Autostimulation in Vagus Nerve Stimulator Treatment: Modulating Neuromodulation

Evolution of the Vagus Nerve Stimulation (VNS) Therapy System Technology for Drug-Resistant Epilepsy

“…Real-world use of the AutoStim Mode has been shown to increase VNS Therapy therapeutic efficacy in both pediatric and adult patients across varying epilepsy etiologies (50)(51)(52)(53)(54)(55). Additionally, patients who elect to switch from a conventional VNS Therapy generator to a closedloop AutoStim generator (e.g., M106, M1000, M1000-D) can experience additional therapeutic improvement upon generator replacement (50,52,56,57) (Table 2; Figure 1).…”

Frequency of Automatic Stimulations in Responsive Vagal Nerve Stimulation in Patients With Refractory Epilepsy

“…Our study group was 30 patients of which 13 received traditional VNS therapy before implanting the VNS model 106 AspireSR (LivaNova, Houston, TX, USA) allowing for automatic stimulation. All these patients were presented in our previous paper (15). One patient from the previous study was excluded because the follow‐up was transferred to another hospital.…”

“…At present, a comprehensive understanding of the efficacy and function of rVNS therapy is lacking. We recently published a study assessing a group of 14 patients receiving rVNS therapy, with prior traditional VNS (models 102 and 103) therapy; in which we described the initiation of rVNS leading to better control of seizures and a decrease in AED burden (15). On the other hand, there is little data about the effect of different VNS settings on the number of stimulations and energy consumption, and there are no practical guidelines for the programming of the rVNS device.…”

Recent Advancement of Technologies and the Transition to New Concepts in Epilepsy Surgery

“…37) Another study also revealed that VNS with AutoStim Mode achieved maintenance of prior-established seizure control with markedly less energy consumption and improved seizure control as compared to the previous models. 38) Patients who did not respond to the previous models only with the open-loop system may obtain seizure reduction by replacement to the Model 106 even though output currents and duty cycles were reduced. 39) However, these additional benefits and the reasons why VNS with autostimulation responding ictal tachycardia works well with less energy consumption, less output current, or less duty cycle are still unclarified.…”