FEASIBILITY OF A COMBINED SEIZURE DETECTOR-VNS SYSTEM

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Some epilepsy patients implanted with the Vagus Nerve Stimulation Therapy System (Cyberonics, Inc) can affect the progression of a seizure by manually initiating on-demand stimulation of the vagus nerve during the clinical portion of the seizure, while others do not benefit from on-demand stimulation because they initiate the stimulation too late or are incapable of initiating it at all during the seizure. The primary objectives of this study are to: 1) Demonstrate the feasibility of using a computer system to automatically initiate on-demand vagus nerve stimulation in patients implanted with the VNS system following rapid, automatic, EEG-based detection of the electrographic onset of clinical seizures, or surrogates (for this proof-of-principle study) such as subclinical seizures or epileptiform activity; 2) Gather prospective data on the sensitivity and specificity of the seizure detection algorithm that is part of the computerized system; and 3) Gather data on how the number of EEG electrodes affect the sensitivity and specificity of the system. Secondary objectives are to 1) Gather pilot data on the clinical effect of timely, EEG-triggered stimulation of the vagus nerve on the duration and intensity of clinical seizures and 2) Gather pilot data to compare the latency with which a patient and our computerized system initiate on-demand vagus nerve stimulation following the electrographic onset of clinical seizures.