A novel implantable vagus nerve stimulation system (ADNS-300) for combined stimulation and recording of the vagus nerve : pilot trial at Ghent University Hospital

el Tahry, Riëm; Raedt, Robrecht; Mollet, Lies; de Herdt, Veerle; Wyckhuys, Tine; van Dycke, Annelies; Meurs, Alfred; Dewaele, Frank; van Roost, Dirk; Doguet, Pascal; Delbeke, Jean; Wadman, Wytse; Vonck, Kristl; Boon, Paul

doi:10.1016/J.EPLEPSYRES.2010.10.007

Title

A novel implantable vagus nerve stimulation system (ADNS-300) for combined stimulation and recording of the vagus nerve : pilot trial at Ghent University Hospital

Author

el Tahry, Riëm

Raedt, Robrecht

Mollet, Lies

de Herdt, Veerle

Wyckhuys, Tine

van Dycke, Annelies

Meurs, Alfred

Dewaele, Frank

van Roost, Dirk

Doguet, Pascal

Delbeke, Jean

Wadman, Wytse

Vonck, Kristl

Boon, Paul

Abstract

Purpose Vagus nerve stimulation (VNS) is an established treatment for refractory epilepsy. The ADNS-300 is a new system for VNS that includes a rechargeable stimulus generator and an electrode for combined stimulation and recording. In this feasibility study, three patients were implanted with ADNS-300 for therapeutic VNS. In addition, compound action potentials (CAPs) were recorded to evaluate activation of the vagus nerve in response to VNS. Methods Three patients were implanted with a cuff-electrode around the left vagus nerve, that was connected to a rechargeable pulse generator under the left clavicula. Two weeks after surgery, therapeutic VNS (0.251.25 mA, 500 μs, 30 s on, 10 min off and 30 Hz) was initiated and stimulus-induced CAPs were recorded. Results The ADNS-300 system was successfully implanted in all three patients and patients were appropriately stimulated during six months of follow-up. A reduction in seizure frequency was demonstrated in two patients (43% and 40% in patients 1 and 3, respectively), while in patient 2 seizure frequency remained unchanged. CAPs could be recorded in patients 1 and 2, proving stimulation-induced activation of the vagus nerve. Conclusion This feasibility study demonstrates that the ADNS-300 system can be used for combined therapeutic stimulation (in 3/3 patients) and recording of CAPs in response to VNS (in 2/3 patients) up to three weeks after surgery. Implantation in a larger number of patients will lead to a better understanding of the electrophysiology of the vagus nerve, which in turn could result in more adequate and individualized VNS parameter choice.

Language

English

Source (journal)

Epilepsy research. - Amsterdam

Publication

Amsterdam : 2010

ISSN

0920-1211

DOI

10.1016/J.EPLEPSYRES.2010.10.007

Volume/pages

92 :2/3 (2010) , p. 231-239