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Importance of timing optimization for closed-loop applications of vagus nerve stimulation.

Ramanamurthy V MylavarapuVivek V KanumuriJuan Pablo de Rivero VaccariAmrit MisraDavid W McMillanPatrick D Ganzer
Published in: Bioelectronic medicine (2023)
In recent decades, vagus nerve stimulation (VNS) therapy has become widely used for clinical applications including epilepsy, depression, and enhancing the effects of rehabilitation. However, several questions remain regarding optimization of this therapy to maximize clinical outcomes. Although stimulation parameters such as pulse width, amplitude, and frequency are well studied, the timing of stimulation delivery both acutely (with respect to disease events) and chronically (over the timeline of a disease's progression) has generally received less attention. Leveraging such information would provide a framework for the implementation of next generation closed-loop VNS therapies. In this mini-review, we summarize a number of VNS therapies and discuss (1) general timing considerations for these applications and (2) open questions that could lead to further therapy optimization.
Keyphrases
  • minimally invasive
  • primary care
  • working memory
  • stem cells
  • depressive symptoms
  • quality improvement
  • physical activity
  • social media
  • functional connectivity
  • cell therapy
  • sleep quality
  • resting state