfer.

Also, the first user input terminal <NUM> and the controller <NUM> are at least temporally connected, in particular for data transfer.

Also, the second user input terminal <NUM> and the controller <NUM> are at least temporally connected, in particular for data transfer.

The connection between the first user input terminal <NUM> and the controller <NUM>, the first user input terminal <NUM> and the second user input terminal <NUM> and/or the controller <NUM> and the second user input terminal <NUM> is a wireless connection, in particular a connection via a wireless network WSN.

Alternatively, or additionally, the connection between the implanted pulse generator <NUM>, the controller <NUM>, the first user input terminal <NUM>, the second user input terminal <NUM> and/or the connection managing module <NUM> can be enabled by a telemetry module and/or Bluetooth module and/or communication module.

In this embodiment, the connection managing module <NUM> allows only unidirectional connection and/or unidirectional data transfer between the controller <NUM> and the first user input terminal <NUM>, the controller <NUM> and the second user input terminal <NUM> and/or the first user input terminal <NUM> and the second user input terminal <NUM>.

In other words, the connection managing module can block bidirectional connection and/or data transfer between the controller <NUM> and the first user input terminal <NUM>, the controller <NUM> and the second user input terminal <NUM> and/or the first user input terminal <NUM> and the second user input terminal <NUM>.

Further, in this embodiment, the connection managing module <NUM> provides only connection and/or data transfer between the controller <NUM> and the first user input terminal <NUM> and/or the controller <NUM> and the second user input terminal <NUM> when there is no connection and/or data transfer between the first user input terminal <NUM> and the second user input terminal <NUM>.

In other words, the connection managing module <NUM> can block connection and/or data transfer between the controller <NUM> and the first user input terminal <NUM> and/or the controller <NUM> and the second user input terminal <NUM> when there is already a connection and/or data transfer between the first user input terminal <NUM> and the second user input terminal <NUM>.

In other words, the connection managing module <NUM> can switch connection and/or data transfer between the different units/devices/terminals of the system <NUM>, cf.

Not explicitly shown in <FIG> is that the system <NUM> enables transfer of data from the first user input terminal <NUM> to the second user input terminal <NUM> or vice versa (cf. <FIG> and <FIG>), the first user input terminal <NUM> to the controller <NUM> or vice versa (cf. <FIG> and <FIG>), the second user input terminal <NUM> to the controller <NUM> or vice versa (cf. e.g. <FIG> ) and/or the controller <NUM> to the medical device <NUM> and/or vice versa (<FIG>).

The first user input terminal <NUM> and the second user input terminal <NUM> access and/or control the applications module, in particular remotely access and/or control the applications module.

Not shown in <FIG> is that the controller <NUM> presents information from the applications module to a user (e.g. a patient) via the display of the first user input terminal <NUM>, in particular input therapy parameters for section may me presented to the user.

Additionally, or alternatively, the controller <NUM> can present information from the applications module to a user (e.g. a clinician) via the display of the second user input terminal <NUM>, in particular stimulation parameters may be presented.

Not shown in <FIG> is that the user interface of the first user input terminal <NUM> can receive input from a user.

The user input can then be processed by the first user input terminal <NUM> and/or transmitted to the controller <NUM> or the second user input terminal <NUM>. In particular processed data can be transmitted to the controller <NUM> or the second user input terminal <NUM>.

Also not shown in <FIG> is that the user interface of the second user input terminal <NUM> can receive input from a user.

The user input can then be processed by the second user input terminal <NUM> and/or transmitted to the controller <NUM> or the first user input terminal <NUM>. In particular processed data can be transmitted to the controller <NUM> or the first user input terminal <NUM>.

Further not shown is that, in particular based on the user input, in particular the processed user input, the controller <NUM> receives an indication of the input from a user, especially an indication of a selected instruction from a plurality of instructions for the implantable pulse generator <NUM>, and transmits the selected instruction to the implantable pulse generator <NUM>.

The selected instruction can comprise at least one of a request for diagnostic data from the implantable pulse generator <NUM>, e.g. measured neuroelectric activity, patient data stored within the implantable pulse generator or at least one input therapy parameter for programming into the implantable pulse generator <NUM>.

The implantable pulse generator <NUM> can provide the controller <NUM> with the diagnostic data or with patient data, or can provide stimulation based on the input therapy parameters selected.

Thus, in other words, system <NUM> can perform the the method according to claim <NUM>.

Also, the system <NUM> can perform the method as disclosed in <FIG>.

The method comprises at least the steps S1-S7.

In a first step S1, by means of the first user input terminal <NUM> the applications module of the controller <NUM> can be accessed, in particular remotely accessed.

In other words, data relating to or of the implantable pulse generator <NUM> and/or the controller <NUM> can be accessed. In other words, the applications module and (indirectly) the implantable pulse generator <NUM> can be accessed.

In step S1, the controller <NUM> is connected to the first user input terminal <NUM> and data are transferred unidirectionally from the controller <NUM> to the first user input terminal <NUM>, cf.

In a second step S2, the information, in particular accessed data from the applications module, can be presented to a user via the first user input terminal <NUM>, in particular the display of the first user input terminal <NUM>.

In a third step S3, the data can be transmitted from the first user input terminal <NUM> to the second user input terminal <NUM>.

In step S3, connection between the first user input terminal <NUM> and the second user input terminal <NUM> and/or unidirectional data transfer from the first user input terminal <NUM> to the second user input terminal <NUM> is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the controller is not enabled, cf.

In a fourth step S4, neuromodulation control data and/or stimulation parameters can be updated on the second user input terminal <NUM>, in particular based on the data transmitted from the first user input terminal <NUM>.

In step S4, no connection and/or data transfer between the second user input terminal <NUM> and the first user input terminal <NUM> or the controller <NUM> is enabled, cf.

In a fifth step S5, the updated neuromodulation control data and/or stimulation parameters can be transferred from the second user input terminal <NUM> to the controller <NUM>.

In step S5, connection between the second user input terminal <NUM> and the controller <NUM> and/or unidirectional data transfer from the second user input terminal <NUM> to the controller <NUM> is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the first user input terminal <NUM> is not enabled, cf.

In a sixth step S6, the installed control commands (input therapy parameters) on the first user input terminal <NUM> can be updated by means of the updated neuromodulation control data.

In step S6, connection between the second user input terminal <NUM> and the first user input terminal <NUM> and/or unidirectional data transfer from the second user input terminal <NUM> to the first user input terminal <NUM> is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the controller <NUM> is not enabled, cf.

In a seventh step S7, the updated installed control commands (input therapy parameter(s)) can be used for programming and/or controlling the controller <NUM>.

In step S7, connection between the first user input terminal <NUM> and the controller <NUM> and/or unidirectional data transfer from the first user input terminal <NUM> to controller <NUM> is enabled, while connection and/or data transfer between the second user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the first user input terminal <NUM> is not enabled, cf.

Thus, the method allows only unidirectional connection and/or unidirectional data transfer between the controller <NUM> and the first user input terminal <NUM>, the controller <NUM>) and the second user input terminal <NUM> and/or the first user input terminal <NUM> and the second user input terminal <NUM>.

Further, the method provides only connection and/or data transfer between the controller <NUM> and the first user input terminal <NUM> and/or the controller <NUM> and the second user input terminal <NUM> when there is no connection and/or data transfer between the first user input terminal <NUM> and the second user input terminal <NUM>.

<FIG> shows a further layout of the system <NUM>, with unidirectional connection and/or data transfer between the fist user input terminal <NUM> and the controller <NUM>.

The structural and functional features of the system <NUM> are described in detail in <FIG>.

In this embodiment, a unidirectional connection between the controller <NUM> and the first user input terminal <NUM> and/or unidirectional data transfer from the controller <NUM> to the first user input terminal <NUM> is enabled.

In particular, the application module of the controller <NUM> is remotely accessed by means of the first user input terminal <NUM> and data are got out of the medical device <NUM>.

<FIG> shows a further layout of the system <NUM>, with unidirectional connection and/or data transfer between the fist user input terminal <NUM> and the second user input terminal <NUM>.

In this embodiment, unidirectional connection between the first user input terminal <NUM> and the second user input terminal <NUM> and/or unidirectional data transfer from the first user input terminal <NUM> to the second user input terminal is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the controller is not enabled.

In particular, the connection enables that data are transmitted from the first user input terminal <NUM> to the second user input terminal <NUM>.

<FIG> shows a further layout of the system <NUM>.

In particular, no connection and/or data transfer between the second user input terminal <NUM> and the first user input terminal <NUM> and/or the controller <NUM> is enabled while neuromodulation control data and/or stimulation parameters are updated on the second user input terminal <NUM>.

<FIG> shows a further layout of an embodiment of the system <NUM>, with unidirectional connection and/or data transfer between the second user input terminal <NUM> and the controller <NUM>.

In this embodiment, unidirectional connection between the second user input terminal <NUM> and the controller <NUM> and/or unidirectional data transfer from the second user input terminal <NUM> to the controller <NUM> is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the first user input terminal <NUM> is not enabled.

In particular, through this connection, the controller <NUM> can be provided with updated neuromodulation control data.

<FIG> shows a further layout of an embodiment of the system <NUM>, with unidirectional connection and/or data transfer between the second user input terminal <NUM> and the first user input terminal <NUM>.

In this embodiment, unidirectional connection between the second user input terminal <NUM> and the first user input terminal <NUM> and/or unidirectional data transfer from the second user input terminal <NUM> to the first user input terminal <NUM> is enabled, while connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the controller <NUM> is not enabled.

In particular, the connection can enable updating installed control commands (input therapy parameters) on the first user input terminal <NUM> by means of updated neuromodulation control data provided by the second user input terminal <NUM>.

<FIG> shows a further layout of an embodiment of the system <NUM>, with unidirectional connection and/or data transfer between the first user input terminal <NUM> and the controller <NUM>.

In this embodiment, connection between the first user input terminal <NUM> and the controller <NUM> and/or unidirectional data transfer from the first user input terminal <NUM> to controller <NUM> is enabled, while connection and/or data transfer between the second user input terminal <NUM> and the controller <NUM> and the second user input terminal <NUM> and the first user input terminal <NUM> is not enabled.

Claim 1:
A system (<NUM>) for planning and/or controlling neuromodulation, at least comprising:
a medical device (<NUM>),
an intermediate computing device (<NUM>),
a first user input terminal (<NUM>),
a second user input terminal (<NUM>),
wherein the medical device (<NUM>), the intermediate computing device (<NUM>), the first user input terminal (<NUM>) and/or the second user input terminal (<NUM>) are at least temporarily connected,
wherein the system further comprises at least one connection managing module (<NUM>), wherein the at least one connection managing module (<NUM>) is configured and arranged for
- allowing only unidirectional connection and/or unidirectional data transfer between the intermediate computing device (<NUM>) and the first user input terminal (<NUM>), the intermediate computing device (<NUM>) and the second user input terminal (<NUM>) and/or the first user input terminal (<NUM>) and the second user input terminal (<NUM>),
- providing only connection and/or data transfer between the intermediate computing device (<NUM>) and the first user input terminal (<NUM>) and/or the intermediate computing device (<NUM>) and the second user input terminal (<NUM>) when there is no connection and/or data transfer between the first user input terminal (<NUM>) and the second user input terminal (<NUM>).