Vagus nerve stimulator and recorder for epilepsy treatment

2018年全球迷走神经刺激(VNS)市场为5.052亿美元，预计到2026年将以11.4%的复合年增长率达到11.95亿美元。VNS是更大的神经刺激市场的一部分，该市场结合了许多不同的刺激技术来对抗一系列不同的情况。1997年，FDA批准了第一个用于难治性癫痫的VNS，即患者不适合切除手术。在早期的设备中，刺激是通过在植入物上移动磁铁来开始的，然后提供固定的剂量。刺激的目的是减少癫痫发作的频率、严重程度或持续时间。标准的VNS设备已经成为许多临床试验的对象，这些试验成功地证明了它的安全性。然而，个人对VNS的反应是不同的。Merten等人。[2019年，[https://doi.org/10.2217/bem-2019-0004][0]]将应答率定义为发作频率减少=50%的患者的比例。植入后一年的这一比率被发现为20%-40%，大约五年后为63%。最近的设备试图通过引入自动刺激功能来提高疗效(LivaNova、ASpireSR(R)和SenTiva(R)，FDA于2015年和2017年批准)。自动刺激与磁开关一起工作，如果心率超过指定的阈值，就会提供额外的刺激。临床试验表明，应答率为30-59%，大于或等于标准刺激物。此外，在63名将现有的VNS刺激器升级为ASpireSR的患者中，71%的患者癫痫发作额外减少了50%。SenTiva(Tm)设备包括自动刺激，还可以无线连接到临床医生以远程控制设备刺激。ElectronRx旨在建立下一代智能VNS设备，可以比目前可能的更高精度检测癫痫发作。这需要识别感兴趣的生物标志物，并开发使用这些数据预测癫痫发作的智能算法，从而允许针对患者的治疗方案以最佳地缓解症状。长期目标是整合ElectrronRx的神经调节平台中的技术，并将一种通用的迷走神经神经调节器推向市场，该调节器适应基于生理输入的应用治疗干预。除了癫痫，该设备还可能用于治疗几种与迷走神经功能有关的疾病。

The global Vagus Nerve Stimulation (VNS) market was $505.2 million USD in 2018, it is expected to have a compound annual growth rate of 11.4% till 2026, reaching $1,195 million. VNS is part of the larger neurostimulation market, which incorporates many different stimulation techniques to combat a range of different conditions.The first VNS for refractory epilepsy, where the patient is not suitable for resective surgery, was FDA-approved in 1997. In early devices, stimulation was started by moving a magnet over the implant which then delivered a fixed dose. The aim of the stimulation was to reduce the frequency, severity or length of seizures. The standard VNS device has been the subject of many clinical trials which have successfully demonstrated its safety. However, individual response to VNS is variable. Mertens et al. [2019, [https://doi.org/10.2217/bem-2019-0004][0]] defined a responder rate as the proportion of patients with =50% seizure frequency reduction. This rate was found to be 20-40% one year after implantation, and 63% after approximately five years.More recent devices have tried to improve efficacy by introducing an autostimulation feature (LivaNova, AspireSR(r) and SenTiva(r), FDA approved in 2015 and 2017). The autostimulation works alongside the magnetic switch, providing extra stimulation if the heart rate increases beyond a specified threshold. Clinical trials have shown a responder rate of 30-59%, greater than or equal to the standard stimulator. Additionally, of 63 patients who upgraded their existing VNS stimulator to the AspireSR, 71% experienced an additional >50% reduction in seizures. The SenTiva(tm) device includes autostimulation and also wirelessly connects to the clinician for remote control of device stimulation.electronRx aims to build the next generation of intelligent VNS devices that can detect seizures with a higher accuracy than is currently possible. This requires identifying the biomarkers of interest and developing smart algorithms that use this data to predict seizures, thereby allowing the treatment regime to be patient-specific for optimal alleviation of symptoms.The long term goal is to integrate the technologies in eletronRx’s neuromodulation platform and bring to market a universal Vagus Nerve neuro-modulator that adapts the applied therapeutic intervention based on physiological inputs. The device would potentially be used in the treatment of several conditions related to Vagal Nerve function in addition to epilepsy.