IntroductionThe general objective of this study was to provide an improved software for safer and more effective neurostimulation therapy.Materials and MethodsTulgar implants, employing combined modulation of stimulation synchronized with heart rate, breathing frequency, and position of the patient (HBP), were applied as vagus nerve stimulation (VNS) for the management of refractory epilepsy in 105 patients who were followed up for 1 year.ResultsFifty-nine out of 105 (56.19%) patients were seizure free, 34 (32.38%) patients had partial improvement in quality of life with a decrease in intensity and frequency of the seizures, and 12 (11.43%) patients did not respond to stimulation.DiscussionOther similar studies, undertaken with non-Tulgar equipment, reported a 10% full recovery, 60% partial improvement in quality of life, and 30% zero response. Comparisons of these results reveal an approximate fivefold increase in seizure freedom, and threefold decrease in the number of nonresponsive patients.ConclusionsThe findings of the present study imply that HBP-modulated mode of stimulation could be safer and more effective in neurostimulation, at least in VNS.