Closed loop adaptive vagus nerve stimulation for personalized neuromodulation therapy – CLAPVNS

Vagus nerve stimulation (VNS) is a treatment offered to patients with drug-resistant epilepsy. It reduces the frequency and intensity of seizures in two-thirds of these patients, leaving the remaining third in a therapeutic dead-end. This lack of effectiveness is related to the difficulty of choosing the optimal combination of VNS parameters. Adjusting these parameters (amplitude, frequency, duration, etc.) is complex and can take up to 2 years. Thus, VNS is currently applied with fixed parameters, obtained through an empirical process that is long for the patient, laborious for the clinician, and costly for society. Increasing the effectiveness of VNS relies on personalization, automatic parameter selection, and closed-loop adaptation to the patient's state. Some methods have been proposed, but they are insufficient because they are limited to the modulation of a single parameter. Our hypothesis is that a self-adaptive, closed-loop VNS with automatic optimization of multiple parameters will improve the therapeutic benefit. The main objective of CLAPVNS is to develop and test an implantable device capable of delivering such stimulation. In vivo experiments on an epileptic rat model will be used to test the therapeutic benefits of this stimulation compared to conventional VNS. This project will be organized into three tasks, focusing on project management, the development of an existing prototype (adding sensors, signal processing), and in vivo experiments with both acute and chronic stimulation. CLAPVNS is an ambitious project that relies on our team's expertise in neuromodulation, implantable devices, and preclinical experimentation, ensuring its feasibility. The potential health benefits are significant, and we expect CLAPVNS to pave the way for the enhanced development of this technique for clinical application.